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Table 3 Instances in which a dietetic referral is provided by primary care providers

From: Nutrition care practices of primary care providers for weight management in multidisciplinary primary care settings in Ontario, Canada - a qualitative study

Themes

Examples of quotes from primary care providers

Patient asking for the dietetic referral

“If they are asking about weight loss I would then tell them that we have a RD for some counselling regarding weight.” CHC, NP – participant 20

Patient was diagnosed with a chronic disease

“So any new diagnosis I automatically refer to the dietitian. For example, any of the triad of cardiac disease, renal failure disease, diabetes, the lipids; those types of patients I refer.” NPLC, NP – participant 5

“There are only one and a half FTE {Full Time Equivalent} RDs so you want to prioritize people and so secondary and tertiary prevention usually takes a hold. Patients are more motivated when they’re sick and in medicine we don’t value prevention as much.” FHT, FP – participant 10

Patient showing motivation or readiness to change

“Their readiness to change. I don’t go on weight or BMI. It is their readiness. It is the same as smoking; I would never refer for smoking cessation if they are not ready. I bring up the topic but then they have to bring it back up to me and show me that they are ready and committed and want to change. If not the failure rates are close to 100%.” FHT, FP – participant 15

Patient was at risk of developing a chronic disease

“I refer for weight management when it’s related to a medical problem or when they are at risk for a disease to develop” CHC, FP – participant 17

Patient with an elevated BMI

“Everyone that has an elevated BMI, or that come in specifically asking to see the dietitian.” NPLC, NP – participant 4

Patient experiencing pain related to obesity

“For people that are obese, it is something I will bring up, like those pain patients.” NPLC, NP – participant 1