July 2009 Issue

Making Money in a Recessionary Economy
By Maura Keller
Today’s Dietitian
Vol. 11 No. 7 P. 30

Take some cool tips from your peers who are finding creative ways to bolster their business despite clients’ ever-tightening budgets.

Although RDs are well trained in the finer points of nutrition and wellness, many may struggle with the challenges of managing the “behind-the-scenes” portion of their business—staffing issues, marketing, accounting, and selling their services to potential clients. And in a recessionary economy, simply staying afloat is paramount for many. In fact, to stay ahead of the competition, today’s dietitians must keep abreast of the changes and innovations shaping the industry while creatively embracing new ways to enhance their bottom line.

The Economy’s Effect on the Industry
Open any newspaper or glance at any online newscast, and you’re bound to see headlines touting the downward spiral of the global economy. While most consumers are feeling the effects of the recession, businesses across myriad industries are feeling the effects of consumers’ penny-pinching mentality. And the nutrition field is no exception.

“There is some impact on the industry, as many [people] view nutrition counseling as an ‘extra’ and not a necessary expense—like they may view a massage. It’s nice but a splurge,” says Rosanne Rust, MS, RD, LDN, a nutrition consultant and the owner of Rust Nutrition Services. “Clients have always had concerns about spending money on healthy foods, and part of the registered dietitian’s job is to help them understand how to choose healthy foods on a budget. I feel that registered dietitians may find it productive to encourage more cooking of simple meals as healthier and less expensive options.”

From a professional standpoint, some RDs may argue that the economy impacts their ability to pay American Dietetic Association (ADA) or other professional dues and other aspects of maintaining their credentials, but Rust believes that if you want to run a successful business, you must prioritize your expenses. “Association with ADA, for instance, helps the RD remain credible,” she says.

Janet Bond Brill, PhD, RD, LDN, author of Cholesterol Down: 10 Simple Steps to Lower Your Cholesterol in 4 Weeks — Without Prescription Drugs, says that dietitians are part of the healthcare industry, a segment of the economy that has not been hit as hard as other major industries in the United States during this recession. “While hospitals have shown weakening in job growth, other segments of healthcare are still robust,” she says. “Dietitians should target those job arenas that are on the upswing, such as home healthcare, nursing care facilities, and physicians’ offices.”

Successful Money-Making Strategies
So what marketing efforts pay off for RDs? “Being assertive—‘the squeaky wheel gets the grease,’” Brill says. “This is especially true in a recession. Get out there, market yourself, be persistent, and persevere. Know your ‘niche’ and zero in on those jobs that you are uniquely qualified for, such as certified [diabetes educators who] make house calls. Look at the trends—there’s a market for that, so go for it. What doesn’t work? Sending a résumé out to every registered dietitian job advertised, sitting back, and hoping the human resources person gets back to you.”

Diversify, Diversify, Diversify
For Jan Patenaude, RD, a consultant, a speaker, and the director of medical nutrition at Signet Diagnostic Corporation, specializing in a specific area and working with people who are unhappy and frustrated because of their irritable bowel syndrome, migraines, fibromyalgia, and other conditions has proven beneficial. “When you have chronic diarrhea or daily migraines and finally learn that there’s a solution out there, you’ll pay for it, even in a recession. Sometimes insurance pays, too,” Patenaude says. “By specializing in an area that truly helps people, the economic market doesn’t have a bad impact.”

To diversify her workload, Patenaude works with patients, trains other dietitians, offers public speaking, and writes articles and other publications. “If there’s a lull in one area, I have something to work on in another,” she says.

Although Jill Jayne, MS, RD, creator and performer in the live rock ‘n roll nutrition show “Jump With Jill,” does not see clients one on one, her colleagues tell her that they are venturing into other realms of the business because new clients are not coming through the door and the old reliables are cutting back.

“I think in all, this economic shift has really forced people out of their comfort zones to try something new, be more creative, make clearer statements of their value, and made free ways to market indispensable,” Jayne says. “Because I am a young business owner who has never really seen any stability, this is what I’ve been doing from the beginning, and I’ve actually seen my business triple since the economy took a dive.”

Embrace Innovative Networking
Social networking is hot, and dietitians are joining in. It’s “free” marketing and reaches a new audience. Blogging is another way that dietitians get their messages out in a fun way to a large audience.

“Registered dietitians seem to be working more with both written and television media as well, such as Food Network’s Ellie Krieger’s Healthy Appetite,” Rust says. “How great to see a registered dietitian cooking simple, healthy meals. It sort of brings a ‘real person’ point of view to the old-fashioned ‘white coat hospital registered dietitian.’”

One way Brian Dean, MS, RD, author of The Back Pain Diet, is gaining new client leads is by expanding his online presence. “I’m accomplishing this through my job as an expert contributor to metabolism.com,” he says. “Myself and a physician who heads metabolism.com are developing a membership-based online consulting service. By consulting members on health-related forums around the Internet, we gain their trust and demonstrate credibility. When the time comes for a client to choose a dietitian for counseling, they will go with whom they know and trust. Having a visible online presence ensures that person is you.”

As Jayne explains, many RDs have “taken to the streets” with Twitter and blogging to increase their visibility and establish themselves, and dietitians in general, as the nutrition experts. “Social media is not only free but it has an incredible targeted reach,” she says. “Find as many free ways to market yourself as possible. Social marketing offers a way to establish yourself as an expert in your area. Although not immediately monetizable, it does build your brand. If you are the only one that can do this specific job, you are in demand.”

Provide Low-Cost Options
Experts agree that RDs need to look at more than one way to market themselves and provide some options to potential clients of various income levels. Your most expensive program package may not meet everyone’s needs, so having options is a plus.

“Registered dietitians sometimes offer ‘specials’ or ‘sales’ as well,” Rust says. “They offer possible savings with a four-session package or a limited-time discount on a program. Offering small prizes can entice people, too. Raffling a ‘health basket’ or giving out pedometers to the first five people who sign up can help motivate people to commit. I believe in ‘the more you give, the more you get,’ so doing some volunteering during tough times is a good choice. Just be sure that you target a group that you are passionate about.”

Rather than giving deep discounts, add more service to your offerings. Rust will provide a wellness workshop, for instance, and then be available via phone or e-mail before or afterward. “I also may add as much value to the workshop as possible or give employees there a discount on my services as an extra perk,” she says. You may even consider doing some work as a courtesy. Be sure to keep it simple and provide your client with a billing statement that states you’ve waived your fee. This way, they know what you generally charge and that you are doing them a courtesy.

Make Sure the Price Is Right
According to Joanne Lichten, PhD, RD, author of the weekly e-newsletter “How to Make More Dough in Dietetics,” in today’s economy, it’s easy to fear that you’re charging too much or that you couldn’t possibly charge a certain amount for your services. And, in some instances, you are probably right—the customer will only pay so much.

But during this past year, Lichten has learned to be less fearful when it comes to pricing her services. “A restaurant chain asked me to submit a flat-fee proposal for a project,” she explains. “While I can’t give you all the details, it was definitely within my scope of work. Unfortunately, it was vague enough that without diving into the project, I didn’t know how many hours it would take.”

But Lichten took her best guess and submitted a quote of $X, along with a breakdown of what she would be doing—namely, the scope of the project. “She called me back the very next day and said that my breakdown of the scope was correct, except she wanted me to also add one more task,” Lichten says. “Then she said, ‘And, for this project along with this extra work, would you say $2X would be a reasonable fee?’”

What Lichten realized was that the potential client had a better idea of how lengthy the project would be and that Lichten had underbid.

“What did I learn from these … experiences? Ask for more details about what the project entails,” Lichten says. “Always ask your client what their budget (or range) is for the project. Then, lastly, discuss your idea of an appropriate quote, if possible, over the phone, to judge their reception and to work with them to resolve any discrepancies.”

Create an Information Product
Many dietitians have an interesting story to tell. “Creating a program or book is an effective and fun way to make a bit of extra money,” Dean says. “Information products are a great extra revenue stream for dietitians in the current economy because they are fairly easy to produce, are based on expertise you already have, and quality nutrition information is in high demand.”

Lichten agrees: “Wish you had something to sell when you speak to clients or a group? Want to write a book but it’s just too overwhelming or don’t have enough time? Write a booklet instead. Chances are you already have a few handouts—why not turn them into a booklet? It’s a quick and inexpensive way to get into the publishing business.”

Jessica Setnick, MS, RD, CSSD, author of The Eating Disorders Clinical Pocket Guide and founder of the Eating Disorders Boot Camp, started hosting Webinars to provide continuing education without any travel expense. “These have been very popular,” Setnick says. “Of the two I have hosted so far, the business topic has far outpaced the clinical topic—about three to one. Sales of the Eating Disorders Boot Camp Home-Study course have increased over past years, and I have taken off all shipping fees from my Web site to further encourage online sales.”

Pay Attention to the Bottom Line
Only take on jobs that are really worth it. “The registered dietitian’s bottom line counts, too, and taking only jobs that you are really passionate about, enjoy, and/or are lucrative enough is the best use of your time and also helps control your costs,” Rust says.

“Price your services higher than a hairdresser,” Setnick says. “Dietitians in private practice often charge the amount they want to make, forgetting about costs like overhead and health insurance that they will have to pay themselves. And if you charge too little in comparison to the market, people assume you’re not good.”

Hire help for or outsource the tasks that do not have to be done by you. Although your time seems free, it’s really worth what you could be earning with it. “Don’t do your own books, reminder calls, or other tasks that you can hire someone else to do for you,” Setnick says. “Free your time to do what only you can—seeing patients and building your business.”

Lichten encourages dietitians to continue charging what they’re worth and open a discussion with clients (or potential clients) about their fees. “Since most of us are undercharging for our services, fight the urge to reduce your fees,” she says. “I think you might be surprised that your clients are willing to pay.”

Try Your Hand at Per-Diem Work
Because per-diem dietitians are less costly to organizations, hospitals and private agencies are aggressively seeking them. “The work is fairly routine, and the pay is excellent,” Dean says. Dean provides per-diem (technically contracted) work for an agency that serves adults with disabilities. “The work is fun, and you make your own hours,” he says.

Also consider networking with other RDs so that when one of you is too busy, you can refer clients to the others and vice versa. Doing so will help fill in the hours or days that you may have available between your own client projects.

What the Future Holds
Industry experts agree that the future is very bright for dietitians. “Even in the current recession, the healthcare sector is exploding,” Dean says. “With the aging of the baby boomers, the obesity epidemic, and the rise of nutrition-related diseases such as type 2 diabetes and vitamin D deficiency, the knowledge and skills that dietitians bring to the table is more needed than ever.”

Brill says that sadly, there is an excellent economic outlook for dietitians due to the precarious state of our nation’s health—a bittersweet situation. “Dietitians are in the business of helping people either prevent or treat diseases and adverse health conditions,” she says. “The twin public health epidemics of obesity and type 2 diabetes and the related healthcare crisis that will surely arise from them in the future clearly shows that there will be jobs for dietitians in the years to come.”

— Maura Keller is a Minneapolis-based writer and editor.