PHYSICIANS EXPECTATIONS FOR QUALITY NUTRITION EXPERTISE AND SERVICE IN PRENATAL-CARE

Objectives To identify physicians' needs and expectations related to quality nutrition services in prenatal care; to rank service characteristics by importance in making nutrition referral decisions; and to identify nutrition services physicians would likely add to their practice. Design We used a market research survey based on the quality service management model. Setting We selected prenatal care as the setting because diet plays an important role in the health of the mother and the infant; specific recommendations exist for physicians to provide for nutrition assessment and counseling during pregnancy; and dietitians are not uniformly represented and used in obstetrics practices. Subjects The survey population consisted of all members of a state obstetrics and gynecology society (N=352). A return rate of 37% was achieved. Analysis Data were analyzed using descriptive statistics and qualititative analytic methods. Results Responses from 130 physicians revealed an expectation that dietitians working in prenatal care must have expertise in prenatal nutrition and skillfully work with patients to achieve compliance with individualized care plans. To be judged excellent, physicians indicated that nutrition care would have to produce desired outcomes in patients. Good communication, documentation, and availability of the dietitian were also important. Financial issues were not of great concern to the respondents. Application The findings from this study help pinpoint opportunities for dietitians to develop and strengthen relationships with physician-customers for the provision of quality nutrition service in prenatal care. Important characteristics of quality nutrition service include timely and effective counseling followed by conscientious documentation and feedback to physician.