The Pros and Cons of Being a Private Practice Dietitian
“If your dreams don’t scare you – then they aren’t big enough.”
As much as I LOVE my job as a private practice dietitian it would not be fair to assume that in my world only rainbows, unicorns and cotton candy for breakfast exist. But a girl can dream, right?
But, if I didn’t think the benefits of running a nutrition private practice clearly outweighed the challenges; then this site would not exist. Truly, in my heart of hearts, I feel like running a private practice (while at times challenging) is nonetheless well worth the struggle. And sometimes friends, the struggle is in fact real.
However, I tend to be a glass is half-full type of gal so let’s review the positives first.
It probably comes at no surprise that I could personally ramble on for days about the benefits of being a private practice dietitian. Instead, I am going to narrow it down and focus on what I personally feel are the most five important benefits of being a private practice dietitian.
The 5 Top Benefits of being a Private Practice Dietitian
You are the boss
It is no surprise that the number one benefit I see of being a private practice dietitian and working for myself is the fact that I am my own boss. As you can imagine this is a pretty awesome feeling. After years of working at a corporate clinical job – now I get to call ALL the shots.
I get to decide exactly how I want to run my practice. From the types of clients I want to work with, to which insurance companies I choose to participate with, to how I want to schedule my patients, right down to how I want to manage my money. I am 100% in charge of everything in my practice.
Complete and total control over your schedule
My schedule is entirely up to me. And after a decade of having this luxury it is not something I would ever choose to give up.
If I want to work week nights and weekends I can. If I only want to work three days a week I can make that happen as well. If I want to go to Italy on a culinary trip with a bunch of other dietitians I don’t have to ask anyone. Well, maybe my husband! But I don’t need to put in a request for PTO. I just need to make sure I block off my schedule and pack my bags. Easy-peasy!
Being able to work when I want (and with WHO I want) is SO friggin’ awesome. if something important comes up (like a trip to Italy!) I can always adjust my schedule to accommodate.
For example, in the Fall and Spring, I teach nutrition courses at a local university. Because I work for myself I can change the days I am in my practice to accommodate the days I teach. I usually know this information months in advance so I just change my practice days. This allows me to explore different opportunities as they present themselves. I never have to say ‘no’ unless I choose to; not because I have to.
Having a flexible schedule in which you have complete and total control is clearly one of the best benefits of being a private practice dietitian.
You can specialize in a practice area that excites you
When you work for someone else you are often told what types of patients you will be seeing. When you go into private practice you can choose the exact population you want to work with. In fact, I highly encourage you to dial in your niche and focus as much as possible on a single demographic. It will make your job much more enjoyable and allow you to streamline your focus and hence practice.
There’s a saying out there and I think it’s a great representation of private practice: if you’re speaking to everyone then you’re speaking to no one. Niching down is a great way to streamline your focus and speak directly to your ideal client.
Increased potential earnings
This is HUGE. When you work for yourself the sky’s the limit with your income. The harder you choose to work; generally, the more you make. This is NOT the case when you work for a corporation or hospital. In those settings, you make a finite salary no matter how many patients you see in a day. But in private practice, the reality is much different.
And as you grow your empire and more and more people become aware of the awesome services you can provide them – the busier you will get. The more patients you see the more money you make. Therefore, there becomes a somewhat linear relationship between your personal output in your practice and your income. Talk about total control.
Profound sense of pride as you teach yourself the ins and outs of running a successful private practice.
I save this one for last – but certainly not least. Running a practice is really hard work. There is SOOOOO much you need to learn. However, with each task you cross off your list, the sense of pride and accomplishment you feel towards yourself is literally priceless. In private practice, you learn by doing.
Take for example billing. When I first taught myself how to do my own billing I wanted to throw up. I had no idea where to begin. Every time I would think about it – I would break out in a cold sweat.
But what I learned then (and still applies now) is that pretty much everything is figureoutable. While there might be some short-term pain involved and a substantial learning curve to overcome, the feeling of satisfaction of teaching yourself how to do something is irreplaceable.
And like I always say, you are a friggin’ RD, there is NOTHING you cannot figure out if you put your mind to it.
Note: the obvious goal of the resources available from The Reimbursement Dietitian is to help take a lot of the guesswork out of starting a successful private practice. But, I would be lying if I said everything will come easy. There are lots of new things you will need to teach yourself. At times your head is going to feel like it is going to explode. But, “If your dreams don’t scare you – then they aren’t big enough.” The reality is the more you know about the ‘ins and outs’ of your practice; the increased likelihood of your success. And the only way to do that is to get comfortable with being uncomfortable.
So in that same vein let’s discuss some of those things in private practice that from time to time make me uncomfortable. In my tenure as a private practice dietitian, I have certainly experienced my fair share of challenges. So let’s take a peek at the ones that I feel are most critical. I will also give you some suggestions on how to overcome and minimize these challenges.
The top 5 Challenges of being a Private Practice Dietitian
You are the boss
You knew this was coming right? As much as being your own boss means you have total control over your job – it also means you are in charge of everything. This means all your policies, systems, forms and paperwork needs to originate with you.
In private practice, you will soon begin to realize that every decision to be made in your practice is made by you and you alone. If you have come from a team environment, and most of us have, it requires some adjustment. As the person at the top, there’s no one to run things by or team members to collaborate with. If you are new to being a small business owner some of this may seem daunting. However, it does not have to be!
The Reimbursement Dietitian Tip
Don’t be afraid to ask for help. You don’t need to invent the wheel. While I did in fact create all the forms and systems in my practice from scratch; the only reason why I did this was because prefabricated resources DID NOT exist.
If someone had said to me, “Hey Am – I have all the resources, systems and forms to help you get started in private practice.” I would have been all in – in a heartbeat. There are SO many things you need to do when you are getting started in private practice. But save yourself a boatload of time and aggravation and purchase The Reimbursement Dietitian – Starter Pack. This way you have all the resources you need and focus all your time growing your empire.
Increased financial risk
When you are an employee there is very little financial risk. You show up for work, do your job and get paid. Often your employer contributes a portion of your health insurance, they assume responsibility for your liability insurance and they even pay you for taking time off.
In private practice the scenario is much different. While your potential income can be MUCH higher; so is the financial risk.
Unfortunately, if your patients don’t show up for their visits you don’t get paid. That is not to say that you cannot charge them if they don’t properly cancel; however in order to make money in private practice you need to have a steady flow of patients. Also if you have a slow month; you still need to pay your rent and cover the cost of your utilities.
Aside from rent you also have additional expenses like liability insurance and start-up costs like purchasing your own computer, printer and fax. In addition, expenses such as small things like toilet paper and paper towels for the bathroom, paper and toner for the printer can all start to add up.
The Reimbursement Dietitian Tip
Don’t quit your day job. Yes, there will come a time when you burn your bra and quit your day job. And I sincerely hope to be there to high-five you. But I would be lying if I said that would be sooner than later. I worked for almost ten years as a clinical dietitian while working my side hustle of private practice. That way I had a steady, uninterrupted flow of income to pay for all the fun expenses of running a startup small business. Was it hard? Absolutely! Did I sleep much? Hardly. Was it worth it? A big giant “Hell Yeah!”
Multi-tasking will likely become your middle name
Hi, my is Amy Plano and I am a registered dietitian and occasional secretary, accountant, social media manager, scheduler, biller, coach, and anything else you can pretty much identify as a job title in a small business! In private practice, we often wear many hats – most of them at the same time.
While it seems evident that your main job should be seeing patients; this is not always the case. First, you have to market your services and get patients through your door. This may be word of mouth, via social media, or through traditional marketing channels. You also need to design packages and establish a fee schedule for your services so you have something to sell these patients.
And let’s not forget the super fun finance piece. You need to bill for your services as well as perform accounting tasks and keep very detailed expense summaries. And sadly these are only a handful of tasks you are responsible for when you are running a nutrition private practice.
I won’t tell you all of this to freak you out. More importantly, I assure you none of these tasks are hard. You are fully capable of executing them all like the champ you are. I just want you to know what you are signing up for when you decide to open up your own nutrition private practice.
The Reimbursement Dietitian Tip
In the beginning learn how to do ALL the tasks in your practice on your own. Even the billing. That way when your business grows and you are in a financially better position you can hire someone to complete the day-day tasks of running your business.
However, if you jump the gun, and hire someone out of the gates #1: you likely don’t have the income to cover the cost and #2: you will never learn the important details it takes to run a successful private practice. You should know EVERYTHING about your business – especially the details. The details really matter. I can provide countless experiences about those dang details but I won’t bore you. Just know that you should know your practice inside and out especially before you let anyone else in. This is your baby and you need to protect all angles at any cost.
No one tells you whether or not you are doing a good job
I know what you are thinking. Big girls don’t need external validation, pats on their backs, or gold stars. Well, sister, I am here to tell you we do. We need all of those things to succeed not only in life, but more importantly in our private practice.
When you work for yourself there is generally no one to critique your performance. You. don’t have a supervisor who regularly monitors your performance, and provides guidance, and/or feedback. You are the boss after all. Therefore, sadly you have no idea if the job you are doing running your practice is satisfactory or requires improvement.
And after 10 + years of running a successful nutrition private practice what I can tell you with 100 % certainty is this – we can all improve in some manner. Whether it be in our skill set as practitioners, how we conduct ourselves in our business transactions, or just in our day-day systems. In private practice, there are so many areas in which we can improve and further develop. But when you work for yourself these areas are not always so self-evident.
The Reimbursement Dietitian Tip
There are no performance appraisals or annual reviews. Which may seem like something you applaud. However, working for yourself requires you to be introspective in nature. You need to be able to systematically assess all areas of performance in your practice and constantly ask yourself what am I doing well? What do I need to improve on? While this may seem pretty straight forward, it requires time, discipline and dedication to yourself and practice on an ongoing basis. I would highly suggest getting a coach or mentor when you first start your practice. That way you have someone to help supervise what you are doing in your practice and provide constructive feedback. Or at the very least provide your clients with comment cards or regular patient satisfaction surveys.
Professional isolation is a little bit of a sleeper when it comes to the downfalls of being in private practice. No matter how many patients you see; without professional interaction, it can get a little lonely in private practice. I so clearly remember the early days in my private practice. I had planned for many things, but I had not developed a plan to manage the isolation that so many solo practitioners face.
Most counselors do not intend or desire to operate in professional isolation. Yet to maintain high patient loads, many of us are forced into over-scheduling clients back to back on days or during periods when both client and counselor are available. Over time, daily pressures and life circumstances leave dietitians in private practice often with limited time for adequate breaks between counseling sessions or time to attend to professional needs, such as supervision and consultation for difficult cases.
The Reimbursement Dietitian Tip
The simplest approach to addressing the issue of professional isolation is for dietitians to seek direct feedback on essential counseling skills such as case conceptualization, treatment planning, intervention, and feedback with difficult cases. I highly recommend and encourage dietitians to stay connected. Whether it be on DPG listservs, closed-facebook pages, seeking out a private practice mentor or joining your state affiliate and becoming involved.
There are SO many ways to stay connected directly to our profession. Technology aided communication can help dietitians in private practice exchange information and perspectives on theoretical interventions, new approaches, clinical treatment, emerging issues and legal and ethical issues.
There is no lack of opportunity for us to engage in professional networking that can lead to personal and professional awareness, and hopefully improved outcomes for our patients.
Here are some of my favorite social media resources for staying connected
The Reimbursement Dietitian FaceBook Page
Dietitians in Private Practice Closed Facebook Page
Insurance Credentialing and Billing for Registered Dietitians Closed Facebook Page
The Unconventional Dietitian Closed Facebook Page
Dietitian HQ Community – for RD Entrepreneurs closed Facebook Page
So it’s not a surprise that there are clearly some awesome benefits to being in private practice. But there are also some drawbacks. However, as a veteran private practice dietitian, I can tell you with an honest heart that the benefits outweigh any of the negative aspects.
Is running a successful practice super hard? Yes, especially at first. But just like with anything in life there is nothing you cannot do if you put your mind to it.
More importantly, The Reimbursement Dietitian and her services help soften the blow. Aside from the free resources offered in this section here, The Reimbursement Dietitian offers additional paid resources and services to help make your dream of running a successful nutrition private practice a reality.