Abstract
Many hospitals have strong political leaders who question the need for a nutrition support service.1,2 In addition, the pressures of economic and health care reform are forcing administrators to cut unnecessary and unproven, albeit beneficial, services.3,4 The challenge for nutrition support services is clear-cut: in order to survive, nutrition support teams must understand the changes in health care and must learn how to adapt to them. This article clarifies the issues and assists nutrition support teams in establishing a new direction.

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