Arizona State Senator Wayne Stump, D.C. Discusses Defeat of Dietitian's Monopoly Bill

House Bill 2406 passed the Arizona House of Representatives rather readily. But, by the time it got to the Arizona Senate to be heard in the Health, Welfare, Aging and Environment Committee it received some very well-orchestrated and well-financed opposition. Prior to its hearing, health and nutritional advocates, lobbyists, and the National Health Federation et al, working in a coordinated fashion contacted many senators in advance of the hearing, providing information about the apparent lack of professional expertise of the dietitians who wanted licensure.

The bill was, of course, very restrictive and would have caused problems for many individuals and firms in the health food industry, including some in the chiropractic profession and for anyone who worked in the areas of diet and nutrition. It is a bill which has caused problems in states where it has been enacted and the resultant shortcomings were pointed out to committee members. By the time hearings were held, committee members had been fairly well informed on the negative aspects of the bill. The day of the hearing some of the folks who had organized in opposition to the bill used my office as a gathering place to coordinate their efforts and personnel; they asked advice of myself and other senators who were opposed to it as to the best way of presenting themselves at the committee meeting and they took that advice. They presented themselves very well as concerned citizens opposing a badly flawed bill and the bill was defeated unanimously. It was a job well done by the various groups getting together -- the chiropractors, naturopaths, health food people, nutritionists and general public. This has been a demonstration of what can be done when people learn about pending legislation, do their homework, coordinate their efforts and present themselves in a very professional manner.

To summarize, despite a tremendous effort by dietitians, the Arizona State Senate on April 3, 1990 soundly defeated House Bill 2406, 39th Legislature. Many objections were based upon the denial of unalienable rights which, if the bill had passed, would have prevented citizens from receiving or using herbs and dietary supplements which they consider necessary in their own health care.

Legislatures around the country have been dealing with this same bill and responsible legislators have voiced their objections, including the charge that dietitians have a documented record in the professional literature of serious malnutrition resulting from their care. The bill would have prevented a nutritionist from practicing as a professional. The bill would have laid the groundwork for capricious abuse of civil liberties, as evidenced by the confusion in other states which have approved the bill.

A groundwell of opposition arose from a thousand individuals citing their rights to freedom of speech freedom of choice, and the right to privacy and self-determination in nutrition and health care.

Evidence was presented to the legislative committee citing a statement of Charles E. Butterworth, M.D., professor and chairman, Department of Nutrition Sciences, University of Alabama, Birmingham (as he testified in Hearing before the Subcommittee on Nutrition of the Committee on Agriculture, Nutrition and Forestry, U.S. Senate, 95th Congress, 2nd Session, on Current Status, Impediments, and Potential Solutions, September 20, 1978, Part I). "... we examined eight indicators of nutrition status of 134 consecutive patients at the time of admission to the hospital for a medical illness and at frequent intervals thereafter. A clear pattern of deterioration was demonstrated among six of eight nutrition indices during the hospitalization. More significant perhaps was the observation that fully three-fourths of the patients with a normal test at the time of admission had an abnormal result for the same test at the time of discharge, transfer, or death. ... According to the American Hospital Association there were approximately 36,000,000 admissions to the U.S. hospitals in 1976. I estimate that at least 2,000,000 persons suffered last year from hospital malnutrition and that most of it was either unrecognized or inadequately treated..." Mr. Clinton Ray Miller, Health Freedom Legislative Advocate for the National Health Federation testified that their 20,000 members opposed the bill and is trying to protect the right of people to choose their own doctors and diets. Evelyn Jarvis-Ferris, director of government relations, for Shaklee Corporation, reported this restrictive type of regulation grants exclusive control over some health services to one type of worker and would protect one group of individuals and provide them with an economic advantage over another group.

Greg Waters, lobbyist, Arizona Citizens for Health Education, introduced Mark D. Smith, nutritional consultant at the Center for Progressive Medicine presented testimony in opposition and stated the bill listed nutrition under dietetics which Mr. Smith felt were two totally separate entities. Ralph P. Bigler, D.C., stated that the practice of good nutrition in certain hospitals and institutions seemed to be the exception rather than the rule.

Mandatory dietitian licensure need not be enacted. In five states, South Carolina, Virginia, Colorado, Georgia and Washington, studies concluded this bill was not necessary to protect the public. The level of malnutrition in U.S. hospitals is reported to be staggering, causing upwards of 50,000 preventable deaths per year, with many more patients being adversely affected. One must contemplate the evidence and the current state of health in our nation. What does the future hold if we as citizens and legislators permitted licensed dietitians to remain in charge?

It is no wonder that after hearing all the testimony, the committee voted down the HB 2406 in Arizona.