August 2012 Issue
Starting a Private Practice — Do You Have What It Takes?
By Faye Berger Mitchell, RD, LDN
Vol. 14 No. 8 P. 22
Author’s Note: This article is the first in a three-part series about starting your own nutrition business. I’ll discuss the pros and cons of starting a private practice and the skills and personality traits you’ll need to succeed. I’ll offer strategies on how to find office space and review the types of office space available and the furnishings and equipment you’ll need. In my final installment, I’ll discuss ways to market your services and build a client base.
Karen, a young dietitian, had always dreamed of starting her own private practice but wasn’t sure if she was ready to strike out on her own. Karen’s uncertainty about making such a career move prompted her to reach out to a former colleague who recommended she examine the pros and cons of business ownership by speaking to RDs who owned their own practices then assess her strengths and weaknesses before making a decision.
After much introspection and research, Karen realized that starting a business and being her own boss would be a huge challenge—a challenge she wasn’t sure she was willing to meet.
Like Karen, many RDs share this dream. Some RDs are new to the dietetics field, while others are seasoned nutrition professionals who’ve worked for other organizations and institutions for several years but are ready to trade in their current employee status for entrepreneurship. If you’re thinking about making this monumental move, it’s important for you to know the pros and cons of business ownership and the skills and attributes you’ll need to succeed.
Pros and Cons of Private Practice
For many entrepreneurs, the pros of owning their own business far outweigh the cons. They have more flexibility in setting their own hours. They can schedule patients around family commitments. And their potential earnings are great because private practitioners can make much more money than employees who work for others, although this requires plenty of hard work.
The downside of self-employment can be the isolation. RDs who thrive on interaction with others must make it a point to have lunch with colleagues, network at professional meetings, and join online communities. Another drawback is that business owners wear many hats, shoulder all the responsibilities, and take the blame whenever something goes wrong. It’s also important to note that counseling patients will be only one aspect of your job and that some financial uncertainty is to be expected. Income can be erratic, particularly when you’re first starting out. Lack of benefits can be an issue, and if you become ill or go on maternity leave or vacation, you’ll temporarily be without an income.
The Right Skills and Personality
Weighing the pros and cons is important before making a decision to start your own practice, but developing clinical and business skills and having the right personality traits are just as vital.
It goes without saying that strong clinical skills are the backbone of most dietitians’ work, particularly those in private practice. Often, private practitioners take a look at their clinical skills and decide to specialize. For example, an RD who’s also a certified diabetes educator most likely will choose diabetes as a specialty when starting his or her own practice.
Just as you work hard to develop a specialty, you’ll need to develop business savvy, a skill that may not come easily to many RDs. It’s important to set payment policies and fees and be comfortable asking for payment.
“It’s hard in the beginning to ask someone for money,” says D. Milton Stokes, MPH, RD, CDN, owner of One Source Nutrition, LLC, a private practice with offices in Stamford and South Windsor, Connecticut. “Telling someone you charge X dollars might feel awkward. Practice it. Say it aloud. Say it in the mirror. Say it to your dog. Then with confidence and decorum say it to your first client/patient.”
Organization and Record Keeping
Another essential skill for entrepreneurs is the ability to keep records. According to Carol Plotkin, MS, RD, CDN, ACSM, the owner of On Nutrition, a private practice in Rochester, New York, it’s important to “keep track of the financial aspects of a business, especially for tax purposes, as well as important record keeping for patient care.
“Collecting client outcomes is very important to show the efficacy of what we do,” she continues. “Maintaining these outcomes in an organized way is beneficial when we need to retrieve that data for physician’s offices or insurance companies.”
Developing strong communication skills is another crucial element for success. According to Plotkin, “In private practice, you have to regularly communicate with clients, other professionals, and insurance companies. Being able to get your message across in a professional and timely way only benefits your practice.”
Call it tenacity or persistence, but successful business owners don’t give up and rarely take no for an answer. “There will be times when you’ll come up against challenges that will threaten to send you scurrying for an online job listing,” says Cathy Leman, MA, RD, LD, founder and president of NutriFit, a Chicago-area fitness studio and nutrition therapy practice. Her advice: “Don’t do it. Call on trusted colleagues to help you work through the stumbling blocks.”
When faced with obstacles, Leman says, “Stay clear in your vision and never give up. If working for yourself were easy, everyone would do it.”
Part of starting your own practice is having the willingness to take risks. “When you work for yourself, there are no guarantees,” says Marci Anderson, MS, RD, cPT, owner of Marci RD Nutrition Consulting in Cambridge, Massachusetts. “I’d describe myself as extremely risk averse, so building my business has challenged me in a lot of ways.”
When her practice grew, Anderson had the opportunity to hire another dietitian, and she was “terrified and excited.” She took the risk, despite her uncertainty, and has recently hired her third dietitian and is “extremely proud of my booming practice.”
Rebecca Bitzer, MS, RD, founder and owner of Rebecca Bitzer, MS, RD & Associates, the largest nutrition practice in Maryland with three locations, believes that having passion for the work you do is key. A business owner “lives and breathes business,” she says. As an entrepreneur, Bitzer says she thinks about her business from the second she wakes up in the morning until her head hits the pillow at night. “It takes this kind of passion to keep going, learning, problem solving, and creating when most others would have quit.”
Several times in her career, Bitzer has been tempted to quit but instead, “I focused on all that I had put into my business, readjusted my thinking, and moved forward to make the business stronger,” noting that ultimately, “you have to love what you’re doing, almost thinking of it as a calling more than a job.”
Entrepreneurship requires passion but also confidence as you branch out into unknown territory. Ann M. Silver, MS, RD, CDE, CDN, a private practitioner with offices in eastern Long Island, New York, and coauthor of Making Nutrition Your Business: Private Practice and Beyond, says, “Confidence means being able to promote yourself 24/7.”
But she says it’s important to “be mindful when promoting yourself. It’s very apparent when a professional is relentlessly self-promoting, and that can actually turn potential clients off.” Not everyone is born confident, she says, but “it’s possible to find your confidence and act as if it was there all the time.”
Toni Bloom, MS, RD, owner of Toni Bloom & Associates, adds, “By confidence, I don’t mean arrogance—just plain confidence in your knowledge and ability to get a job done and done well.”
Last year, a well-respected colleague referred a project involving iPhone app development to Bloom because it was a little on the edge of the colleague’s comfort zone. Bloom never had helped create an iPhone app, but “I was confident in my nutrition knowledge and knew I had expertise in what the average consumer needs and wants.”
Making Your Decision
Once you’ve considered the advantages and disadvantages of starting a nutrition business and decided you’re up for the challenge, evaluate the skills and personality traits discussed above and determine where you stand. It’s not necessary to be good at everything, but it’s important to examine the areas in which you may need improvement.
Once you know your strengths and weaknesses, set goals to improve those areas in which you need to grow. Call it a skill or a personality trait, but one thing that’s key to any business owner is realizing when to hire others to help. For example, if record keeping and organization isn’t your forte, consider hiring someone to help organize your office and keep your records.
Nevertheless, starting and growing a successful private practice can be extremely gratifying. For those of you who’ve evaluated yourselves, done some research, and are ready to take the next step, congratulations on making this monumental decision.
— Faye Berger Mitchell, RD, LDN, is coauthor of Making Nutrition Your Business: Private Practice and Beyond. She’s helped thousands of dietitians nationwide start their businesses through her workshops, speaking engagements, and Be Your Own Boss Starter Kit.