My RD Journey

From Undergrad -> Internship -> RD -> Private Practice!


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Starting a Private Practice: First 5 Steps

Back in 2017, I wrote a blog called “First 10 Steps to Starting a Private Practice.” Today’s blog post is an updated version that highlights the priority steps to starting a private practice and also incorporates additional resources.

Please note that this blog post is just of my experience with starting a private practice in Pennsylvania, USA. All information is for educational purposes only.

Priority Steps
1. Get an EIN – The EIN is your federal tax ID number that is used to identify your business entity. Generally businesses need this. You can apply for your EIN for free on the IRS website and you get the EIN immediately. Before starting the online form, make sure you know which address you will want to associate with the EIN, what your business name will be (if practicing under a different name than your own) and the type of entity you will go with (like sole proprietor or LLC). Be sure to check your individual Department of the State website to see what regulations are in place. For more information on business structures. For more information on the EIN.

2. Get Your NPI – The NPI (or National Provider Identifier) is a unique, 10 digit, ID for covered health care providers. If you are planning to accept insurance as a provider, you will need to get an NPI. It only takes a few minutes to apply for an NPI online. There are two different types of NPI: type 1 is an individual NPI and type 2 is an organization NPI. I have a Type 2 NPI for my LLC and a Type 1 NPI for me as an individual provider. For more information on the NPI. To apply for an NPI.

3. Get Professional Liability Insurance – Professional liability insurance (PLI) is insurance that can protect you as a health care professional against claims initiated by clients for negligence. When choosing your liability insurance, think about your scope of practice, the services you are going to provide, and the amount and type of coverage you need. If you are a member of the Academy of Nutrition and Dietetics, they offer Dietitians a discount for Proliability by Mercer. For more information on Proliability.

Additional Steps to Take if Planning to Accept Insurance
4. Set-up your CAQH profile – CAQH ProView is an online credentialing database that basically helps to eliminate duplicating paperwork that you will provide for insurance companies. Some information you will provide on this form includes: personal provider information (like your address and education), mailing address, business EIN, professional licenses, business hours of operation, liability insurance paperwork, etc. For information on CAQH ProView.

5. Apply for Each Insurance – Once you have the CAQH set-up and approved, you can start the application process for each individual insurance company. Most insurance companies have a link on their website that says, “join our network,” or “become a provider.” A lot of insurances are using online forms that include a spot for your CAQH number. Once your application is approved, you will be contacted for credentialing and contracting. This can take several weeks (or months) so get started early!

While becoming an insurance provider can be a complex and time-consuming process, it allowed me to expand my referral sources (i.e. connect with other health care providers like physicians) and grow as a practice since my services were more accessible to clients.

What to Do Next?
At this point, you can start to work on the other steps involved in building a private practice like:

  1. Deciding on payment policies and procedures – blog link
  2. Deciding how you will see clients (in-office or virtually) – blog link
  3. Building your online presence (blogs, social media, web design)
  4. Creating your practice paperwork (new client forms, consent forms, policies, privacy notices, etc.)
  5. Building partnerships – blog link

For more information, check out the My RD Journey Podcast on starting a private practice

Disclaimer: Information provided is not intended to constitute legal or medical advice. All information is for educational purposes only.


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Career Paths in Dietetics

Today’s post is all about career path options in Dietetics! Check out the podcast on this very topic over on My RD Journey.

Clinical Options

If you are thinking about clinical work, some potential jobs could include:

  • Working as an ICU dietitian to identify those who are malnourished and at nutritional risk and providing recommendations, which could include tube-feeding calculations.
  • Providing medical nutrition therapy in an in-patient or outpatient setting for those with cardiovascular disease, Diabetes, renal disease (dialysis clinic), or cancer (oncology). Often, this would be under the umbrella of a hospital system.
  • Working in a long-term care facility, which could include a dual role as a food-service manager.

One thing to keep in mind is that you DON’T need to go into clinical care after the internship. I went straight from my internship to a community center and then to a supermarket as a retail Dietitian. I knew my long-term goal was to work in the community (now in private practice) so I didn’t feel the need to spend time in a hospital setting. 

Food Service Options

Food service may be your passion and if that’s the case, some potential jobs could include working in the school-districts or long-term care facilities to develop breakfast/lunch menus, recipe analysis, and food safety standards (in conjunction with or as a food service manager). Sometimes, a food service role may overlap with nutrition education in the classroom or nutrition-related training for food service staff.

Community Options

There are so many options for working in the community as a Dietitian! Some potential jobs could include

  • Working for WIC providing nutrition and breastfeeding education to clients and providing training for staff
  • Working with a non-profit center to provide nutrition workshops, counseling, and group nutrition classes
  • Teaching in higher education – college or university level
  • Working for a supermarket as a Retail Dietitian where you might provide nutrition counseling and run cooking demos and classes

Private Practice

Once I learned about the option of having/starting a private practice as a Dietitian, that became my long-term (and current) plan. I wanted to work for myself, have more flexibility, and be more creative with my offerings as a Dietitian without jumping through corporate hoops!

There are so many things you can do in private practice like: providing 1-on-1 nutrition counseling, providing group counseling, hosting a webinar for clients or as a partnership with a company (contract work), partnering with food brands to develop recipes, products, or nutrition education materials, selling products (like meal plans or online workshops), and more!

Have a question about career options for Dietitians? Drop it in the comments below!

If you are interested more in private practice, check out Episode 5 of the My RD Journey Podcast – Should You Start a Private Practice?

Helpful Resources 


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How To Set Business Boundaries

Welcome to My RD Journey. I’m Felicia, Owner and Registered Dietitian at Porrazza Nutrition!

Setting and keeping professional boundaries in business can be hard. As a Dietitian, if I let my boundaries become too flexible, I end up stressed and burnt out. In this post, I am going to share with you my top 3 questions to ask yourself when setting and keeping boundaries.

What matters to you?
Think about what you value like family time, being active, spending time with friends, etc. What “fills you up”? If you are setting a professional boundary so you are able to spend more time with your family, remind yourself of that when you are faced with crossing your own boundary.

I’m guilty of checking emails and writing outlines during my “me time” which leaves me feeling like I worked all day and didn’t get a break. I doubt my clients are checking their emails from me at the dinner table!

What do you want your day to look like?
Think about if you want to have back-to-back clients on certain days without a break or if you prefer to space out your clients to every few hours.

I like having a few clients scheduled back-to-back in the morning and then having a gap and 1-2 night clients. Normally, I only have 1-2 late nights per week.

If I overbook, I end up stressed out and really just not at my prime. This means not compromising my schedule if a client needs to reschedule. This is hard because I always want to be flexible, even at my own expense. It rarely has happened that someone doesn’t want to wait for an appointment.

How can you communicate what you need?
In my initial client paperwork, I have clear boundaries outlined for clients to review. Some examples of boundaries I set include:

  • Not answering emails/texts after 7pm (will respond the next day).
  • Not responding to calls on the weekend (unless I have Saturday hours).
  • Not accepting personal social media friend requests.

I also make it clear that my response time-frame is within 1 business day for email and within 2 business days for phone calls. I make sure to review these boundaries with clients periodically, especially if it is a long-term client.

 

Leave me a comment and let me know what your tips/strategies are for keeping your work and personal life in balance with boundaries.

 

Video version can be found on YouTube here


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5 Tips For Success In Your Dietetic Internship

Are you a dietetic intern gearing up for your first internship or a current intern looking to finish your rotations strong? Having been a dietetic intern myself and now current internship preceptor, I wanted to share my top 5 tips for dietetic internship success!

Tip #1 – Show up on Time
Plan to always get to your rotation early, not just on time, to allow a buffer in the event that your commute takes longer than usual. If you do happen to be running late, always contact your preceptor. Give them a quick call or send a text letting them know why you are running behind and your estimated time of arrival. If your rotation is remote, make sure you arrive to meetings early to ensure there are no technical issues on your end.

Tip #2 – Be Professional
Be professional in how you dress and how you respond in emails. For the dress code, contact your preceptor before your rotation starts to see what is expected. You may be wearing scrubs or you may be expected to wear business casual. When writing an email, make sure you are clear and concise about what you need and always spell check! Don’t make your preceptor guess at what you are trying to say.

Tip #3 – Come Prepared
Whether you are heading in for an initial interview with a potential preceptor or your first day on-site, come PREPARED! Know exactly what your rotation entail, what assignments need to be completed, what tasks need to be checked off, and the paperwork required for the rotation. Don’t assume your preceptor will have that information, nor should they. The first few days of your internship, make it a point to set aside time to speak with your preceptor to review everything.

Coming prepared also means making sure you have something to do when there is downtime. This could be reading research articles, working on assignments, or studying for your RD exam. Ask your preceptor what the expectation is. Do they want you to be working on something for them? Do they want you to work on your assignments?

Tip #4 – Engage and Ask Questions
Asking questions about something is not a sign of weakness at all. For me, it shows that you are willing to learn, grow, and challenge yourself. If anyone ever gives you a hard time for asking questions, ask them if there someone else you could ask/talk to when questions arise or if there is a better time to approach them for questions.

Tip #5 – Be Open to Learning & Growing
You might not love every rotation and you might already have an idea of which area of dietetics you want to go into. This doesn’t mean you should just do the bare minimum for the rotations. You never know when you might find a new passion or learn something exciting.

Being open to learning also means being open to feedback, even if it is negative. Feedback is crucial since it can help to shape you into a better professional. Always be open to getting feedback from your preceptor, even if it is negative. Get used to giving feedback as well. Don’t just say everything is great when it isn’t. You can always attempt to improve a situation (or work environment) by giving constructive feedback. This is your internship and your experience, so don’t be afraid to speak up.

I hope this list helps any current or potential interns out there to enhance their experience in the dietetic internship. Let me know if you are gearing up for your first rotation or if you already started, let me know how things are going!

Click here for the video version of this very topic on YouTube 


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10 Tips For Your First Dietetics Counseling Session

Welcome to My RD Journey. I’m Felicia, Owner and Registered Dietitian at Porrazza Nutrition! 

Are you a newly credentialed RD and gearing up for your first solo counseling session? In today’s post, I am going to share with you my top 10 tips to help you prepare and execute your first session; along with planning for the follow-up!

Tip 1 – Consider Holding a Discovery Call or Freebie Session
As you probably know already, most people have no clue what a Dietitian does. Having a 15 or 20-minute freebie session (or discovery call as some call it) with a potential client can allow you to ensure that this is going to be a good fit for you both.

On my website, I allow clients to book a free session with me. During this time, I will review what brought them to a Dietitian, who referred them to my practice, what goals they have in mind, what they are hoping to get out of our time together, and the process for scheduling and on-boarding as a new client. This is the time where I will review coverage for insurance, payment policies, cancellations and reschedules, and initial client paperwork.

Typically, a client schedules their first session at the end of this call or this is an opportunity for me to refer them to another practice. 

Tip 2 – Prepare the Business Paperwork 
Before your first session, you want to have a few key things in place:

  • Session location – will you see clients face-to-face or via a telehealth platform?
  • Payment policies – is the client paying out of pocket or using insurance? How will you accept payment (CC, check, cash, HSA cards)?
  • Forms – some forms include: a new client form (medical history, goals, demographics, insurance info, etc.), informed consent for nutrition services, practice policies (billing, cancellations, lateness, reschedules, etc.), HIPAA notice of privacy practices, communication consent forms, release of information, etc.

I require all of my new clients to fill out and return forms 24-hours prior to their first session via my EMR. This allows me to get to know them and better prepare for the session to make good use of the time.

Tip 3 – Send a Reminder Email/Text/Call
Depending on the client’s preferred method of contact, I find it best to send a reminder prior to each session. I confirm the date/time of the session, confirm the appointment location, remind them about paperwork if not completed, and remind them of my cancellation policy.

Tip 4 – Prepare for the Session 
Once I verify all forms are in, I prep for the session. Typically, I do a quick review once the forms are sent in and then a more thorough review the morning before the session. In looking at the client file, I look for a few key things, which will depend on your forms:

  • What diets have they been on in the past?
  • What are their main health concerns?
  • Why are they seeing a Dietitian?
  • What does their medical history look like?
  • What goals they are hoping to achieve?
  • Red flags that indicate a referral to another professional.

I primarily do telehealth now so I don’t do much printing. I have all of my client handouts saved to a flash drive and have that pulled up on my computer. Sometimes, I will screen share during a session or send handouts via email right after.

When I primarily did face-to-face appointments, I would prep the night before. All of my new clients received a folder with a food log, goal setting worksheet, 1-2 handouts, and my business card.

You also want to consider how you will take notes during the session. Will you take notes on your computer during the session? Will you take quick notes on a notepad and type them up later? Will you have a notepad for the client?

Tip 5 – Consider How You Will Start
In preparing for the session, think through key questions you could ask to keep the client engaged. I would always thank them for being there and for filling out the forms. Depending on your preference, you can start with questions like:

  • “What questions do you have for me about the paperwork you have filled out?”
  • “What is your primary goal for today’s session?”
  • “What do you hope to get out of today’s session?”

Another option I have used is to open with a summary of the session and time like:

  • “We have about 50 minutes for today’s session. My initial sessions are pretty flexible and a time to get to know you and your goals for our time together. Is there anything you would like to get started with today?”

If they say “I’m not sure” or “You tell me,” you can follow with something like, “What lead you to making the appointment with a Dietitian?”

Tip 6 – Keep the Client Engaged
Normally, I don’t find issues with engagement for the first session since most people are excited and ready to get started; however, life gets in the way. A client may be preoccupied during the session with other things happening in their family or social life.

If you start to see the client disengage. Ask an open-ended question and check-in. I might say, “I just want to check-in with you. What are your thoughts on the session so far?” or “What topics might you want to explore next?” It could be that you are on a topic that is upsetting or one they aren’t passionate about. They could be feeling rushed into goal setting or even overwhelmed. Take a step back and reassess. Use your motivational interviewing skills – open ended questions and reflections. Be mindful and listen actively, don’t just listen to respond. 

Tip 7 – Don’t Overload the Client
Overloading your client can also lead to disengagement. One of my mistakes right after becoming an RD was that I gave each client 15 handouts in a session. It wasn’t effective and it was overwhelming (not to mention a waste of paper)! This first session is a time to build rapport with the client and outline a road map for future sessions. Don’t try to cram everything into the first session since this can make the client feel “unheard” and/or rushed through the process.

Tip 8 – Expect the Unexpected
If a client is not giving you much to work with, start with a menu of options like:

  • “We can start off today’s session in a few ways: reviewing your current eating plan with a food recall, brainstorming your wellness vision, or going over general healthy eating tips. Do any of those options spark interest for you or do you have something else in mind?”

Leave the choice in the client’s hands so they are in control, which helps with engagement. Another open-ended question I might ask to encourage conversation is:

  • “I noticed in your paperwork, you were interested in disease management, could you tell me more about that?”

If you find a client is getting too far off topic, check in with them. Make sure what they are talking about now is what they want to spend their time on.

Tip 9 – Close the Session Effectively
As we get closer to time, I might say, “We have about 5 (or 10) minutes left in today’s session, was there anything that we didn’t cover that you want to touch on now or in a future session?”

You can also offer a summary of the session that highlights key points and action items. Make sure to clarify how you will check-in. Do you have another session scheduled? Will you communicate through email or text?

Lastly, you might want to ask for feedback. A question I have asked is, “What was the most helpful part of today’s session?” You could also ask them if there is anything they want you to do differently for next session.

Tip 10 – Organize Yourself After the Session
After your session, you will want to chart on the client interaction. This could be in the form of SOAP notes, ADIME notes, or another method that suits your practice. I always include specific topics discussed, goals, client questions, and anything I will be sending them after the session. If you are sending a client information between sessions, make sure to note when you will send that.

Lastly, reflect on the session. What went well? What needs improvement? You will learn different skills and strategies with practice and you will find what works for you as a Dietitian!

Remember to give yourself a pat on the back too! Your first session as a solo RD is new, exciting, and scary. I remember thinking I didn’t know enough to do this on my own and I wouldn’t know basic things clients asked! But, I got through it and I run a successful private practice with clients I have maintained over 5 years. 

 

If you are gearing up for your first session, let me know if there was a tip that was helpful for you or what you found to be helpful in preparing for your first session.

 

Video version is available on YouTube by clicking here.


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5 Interview Tips To Land Your First Job as a Dietitian

Looking to land that first job out of your dietetic internship? Read on for my top 5 tips for getting and nailing that interview in dietetics. 

1 – Enhance Your Resume 
First things first when landing a job, you need to have a good resume with relevant experience. This means getting in experience now if you don’t have any. Some ways to get experience could be as a food and nutrition aide at a hospital or long term care facility (great for RDs2B), volunteering at a food bank or with your local dietetics association, or even shadowing a Dietitian. If face-to-face isn’t an option, see if any private practice RDs are looking to hire for a per diem position.

2 – Do Your Homework
One question you will likely be asked at any interview is, “Why did you choose our facility?” To answer this question, spend a few minutes on the company’s website or Facebook page before the interview. What are some exciting programs that they run? What is it about their philosophy for wellness or patient care resonates that with you? Think about the key points you can touch on in the interview.

3 – Bring the Essentials
For my interview, I brought in my resume, CV (which had more detailed information about my education), cover letter (tailored to the job), list of 3-4 references, and some examples of my work. Even if the information was submitted already online or via email, I always brought hard copies with me. I have had interviewers put copies in my employee file or review them with me during the interview.

When thinking about bringing work examples, make sure to tailor the information to the type of job you are seeking. With my first teaching position, I brought sample lessons I wrote for high school students and adults. With later teaching interviews, I brought sample handouts I might give to students along with lesson plans. With my retail position, I brought tip sheets and newsletters I made. I normally would wait to bring out my work samples until it came up in conversation.

4 – Be Prepared
Get prepared for your interview by practicing with a family member or friend. Go through some of the most common interview questions like:

  • What are your strengths and weaknesses?
  • What is your nutrition philosophy?
  • Why would you be a good fit for this position?
  • How would you handle conflict when working in a team?

Depending on the job, they might ask specific nutrition questions like, “What diet would recommend for _____?” With community positions, I was asked about how I would engage the public for nutrition programs.

Remember to come to the interview in your best professional attire even if you know the position you are applying for involves wearing scrubs.

5 – Come with Questions
Always come prepared with questions. The last thing you want to do is get into a job and realize it was not what you expected! 

Some questions I have asked in the past are:

  • What are the benefits being offered?
  • Will they cover continuing education? Licensure requirements? CDR fees?
  • Hows does professional development work? What opportunities are available?
  • What does a typical day look like for a Dietitian?
  • Do you report to another Dietitian or a manager?
  • Do they provide resources for nutrition education or are you expected to create your own materials?
  • What is next in the interview and hiring process?

Don’t be afraid to come with a list of questions to ask. Coming with questions shows you are organized, prepared and that you care!

I hope this video gives you some ideas of how to enhance your resume and nail your interview as a Dietitian. Leave a comment below and let me know what tip was helpful for you or if you have any to share!

 

Video version of this blog can be found here.


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Dietitian Q & A – Offices, Marketing, & More

Welcome back to MyRDJourney! Things have been going well around here. I’ve gained quite a few new clients with the weather breaking and more people ready to get back into the swing of healthy eating. I have a walking group launching in April and I am so excited for it! I spent some of my downtime this past month re-evaluating my business and deciding what my next “move” will be. I like what I am currently doing; however, some of the parts I love are the in-home cooking sessions and personal training. I really want to work on promoting and building up that aspect of my business this year.

Today’s post is a bit of a Q&A based on the top 5 questions I get from fellow Dietitians who are just starting out in private practice. Let’s get started!

How Do You See Clients if You Don’t Have an Office Yet?
There are a couple of options for this one. You can do in-home counseling sessions (if insurance allows), which means you go directly to your client’s home. Some perks to this would be that it is more comfortable for the client, client’s can show you products they have in their home, and you may even end up with less cancellations. Some cons to this are that you will be doing more traveling so scheduling your clients geographical smart is key. You can read more about in-home counseling here. If you don’t feel comfortable with that, you could look at shared office space (cuts down on the cost). You could also check out co-working spaces where you can rent office space for an hour or two (way cheaper than a lease + more flexible). Another option is to join your local Chamber of Commerce as many of them will allow you to use office space as apart of your membership. Lastly, you can do virtual consultations, which is very convenient; however, if you take insurance, a lot of plans don’t cover this just yet.

How Do You Get Started with Marketing Your Business in Your Community?
The first place I started with was Google. Literally. I Googled every business in my area and made a list of those who aligned with my mission. I reached out to some through email and then followed up with a call. Other businesses I just showed up and dropped off promo materials (newsletters, business cards, flyers for events I was hosting, freebies, etc). Depending on the business, an email is more appropriate first since the person you may need to talk to may not actually be available for drop-ins. You can always schedule an in-person meeting once you make that first contact. You can read more on building partnerships here.

How Do You Advertise Your Business?
Outside of what I mentioned above, I would strongly suggest an online presence in the form of a website and at least one social media platform. I consistently use Facebook & Instagram. One big thing to keep in mind is where your ideal client is hanging around. Are they using YouTube? Twitter? Facebook? Instagram? No matter what platform you use, remember to be consistent with your messaging and when you post (even if it is just once per week to start).

How Do You Figure Out Your Appointment Structure?
Honestly, getting your counseling flow can take a bit of practice and even with that, you are bound to have a client through you off. Most of my counseling sessions start off with me asking the client, “Are there any initial questions you have?” (initial) or “How have things been going?” (follow-up) or “What would you like to gain from today’s session?” (initial or follow-up). Usually, clients will jump into a story or a bunch of questions, which is great! Sometimes, I have clients who are a bit unsure of what to ask or even how this interaction should go, especially if they are new to seeing a Dietitian. From there, I take the reins and start with a 24-hour recall. We then talk about where they see possible areas of improvement or positive aspects of their diet already. That is usually the first 30 minutes right there. At this point, I stop and ask if they have any questions. Depending on the time, I talk about other things besides food like exercise, fluid, sleep habits, and even family expectations. If we don’t cover this in the first session, I always weave it into the first follow-up. I end all of my sessions with goal setting and acknowledgement of possible barriers (so we can make a plan around them). All of my clients get a physical recommendation sheet with their goals and action items so they can post it as a reminder to themselves.

How Do You Go About Taking Insurance?
First things first is you want to create an account on CAQH ProView. This is going to take you a while, but it is worth it! You basically put in all of your information as a Dietitian and business owner. Once you have that completed, you will use your ID number for individual insurance companies. What I mean by this is that every insurance has its own form for becoming a provider. I started by Googling “become a provider for ______ (insert insurance company name here).” Usually, the individual insurance forms are shorter since most of your information is in the CAQH. Once you submit the provider interest form or application for each insurance company, you will be contacted by the contracting department to do all the signing. Getting in network with insurance is a lengthy process, so I would highly suggest getting started sooner rather than later if you are going this route.

This surely wasn’t an exhaustive list of all Dietitian questions, so feel free to email me or schedule a Free Coaching call via my website for anything you are wondering about!

If you are new to private practice, check out my blog on The First 10 Steps to Getting Started, which covers professional liability insurance, deciding pricing and more.


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A Week in the Life of a Private Practice Dietitian

When I first started brainstorming my blog for the month, I was planning a “day in the life” post. I realized that this wouldn’t truly be representative of what I do as a private practice dietitian since every day is different. Here’s a little peek into what this past week looked like for me. I hope this is helpful for someone thinking about private practice and what that looks like (or if you are just plain curious).

Background
My weeks will vary based on client cancellations/reschedules or new partnerships/appointments. There also tends to be an eb and flow with private practice based on the seasons (i.e. more clients in Jan, Feb, April, May, Sept, and Oct). I also primarily see clients in-home with the occasional on-site appointment for employees of businesses that I work with. Mixed into that are various classes (cooking or virtual). My income isn’t solely based on insurance, which is a good thing and outside of what I mentioned before, I also sell hats on Etsy and lesson plans on Teachers Pay Teachers.

Most days, I am up by either 6am (teaching days) or 7am. If I see morning clients, they are typically 10am or later. I spend the majority of my morning hours planning out my day, prepping last minute for an appointment, answering emails, and returning voicemails. I also don’t always note this below, but I do spend some time keeping up with social media for my business (Instagram on the day-to-day) and hanging with the BF. Besides having a private practice, I also teach part-time at a local community college. I am also the Community Liaison for the Greater Holmesburg Business Association, which means I am apart of event planning and managing their social media (i.e. Facebook).

Monday
The first couple hours of my Monday were spent on the phone with an insurance company that I had been battling with since last JULY. I had 8 claims denied due to an error in their system (saying I was out of network when I wasn’t). While on hold, I planned out my to-do list for the day, wrote an outline for a class I was running that night, scheduled a newsletter for my virtual class, and answered some emails. After an hour and a half on the phone, I finally had confirmation that they were paying out! I’m only partially celebrating until I get that check in my hand.

Mid-afternoon, I went to the gym with my Dad, which ended up being about an hour. Once home, I quickly ate and started getting myself together for a new client in-home fitness assessment. The assessment ended up being about an hour and a half, even though I only blocked off an hour. That was totally my fault since I am still working on my personal training flow and ultimately being more efficient. Once home, I grabbed a small snack before my 6pm virtual Healthy Habit Jump-Start class started. I had originally planned to do a virtual workout at 7pm; however, by the time I finished up my class and tried to log-in, it was past 7pm (and I hate showing up late, even if it is virtual). I spent another hour or so creating a landing page for my new walking group (created this after feedback from my class). Finished up the day by making dinner and knitting.

Tuesday
I teach an 8am face-to-face nutrition class on campus at my local community college on Tuesdays and Thursdays. This particular Tuesday was a faculty meeting, so I stayed after class and did some reading on the latest fitness research while I biked at the gym. Made it back home around 2pm, ate and then headed out for a night in-home session. Usually, my in-home sessions are always an hour. I try to do my charting and billing right after the appointment, so it is doesn’t pile up and seem so overwhelming. I had a little bit more time this night to cook, so I prepped for tofu and veggies for the next few days.

Wednesday
I was up at 7am this day and answered emails and returned calls. I also packed my lunch for Thursday and then headed out for an in-home appointment. After the session, I went straight to the grocery store to buy stuff for myself and also for the cooking demo I was running Thursday. Came back, charted, ate lunch and brainstormed my new walking group I am planning to launch in May. Then, I had a video call in the afternoon with a fellow Dietitian. We typically chat every month or so to catch up on our businesses and lives in general. This particular call was about an hour and a half. Went to the gym right after (again with my Dad). Once I got home, I spent a good 2 hours prepping for my cooking demo (muffins and chia jam). Ended the night with some dinner and of course, knitting.

Thursday
This was probably my busiest day for the week. I had class in the morning, followed by office hours (that no one ever comes to). I typically use my office hours to grade papers/quizzes and lesson plan for the following week. After office hours, I had an hour downtime before my cooking demo, so I worked on some business stuff (emails/calls + client check-ins). I started setting up for the demo at 12pm and finished cleaning up by 2pm. Once I was home, I unpacked everything, ate, wrote my demo event report, and then headed out for back-to-back in-home night sessions. I wasn’t home until after 7pm (2.5 hours for the two sessions) so I didn’t feel much like charting and billing then. Ate and just relaxed until I passed out on the couch.

Friday
Mostly my Fridays are spent cleaning and catching up on business-related stuff. I wasn’t really in the mood for social media planning, so I pushed that to do on Saturday. I returned voicemails mid-morning and scheduled a new client for March, so that meant I needed to create their profile in my EMR and send them the initial welcome email with paperwork. After that, I reviewed my end-of-month financials from February, assessed client appointments, did some cleaning/laundry and prepped for a mock personal training session with a fellow Dietitian/friend. I’m still fairly new to the personal training piece and am working on my “flow.” It really helps having some awesome friends that let you practice with them! Hit the gym mid-afternoon and then prepped for dinner that night. The rest of the night was spent doing my personal training session, eating, and just all-around good conversation.

Weekend
Usually, I try not to do too much “business-related” stuff on the weekend. This past Saturday morning, I planned out my social media calendar for March (Facebook posts, blogs, and videos). After hitting the gym and doing some food prep, I originally planned to visit family. That fell through due to someone having the stomach bug, so I spent the remainder of the night finishing up a personal training workout plan for a new client.  

Today (Sunday), outside of posting this blog, I plan to do some reading (research articles on fitness), vacuum, knit, and of course, go to the gym. I have a busy week coming up, so I’ll also plan to prep some food for the next few days!

Hope this gave you some insight into my life. I am curious to see what a week-in-the-life of other dietitians looks like, so drop and a comment (or send me a message) and let me know!

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Why You Should “Specialize” in a Niche

Welcome back to MyRDJourney! In last month’s blog, I talked about finding your ideal client and I had a lot of questions come up about whether you should identify a “niche.” I wanted to address that today since there seems to be a big debate on whether or not identifying a niche causes you to attract more clients or stifle creativity.

What is a Niche Really?
A niche is basically your business focus; something specific you specialize in. It could still be broad in the sense that you are focusing on one disease (Diabetes) but seeing all age groups (teens to adults) and types (type 1 and type 2). Another example could be focusing on plant-based diets (broad, but still a niche). You could be even more specific saying plant-based athletes, plant-based families, plant-based kids, etc. You can decide on how specific you want your niche to be.

Is it Bad to Have a Niche?
In short, I don’t think it is a bad idea to have a niche. Some websites I researched for this blog said that a niche stifles your business and limits creativity. I found just the opposite. It was easier to create content once I had a specific focus. It also opened my doors to more clientele that I wanted to work with and that needed my specific service.

Think about the comparison between a primary doctor, who has a broad knowledge base for diseases and illnesses and a gastroenterologist, who specializes in the gastrointestinal tract. If you go to your PCP with GI issues, they might run some labs and basic tests. If you continue to have issues, they would send you (hopefully) to the gastroenterologist; someone who has more knowledge and experience in this area to treat you more effectively.

If you are having GI pain and want to see a Dietitian, would you choose the one who specializes in GI and has content online specific to that (i.e. recipes, tips) or would you go to a Dietitian promoting general healthy eating (not a bad thing)? Chances are, you would resonate with the Dietitian who has the specialty because their content would speak to you and your pain points.

What About Multiple Specialties?
It does make me skeptical when I see a Dietitian claim on their website that they specialize in 8 different things. Without identifying the company, here is what Dietitian X says they specialize in on their website: weight loss management, sports nutrition and performance, nutrition during pregnancy, grocery store tours, eating disorder counseling, GI disorders and food allergies, and disease prevention and management. Here’s another list from Dietitian Y: weight management and behavior modification, diabetes, high blood pressure, heart disease, cancer/prevention, kidney disease, food allergies and intolerances, stomach issues, chronic fatigue. That’s a lot of “specialties” for one practitioner to maintain. Some Dietitians might work in a team where each Dietitian provides a certain specialty; however, this was not the case with Dietitians X and Y.

I find it completely acceptable for a Dietitian to assert that their company provides services in each of these practice areas; however, I don’t think it is fair or accurate to proclaim that the company ‘specializes’ in each of these areas. One thing to ask yourself is, “Can I keep up-to-date in all of these specialties and provide my client the best service possible?”

Let me clarify my assertion with an example. Say you specialize in diabetes. Chances are, you are still going to see clients with more than one chronic disease (like diabetes and cardiovascular disease). I am not saying you can’t see these clients because one is not your defined specialty. Also, both diseases can impact one another (and your client) so it would be important for you as a health professional to be competent in both. What I am questioning is if you see a client come in with diabetes and cardiovascular disease who now needs dialysis for renal failure, would you be doing a disservice to them by continuing to meet with them versus sending them to a renal dietitian who does this all day every day , i.e. specializes?

If you want to learn more about the stages of competence, check out this great article. 

I for one fell into this trap with a client who had IBS (Irritable Bowel Syndrome). I had worked with clients with mild IBS before; however, I never worked with a client who was following a low FODMAP diet. Honestly, I didn’t even know all that this diet entailed. I thought at first I could just get resources for the client and wing-it, but after conducting a reasonable amount of research, I knew I wouldn’t be able to answer questions and truly help this client (even though I had provided IBS counseling before, and I really wanted to assist). Not going to lie, I did meet with the client for an appointment before I said to them that I needed to refer out. Clearly, I was not the best person to help since they needed an expert, an actual specialist, to work through all of their questions surrounding the low FODMAP diet and the only information I could provide was very basic (something they could have Googled on their own). I just hope that any health professional would understand the limits of their current knowledge and make the decision to refer clients with specialized needs to a specialist when appropriate.

Moving on…

Finding Your Niche
If you are a new Dietitian or just starting in private practice, you might not know the area you want to specialize in just yet, and that is okay! In the beginning years, I found it helpful to see a variety of clients in different settings and then assess whether I enjoyed working with these clients/situations. It took me four years into my practice to discover that my niche, and now my specialty, is in plant-based diets and strength training.

I am still working on transitioning content on my social media and website to align my messaging and marketing to consumers who need or want that specialized consulting. My Facebook is still general content for nutrition, my YouTube is general tips plus new recipe videos (vegan/gluten-free) and my Instagram has been focused on plant-based for a while. Over the next few months, I will be transitioning my Facebook content to more plant-based tips. YouTube will stay the same, just with more recipe content and better video and sound quality (thanks to my BF). Instagram posts on plant-based food will be more consistent and workout videos will be added to my stories and highlights.

Don’t be afraid to create a niche that isn’t quite there yet. I was having a hard time finding information on plant-based (vegan) diets and strength training for myself. A lot of information I found online was specific to endurance athletes. Since I wanted this information for myself, I pursued a Certified Personal Training credential (yes, I passed my exam) and I am learning all I can about combining the two for use in my business.

Remember, you don’t have to be a specialist in everything as this is the fastest way to burn-out! Be really good/unconsciously competent at a few (or just 1) things! Focus your energy on specific skills and building your knowledge base around the niche you want to pursue. Only then, will you really have the competence to provide specialist services to your clients as a Dietitian. 


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Feeling Stuck – Ideal Clients & Taking Action

Welcome back to MyRDJourney! Have you ever just said to yourself, “What am I even doing with my life?!” Maybe, feeling a bit stuck and unsure of what to do next?

That was me over the past few months (and part of why I was on a blog hiatus). I hit a point in my business where I just plateaued. I could live comfortably where I was; however, it was starting to become less fun and exciting. I wanted to re-find my passion and be challenged again.

I really started to think about my 5 year goals, short-term goals and how that did (more like didn’t) align with what I was currently doing in the business. I spent a lot of time re-evaluating my business and working ON it (instead of in it). I talked to a lot of other Dietitians and began to realize this was a pretty normal thing to go through in business and not to be too hard on myself. I have only been in business for 3 years (2 years full-time), so I really needed to first cut myself some slack and second start to plan.

One crucial thing I did this month was to figure out who my ideal client was and how my services aligned with them and their needs. I dug deep into their struggles, their barriers to change, what they needed to succeed, and most importantly, where they find nutrition information. I started to connect the dots between my ideal clients, services, and goals.

It became really clear to me that there were a lot of instances where my business offerings didn’t match my current target client. For example, I started a Weight Management Support Group in July as a beta-program. I had 12 participants. For the paid group in the Fall that dropped to 3. I ended up re-branding it as the Healthy Habit Jump-Start for 2019 (still in open enrollment). I just now realized that this online program doesn’t target my current clients and how they receive nutrition information. A lot of my face-to-face clients prefer the face-to-face, aren’t comfortable using online programs and are too busy to have a specific class time (as in they prefer a more self-guided program). There was so much disconnect that was stunting my business growth and I was completely overlooking it until now.

IDEAL

With all of that in mind, I took a few days to lay out the following in a chart (email me if you want a copy):
-My ideal client profile: demographics, struggles, barriers, needs
-My current (and planned) products/services
-How my products/services are beneficial to my client
-What changes I needed to make for that specific product/service
-How I was currently promoting the product/service
-What actions I needed to make
-What tools I would need to succeed

I took a look through this chart and asked myself, “What am I doing that I am no longer passionate about or no longer find fun?” I also thought about my current partnerships and how they fit into the mix. I stepped away from a few that were very one-sided (not in my favor) and others that were a complete time-suck with little to no benefit to my business. It is hard to let go of things (check out my blog on this). It’s like when you clean out your clothes closet and try to get rid of things you never wear. You play a mind game with yourself by saying, “I might wear this again.” They usually say if you haven’t worn it in the year, you probably won’t ever. I tried to apply this same line of thinking with certain clients/partnerships, “If it is not working well now (or you hate it), chances are it won’t get better (and it needs to end).”

Watermelon-adult-seeds-pompomAfter doing that, I created my urgent action goals, 1-month goals, and daily action items, which I scheduled in my calendar. A lot of my monthly goals are focused on social media content (blogs, Facebook posts, Instagram, YouTube videos, etc) and developing some of my newer products/services. Some of my new business ventures are fruit-themed knitted hats, fruit and vegetable songs (using my piano-playing skills finally), and a plant-based fitness component. I am hoping to pass my ACSM Personal Trainer Certification in the next month to be able to tie in my passion for a plant-based style of eating and fitness (specifically strength-training). I am doing a bit of test marketing and building of my online presence through Instagram for now, since that is where my ideal client is. Follow me @plantedinfitness!

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All-in-all, I am really happy with with what I have accomplished over the past few years and I am excited for 2019 now that I have a clear idea of my target clients, goals, and actions. If you are feeling stuck or if you are in the process of planning for 2019, remember to ask yourself this key question, “Is the thing that I am doing (or striving for) my passion?” If the answer is no, you might want to do some re-evaluating before launching or moving forward. Remember, I am always here if anyone wants to bounce ideas off of me. Shoot me an email or schedule a Free Coaching call via my website!