History of a Dietitian
History of a Dietitian :
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.
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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