My RD Journey

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


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Tips for Handling Client Cancellations

Welcome to MyRDJourney! I want to talk about handling those dreaded client cancellations. As much as we hate for a client to reschedule or cancel, things happen. There can be many reasons a client cancels on us: weather is bad, kids are sick, or they simply lost their motivation for eating healthy. How you handle your client cancellations can really set the tone for your practice and ultimately the relationship you have with your client. 

1st things 1st, make sure you have a cancellation policy in place that includes details on rescheduling appointments. Do clients need to call/email within 24 or 48 hours of the appointment? Do they need to go on your website to cancel?  Have your policy in writing and make sure the client is aware. You want to be transparent. Usually, I discuss my policy with my clients on their first call with me and include it in their appointment reminder email. I also have it posted to my website for ease of reference for the client. 

Since a lot of my clients use their insurance for the appointments, many do not realize the insurance plan will not cover cancellation fees. I make sure all of my clients are aware of this and ultimately what the charge would be if they reschedule, cancel or no-show last minute. 

Prior to the first appointment with a new client, they are required to review, complete, and sign all of my paperwork. This includes my practice policies (including late and cancellation fees), HIPAA information, privacy notices, client releases and a new client form. The hope is that the client will review everything in detail and sign that they acknowledge all of the information. Despite what you do to make the client aware of your policies prior to the appointment, you may still have clients who do not read the paperwork before signing or forget about it by the time of the session. Again, this is why I like to include the policy (in short) within my appointment reminder email (sent a week prior to the session).

One thing to think about with your policy is consistency. I am all about being flexible; however, you don’t want to be perceived as playing favorites with your clients if you waive the fee for one and not the other. So, create the policy, make the client fully aware, and be consistent in how you handle it. If you are flexible when a client cancels late for the first time, then do that for all of your clients.

You will get thicker skin with this, so don’t be afraid to put your foot down. Every client cancellation, late reschedule, or no show is money that you are not making and time that could have been spent helping others. Also, think about when you schedule a doctor’s appointment, they have similar policies in place too! 

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If you have any questions about cancellations and reschedules, feel free to leave me a comment below!

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Pros and Cons of In-Home Counseling Services

When I first started my practice, I thought I NEEDED to get office space. After a few months of searching, I realized I was either going to be paying the same amount I do for renting a duplex or have to travel a distance for something more feasible. Instead, I decided to try my hand at in-home counseling sessions. It would cut down on costs (as in overhead) and allow me to build a client basis without the added stress of paying monthly rent.

I found a lot of my clients were more comfortable being in their own home versus a formal office. It also allowed them to show me products in their cabinets and give me a visual for their environment. I could also set up sessions for cooking and meal prep, since so many tell me that making healthy food is difficult for them. I find my home-session clients are less likely to reschedule and rarely cancel since weather, running behind, etc is less of an issue.

Most of the insurance plans I take in my practice cover in-home counseling, which was make or break for me when my only option was in-home counseling. Some insurance companies in your area may have different regulations for nutritional counseling, as in only an office setting. I would suggest checking the provider resource center for each individual insurance company or calling your network coordinator to find out what applies to your service.

While home-counseling sessions are definitely a great option, there are also some heavy downsides. One of the biggest downsides to home counseling is the travel. Home-visits really cut down the amount of clients I can see in one day. I really try to chunk my client areas so I am not going all over the place; however, some days this works better than others. Ultimately, you are still paying for gas and wear-and-tear on your car, but, you won’t have the looming monthly rent payment due. This could be great for someone just starting out. I make sure to track all of my mileage and tolls to use for tax purposes.  

To be honest, you never REALLY know what you might walk into with a client appointment, let alone one in the home. I always do a phone consult first to get an idea of the client. A lot of my clients are from referrals from companies or business relations, so I feel comfortable entering the home. I also make it a point to recommend a quiet space in the home (usually the kitchen or living room). Some things you might want to ask before entering a client’s home is if they have a private space available in the home to speak and whether or not they have pets (especially if you are allergic or fear them).

While most of my clients are in-home and on-site (as in worksite wellness), I do have a few clients who would prefer an office-based setting. In that case, I utilize office space at my local Chamber of Commerce since I am a member there. I have met clients at coffee shops; however, this is not a very private setting and is not covered by insurance.

One last thing to keep in mind with home-visits or traveling appointments overall is what you will take with you. I always have with me a notepad, handouts, new client folder, business cards, paper portion models, and a plate picture or model for reference. I almost never bring a scale with me (unless specifically requested) since most clients have one at home. I also don’t like to focus on weight and instead healthy habits.

All-in-all, I wouldn’t change how I started my business; however, for the future, I am starting to move away from a lot of the face-to-face and building more of the virtual end. A lot of my clients want online support, books, programs, etc. The face-to-face component will always be apart of my business, but the amount of time will definitely be changing. I hope my pros and cons will help you in deciding where to take your business!

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Private Practice – 1 Year in Review

I can’t believe I am saying this, but, I have officially been in full-time private practice for 1-year! I have had my practice since 2014; however, December 5th of 2016 was when I left my safe, full-time 9 to 5 job to grow my business.

So much has changed in just one year. I now have a full client load, in which I am scheduling about 6-weeks out for appointments. I am comfortable and competent with billing and calling insurance companies for claims. I eliminated aspects of my business that were just a poor avenue of income or a drain on my emotional well-being. I built and maintained partnerships with companies to bring wellness to them. I started teaching at the college level for the first time and am able to continue doing so with my practice in 2018. There are just so many wins I have had with my business and I am grateful to all of my friends/family who have given me guidance and encouragement along the way.

For today’s post, I wanted to share with you just some of my tips/insights from being PorrazzaNutrition for a full year.

Diversify 
I have had many partnerships change over just a few months. Some, I ended due to lack of professionalism. Some, were a steady source of referrals until they hit a business slump, which caused my client intake to decline too. All-in-all, make sure you reach out and connect with a variety of businesses to get your name out there. Don’t just rely on one company/partnership to make or break your business. Having a diverse number of partnerships will also put you in a better bargaining position, should that time come.

Find Your Passion and Motivation 
What motivates you to be in private practice? Is it the flexibility? Is it the freedom of designing your own path? Is it being able to help a greater network of clientele? Find out what motivates you! If I get overwhelmed or stressed, I stop and think about WHY I am here in the first place. This can really help me to get over the negativity I am feeling and push me to do more.

Always Make Use of Your Time
Being an entrepreneur means that you ride the roller coaster of financial and emotional ups and downs. If you find your business in a bit of a slump, maybe around the holidays, do something productive. Can you work on social media posts, blog topics, website design, or new programs? During my free time, I like to divide my days into “business” and “personal.” I make a list of things I want to accomplish when I don’t have clients to be able to grow my business. On the other side of things, I brainstorm what personal items I want or need to get done. I try to stick to the hours or days I determined I would work on my business to keep a personal boundary for myself.

Create a Positive Support System
The support I have gotten from my boyfriend, family, and friends has really lessened some of my bad days. Find at least one person that can be a sounding board for you. Someone who can tell you that you can do it. Someone who can push you to do more than you think is possible. Someone who can tell you when something is a terrible idea (it has happened to me on a few occasions). If you don’t have anyone personally you can count on for the moment, look to online groups. I am in a few different ones on Facebook and also within email threads. It’s nice to see you are not alone in your efforts and that many have been in your same shoes. It’s also a really awesome feeling to be able to support someone else in their private practice journey.

Take Time to Assess 
I have been keeping a business journal since the first day I started my business full-time. This has been a really useful tool for me. I write about positive and negative things I encounter in my practice, brainstorm new ideas, or just vent when I need to. Over the months, I can go back and see how far I have come in business and also reflect on some of my successes. I feel like keeping a journal has been a very grounding experience and also a way for me to just write and move on from something I may be overthinking.

Take the Chances
You never know what you might become or what you might do in the next month or year. So, don’t limit yourself by saying, “I can’t.” Take the opportunities when they arise, and not just for financial reasons, but for experience and growth. Network with others, keep your business connections, and stay open to new possibilities.
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Business Planning for 2018

The holidays are fast approaching and that means 2017 is coming to a close! I feel like this year flew by for me. This was my first year as a full-time business owner and I have loved every minute of it (even the stressful ones). Over the past few months, I found myself working IN my business versus ON it. I realized with overbooking myself, I was stunting my business growth. While the income was great, I was just going through the motions daily without creating anything new or challenging myself.

With that, I decided to start working on my business goals and strategy for 2018. I wanted to have a plan in place so I can start taking action steps for the many ideas that I have. Below are some of the questions I asked myself when thinking about my 2018 plan.

Questions to Ask Yourself
1. What is your ultimate vision for the end of 2018?
-Think of what you want your business to look like by Dec 2018. What does your day-to-day include? What is your schedule like? What types of clients are you seeing? This can help you to identify goals and action steps to take monthly and daily.

2. What are your large goals for the year?
-This could be launching a practice or starting a new program. Think about larger goals being more long-term (i.e. to accomplish in 6-8 months).

3. What are your smaller goals for this year?
-This could include working on marketing to local businesses or incorporating more social media posts. Think about smaller goals as being more short-term (i.e. weekly or monthly).

4. Why is all of this important?
-Think about the importance of each of your goals. This will help with driving your motivation and also developing a targeted strategy for building and marketing.

5. What pitfalls do you want to avoid?
-Think about the hangups you had this year in business. Did you tend to overbook yourself? Are you doing too much on your own? Are you lacking personal time? Are you saying yes too much? Be aware of the things you want to work on and build them into your goals and ultimately your schedule. Write out monthly reminders to yourself to help avoid these pitfalls throughout the year.

After I asked myself the questions above (doesn’t have to be in this order), I brainstormed all of the steps I needed to take for each of my ideas and goals. I actually did this over a few days while on the train and waiting for appointments. After I had a comprehensive list, I organized the steps into a logical order and began to map them out on my calendar as due dates.

I also planned out the dates I wanted to schedule clients and when I would be working ON my business. One of my main goals for this year is to not overbook myself and instead stick to the boundaries I set. Although this will include my having to say “no” sometimes, I know this will be really important for my business and my sanity!

I hope this post helps you to plan out a successful 2018! Happy holidays!

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Ask the Dietitian (Student Edition)

Welcome back to My RD Journey! I am finally getting into a groove of teaching and running my business. I am looking forward to the holiday break when I can work on planning some more online packages for my clients. My goal is to have a fully functional online business with products and downloadable content to lighten up my face-to-face service. All in good time.

Over the past week, I moderated two career panels with Dietitians for students at college-level. The students had a lot of great questions and it prompted me to expand more on some of the topics in today’s blog. I have been thinking about doing an, “Ask the Dietitian,” within my blog anyways and I figure that this would be a great topic to start with!

How do you get experience?
For both the dietetic internship (DI) and future jobs, experience is going to be key. For RDs-to-be, you can start with your local hospital. See if you can land a position as a food and nutrition aide in the kitchen. If no-one is hiring, look at volunteer positions. Can you volunteer at a hospital, long-term care facility, food bank, food pantry, soup kitchen, etc? Reach out to local RDs and see if you can shadow them or help on a project (like a class). One really awesome thing that a fellow RD said this past week was that it isn’t necessarily the type of position you get, but the experience YOU gain from it and how that can be related back to dietetics. Let’s say you are a server at a restaurant. You could be gaining customer service skills and food safety knowledge; all of which are critical in dietetics.

How do you deal with the monetary aspect of the DI?
Start saving now! Put away that Birthday money. Put your tips and checks right into the bank. Think twice about spending on frivolous items.  I didn’t realize until my Sophomore year of college that there was a DI AND it was unpaid AND we paid them AND it was after graduation. I worked since I was 14-years-old, and I was used to putting away the money I earned, since my parents were huge on saving (thank you Mom and Dad). Besides saving, look at internships that offer financial aide, scholarships, and/or stipends. Also, do some research into scholarships from the Academy of Nutrition and your state and local groups. From what I hear about these scholarships, they often have minimal students even apply, so your chances are good!

Can you work during the DI?
Going along with the previous question, yes you can work during the DI. A lot of internships will tell you not to do so; however, it really depends on your work ethic and level of time management. I worked weekends during my DI and the occasional weeknight. I know other interns at the time, who could barely keep up with the workload, let alone a side job. If you can handle a job on the side, without sacrificing your learning experience, great. Just remember to be clear with your boss on what the DI entails. Look for positions that are flexible with hours and can accommodate a changing intern schedule. Even if you don’t work during your DI, you still want to make sure you plan your time well to accomplish all of your competencies and assignments.

What are some of the top skills for the DI and career that you feel would lead to success? 
I wrote a blog on this topic a few months back; however, I want to hone in on one really key point, “Never burn a bridge in dietetics.” Really though, the world of dietetics is so small! The dietitian who took my position at my last job before starting my practice full-time had interned with a Dietitian I knew and went to school with. I learned about my current teaching role from an RD I connected with about a year ago and kept in contact with on social media/listservs. I would have never known about the teaching position or maybe even gotten the job had I not been friendly with her. So, even if you don’t think you will need a connection, always keep it open and professional. Save business cards. Follow-up with old preceptors. You never know when you might run into that person again!

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Feel free to post a comment with your question for the Dietitian! I will answer and include in my next “Ask the Dietitian” post! 


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Top 5 Tips for Building Partnerships

Over the past few weeks, I have been writing about my tips for gaining clients. One aspect that I did not mention was on building partnerships with other health/medical professionals (or any professional for that matter). I had touched on this in week 2 of my full-time practice; however, today, I wanted to go a bit more in-depth.

Tip #1 – Do Your Research
It is a good idea to do a little recon before you reach out to any medical office, gym, health center, etc. Spend 3-5 minutes browsing their website or Facebook page. Get to know their mission, clientele, offerings, etc. This initial research not only prepares you for the connection; however, it can weed out companies that do not align with what you are doing. Say you find a health center that pushes a lot of supplements and has a nutritionist that gives out meal plans. If you do partner with them, would you be fighting an uphill battle? Do you agree with the types of meal plans they are promoting? How about the supplements? There is no harm in checking out the company and making the first connection; however, just be mindful of whom you are aligning yourself and your business with.

One of my biggest pet peeves is when an individual (or company) reaches out to me to partner (or utilize my expertise) without doing any research on myself or my business. I have had companies misspell my name or think I work in a different field (i.e. clinical or food-service). With a quick Google search, you can find out a lot about my business. It is off-putting to me when someone says incorrect information about my practice that is clearly stated on my website. It makes me think they didn’t do their research and that this relationship is not truly a priority for them.

Tip #2 – Make a Meaningful Connection
Make your first impression with any potential partner a meaningful one. Now, this doesn’t mean swinging by the place of business with your business cards and just dropping them off. Send an initial email or call-in. Schedule a good time to come in to speak with the owner, office manager, or doctor. During this time, discuss what you offer and how that could benefit the facility. Be clear about your expectations and how referrals or services will be rendered. Bring your business cards, but also bring samples of your work (i.e. newsletters, handouts, flyers about services, etc). These could all be things that you leave at the facility, which could bring clients to you.

Tip #3 – Offer a Freebie
As I just mentioned, newsletters or flyers about your services could be great items to bring by an office or health center. Often, companies will want something else for free in turn for sending clients your way. Offer to do employee lunch-n-learns for nutrition or offer free seminars on Diabetes for the patients (in-office). With both of these situations you could be handing out business cards and touting your services. A sample conversation could be, “Thank you for agreeing to meet with me today to brainstorm how we could work together to help patients lead healthier lives. I appreciate your willingness to leave my cards at your main office desk. Another service that I could offer to you and your facility would be my lunch-n-learns (or seminars). This would increase not only patient knowledge of _____, but also, help to get the word out about nutrition counseling. This, in turn, could improve patient outcomes and save some time for you and your staff (as in less education in the room).”

Tip #4 – Follow-up 
After your first connection, schedule a date to follow-up. You could discuss a date/time to follow-up at the end of your initial meeting. An example could be, “Thanks for taking the time to meet (or talk) with me. I can plan to follow-up in a week if that works well for you.” If a potential partner says they will follow-up with you after the meeting, I usually wait 1 to 2 weeks (max) before sending an email or making a call. Sometimes, people just get busy and forget. Other times, I had individuals who were not interested in my services and simply neglected to call and let me know. So, you take the responsibility to check-in and move forward with building a connection.

Tip #5 – Communicate Frequently 
One of the ultimate keys to building a lasting partnership is effective and frequent communication. This could be done in-person or via email or phone. Discuss how things are going. Are the referrals working? Has there been any feedback (positive or negative) about the services? Is the partnerships still worthwhile? What things need to change? When you have that open dialogue from both ends of the partnership, it sets a higher standard for both parties and shows the level of importance. I always think about how communication is essentially nurturing the relationship, whether it be personal or business-related. If you don’t communicate, you can’t address issues or celebrate successes that will ultimately improve the partnership.

What tips do you have for building lasting partnerships? Leave a comment and let me know!


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5 Tips for Gaining Clients in Private Practice (Part Two)

Welcome back to My RD Journey! If you read last week’s blog, you will already know that this is part-two of my tips for marketing yourself and gaining clients. (Click to read last week’s post). I hope part one gave you a few good tips to get started with marketing within your business. One thing is for sure, marketing yourself and your services is a constant. Don’t fool yourself into thinking that one ad will do the trick or one networking event will give you all the clients you need. For part two of my marketing tip series, I delve into more of my tips that revolve around the “constant marketing” idea. Enjoy!

#6 – Always Carry Business Cards
No matter where you go, always carry your business cards with you. I have handed out my card to clients on the train or even while waiting in line at the supermarket. You never know when an opportunity may arise for you to build a connection. I typically carry 5-6 cards in my wallet, so I always have some with me, and a small stack in my purse/work-bag.

#7 – Attend Networking Events
Make it a goal to attend some sort of networking event at least once per month. Join your local business associations or Chamber of Commerce to find events that would be worthwhile for you to attend. When going to networking events, be open-minded with everyone you speak with. Even if you think someone would not benefit from your services or even be interested, they may know someone who is. Also, don’t just push your card on someone within the first few minutes of meeting them. Get to know who they are, what they do in business, and even goals they may have. I will often ask fellow business owners how they got into their current role and if they see themselves growing or changing in the future. Don’t just talk to someone with the sole purpose of giving them a card and walking away. Make a more meaningful connection. Often times, I will wait until the end of the conversation to say, “I had a great conversation with you, would you like to swap cards so we can chat more in the future about ___?” Sometimes, I will even wait until the other person asks for my card, which almost always is the case. I also try to follow-up with a short email a day or two after the event.

#8 – Don’t Be Afraid to Try Something New 
If you feel like you have been trying everything to get your name out there, you may have thought about paying for advertising. While my first paid advertisement was a total waste of money, I learned a lot about my business and future marketing campaigns. Before paying for advertisement, think about whether or not the ad will target your ideal client. My first ad was on a food placement at a diner. I don’t even read those things and for some reason I thought it was a good idea to try my first year in business. Needless to say, I didn’t get any clients after the ad ran for practically 4-months. Yet, I recently had the opportunity to run an ad in my local paper (FREE) and I gained 3 new clients the same day the paper went out. The second time around, my ad was much better and the paper actually reached clients in my area. Bottom line here is that just because something failed once, doesn’t mean you can’t try again. Be open to changing your strategy.

#9 – The Power of Word-of-Mouth 
I would say about 80% of my clients and 100% of my contracts have been from word-out-mouth marketing. It is oh so powerful! How people perceive their health and nutrition is often very personal (and emotional), so having a warm referral from a friend or family member will make it much more likely that they will use your services versus searching out another Dietitian (even if they are closer). I have spoken at conferences and had audience members refer businesses to me. I have done lunch-and-learns and had my facility contact recommend me to other partners for cooking classes. I have even had Dietitians recommend me to other RDs for help on starting a business. Do not assume that in order to get clients you need to pay for ads or marketing in some way.

#10 – Do Your Best Always
Tips #9 and #10 really go together in the marketing sense. Word-of-mouth marketing is so strong when you make a positive impact on someone. To put it simply, if you are good at what you do, your work/service sells itself. If your clients/partners see that you have a passion for nutrition and really go above and beyond for their needs, then they will have no trouble singing your praises. Take your role seriously in any opportunity you have, whether free or paid. Even if you feel like an event is not worth your while (once you have arrived), still strive to perform and show your best side. This includes the idea that you should not “burn your bridges” because I always find a previous connection resurfaces later in my business. I tell my interns and any new RDs I work with that, “You never know who is watching.” As I mentioned previously, I have had a lot of big contracts form after someone recommended me after hearing me speak. Again, the person who saw you may not be your ideal client; however, who they recommend you to just may be. Bottom line, do your best, even if you think no one is watching (or reading).

What marketing tip has helped you the most? Share with me how this post has helped you or share another tip you have for gaining clients!