My RD Journey

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


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Top 10 Skills for Dietitian Entrepreneurs

Have you debated going the entrepreneurial route? Thinking about starting a private practice as a Dietitian? You may be wondering if you have what it takes to succeed. After being in business for 3 years now, I have learned a lot about my skills and what I need to hone in on to have my practice thrive.

Below, I outline 10 different skills/traits that are crucial to your success, whether it be in private practice or in another business venture. While you may not feel that you are strong in all of these areas, the more you push yourself and your comfort level, the more enhanced these skills will become.

#1 – Passion 
Whether you will enter the realm of entrepreneur as a Dietitian or any other professional, you need to be passionate about what you do. This passion will drive your business and fuel your motivation through tough times.  Your passion will resonate with clients and show them that you truly care about what you do.

#2 – Perseverance
Throughout business, you will have many ups and downs with both income and overall success. Contracts may fall through, clients may drop out, your business may change, etc. Perseverance is key to keeping yourself from throwing your hands in the air and walking away. All of your hard work will pay off!

#3 – Self-Confidence 
While you may not feel confident in every aspect of running a business, be confident in your niche, your talent, what you bring to the table. As an entrepreneur, you are constantly selling yourself and your products/services. If you don’t believe in yourself and have confidence in your abilities, why should prospective clients or companies?

#4 – Self-Motivation
As an entrepreneur, you are the boss. You don’t have a manager telling you what to do at all hours of the day. You are not walking into an office where there is a list of duties or set of expectations for your role. YOU create that role. YOU create those expectations. Can you motivate yourself when no one is standing over your shoulder? If you are struggling with how to motivate yourself, take some time to figure out what drives you to succeed. Is it making more money? Having more freedom? As an entrepreneur, I can say from experience that you won’t necessarily feel motivated, or confident for that matter, every single day. You should be able to motivate yourself and be a self-starter at least 90-95% of the time.

#5 – Strong Work Ethic 
Having a strong work ethic can be described in a number of different ways. I like to think of quality, integrity, and responsibility as attributes that someone can exhibit within their “strong work ethic.” Your quality of work and service will speak for itself and drive clients to your door (I have seen this first hand without the use of paid marketing).

#6 – Ability to Multitask 
Being the boss means that you may wear many hats (especially if you work alone), but, it can also mean you oversee many departments and thus need to be aware of the inner-workings of each. I feel that there is a fine line between what is effective and what is overwhelming and hinders production. When I think of multitasking, I think of the various things I need to accomplish on a daily basis: posting to social media, seeing clients, fielding calls, answering emails, writing content or lessons, etc. Some of these things may happen simultaneously. The key is not stretching yourself too thin, but managing these tasks efficiently.

#7 – Effective Time Management
Number 6-8 all go hand-in-hand. With having multiple items on your plate each day, you need to learn how to effectively manage the time you have. Know when your best hours are to work on administrative tasks. Know when you tend to see and schedule clients. Remember to leave some time for yourself daily (if not weekly) to recharge your batteries. Running on empty will hinder your productivity and ultimately ruin plans for time management. Before you know it, you are sucked into 3-hours of Netflix and haven’t accomplished a thing for your business.

#8 – Organization
I would say the number one skill to have as an entrepreneur is a high level of organization. This is especially important in the beginning stages of your business planning. If you are a Dietitian and plan to become an insurance provider, you will need to keep track of applications, billing codes, claims, etc. Being organized means that you manage your time well, finish tasks by their deadline, and are on top of scheduling. One of the key things I have learned with keeping myself organized is to prioritize my day-to-day tasks and anticipate when I will accomplish the non-priorities. I also found having systems in place for my administrative tasks is helpful. I have a system for how I schedule clients, how I store files, how I chart, etc.

#9 – Flexibility 
You may have your day or even week planned to a perfect T and then, disaster hits. Two clients need to reschedule, you get 2 new calls of potential clients, your seminar outline is taking longer to write than you thought, etc. Within any role, as an entrepreneur or an employee, you need to be flexible. Things will happen that will throw your day off. Take a minute to regroup and then prioritize what is ahead of you. Being flexible means using many of the other skills mentioned before: time management, organization, strong work ethic, etc. Every day will not go as planned and that is okay!

#10 – Continuous Learner
One final skill I want to touch on is being the continuous learner, which can be related to the field of nutrition or business. Never stop challenging yourself or pushing your boundaries. Continue to learn, enhance your skills, and become a polished professional.

After reading through this post, what can you identify as your strengths and weaknesses? As I mentioned earlier, you may not feel strong in all of these areas of your business. If you do feel one or two areas need improvement, can you take an online course to enhance those skills? Or, could you take on a partner or an employee that would fulfill these tasks? As an entrepreneur, you may not be able to handle everything in your business, especially as it begins to grow. Identify what your are priorities and where you can delegate or outsource other tasks.

Leave a comment and let me know your thoughts!

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For more information on preparing yourself for private practice, click the LINK.

For tips on starting a private practice, click the LINK.

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Setting Income Goals – Billable vs. Non-Billable Hours

Hey there! A few weeks ago, I posted about setting fees in your private practice. As a follow-up to that, I wanted to break down how I determined my monthly and yearly income/expense benchmarks. This is just my way of setting income goals and it is by no means perfect. I am not an accountant or even have a business background, just a dietitian running a private practice and learning things as I go! You don’t necessarily need to do every step listed in every order, again, I am just posting this as a guide for my fellow private practice RDs and RDs-to-be.

Step 1a: Figure Out Your Personal Expenses
I separated my expenses into business and personal, but since I am self-employed, both get factored in to my equation. I found it easiest to figure out what my expenses were per month and then times that by 12 to get the yearly expenses. Any expense that was paid yearly (car insurance, etc), I divided out to see what a monthly average cost would be. My estimated monthly personal expenses ended up totaling $1470, which brought my yearly personal expense total to $17,640.

Examples of personal expenses: food, living (rent, utilities), medical (bills and medications), car-related (gas, inspection, etc), gym membership, phone bill, etc. I also added in here an extra $100 for miscellaneous expenses (i.e. gifts, clothes, etc).

Step 1b: Figure Out Your Business Expenses
Many of you who have been following me the last year or so may know that I do primarily in-home counseling and some work-site counseling. I don’t have any overhead for office space rentals, etc. I just wanted to throw that out there since my monthly business expenses may seem a bit low. My estimated monthly business expenses ended up totaling $400 initially; however, I did have to add in health care costs since I pay for my own insurance now. That brought me up to about $700/month for business expenses.

Examples of business expenses: office supplies (ink, paper, etc), travel/parking for classes/counseling, cooking class materials, referral fees, memberships, business banking fees, health care, liability insurance, faxing services/machine, etc.

Step 2: Figure Out Yearly Income 
Right off the bat, I know that I need to make at least $26,040 to cover my personal and business expenses (monthly expenses x 12). I also wanted to be able to save some of my income and not just live paycheck to paycheck. When I first figured out my desired income, I settled on $40,000 for the year. This level of income would cover my expenses + estimated taxes. For estimated taxes, I averaged about 15.3% being paid towards federal (SS + Medicare) and about 4% for PA tax. I rounded this up to about 25% just to cover myself. With taking out about $10,000/year for taxes and $26,040 for expenses, that left me with about $3,960. This number could vary in real life since I overestimated for expenses and taxes. Also, when doing taxes for the year (or quarterly), you do get some tax breaks for being a business owner and a lot of my expenses were write-offs. Regardless, I still wanted to have a rough estimate to figure out my income goals. If you wanted to have $40,000 be what you would see after taxes, just do the following -> ($40,000 x 25%) + $40,000 = $50,000. You could also think to yourself that you just want to make ends meet. In that case, you could do the following -> (Yearly expenses x 25%) + Yearly expenses = Desired yearly income.

Step 3: Figure Out Monthly Income Goals
One easy way to figure out monthly income goals would be just to divide out your desired yearly income by 12. Still using the $40,000, that would be $3,333/month. With $50,000/year that would be about $4,167/month. From this point, there are a lot of ways you can figure out client goals; however, below I list just two of them. Before I get into that, I just want to point out that you will need to think about what is considered billable versus non-billable hours. You may work a 40-hour week and end up only being able to bill for 20 hours of that. Billable time is what you are getting paid for (i.e. counseling appointment time, class time, etc). Any office work, emails sent, time prepping for an appointment, etc may not be time that you can necessarily bill for. So, when thinking about client goals just know that this is the billable time or amount of time in which you receive payment for services.

Step 4: Figure Out Client Goals (Option 1)
Let’s say you have an income goal of $3,333 per month, this breaks down into a weekly goal of about $833. If you only have 8 hours available for billable hours (i.e. 8 hours to see clients) then this means you will need to charge at least $104 per client and see at least 8/week ($32/month) to be able to reach your desired income goal. If you don’t take insurance and you already know that you charge $120/hour, this cuts the number of clients you see per month to 28 versus 32. You can think about what your time is worth and determine a rate for counseling or general services that is even higher and ends up cutting down on how many hours you need to spend doing things that count as “billable.” If you accept insurance, you are bound to the fee schedule that they set for you. So, if you get reimbursed $120/hour for initial appointments and $108 for follow-up appointments, you may need 10 initials and 20 follow-ups to hit your monthly goal.

Step 5: Figure Out Client Goals (Option 2)
If you do more than just provide counseling services, you can use this option to determine client goals. Working with the $3,333 as a monthly income goal, let’s say you run cooking classes or a nutrition class every month. Let’s say you make $800 per month to run this class 3 times. This leaves you with $2,533 ($3,333 – $800 class) to still make for the month. This could mean about 24 follow-up appointments at an average of $108/hour or it could mean 5 initial appointments at $120/hour and 18 follow-ups at $108/hour. Although this seems like a lot of numbers and scenarios, it helped me to figure out how many clients I wanted to be able to see per month. Once I figured out a client goal number, I worked on a marketing plan. I mentioned in my last blog post that I wanted to work on more programs and content versus services. I love what I do as a dietitian; however, I find myself working a lot and only being able to bill (I accept insurance) for a portion of that time. I want to free-up my time and still hit my income goals, which would mean decreasing the “service” portion and increasing the “product/program” portion.

Step 6: Overview 
In summary –> Desired Yearly Income (Factoring in Business + Personal Expenses + 25% for Taxes) divided by 12 months = Monthly Income Goal. Another option = Desired Yearly Income divided by 52 weeks (or 50 if you take out a week for vacation and another week for sick/personal time*) = Weekly Income Goal. From your monthly income goal, you can determine how many billable hours (and ultimately clients or classes) you will need to reach this. It really helps knowing your hourly rate.
*Normally, with being employed, you may get paid for personal, vacation and sick days. If you are self-employed and offer a service, if you don’t provide the service you don’t get paid.

As a way to check my progress monthly, I created two sort of “snapshot” documents for my finances. The first is the yearly look at my total income, total expenses, and net profit. I made this so I can see where my peak months are for income. The second document I created was for my monthly overview. I tracked the number of appointments (scheduled, cancelled, re-scheduled), classes ran, business and personal expenses, and total income received from both classes and counseling. I also include how many miles I drove that month for business. I was using apps to track my expenses/income before; however, I really like having the paper copy to just have it all laid out in front of me. I just recently got Quickbooks and I really love it, but again just like having my own sheet that makes sense to me.

I hope this blog helped you at least a bit in figuring out your own income/expense goals. As someone who doesn’t have a background in finance/accounting, I wanted to just be able to share my process for setting income/client goals. Leave a comment and let me know what other resources have helped you with figuring out finances. I hope to post my snapshot documents on my website; however, if you wanted a copy to get you started, shoot me an email 🙂


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Working with Eating Disorder Patients

I can finally see the light at the end of the tunnel as I finish my last 2 weeks of my dietetic internship! I can’t believe how fast the time went already! In my last leg of the internship, my outpatient rotation, I am in a facility with eating disorder patients (both inpatient and outpatient). The hospital also has a couple other wings with patients suffering from mood disorders (adolescents and adults), which I also get to work with occasionally for consults.

This is my first time working so closely with eating disorders (ED) and it was a bit overwhelming the first couple of days. I never realized how much time the RD spends counseling and how important it is. The patients see the RD 1x/week for a session; however, the RD ends up seeing and talking to some of them almost every day. The RD will walk onto the unit and patients start calling to talk to her about their weight, their meal plan, etc. It takes a lot of reassuring and challenging of eating disorder thoughts. Some of the patients will become so upset if you need to up their meal plan 200 calories due to not gaining weight or weight-loss that it is hard to calm them down. You have to be patient and understanding when giving news that they will not take lightly.

Some of the best lines I learned in counseling were, “How do you feel about what I said,” “Where do you think your weight is,” (They find out their weight 1x/week and that phrase is asked prior to them knowing) and after a patient says something so absurd “Reality check does eating an orange really make you fat.” You can’t be afraid to challenge an ED thought, you just need to know how to phrase it towards each person.

One of my biggest fears with ED is saying the wrong thing. I’m always thinking that I will say something that will trigger one of the them or make them upset. I learned that besides practicing, the key things you need to do are: be empathic, don’t downplay how they feel, always give praise when you can (for finishing a meal, etc), let the session be guided by the patient, ask “why they feel that way” when they have something to say about their body image or weight, and ask as much open-ended questions as you can.

There are also a ton of meetings every day with MDs, RNs, social workers, etc. The care team needs to really collaborate on the treatment plan, not only to aid the patient in recovery, but to provide a united front. Some of the patients are very sneaky and will lie to your face about purging or hiding food. It is really helpful to have team meetings to see if what the patient says, or doesn’t say, is consistent (they tend to slip up when they lie). Seeing the food rituals some of the patients have is crazy. Some of them tend to be very OCD (they have to have even numbers of foods or eat in a certain manner) and you can definitely tell when you observe their meal times.

Some of the comments/situations I heard this week that will show you how distorted some of the thoughts ED patients have are:
1. I am morbidly obese and I am concerned about breaking the chair. (Patient is underweight).
2. RD: “If your BMI is in that range, you will be considered emaciated”. Patient: “That’s okay with me.”
3. Scales don’t apply to me. (Patient stated after saying her family is genetically modified to need less food than everyone else),
4. Since I got my menstrual cycle, I know I gained too much weight. (In case your not familiar, patients with eating disorders tend to lose their cycle. Some patients have not had 1 in over 5 years).
5. I’m concerned with getting diabetes from eating all this food. (1600 calorie diet that is).
6. I don’t need to eat to live.
7. I don’t know why I am here. I am fine. I just purge after each meal and when I drink water.

If you every work with eating disorder patients, be prepared to hear comments like the ones above. Some of the ones I hear every day are centered on feeling fat or bloated and being disgusted with themselves. It seems silly to think about a 100lb person being fat; however, these patients truly believe that the distorted thoughts they have are in fact real. It definitely takes a lot of patience and empathy to work with EDs every day. While I love being in this rotation and learning so much so quickly, I can say that this is not the field of nutrition I would want to work in at all 🙂


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Food Service Management Rotation: Tips and Information

This Monday, I will be heading into week 8 of my Food Service Management rotation of my Dietetic internship. It seems as though the time is flying by! I can’t believe I am halfway through my longest rotation of my internship. Things have gotten a little more stressful; however, I found that being able to manage my time efficiently has worked to my benefit.

 

Throughout the past few weeks, I really had to step up, in terms of leadership and initiative. My old preceptor (an RD) had left to join the Navy. My new preceptor was the General Manager, who had a ton of things to do already. My new preceptor would run errands around the schools in the morning and attend various meetings. This left me alone in the office for the majority of the time. I found myself becoming the RD for the school district. All of the carb counting and menu nutrition questions came to me. I also sat at the RD desk and answered various parent and employee phone calls. Some of the calls were pretty basic (how do I load money on my child’s account) while others required a lot more thought and time (child allergies and special diets).

 

The school district I am working with uses a program called PrimeroEdge, which is similar to NutriKids, just way more in depth and complicated. This program was where you inputted ingredients, recipes, and cycle menus for the district. It was my duty to create the menus in the system, and assign them to the schools in the district so they could complete their production records. The program is a very useful tool; however, the first few weeks were very difficult, as I was teaching myself how to use it. Once I mastered certain aspects of the program, things ran a lot smoother. One thing I had to consider was the slowness of the program. It is internet-based, so it gets very overloaded at certain times of the day (mid morning and late afternoon). Just adding in 1 ingredient to 1 day often took 5 minutes because of the webpage loading time. I had to plan when I would input and assign menus, so that I would not be using the program at its slow times.

 

The past few weeks were very stressful; however, the experiences I had strengthened my leadership and conflict negotiation skills. I also got much better at handling employee issues and multi-department management. I had to make a lot of decisions, so it was important to trust my knowledge and use good judgement. Management was very impressed with my work ethic and ability to handle what was thrown at me. I just did what I needed to do because at some times, no one else had the training I had to do it (answering carb or specific nutrient questions). It felt really good when upper management talked about me so highly to other administrative employees. I wasn’t just an intern working there anymore. I had gained a lot more respect than that. When the new RD came in, I found myself training her. It was a very weird feeling for me, the intern, to be training someone in a higher up position, none-the-less, an RD. Much of what I trained her on was office procedures, PrimeroEdge (she had been using NutriKids), kitchen location, etc.

 

During her first week, the new RD had brought in a lot of materials for me to look through; including her RD test review binder, teaching resources, and a ServSafe training manual. The ServSafe book was a better resource for me than my college food service textbook. It laid out everything in a short and simple format. I would definitely suggest adding this to your resource library. She also brought in a book called “Strengths based Leadership.” I haven’t gotten a chance to read the whole book yet; however, after glancing through a few chapters, it is well worth the read.

 

Another major portion of my time over the past few weeks was spent on various lesson plans, presentations, and building promotional materials. My next blog will be on the lessons I taught and tips for teaching various age groups.

 

Tips for FSM Rotation

1. Whether you are in a distance or on-site program, it is really important to plan out your assignments at the beginning of your rotation. Try to knock out the easier assignments/tasks in the beginning. Since I needed my preceptor’s help with scheduling things for other assignments, I tried to do what I could on my own.

2. Give your preceptor an updated assignment list after you have gone through a few weeks. My preceptor needed to be reminded of my assignments on a daily/weekly basis. He was very busy with other duties of his own, so this was pretty typical. It helped to scale down my assignment sheet to things that just dealt with him. It made it easier to work through assignments and get things planned ahead of time.

3. Be flexible! As much as planning is helpful, always be prepared to change up what you are doing. An employee might call about an issue that needs to be handled ASAP; you might have to switch up dates for meetings or presentations. Expect change to happen and roll with it. It will just make everything run a lot smoother.

4. Be able to multi-task. A lot of times I would be working on something (making a poster, writing a lesson) and I would get phone calls, or questions handed to me. Being able to handle multiple tasks, without stressing out, will really help your rotation run smoothly.

5. Work on negotiation and conflict resolution skills. If you haven’t had much training or read a lot on these 2 topics, do so. I found myself researching them a lot as I moved through the leadership portion of my rotation.

 

Lastly, if you are still working at a job during your internship, kudos to you! If you are thinking about whether or not you should keep your job, know that it is manageable with the internship. I still maintain my position at a YMCA teaching nutrition. I have 7 different classes during the week that I teach. I am lucky, in that I was able to schedule the classes at a certain time that worked best for me. My earliest class starts at 4:45pm. This gives me enough time to get from my internship to the teaching site. While my weeks are very busy, it is manageable with proper scheduling and time management!

 


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Preparing for Your First Internship Rotation

In exactly 11 days, I will begin my first dietetic intern rotation in food service management (cue the bells and whistles). I am very excited/nervous to begin my next step in my RD journey. A lot of people in my internship program have already started their rotations. Hearing their positive experiences have really made me antsy to have my own and just get started.

 

With my internship, I also take a certain amount of graduate credits. At first, I thought this would be a ton of work; however, the assignments and lectures are spaced out and prepared very well. Also, with the online format, it is easy to jump on and work for an hour or two, then move on to something else.

 

Some ways I have been preparing for the rotation are: 1. Complete quizzes and lectures supplied by my internship (If your internship does not have these, there are plenty online). 2. Read through my foodservice organizations book. 3. Read through all the assignments I will be completing. 4. Create a semi-timeline of the rotation. 4. Give an overview of assignments to my preceptor (I am in a distance program). I also found it to be helpful to gather all of my rotation materials in one binder so that I can reference assignments or notes with ease. I also read through some of my notes from my food service management classes and quantity food production class that I had in college

 

Besides preparing myself for the work portion, I have been mentally preparing myself for the rest of the program. Not only do I not know my surroundings, but, I also don’t know my preceptors very well, or what their schedules are really like. It is more of preparing myself for the unknown of that first day; accepting what will happen and just going with the flow. There is always that feeling that “maybe I don’t know enough” however, the comments and feedback I have heard from the other interns have really made me excited and know that I can do it. Having the other interns to talk to and share stories with has been such a great addition to my internship. I know that if I need help with assignment I can always turn to the other interns. Also, seeing that some of them struggled with similar assignments has really made me think that I wasn’t the only one to be in that situation.

 

Just some final words of advice to those of you who have either just begun your internship or are waiting to start:

-Don’t feel like you are alone in the process! You will always have the other interns and your directors to turn to for help or guidance.

-Have confidence in yourself and know that you can do it! Trust the knowledge you have. Brush up on some information to boost your confidence.

-Be flexible and go with the flow. As much as you want your first day to go smoothly, know that it will probably be crazy or very different than what you are used to. Embrace the change and accept what is in front of you.

-Prepare your materials ahead of time so that it is one less thing to worry about.

-Get to know your preceptor and supply them with your assignments prior to starting. It will help the process run a bit more smoothly.

-Lastly, share your story with others! It always helps to share your positive experiences with others who are just starting.