The Critical Role of Follow-Up in Patient Care

Savannah Helm

By: Kathy King, RDN, LD, FAND and Alicia Jerome, MS, RDN, with 

Copyediting by Martha Boff, RDN


Believe it or not, for many decades, dietitians following the traditional medical model have been relying on one-off nutrition appointments to transform people's eating habits. As we know, this approach rarely works unless the patient or client is highly motivated. Recently, I heard a story from a woman at a Chamber luncheon who shared her underwhelming experience with a dietitian. After a brief consultation that consisted only of a list of foods to avoid, she was told, "Call if you have any questions," and sent on her way. Understandably, the woman felt abandoned and frustrated by the lack of guidance and support.

As dietitians, it's our responsibility to ensure our patients receive the comprehensive care they need to make lasting changes. Professionals who don't have the time or resources to provide follow-up care at the time, should consider referring patients to local, public health, or tele-nutrition colleagues who can provide the support they need. For efficiency, practitioners can maintain a list of qualified RDNs along with their nutrition specialty areas for patient referrals. The woman I spoke with was willing to pay for follow-up care out of pocket, which highlights the importance of offering comprehensive care to those who need it. As healthcare professionals, we have the power to make a difference in the lives of our patients. And as a profession, we must strive to work together to establish an excellent continuum of care.

As such, nutrition counselors have been implementing coaching principals to elicit behavior change as they follow up with their patients. Coaching may be a newer term, but the concept of helping and mentoring others has been around for ages. Coaching centers on the present, building a strong relationship, assessing an individual's capacity for change, and identifying areas where they want to grow. With guidance, support, and wisdom from a RDN coach, individuals set their goals and create actionable steps towards achieving them. Successful nutrition counselors understand the importance of these skills, as they’ve been utilizing them for decades to help patients achieve better health.

Positive Psychology categorizes traditional counseling as “why” and past oriented. Counseling is often focused on controlling illness or dysfunction with the practitioner as the authority.1 However, coaching takes a more collaborative approach. Rather than simply dispensing information, a nutrition coach empowers patients to take control of their own health journey with the practitioner giving guidance and support along the way.

As Charles Duhigg, author of "The Power of Habit," notes, experimenting and failing are critical to resilience, and changing and establishing new habits. In fact, 40% of the actions we perform each day are habits, freeing up our brains to focus on other things.2 We want healthy habits to become established. But building resilience in the face of setbacks can be tough, which is where a skilled nutrition counselor who knows how to use coaching comes in.

Counseling is challenging: patients bring their own histories and motivations, and counselors must establish rapport, determine the nutritional diagnosis, and provide nutrition guidance. But perhaps with more time to allow embracing counseling principles (coaching, mindfulness, motivational interviewing, cognitive-behavioral, and intuitive eating, etc.), and working collaboratively with our colleagues, we can create transformative experiences that empower patients to take control of their health.



  1. Miller K. How do coaching, mentoring, and counseling differ? 2/24/22. Accessed on 4/8/23.
  2. Dhigg C. The Power of Habit: Why we do what we do in life and business. 2014. Random House, New York.

Older Post Newer Post