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History of a
Dietitian? |
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The United States Public Health
Service (PHS) celebrated its bicentennial year in
1998. Its mission is to promote the health of the
nation, understand and prevent disease, assure safe
and effective drugs and devices, deliver health
care services, and supply health expertise in time
of national emergencies. Whether serving as either
Civil
Servants or Commissioned
Officers, dietitians and public health nutritionists
play an integral part in the mission of this distinguished
service.
During the late nineteenth century, records indicate
that proper nutrition and nourishment of hospitalized
patients were regulated under the direction of a
hospital steward. By 1902, preparation and food
service responsibilities were charged to pharmacists,
the only professional personnel other than the medical
officers attached to the hospitals. The importance
of nutrition and dietetics in the provision of health
care quickly became recognized as a required component
of hospital care. |
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The service of dietitians
and nutritionists in the PHS dates back to the year 1919.
During that year, the first dietetic section was organized
in the PHS Division of Hospitals which operated a medical
care program for American seamen. These hospitals were
primarily located in port cities with in-patient capacities
ranging from about 100 to 1,000 beds.
Ms Hallie Corsette, the first dietitian employed by the
PHS, was accorded the title Superintendent of Dietitians.
She supervised this newly created dietetic section of
the Division of Hospitals. The dietitians were placed
under the organizational structure of the medical officer
in charge of a facility. Ms. Corsette spent the majority
of her time planning dietary departments and recruiting
dietitians for the hospitals. By the close of 1919, there
were approximately 85 dietitians in the Division of Hospitals;
that number doubled over the next two years. During those
early years, a dietitian's duties were focused chiefly
on the purchase, preparation and delivery of food.
In 1919, the PHS was charged with the responsibility of
furnishing medical and hospital care to sick and disabled
veterans of World War I. In 1922 the Veterans Bureau was
established to provide on-going medical care to war veterans.
As a result, the responsibility for supervising many of
the Public Health Service Hospitals was transferred to
the Veterans Bureau, later known as the Veterans
Administration. Over 145 PHS dietitians were transferred
to those facilities to care for disabled war veterans.
The remaining PHS dietitians were placed under the general
direction of the Office of Nursing, Division of Hospitals.
Although the dietetic section was abolished as a result
of the transfers, dietitians continued with their primary
duties of food service administration and took on the
additional role of providing patient nutrition education.
During the Second World War, PHS dietitians worked as
part of the Civil Defense Mobilization Program. They were
responsible for developing recommendations for foods,
food storage, equipment and service that could be used
if communities suffered bombing attacks.
The functions and responsibilities of the PHS expanded
rapidly during the late 1930s and the early 1940s. Likewise,
the role of dietitians within the PHS continued to expand
beyond the hospital setting as dietitians were hired by
state and local health departments. The creation of the
Children's Bureau in 1912 provided states with grant-in-aid
for Maternal and Child Health, Crippled Children's Services
(Title V) and Child Welfare (Title IV). Subsequently,
in 1936 Ms Marjorie M. Heseltine was employed as the first
nutrition consultant in the Children's Bureau. Five years
later, the Bureau hired a second consultant, Ms Helen
Stacey.
In 1942 the PHS established mobile field units to conduct
nutrition appraisals in selected states. A medical officer
was also assigned to work as a nutrition consultant for
public health officials. Nutrition clinics were developed
in a few state and local health departments. Today, both
the Maternal
and Child Health Bureau and the Centers
for Disease Control and Prevention still continue
to play a vital role in providing nutrition leadership
and expertise to the state and local health departments.
As the work of the PHS expanded and the science of public
health developed, the need for collaboration between related
professionals in the public health field became evident.
With the passage of the Public Health Service Act in 1944,
a series of laws were passed which significantly affected
the nation's medical research, training efforts and increased
health services in the United States. The expansion of
the PHS required people with additional specialized skills
that could be rapidly deployed in response to public health
emergencies. The Regular Commissioned Corps was expanded
to include dietitians, nurses, veterinarians, scientists,
physical therapists, and sanitarians, and other health
professionals.
The authority to commission dietitians as PHS officers
was granted on July 1, 1944. At that time, the dietetic
section of the Division of Hospitals was reestablished.
Ms Marjorie Wood, the first commissioned dietitian and
the PHS Commissioned Corps' first Chief Dietitian, headed
the unit. The section was renamed the Dietetic Branch,
Office of Professional Services, and was charged with
the responsibility of developing, establishing and maintaining
dietetic standards in PHS hospitals; a major emphasis
was placed on therapeutic nutrition and teaching programs.
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