August/September 2024 Issue
Thriving in Private Practice
By Ginger Hultin, MS, RDN, CSO
Today’s Dietitian
Vol. 26 No. 7 P. 24
Essential Steps for Growth
Growth in a dietitian’s private practice requires both nurturing existing relationships and branching out to diversify and partner with others in innovative ways. The strategic use of networking to foster strong referral systems and create a trustworthy source of new clients is key. Utilizing both external partnerships and taking insurance to increase accessibility can have a profound impact on growth.
An impactful digital presence complements traditional networking, providing a platform to engage with clients and build a community around your practice. Creativity with technology in private practice can enhance the client experience but also boost income through more passive streams. Thoughtful networking, a strategic online footprint, and the smart integration of technology and unique offerings are crucial to a dietitian’s practice growth. Each element works in synergy to not only attract clients but also provide
them with value that extends well beyond the initial consultation.
Growth Strategy Fundamentals
Before exploring more advanced strategies, it’s important to review the fundamentals. At times, overlooked or underappreciated, these pillars help set the stage for a flourishing practice.
Building Referrals
Building a strong referral network is a cornerstone of successful dietitian practice growth. Referrals and partnerships function as a bridge connecting your practice with clients who trust and rely on the recommendations of others, particularly health care professionals. The primary benefit of creating these connections is the cultivation of a self-sustaining client base that grows through trust and word-of-mouth, one of the most effective forms of marketing.
Forging partnerships with local health care providers, such as doctors and wellness centers or gyms, can result in a mutual referral system. Establishing a rapport with these professionals ensures they are comfortable referring clients and patients to you, knowing that you’ll provide them with excellent care. Cathy Visser, MPH, RDN, CD, specializing in Intuitive Eating coaching and eating disorders treatment, attributes much of her success to referral networks and collaboration.
She explains, “I have built relationships with local mental health counselors specializing in eating disorder treatment by providing them with information about my services. Through these referrals, we both benefit by ensuring that our clientele have the mental health and nutritional support they need to heal. In addition, I have good relationships with outreach and provider staff of local eating disorder treatment programs like The Emily Program and Center for Discovery; relationships I have fostered through attending eating disorder training sessions and virtual monthly consultation groups.”
Los Angeles-based RD Mascha Davis, MPH, RDN, specializing in nutrigenomics and health optimization, and author of Eat Your Vitamins, has also leveraged strategic connections for growth in her practice. “Partnerships and referral networks are also fantastic for building your practice. I have partnered with a private members club here in LA and work with their wellness center to provide nutrition services to their members. It has been absolutely wonderful—the members are happy that the option to meet with a dietitian is available, and it’s been a great addition to my practice.”
Utilizing Professional Groups and Associations
Joining dietetic associations and local business groups can be tremendously beneficial. These associations offer many resources and professional development opportunities and serve as fertile ground for networking. Active participation in these groups can elevate your profile among peers and the wider community. Visser notes how being involved has been helpful for her practice. “My membership with the Academy of Nutrition and Dietetics has provided me with information and training in insurance credentialing and billing. Early in my practice, I was active with the Nutrition Entrepreneurs Dietetics Practice Group for their informative webinars and information needed to build my practice. I am active with my local area dietetic association as well for peer support, although the best benefit has been the friendships I now have with local dietitians.”
Engaging with local university programs to develop a connection with dietetic interns and acting as a preceptor not only contributes to the field by guiding the next generation of dietitians but also helps support and grow your practice. Interns can become advocates for your practice and can support business needs for growth that you need help
with. This also helps them build their
skills in a mutually beneficial way.
The Benefits of Accepting Insurance for Practice Growth
Accepting insurance can help broaden your client base and take the pressure off intensive marketing strategy. Insurance increases patient accessibility, as potential clients are more inclined to seek services that are covered by their plans. The credentialing process, though a sometimes-arduous process that may take several months to complete, opens the door to a segment of the population that might otherwise be inaccessible.
Visser notes how helpful insurance has been for her business. “My practice has grown exponentially in the past four years, primarily because I am in-network with public and private insurance companies like Medicare, Medicaid, Regence BlueShield, and Premera Blue Cross.” She has advice for making insurance work for a practice that involves an intersection of collaboration with other RDs, seeking connections and referrals, and getting creative with the insurance accepted.
“Ask private practice dietitians in your area for recommendations about which insurance companies they have had the most success with in terms of client referrals and reimbursements. Consider credentialing with Medicare if you specialize in diabetes care or expect to see older individuals who may have Medicare and another insurance carrier like Regence or Blue Cross as their secondary or supplemental insurance. Becoming credentialed with Medicaid expands the reach of our practice and provides low-income clientele with the opportunity for care. I love being able to serve people living on a limited income and being credentialed with Medicaid means that providers seek me out with other insurance referrals as well.”
However, surveys show that RDs’ knowledge of billing code use and reimbursements is generally low.1 Changes in reimbursement for medical and nutrition services continue to expand in positive ways, and there may be new opportunities for RDs to bill through insurance.1 Researchers who conducted a large billing and coding survey concluded in their 2020 study that there is a need for individual RDs to understand the business side of MNT practice.1 Private practice dietitians are in a unique position to educate themselves about insurance billing and coding to drive growth and revenue in their businesses.1
Consider using insurance in creative ways. Many insurance policies cover telehealth appointments, which can also be used to create and run insurance-covered group programs. A survey about telehealth in the Journal of the Academy of Nutrition and Dietetics found that telehealth use among dietitians during the COVID-19 pandemic hit an all-time high of 78% among those surveyed. Benefits from participants (n=2,016) included scheduling flexibility and good insurance reimbursement.2
Essential Technologies for Practice in a Postpandemic World
In a world in need of digital solutions following the pandemic, incorporating essential technologies into a dietetics practice is no longer a luxury—it’s a necessity. A strategic social media presence, well-crafted website, and unique offerings (including digital options) can help set you apart and make connecting with you a seamless experience for potential patients.
An Enticing Website and SEO Strategy to Serve Your Clients
A successful website combines user-friendly design with professional aesthetics. It should provide easy navigation to allow potential and existing clients to find the information they need quickly. Features such as online appointment booking, clear service descriptions, a dynamic and descriptive “about” you section sharing your background, and responsive design for mobile devices are important elements that can help drive traffic and prompt patients to engage with your services.
Basic search engine optimization (SEO) principles are crucial to increase your online visibility and increase patients reaching out. By integrating relevant keywords, maintaining a blog with regular updates, and optimizing website speed, you can rank higher in search engine results, making it easier for clients to find you.
Social Media for Growth
Leverage social media platforms and online advertising campaigns such as growth funnels and email marketing campaigns to drive traffic to your website. These tools are powerful for engaging with a broader audience, sharing useful content, and directing potential clients to your services. Malina Malkani, MS, RDN, CDN, owner of Malina Malkani Nutrition, @healthy.mom.healthy. kids on Instagram, and author of Safe and Simple Food Allergy Prevention, explains, “Social media offers a free, effective way to market and showcase your services to your target audience while giving potential clients a closer look at who you are, what you stand for, and how you work.” She also speaks of the importance of letting your audience get to know you while you get to know them. “When you are connected and engaging with your audience, social media also gives you valuable insights into what nutrition-related challenges your target customers are experiencing and how they would prefer to receive your help.”
Davis has also experienced many benefits from her large social media presence. She explains, “Social media has been integral in growing my business and private practice. Even if you don’t have a large social media presence, I think it’s essential to have one. My clients may or may not find me through social media, but many of about me and have said things like, ‘I felt like I knew you much better after looking at your Instagram, and it made me feel more comfortable scheduling with you.’ This can be an important source of traffic as well, and it has led to some great consulting and brand opportunities.”
Dietitian-produced content online via blogs and social media is both valued and needed in an effort to communicate, educate, and provide evidence-based information while also networking and brand promoting.3 A 2020 qualitative study comparing nutrition advice communicated by RD and non-RD bloggers by Chan et al found that dietitian bloggers were more likely to be lifestyle-focused, promoting a holistic approach.3 These bloggers often shared messaging about the connecting between nutrition, food, health, and community. The messaging was inclusive and broad, promoting healthful dietary patterns. Themes from non-RDN blogs included challenging conventional medicine while promoting alternative medicine, including the use of foods and supplements to treat specific medical conditions. “Fear appeals” involving vivid descriptions of damage to trigger an emotional response was a tactic used by non-RD bloggers in this study. These researchers concluded that there’s a need for continued balanced health and nutrition education from qualified bloggers such as RDs.3
Designing and Marketing Nutrition Programs for Your Site
Creating specialized nutrition programs, group options, e-books, or downloadable content and featuring them on your website can address specific needs that attract a targeted audience in your niche. It’s also a way to generate passive income, which can help give your business a boost (and serve more clients!) without individual calls or meetings. Malkani has a word of caution about doing your homework first before diving into content creation, “It takes enormous effort to create not only digital nutrition programs and products but also the surrounding infrastructure that enables you to deliver them. Before spending time, energy, and money on the process, I’ve found that one of the most important first steps is to figure out whether your idea solves a problem your target audience is experiencing and whether they are willing to pay to solve it.” When it comes to marketing these digital options, utilize a mix of promotional tactics, including email marketing, social media campaigns, and partnerships with other health professionals to spread the word and increase sales.
Studies show that dietitian-led online programs and groups are effective and create better health outcomes. A large study comparing the effectiveness of web-based behavior change intervention (n=1,298) found that web platform plus dietitian coaching created greater mean weight loss, increased vegetable and fruit consumption, and greater decrease in ultra-processed food intake after 24 weeks.4 Personalized feedback from online RD coaches increased program user engagement and a higher chance for participants to achieve significant weight loss.4
Getting Creative With Additional Offerings
Dietitians provide individualized care, often referred to as personalized nutrition. As technology advances and the ability to incorporate personalized testing from blood labs, microbiome results, continuous glucose monitors, hormonal testing, nutrigenomics, and beyond expands, so do opportunities for dietitians in private practice.5 Dietitians can increase offerings in their practice in unique ways. Nutrigenomic or other testing, ordering labs through qualified third-party sites, or engaging in medical-grade supplement offerings can increase value for your patients and also boost your income, fueling growth.
As dietitians expand their practice offerings, it’s important to keep ethics and scope in mind. Personalized Nutrition Guiding Principles have been developed by the Academy of Nutrition and Dietetics.5 Overarching themes of these guidelines include considering the appropriateness and applicability of personalized testing with clients and using accurate and relevant data.5 Clear communication of benefits and potential limitations should be clearly communicated with the patient.5 Privacy protection and ensuring that you have the right training and competence to utilize unique offerings with your patients are also important considerations.5
Studies assessing the future of dietetics also point to creative offerings and technology as opportunities for nutrition practitioners. 6 Studies indicate that there will be a need for more dietitians in the areas of community-based chronic condition prevention and management, personalized nutrition, aging populations, and digital health.6
Putting It Into Practice
Putting the strategies discussed into practice can become a catalyst for growth and innovation in a dietitian’s professional journey into a successful, thriving private practice. From nurturing referral networks and considering an insurance-based model to embracing a strategic digital presence and the use of creative technology, each step paves the way toward growth and income. By implementing these strategies, dietitians can broaden their reach, enhance their service delivery, and create a more engaging client experience. It’s an invitation to step forward and redesign the contours of traditional dietetic services to align with the evolving expectations and opportunities of the constantly changing private practice climate.
— Ginger Hultin, MS, RDN, CSO, is a nutrition and health writer and board-certified specialist in oncology nutrition based in Seattle. She runs a virtual, concierge nutrition practice, Ginger Hultin Nutrition PLLC.
References
1. Jortberg BT, Parrott JS, Schofield M, et al. Trends in registered dietitian nutritionists’ knowledge and patterns of coding, billing, and payment. J Acad Nutr Diet. 2020;120(1):134-145.
2. Rozga M, Handu D, Kelley K, et al. Telehealth during the COVID-19 pandemic: a cross-sectional survey of registered dietitian nutritionists. J Acad Nutr Diet. 2021;121(12):2524-2535.
3. Chan T, Drake T, Vollmer RL. A qualitative research study comparing nutrition advice communicated by registered dietitian and non-registered dietitian bloggers. J Commun Healthc. 2020;13(1):55-63.
4. Beleigoli A, Andrade AQ, Diniz MD, Ribeiro AL. Personalized web-based weight loss behavior change program with and without dietitian online coaching for adults with overweight and obesity: randomized controlled trial. J Med Internet Res. 2020;22(11):e17494.
5. Rozga M, Latulippe ME, Steiber A. Advancements in personalized nutrition technologies: guiding principles for registered dietitian nutritionists. J Acad Nutr Diet. 2020;120(6):1074-1085.
6. Boak R, Palermo C, Beck EJ, et al. A qualitative exploration of the future of nutrition and dietetics in Australia and New Zealand: implications for the workforce. Nutr Diet. 2022;79(4):427-437.