September 2010 Issue

Field of Dreams
By Juliann Schaeffer
Today’s Dietitian
Vol. 12 No. 9 P. 26

Maybe you’d like to mingle with mutts as a “doggie dietitian” (how fetching!). Or tend to crops and harvest nature’s best nutrition as an RD farmer. Whatever your fondness in this field of vast opportunity, we hope this article will inspire you to pursue your passion.

Tired of the day-to-day drudgery of a clinical 9-to-5 job? Or maybe you love what you do but you’re feeling an itch for “something more” or the twitch of “what’s next?” in your soul. Searching the job boards may worsen that feeling. Marianne Patino, MS, RD, CDN, co-owner (with her husband) of the job-listing site DietitianCentral.com, says the vast majority of job postings she sees are of a clinical nature. “Ninety-nine percent of [postings] are mostly clinical positions, either in a hospital setting or a nursing home setting; that’s the majority,” she says.

That doesn’t mean the more clinical positions are completely lacking in excitement or joy, as many RDs can attest. But if you’re looking to break out of your nutrition shell and try something new, you’ll be happy to know there are a host of less-traditional dietetics opportunities out there. Whether it’s a nutrition clinician for clients on all-fours, an RD who spends her days in the sun tending to fields, or a dietitian who caters to a celeb clientele, this sampling of unique jobs may just give you the courage to explore the less-traveled RD path—or maybe even make your own.

Farmer
Postings for farmer-RDs may not make it onto job sites, but that doesn’t mean opportunities don’t exist for those who are interested in trading in their current title for a complete lifestyle change. And a small but growing group of RDs who double as commercial farmers is giving some credence to the also-growing sustainability movement.

Diana Dyer, MS, RD, is one such RD who took the plunge in 2009, purchasing the property of what would become The Dyer Family Organic Farm in Ann Arbor, Mich., after 20 years of working in an ICU as a nutrition support dietitian along with multiple other endeavors.

After 40 years of growing and preserving her own food on a smaller scale, Dyer now grows 40 varieties of organic garlic that she sells to local restaurants and personal chefs and at several farmers’ markets. And for those who are thinking about getting their feet wet in farming, she says to get ready for the unexpected because “there is no typical day, which in our case is probably at least partially attributable to the fact that we are still very new farmers and still on the steep end of the learning curve in terms of the business management side of farming.”

Dyer explains that in a farmer’s life, planned activities are dependent on weekly and daily projected weather forecasts, “which is always subject to change based on—how can I say this—’crisis management.’” Barn building and hoop house planning, determining future crop plantings and actual plantings, and crop maintenance and record keeping are just a few of the multitude of any farmer’s responsibilities.

Add to that the networking, researching, and education that are required—because even if you’ve dabbled in backyard gardening before, learning will be a nonstop duty once you’ve taken the leap to full-time farmer. Sprinkle on top a bit of cleaning and a lot of laundry, and it all keeps Dyer and her husband “very busy and sleeping well at night.”

Still interested? If so, Dyer explains that clinical experience may help you as much as it’s helped her acclimate to this new working pattern: “Being a pioneer critical care/ICU dietitian in the initial years of nutrition support taught me how to be a team player, network, and market the strengths and attributes that my nutrition knowledge brought to patient care. These same skills are beneficial and will help us both see and make the connections in our local food community in order to make our farm profitable as a local business.” She notes that critical thinking, problem solving, and creativity skills all come in handy on the farm.

Dyer’s fondness of feeling connected to the earth—having her hands in the soil, feeling the sun on her face, and most importantly knowing where her food comes from—first attracted her to this new way of life, but what holds her interest? “No two days are alike,” she attests.

She explains that RDs looking to get their hands dirty daily “need to fully understand all the factors that allow us to be at the starting point of ‘we are what we grow’ instead of ‘we are what we eat,’ which is the typical starting point of how dietitians’ traditional training has us usually think.

“In addition, obviously RD-farmers are running a business, so we need to know all aspects of how to do that profitably, all the while knowing that extreme and unforeseen and uncontrollable weather can undermine all your planning in a minute,” she adds.

And while the challenges faced by farmer-RDs, especially new farmers, are many and myriad (“Many things to do with not enough hours in the day to do them all, and they all feel like they should have been done yesterday!”), Dyer says she sees this newest endeavor as the purest kind of disease prevention. “In my view, farmers are really our frontline healthcare practitioners by maintaining the healthy soil that grows healthy food that nourishes healthy people who create healthy communities,” she says.

Celebrity Dietitian
If you’re intrigued by how the rich and famous stay healthy and beautiful and are looking to counsel high-profile clientele, then Los Angeles may be where you want to be—practicing, that is. At least, that’s where Ashley Koff, RD, founder of Ashley Koff Approved, sees patients on Tuesdays and Thursdays.

There are definite perks of working alongside celebrities, and as such Koff notes having the opportunity to dine at some of the greatest restaurants with clients and pick out their order, or even just dine with them, in addition to plentiful travel opportunities for her corporate clients. “I also get to have meetings backstage before a rock concert, on a set, or [at a] ball game—and that’s been fun, too—but it’s where my clients work, and I have to remember that, too,” she says.

Remembering to keep your cool and having confidence in your nutrition expertise, even in the company of celeb clientele, are requisites for this dietetics position, as is keeping mum about client names (no matter how famous) in order to stay within HIPAA privacy regulations.

Be advised, however, that counseling higher-profile clients sometimes brings higher demands, which can either add excitement or stress to your day, depending on your personality. “I’ve been asked to meet people at their private plane, work with a hotel or private chef, or visit them in the hospital to coordinate their care with professionals there,” says Koff, who thrives in this fast-paced environment.

Whether dealing with actors and actresses, princes of other countries, or people unknown to the masses, Koff says her approach is always the same. “I guess the most important thing is to realize that these clients are people and I need to work with their personal health goals, not their media image,” says Koff. “Because I work with digestive issues a lot, I jokingly say that their farts smell the same as anyone else’s, and I help them address that the same as I would someone else.”

Even Alyse Levine, MS, RD, founder of Nutritionbite LLC, a nutrition consulting firm in Los Angeles, found that out herself when she first moved to Los Angeles, expecting to see clients just looking to lose that last 5 lbs: “I was very surprised to find out that the population seeking my services was not any different from that on the East Coast. Most have a great deal of weight to lose (with medical issues going along with it), they have extremely stressful lives with little time for self-care, and they are looking to make realistic lifestyle changes that they can stick to rather than go on another fad diet.”

One new challenge Koff learned through her jet-setting clientele was how to respect her own time—even if someone else didn’t. “I am always up front about what my fees are and if someone wants me to jump on a Saturday to see them—and I am available—I will let them know that my time costs more that day than if they want to wait until an office visit,” she says.

She also suggests that RDs looking to work with celebrities know their comfort zone and stay within it. For example, “I am happy to drive to meet a client vs. having a car sent. But if I can get work done in that car service and that means I can work with more patients that day, I might take them up on the offer,” Koff explains. “But when I was asked to stay in my own hotel room on the same floor as a client ‘just to be available,’ I politely declined. My cell phone and e-mail work great for making me available.”

Koff remembers a day early in her career when she was driving to a musician’s house—one whom she had worshipped as a teen. “Driving up to the house, I had to take a deep breath and then I just screamed to myself in my car ‘I can’t believe this!’” she remembers. “Then I went into the house, met the wife, the kids, and we sat down and talked about his personal health goals. Just another day at work, eh?” Just another day at work … at this dietitian’s dream job.

Professional Sports RD
Are you the biggest NFL (or NBA, NHL, etc) fan you know? If so, imagine merging your love of sports with your profession; that’s exactly what team dietitians do.

Otherwise known as sports nutritionists, RDs in this position are employed by a professional sports team and work in both a one-on-one and a team setting, developing menus for players and answering their food-related questions and queries. A sports nutritionist works as part of an interdisciplinary team of professionals who work together with one end goal in mind: maximizing athletes’ potential.

For those with a desire to break into this nutrition niche, beware but don’t be daunted: The opportunities are limited, as not all sports franchises offer such opportunities. It’s also a highly coveted position, and it’s typically not full time, so determination and flexibility are keys to nailing down a position in professional sports nutrition.

Roberta Anding, MS, RD, LD, CSSD, CDE, an American Dietetic Association spokesperson and sports dietitian for the Houston Texans NFL franchise, explains: “The time commitment for me is about 15 hours per week and flexibility is the key. In sports dietetics, you have to be there when the athlete is available. In the NFL, players can be fined for being late for meetings, which oftentimes begin at 8 AM, so I am at the stadium at 6:30 AM or at lunch,” she adds.

Mitzi Dulan, RD, CSSD, has been the team nutritionist for the Kansas City Royals baseball team for roughly six years. She served as the team nutritionist for the Kansas City Chiefs for eight years and has also worked in different capacities with professional basketball and hockey teams, so she can attest to the wide variety of duties a sports dietitian can have. She even coauthored the first book written by a pro-athlete and his dietitian, The All-Pro Diet, with NFL-er Tony Gonzalez.

For the Royals, she visits with the team two or three times per month when they’re home, where she’ll touch base with players and make diet suggestions—for general meals and for what to eat before and after batting practice and games. She also provides a yearly team presentation during spring training. Then, on a more ongoing basis, she responds to various athletes’ needs as they come up—whether it’s answering questions about a certain supplement, giving athlete wives cooking ideas, setting up personal chefs for athletes, or texting with players who have quick nutrition questions about foods when eating out or grocery shopping.

Anding explains, however, that there are qualifications—beyond just having an RD behind your name—that are necessary for getting into this field. “Fundamentally, just being an RD does not qualify you to be a sports dietitian. … You can’t just ‘do’ sports nutrition,” she explains. “You have to develop and maintain the skills.” She recommends that RDs earn the CSSD credential if considering pursuing this type of opportunity.

“If someone’s considering getting their master’s in nutrition, I would suggest instead to get their master’s in exercise physiology if they have an interest in sports nutrition,” says Dulan.

The jobs in this niche are few and the competition fierce, but the perks for a sports fan are unmatchable. “It’s definitely fun, especially if you’re a sports fan. You get to go to games and get good seats,” says Dulan.

Yet even for those who get the chance to work with these teams, ethics can be an issue, says Anding: “There are 32 teams in the NFL and not every team employs an RD. As such, these are high-profile jobs, and someone is always looking to take your place.”

Even with the challenges and hardships that come with seeing athletes get cut and coaches get fired, Anding still feels privileged and blessed to work with some of the best athletes in the world. “The average life expectancy of NFL lineman historically has been 57. These men are fathers, brothers, sons, and husbands. … Preventing chronic illness is a significant part of my role on this team,” she says. “The Texans’ owner, Mr. Bob McNair, believes in health and wellness, and this is evident throughout the culture of the team and its work in the community. Who wouldn’t want my job?”

Military Nutritionist
This offshoot of sports dietetics involves working with another distinguished set of athletes: our nation’s soldiers, sailors, marines, and SEALs. If you think you have what it takes to counsel the brave men and women who serve our country, then this career might be for you.

Lori Tubbs, MS, RD, CSSD, is one such nutritionist who works as part of a Navy SEAL human performance team that also includes an athletic trainer, a program manager, and a certified strength and conditioning specialist. She’s been working with the SEALs community for the past 12 years.

“I am a Department of Defense employee working for Naval Special Warfare in Virginia Beach. As a civilian working for the military, the field of sport dietetics is in its infancy. … Rather than working within the healthcare setting, my work involves improving healthy military athletes by teaching nutrition principles based on the professional sports model,” she says.

As is common with many nontraditional jobs, there is no one typical day as a military nutritionist, where training cycles dictate many of the needs for individual troop members and nutrition-related requests from military leaders. “This includes travel to training sites to evaluate the nutrition environments and develop meal plans using local vendors to assist in feeding these athletes,” Tubbs says.

Like any job in sports dietetics, obtaining a CSSD is crucial for counseling these athletes. And being active yourself also helps in securing these off-the-beaten-path opportunities, explains Tubbs: “As a sports nutritionist, walk that walk by being active and participate in many local community activities. Being an athlete or having exposure to athletes is important to have the ability to communicate with athletes.”

While travel opportunities abound with this job and Tubbs enjoys the appeal of educating the fittest of the fit clientele in Navy SEALs, she admits that her job, like any job with great rewards, has its downfalls for which anyone interested in this type of position must prepare. “When my athletes don’t come home,” she admits, is one of the hardest aspects of her work. “I have had my share of memorials that hurts the entire community.”

Above all else, Tubbs says seeing her military clients excel keeps her excited about going to work each and every day. “The people I serve and the duties they perform for our freedoms keep me going to work eagerly,” she says. “I have been able to see these men over the years now become great military leaders and it motivates me to continue to assist their success by being part of a team here that watches over their families while they are deployed.”

Pet Nutrition Clinician
Animal lovers may drool over this next profession: a so-called doggy dietitian. One such pet nutrition clinician, Helen Porter, MS, MPH, RD, LD, of Porter Pet Pals Animal Nutrition Services, says, “The focus of my practice is on pets or other animals in need of a nutritional care plan or diet management. I work with veterinarians who have patients (the animals) and clients (owners) who want to improve the health and happiness of the animal.”

Referrals are a must in this line of business. Porter first receives a referral from a veterinarian or client and then contacts either one as needed to clarify the nutritional need. “Then I prepare the care plan and dietary recommendations. The veterinarian always gets a copy of the report for the file and review,” she says.

In the past, Porter has worked with various animals in assorted capacities. For example, she developed an enrichment and feeding program for otters at Busch Gardens in Florida and she also helped design a feeding program for orphaned river otters at the Mississippi River Museum in Dubuque, Iowa, where she even calculated the calorie requirements for a pregnant river otter. However, most of Porter’s clientele are domestic pets, with only a small portion coming from work with zoos.

While regular RDs must master the dietary recommendations of a diverse human clientele, a pet nutritionist must be knowledgeable about all of the particular nutritional aspects of different groups of animals as well as the information sources to turn to for answers along the way. An ability to relate to clients will come in handy in this role, says Porter, who notes the importance of keeping the cost and time of these care plans to a minimum “so the plan will work in the home setting.”

Porter’s general love of animals may have piqued her interest in this self-made opportunity, but earning a master’s degree in animal science with an emphasis in animal nutrition helped ensure she could serve her clients best. Those who are thinking about trying out this consulting business may want to keep Porter’s experience in mind and ally with a local veterinarian, who can act both as a mentor and a future referral source.

Even with all of the differences between people and their furry friends, Porter says the challenges can often be quite similar. “If I have a client who does not follow the recommendations and then wonders why the pet does not do well, it is very frustrating,” she says, noting that many veterinarians do not yet understand the value of nutritional intervention. “This field is where human nutrition was many years ago, so time is needed to close the gap,” she says.

How many other pet nutritionists are out there is currently unknown, and Porter has primarily had to create her own path down this animal-focused profession. But her practice has thus far survived an unwelcoming economy, which gives hope for other animal-loving RDs.

However, if you’re thinking about extending your clientele to those with four legs, you may not want to quit your day job—just yet anyway. Porter explains that she works as a clinical dietitian in a hospital full time and then consults as a pet nutritionist on the side. “When I started working with the internal medicine specialist veterinarian, who now sends the most referrals, he told me, ‘Don’t quit your day job.’ Good advice, as this field is very new and does not provide enough income to live on,” says Porter.

Overseas Dietitian
Sometimes a less-traditional dietetics position can stem less from its duties and more from its location. RD overseas positions are as varied as their locations, and options can seem endless. Whether as a hospital dietitian in the United Arab Emirates or an RD working on immunizations in Kenya, one thing is for sure: This type of opportunity promises cultural challenges on top of those associated with typical job responsibilities.

Maria E. Bovill, DrPH, RD, LD, a lieutenant colonel on active duty in the U.S. Army, is currently stationed in western Kenya as the director of the Kombewa Clinical Research Center (CRC), “the first time a dietitian has ever held this position,” she says. “This assignment and position for an Army dietitian is quite nontraditional, as the majority of our positions are located in Army hospitals. Our CRC primarily conducts vaccine and drug malaria clinical trials as well as other related infectious disease research.”

Bovill explains that while her responsibilities can range from managing a staff of almost 200 in directing research to writing nutrition protocols and conducting nutrition missions, “The most important characteristic to master is flexibility and an open mind. The cultural exchange is incredible and challenging, if you are open to it.”

Bovill’s curiosity about the world beyond U.S. borders cultivated her desire to work abroad, yet she notes that it’s certainly not without its challenges. “The challenges in this job are many. Adapting to the environment and cultural differences has been fascinating. Learning to focus on how to be effective and be a part of sustainable changes has been a daily lesson,” she explains, recommending that any RD interested in overseas opportunities check out the American Overseas Dietetic Association at www.eatrightoverseas.org.

For Erin Boyd Kappelhof, MS, MPH, RD, a manager of global nutrition communications at food and beverage manufacturer Unilever, who works in the Netherlands, the job’s international aspect keeps her energized and intrigued on a daily basis. “On any given day, I get to interact with colleagues throughout Europe, Asia, Africa, Latin America, and, of course, North America,” she says. “Having the opportunity to work with and get to know so many different people from all over the globe is such a thrill for me.”

Or consider Amanda Paltzer, RD, who was a nutrition consultant in Zambia, as your inspiration for finding dietetics work around the world. Finding herself in the African nation due to her husband’s work, she created a nutrition niche for herself. “I conducted nutrition counseling at two different clinics where I saw a variety of patients—from undernourished children to adults with hypertension and diabetes. Patients were referred to me by the physician,” she says.

Paltzer found the lack of emphasis on and knowledge of nutrition abroad to be a primary challenge for her. “Dietetics is not well recognized or understood in Zambia at this time, so while I worked I also had to promote the importance and need of the profession among patients as well as colleagues,” she explains.

She notes that language and cultural preferences can be barriers in any foreign land. “I learned some of the language to better communicate and had to be very aware of cultural preferences and dislikes when it comes to food,” she says.

For any dietitian considering taking the leap across the pond for a renewed exhilaration in dietetics, Paltzer says flexibility, cultural awareness, and sensitivity are all must-haves. “You must be aware of your own culture and how it contrasts with the culture of the person you are working with,” she says. “You also have to be careful to not let your own ethnocentricity affect the way you work with people.”

Yet even in another country, with different people who speak a different language, some challenges stay the same. Paltzer details the frustrations she faced with clients not understanding or complying with advice: “Many people assumed I was like a doctor and could prescribe something to take away their problems. It was difficult for them to realize that I was giving advice and they were the ones who had to make the changes. I think this is similar to what a lot of RDs face but just in a different context.”

Open to Opportunity
“Keep your mind open to all opportunities, near and far,” advises Bovill. And when the job you’re seeking seems out of reach (or nonexistent), follow the path of these RDs—and do the work to make your own dietetics dream job come true.

— Juliann Schaeffer is an editorial assistant at Today’s Dietitian.