Influence techniques and activities clinical dietitians use when interacting with physicians

A national survey was conducted to identify and differentiate influence techniques clinical dietitians use when interacting with physicians, to ascertain which of selected demographic variables explain variations in influence techniques used, and to identify and differentiate activities clinical dietitians perform. A three-part (influence, demographic, activity) questionnaire was developed and mailed to 600 randomly selected members of the Nutrition Support dietetic practice group. Usable responses were received from 458 dietitians, yielding a response rate of 77%. Factor analysis revealed that respondents assumed five of six possible postures of influence techniques (block/threaten, ingratiation, coalition, assertiveness, and transitional rationality) and three of four possible postures of activity (diet oriented, physician oriented, and case oriented). Multivariate analysis showed use of ingratiation techniques related inversely to age and education of practitioners, use of assertiveness techniques related inversely to age, and use of transitional rationality techniques related positively to age and education combined. The survey indicates that somewhat of a paradox exists among clinical dietitians; i.e., even though the percentage of selected practitioners performing high-level case-oriented activities has apparently declined since 1982, a critical number perceive themselves to be acculturating toward the sixth and highest influence (convincing rationality) and the highest activity (diagnosis and research orientation unique to dietetics) postures to be attained.