My RD Journey

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


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Sprucing Up Nutrition Counseling Sessions

Welcome back to MyRDJourney! With the end of Summer nearing, I have gotten a spike in new clients. It feels good to see my business pick-up after having a previous slump last month. I’m also excited for September since I am running my first paid virtual support group and working with a new company for some contract food demos. I initially had a heavier basis of individual clients; however, I am morphing my business into more online programs/classes. If you are looking to take your business to the next level, you can read my previous blog on that exact topic here.

Today, I wanted to talk about something a bit more personal, the counseling rut. Do you ever start to question your Dietitian-self in counseling skills? Wondering if you are really doing everything you can for your clients? Wondering how to make sessions more effective, especially with long-term clients?

Sometimes counseling can get stagnant. You might feel like you are telling your clients the same things over and over again. The client might not be asking you for much and honestly, they might not know what to even ask for. The flow of your counseling sessions could start to get choppy and even seem forced.

I always felt like the first few sessions with any new client were pretty “easy.” Most came in with a clear idea of what they wanted to get out of the session. The session just seemed to flow with me mainly giving education and answering initial nutrition questions. After a few sessions, the harder work comes in. I started to see a need for more motivational interviewing, as some clients were frustrated that they weren’t hitting their goals as quickly as they anticipated. A lot of my clients at this point “knew what to do;” however, they were just having a hard time “doing it” consistently.

If you hit this point throughout your Dietitian career, that is okay! Knowing how to handle ruts will improve your overall counseling skills and build trust with your clients (ultimately leading to their success).

3 Ways to Get out of a Counseling Rut and Spruce up Nutrition Sessions

1 – Re-Evaluate Their Reason Why
First things first, figure out if your client’s “reason why” has changed. If their “reason why” or motivation for getting healthy has changed, this could mean that their goals, actions, and ultimately feelings are not aligning. This disconnect can impede nutrition progression and cause your sessions to flop.

2 – Ask Open Ended Questions
There are 3 key questions I ask my clients that help to reestablish counseling flow or give talking points and really dig deep:

  • What are you currently struggling with? – Good to ask in the beginning of the session.
  • What do you hope to gain from today’s session? – Also good to ask in the beginning of the session since it give direction.
  • What can I do on my end either now or after our session to help you reach your goals? – Good to ask towards the end of the session. Some clients end up asking for email support or text message motivation. Usually, it ends up being some form of accountability.

3 – Spruce Up Your Handouts/Goal Setting Sheets
If you don’t have a goal setting sheet, now is the time to make one. I created a half-sheet of paper that lists my contact info, follow-up appointment date/time, product recommendations, goals, actions, and any nutrition prescription information (i.e. fiber, carbs). For each goal I set with a client, we determine their daily actions that help them reach their goal. Doing this helps them work through barriers during the session since we can actively brainstorm solutions. I find that a goal  sheet creates more inter-activeness during the session and heightens the likelihood that the client will succeed. I find a lot of clients like physically getting something from the appointment, and the goal sheet satisfies that.

Leave a comment and let me know how you are sprucing up your counseling sessions!

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7 Ways to Take Your Business to the Next Level

Welcome back to MyRDJourney! Have you been feeling lately that you need to take your business to the next level? Maybe, do something that will get you out of the business slump I talked about in my last blog?

The time will come in your business when you need to step it up. You will know when that time comes. I started my practice in 2014 and every year, I felt like I took it up a notch. I started accepting insurance in 2015. I re-launched my website in 2016. I built new partnerships and ended poor ones in 2017.

I describe it as an “itch” you need to scratch. A time when things feel too repetitive and you crave more. A time when clients might be even asking for more. This time came for me a few months ago when I decided to launch a free, beta, weight management support group. I knew my clients were looking for more support between appointments; however, they couldn’t all physically make it to a location every week. Cue the virtual class!

If you are scratching your head at where to start in stepping things up, read on for my “7 Ways to Take Your Business to the Next Level.”

1 – Assess + Set Goals
Think about your business now and ask yourself these questions: What is working well? What is not working well? What do my clients want? What do I know my clients need? What part of my business really excites me?

In assessing my business, I realized I was inefficient in how I was scheduling and charting clients (cue the EMR platform). I also knew I wanted to have more of a “virtual” income, yet I wasn’t doing much about it (cue the virtual weight management support group).

2 – Find Your Niche (If You Haven’t Already)
If you don’t know what your niche is or who your ideal client is, ask yourself these questions: What are your passionate about? What do others say is a skill of yours? What is your vision? What are you good at? Finding your niche will help you create more (and better) content and will fuel your drive to do more in your business.

Identifying my niche was really hard for me since I felt like I had a lot of ways I wanted to go with my practice. I ended up narrowing down my ideal client to working adults who are struggling to eat healthy with a busy work-personal life. My ideal client is someone who has been on multiple diets in the past and is ready to make a lifestyle change and end the cycle of dieting. I am still fine-tuning my niche; however, this was a great starting point for me.

3 – Brand Yourself/Business
Something that is often skipped/overlooked when setting up a practice is the branding aspect. Do you have a website? Does all of your copy and content speak to YOUR business brand? What do you want your client to feel when they read your content or visit your website?

I knew I was at the point in my business where I needed a logo. I needed that branding, especially if I was going to create a stronger online presence. I also knew I needed to re-do my website since it was bleak and hard to navigate. If you are feeling stuck, reach out to you current clients or someone you work with professionally to get their input. From there, you can determine your next steps in branding.

4 – Enrich Your Offerings
What can you do to enrich what you offer your clients? What more are they looking for? What do they need to reach their goals?

In enriching my business/services, I added monthly coaching, meal plan templates (for use by RDs and clients) and more lessons to my TPT store. All of these add-ons were in line with my business goals of going more virtual. I also added in new client folders with recipes and handouts, which helped to enrich my clients’ face-to-face experience with me.

5 – Ramp Up Your Online Presence
I already mentioned refreshing your website if needed; however, think now about your overall online presence. What social media platforms do you use? What social media platforms do your clients use? How consistent are you with posting content? Can you team up with another health professional to do a guest blog/video?

I had been blogging and posting on social media consistently; however, I really wanted to expand into video content. I dabbled in YouTube in the past; however, video editing is not my cup of tea. A few months ago, I started doing Facebook Live videos and they became a hit with my clients. I love doing them and my clients refer to them quite frequently now!

6 – Invest in Yourself
I tell my clients all of the time to invest in themselves and their health. This could mean a financial investment (i.e. gym membership or more healthful foods) or even just time (i.e. going to the gym or cooking more). This point translates really well into business.

I invested in myself this year by attending the Today’s Dietitian conference (i.e. knowledge + business connections) and by purchasing sports nutrition materials to expand my knowledge in this area. I’m looking to study and get my PT certification by the end of the year. This is something I am passionate about for myself and know will help me better help my clients. What aspect of your business-self can you invest in?

7 – Take Care of Yourself
In taking your business to the next level, don’t forget to take care of yourself. The last thing you want is to get started only to burn out in a month.  Don’t let your personal life go or things that you enjoy doing. For me, I schedule in my gym time during the day to take a mental break and I knit at night to relax. How will you take care of yourself?

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Leave a comment below and let me know how you plan to take your business to the next level!


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Working Through Business Slumps

Welcome back to MyRDJourney! If you read my last blog on EMR platforms, you will know that I just switched from paper/doc charting to an EMR! Let me tell you, this alleviated a lot of stress, time, and back-and-forth between clients for appointments and initial paperwork. No matter what platform you end up with, I would highly suggest looking into this for your business.

With the holiday just last week, there has been a major slump in business, which I kind of expected after 4 years of tracking the ebb and flow. I do have a lot of great clients who stay the course throughout the Summer; however, most of my new clients come in September once vacation time is over. This ebb and flow can happen in any business and you will feel it even more as an entrepreneur versus working for a company since the income changes too.

Normally, I schedule days where I don’t see clients so that I can work on my business (i.e. product development, content creation, etc) or so I can have some R&R. I try to have a list of on going to-dos to refer to quickly versus trying to figure out what to do in the moment.

During the Summer, there could be more days of administrative work than client seeing depending on holidays and such. I hit a Monday 2 weeks ago where I had 2 cancellations, 1 reschedule, and 2 client no-shows. What was supposed to be a productive day of seeing clients followed by working on product development turned into a slump of all slumps. While I should have been happy with the extra 3 hours I had to “be productive,” I really ended up unmotivated and downright frustrated.

After wallowing in self-pity for a bit, I did the following mini-exercise which I felt like got me motivated to move forward with the day. I hope this exercise helps you when your feeling an unexpected business slump.

1 – Wallow if you must for no more than 5-minutes
You can do this internally or even vent to a friend about it. Journaling can help in this situation too. Just get all of that negativity out!

2 – Do something non-business related
This can help you to clear your head of negativity and a lack of “productiveness.” I like to either cook a meal for myself, knit, go to the gym, or even go for a walk.

3 – Create an action plan for a 15-minute task
Now, it is time to get the creative juices and productivity flowing. Fifteen minutes is short enough to be “doable” but long enough for you to make progress and have sense of accomplishment. Think about something you have been putting off for the day, week or even month. In my 15-minutes, I ended up making a lesson plan template. I want my lessons to look more professional and consistent when I upload them to sell on Teachers Pay Teachers.

4 – Think about your “why”
Why is it important you do x, y, or z? What will your current or potential clients gain from your efforts? My “why” was not just for income purposes. I wanted to create more credible nutrition lesson plans from RDs in the marketplace.

5. Do it
Plain and simple. I did what I said I would, felt good about it, and even worked for another hour on products because I was motivated and redirected to a positive portion of my business! If after 15-minutes, you aren’t ready to move forward, that is completely fine too. Know your limits for the day and revert back to #2 if needed!

I feel like this simple exercise really helped me when I had an unexpected “slump” in my day and felt particularly unmotivated. I also find it to be really helpful to schedule in co-working dates and meetings with other professionals (dietitians or business owners) at least 2-3 times per month. I always feel encouraged and excited about my business after a coffee date!

One last thing I want to leave you with is more so on a more personal note. If your feeling like nothing is working to get you motivated in your business or in general, NEVER be afraid to ask for help. This could be asking for help from a friend, family member, or even a professional. Sometimes you need a more in-depth emotional work-through and that is 100% okay. I’m always here if any of you reading this need a call, video conference or even want to meet up to chat through some business slumps!


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5 Tips for Running a Nutrition Support Group

Have you ever sat through a meeting, group discussion, or any class for that matter and thought, “I really wish ___ would stop talking and give someone else a chance?” This is one of the exact situations you want to avoid in leading group discussions within a support group (or class).

After running multiple weight management support groups and nutrition classes, I found the most effective sessions were those that had a designated topic and were gently guided. Below are 5 of the key tips that will help you run an effective support group style class!

1 – Come Prepared
Having a topic for your group discussion is absolutely key! This gives the class direction and focus. I would also suggest creating an outline with estimated time frames and talking points. I also had “extra” notes on my outline in case the class was smaller and/or a bit more quiet. Think also about 1 relevant topic handout you could provide and a recipe or two.

2 – Set Ground Rules
In the beginning of the first couple of classes, I laid out the ground rules for all of the participants. I made it a point to say that everyone is in a different place in their health journey and to be respectful of others’ viewpoints and struggles. You would be surprised how many times I had to remind adults of this. I also outlined the flow of the class (see below), noted the time constraint, and asked all phones to be put on silent or turned off.  

3 – Be Aware of Group Dynamics
During the first class or two, you will start to see different personalities emerge. I usually had a small group of participants who were the most engaged (i.e. always giving feedback/input), a handful of really chatty ones (who I often needed to cut off), a few silent listeners (some of which preferred to ask questions after the session finished), and maybe one (if any) aggressive or very negative participant. While you don’t want to put anyone in a “box” necessarily, being aware of the dynamic will help you facilitate more effective discussions and know when you might need to intervene. There are a ton of resources online that can help you in managing certain group dynamics if you feel stuck.

4 – Take Charge of the Discussion
After leading quite a few group classes, I began to realize that the most positive feedback I received was in regards to how I kept “in control.” Taking control of the class means allowing meaningful discussion, yet redirecting when needed. This also means (politely) cutting someone off who is chatting too much. This also means spinning negative comments into positive and actionable ones. If you feel like the class got a bit off track, don’t be afraid to redirect the discussion. Often I would say things like, “Suzie, you make a great point about exercise being a struggle. I will make note of your comments so we can focus on them when we get to that topic.” Avoid getting too far off track during every session since many of your participants could be really looking forward to the topic originally planned and may feel upset that it didn’t receive adequate time/attention.

5 – Create Actionable Goals
At the end of every group session, I would take about 5 minutes to have all participants write down an action goal for the week. I would give everyone the opportunity to share their goals and provide encouragement and support for others. I felt like this tied the discussion topic together and gave participants something positive to work towards (other than just weight).

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Sample Class Flow (1-hour)
I have run 45 and 60-minute support groups before. I always did the weigh-ins prior to the class (optional) and avoided talking about weight during the class discussion in an effort to keep things positive for all.
-Optional weigh-ins prior to class
-Introduction to myself (2 min)
-Ground rules/reminders (3 min)
-Discussion of last week’s topic/goals – what worked, what didn’t, questions (10 min)
-Topic introduction from Dietitian – why this topic is important, what I want to discuss (2 min)
-Main topic – Dietitian has talking points, ask class about struggles (8 min)
-Class input on topic – strategies that worked well for them (10 min)
-Additional questions/Dietitian recap (5 min)
-Goal setting + sharing (10 min)

Sample Support Group Topic Ideas
Be specific when choosing a support group topic. I tried to avoid broad topics (like weight-loss) and instead focus on particular habits or health attributes.
-Healthy snacks – components, samples
-Reading labels – what to look for, samples
-Eating on-the-go – can be broken into eating-on-the run and eating out
-Mindful eating – what is it and how to incorporate
-Tips for incorporating more fruits/veggies
-Incorporating exercise into a busy schedule
-What is meal balance – i.e. what should be on your plate
-Strategies for eating well: on vacation, over the holidays, at BBQs, etc


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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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