My RD Journey

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


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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!


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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!