The dietetics and naturopathy professions: perceptions of role boundaries

Abstract

Dietary counselling and management form core parts of both dietetic and naturopathic practice. However, each profession is unique with its own philosophies and requirements for membership. The neo-Weberian ‘sociology of professions’ provided the framework for the thematic analysis of in-depth interviews with ten leading clinicians. This study aimed to explore the perception of roles and role boundaries between practising naturopaths and dietitians using a specific example: food intolerances expressing as functional bowel disorders (FBDs). The similarities and differences in the ways dietitians and naturopaths diagnose and treat FBDs were examined. Three main themes were apparent (i) patient-centred care, (ii) evidence-based practice, and (iii) perceptions of the ‘other’ profession. Far more similarities than differences between the two professions were evident: individualised, holistic treatments, use of referral networks and evidence-based medicine formed core components of both. The main difference centred on naturopaths’ use of both traditional knowledge and scientific evidence during diagnosis and the formulation of treatment plans, including prescribing ingested medicines. Both groups deployed marked exclusionary strategies to protect their professional boundaries, including the use of discursive strategies to discredit each other, reinforced by commonly held misconceptions about the ‘other’ profession. Dietitians also used a credentialist strategy to elevate and protect their status.