Making the transition from solo provider to group nutrition practice is an exciting and sometimes, daunting, journey.
Often times, dietitians look to establish a group practice when their workload becomes too much for one person to manage. As a solo provider, there is a limited number of clients that you can realistically see in a day. Bringing on other providers, will allow you to grow your client base, increase revenue and extended the reach of your brand.
Beyond this, a group practice offers other benefits to dietitians. It can often be isolating to work as a solo provider, especially if you see clients virtually. Transitioning to a group practice creates a team atmosphere. Dietitians can share information, discuss difficult cases and nurture each other’s professional growth.
However, there are many legal, financial and technical aspects to consider when establishing your group practice. Establishing the right legal and financial structures for your group practice is essential. You’ll also want to think through your group dynamics and how you’ll hire to achieve that.
In this guide, we’ll walk you through the steps to take in starting your group nutrition practice, ensuring a strong foundation for your new business.
1. If you haven’t already, set up your business as a legal entity.
As a solo provider, you may already have your business setup as a sole proprietorship. When you transition into a group, you’ll want to establish your practice as an incorporated business. This is important to protect yourself, your assets, and limit your liability. Setting up your business as a separate entity ensures that your personal assets are protected and separate from your practice assets.
There are several different ways to establish your group practice, and setting up the right type of entity should be discussed with legal consult. There is a difference in state requirements and how your business will be taxed. A business attorney and accountant can help you navigate the differences.
A group practice can be set up as an:
- LLC (limited liability corporation) or PLLC (professional limited liability corporation)
- Corporation or PC (professional service corporation)
PLLCs and PCs are designed for certain professions that require state licensure. If a group of such professionals (ie. licensed dietitians), want to create a company together, they may need to form a PLLC or PC. What constitutes a “professional service,” varies depending on state. You’ll want to look into your state’s legal process for forming a PLLC or PC. The main difference between the two entities is that PLLCs consist of members (they do not own shares or stock) and PCs consist of owners.
2. Get your legal and financial paperwork in order
Apart from consulting a business attorney, there are a few reasons you should seek additional legal consult. You may want to consider hiring an Intellectual Property (IP) specialist, to discuss protecting your brand and intellectual property. This will be important for including in your new hire contracts.
Another way to protect your business (and brand) when brining on new providers, is through a non-compete agreement. This could protect you in the case where one of your providers leaves the group and starts their own practice nearby, potentially taking clients with them.
A non-compete example, could prevent the signee from providing nutrition services in a private practice setting within a certain distance (ie. not within 10 miles of the group practice) or timeline (not within 6 months of leaving the group practice). It’s up to you and your legal consultants to determine if a non-compete should be included in your contracts.
In addition to legal consult, you’ll also want to hire and accountant/CPA. This will be incredibly helpful in the financial planning and budgeting of your company, as well as how to set up taxation for your group practice. Checking in with your accountant regularly will help you stay financially on track.
3. Decide on your practice management system/EHR
Managing a group practice quickly becomes a busy job. Coordinating provider schedules, booking client sessions, processing billing (or insurance claims) and maintaining oversight of your providers are all important tasks. Even if you have the help of an office assistant, you’ll still need to think through managing your team and marketing your group practice.
Your EHR (electronic health record) system is your platform for charting and maintaining client information. A practice management system will help you manage all of your office and facilities needs including scheduling, billing, payment processing and client paperwork/forms. Having a HIPAA-compliant practice management system and EHR integrated in one platform, is a great way to streamline your practice
Healthie provides all of the tools that a group practice needs, allowing your providers to each have their own accounts for charting as well as access to the groups intake forms, calendar and billing system.
Monica Auslander, MS, RD, LD/N and founder of Miami-based group nutrition practice Essence Nutrition (featured above), advises on an all-in-one practice management program. For Monica, it allows her to seamlessly onboard new hires, which could otherwise be a daunting process. Having the Healthie platform saves her time and energy, so that she can focus on effectively managing and marketing her team.
4. Find your office space(s):
If you have an office currently, it may not fit the needs of a growing practice. One option is to find a larger space that can accomodate your new business. Or, you may want to consider having more than one rented office space. You can start by looking at nearby doctor’s offices, health spas, fitness clubs or therapy spaces that may be willing to rent you an office for certain days.
This offers a strategic way to gain a new client base, as clients are already coming to that location for health-related reasons. You can essentially setup a partnership with the other providers in the office and cross-refer clients.
5. Put together your paperwork
It’s important to have all of the right forms and policies ready to go when you start seeing clients. As a solo provider, you most likely have most of the intake paperwork you need, but this is a good time to review your forms and make any changes.
Apart from a new client registration form and policy forms, you may want to consider a cancellation or no-show policy. It’s important to keep in mind that your providers will likely be paid per client as independent contractors, so if a client doesn’t show, they won’t be paid. A strict and clear cancellation policy can help protect your provider’s time and income.
6. Determine how you’ll legally define your team
How you classify a new hire (employee or contractor) will be important to your business structure and taxation. If you hire a provider as an employee, then employment and labor laws will apply, and you’ll want to meet with a CPA to determine wages, benefits and tax withholdings.
Labor laws do not apply to an independent contractor. This is the more likely way a new group nutrition practice will classify new hires. Generally, providers will be paid a certain percentage or flat rate per client seen, as opposed to a salary.
You’ll want to have an employment attorney review your new hire contract. This will ensure that you are clearly defining the role of your new hire, and your practice policies.
If you’re hiring independent contractors, it’s important to ensure that they are properly licensed according to your state. Keeping up-to-date on professional liability insurance is essential, and you should ask for a certificate of insurance every year. In some states, it may be required for contractors to also have workman’s compensation. Whether you hire employees or independent contractors will play a factor in who is responsible for paying for workman’s comp. Having up-to-date liability insurance and workman’s compensation policies for all of your providers will help protect them and your business.
7. Staffing the right individuals to fill out your team
Hiring a new provider for your practice is an exciting, but serious endeavor. When transitioning from a solo practice, it’s natural to be protective of your brand and business. You’ll want to bring on providers that you can trust and mentor. For many new hires, this may be their first time working in a private practice setting.
It’s important to search for qualified candidates with a strong nutrition background, but also someone you can see being personable with great social skills. When hiring someone new, Lisa Moskovitz, RD, CDN, CEO & Founder of the group practice NY Nutrition Group, looks for someone who ticks off both credentials and passion.
“First of all, they must be a registered dietitian, have a passion for nutrition counseling and be easy to talk to! Private practice is all about talking to clients and building relationships.”
Essence Nutrition founder Monica, emphasizes the importance of having open communication and compassion among her team. She believes that being open and honest is always the best policy. As a manager, Monica makes sure she is investing in her team, since they are investing in her business. A few ways she achieves this is by offering continuing education opportunities, hosting guest speakers and holding regular team meetings.
Both experts agree, making sure their providers are comfortable asking questions or sharing difficult cases helps with retention and stability of their teams.
8. Consider your group dynamics
If your brand is closely tied to your area of expertise (ie. eating disorders or digestive disorders), bringing on more providers who are experts in this area will further add credibility to your practice.
Another group dynamic to consider, is bringing on providers with varying expertises (ie. you specialize in eating disorders and you bring on someone else who is a certified diabetes educator). Adding to your practices’ list of specialties will help make your group well rounded, and capture a larger client base.
Some groups choose to bring in providers of other disciplines. This allows the group practice to treat clients as a whole (ie. you’re a dietitian specializing in eating disorders, and you hire a therapist or mental health counselor). This can be an incredible value-add to your clients. Coming to one single location for multiple services is extremely convenient. In addition, help drive up your client referrals, as you’ll be able to cross-refer patients.
9. Determine your management style
As a solo provider, you’ve had 100% of the decision making power and control of your brand, voice and image. Bringing on other providers will require a shift in how you view and structure your business.
Learning how to delegate your work, streamline your business and develop your management style will be something that you learn as you go. Most often in group nutrition practices, providers are part-time employees. They may have full-time jobs working in another sector of nutrition (ie. they work in a clinical setting). A private practice setting requires a dietitian to develop new skills. As a manager, you’ll likely also fill the role of mentor.
Lisa advises that getting over your initial fears of failure is the first hurdle to becoming an effective manager. Moving past the fear of not succeeding or generating enough income, allowed her to focus on what really matters: growing a business that she’s passionate about.
If you’re ready to start your group nutrition practice, learn how Healthie’s group practice plan can be the right fit for your team. Schedule a free demo today.
The information on these pages is provided as general guidance. Should you have specific questions about the laws in the formation of a professional entity, please seek personal legal counsel.