As a solo provider, you have invested your time, energy and money into growing your nutrition private practice. It may seem like a far-off goal, but you may be ready to think about the next logical step: bringing on other providers into your practice. Branching out into a group nutrition practice can be an effective way to expand your brand reach and increase your client base.
Here’s 4 ways to know if you’re ready to expand into a group nutrition practice:
1. There aren’t enough hours in the day, so you’re turning away prospective clients.
It’s a bittersweet moment when your client load has grown to the point where you can’t take on any more new clients. It’s a great success and reflection of your hard work, however, there are still clients that would pay to work with you, and could benefit from your services. As a solo provider, there’s a limited number of clients that you can really see in a day. Bringing on another provider can be a great way to expand your practice, and make sure that you’re maintaining a reasonable client load.
2. There’s a long wait between follow-up sessions, or you can’t always support your clients between sessions.
Healthy diet and lifestyle changes takes time, support and accountability. Part of what makes clients so successful when working with you, is that support you’re able to provide. The frequent follow-ups, check-ins, food diary reviews, motivational words — all add up to helping your client successfully reaching their goals. If you’re finding that you don’t have the time to make these connections, or see your clients as often as you’d like, then you may want to think about expansion. Providing the same, high-quality support and service to your clients is important, so once you feel that service and attention is being diluted, it’s time to restructure.
3. You’re feeling mentally taxed and burnt out.
Working with clients day-after-day, is rewarding but also can be mentally exhausting. Especially if you work with clients back-to-back, you can quickly start to feel the drain of long counseling days. When working with more clients just seems emotionally impossible, you should consider bringing on another practitioner to share the load.
4. You’re lonely, and miss the collaboration of a team.
For many dietitians, working as a solo provider can be lonely and isolating. Bringing on more providers allows for the opportunity for a team to share ideas, talk through difficult cases and review important client strategies. This collaboration helps the group to feel supported and allows for ongoing professional growth.
If any of the above-mentioned reasons resonate with you, then you may want to think next steps towards expansion. To lead us through the transition experience, we sat down with Monica Auslander Moreno, MS, RD, LD/N and founder of Miami-based group nutrition practice Essence Nutrition.
After launching her solo practice in 2016 and heavily investing her time to its growth, Monica found herself ready to expand. Although it was a difficult, and emotionally taxing process to build her business, deciding to bring on other providers to build a team was an easy one. Three years later, she expanded her practice and currently operates a team of four RDs and an occasional dietetic intern.
Follow along as Monica walks us through her rationale and process of expanding her nutrition business, and offers detailed advice on knowing when it’s time to take the plunge.
When did you realize that you were ready to expand your practice and bring on additional dietitians?
When I was running my practice as a solo provider, I was seeing clients but there was so much more behind the scenes. In a typical week, beyond seeing clients I was also responsible for:
- Administrative tasks like managing the schedule, booking clients, making sure client forms and policies are filled out and up-to-date
- Managing taxes and financials for my business
- Manage website and creating marketing content (social, newsletter, blog, content calendar)
- Connecting with my clients on Healthie through messenger and reviewing their food journals
- Chasing down prospective clients and pursuing potential leads or opportunities
- Constantly refining how to improve dietitian and client experience
- Client materials, branding
Personally, I found myself unfulfilled after almost two years alone. I was beginning to harbor resentment. I was burning out and I was struggling to find joy in my work.
When I decided to bring on more practitioners and expand into a group practice, there wasn’t any strife. It literally was just a moment where I thought, “what if I enlisted people who WANT to see private clients to do it, and I could them lead them, manage them, and guide them?” Plus I evaluated the unique skill set and intellect they could bring to my brand, and how that would be beneficial for my business.
Once you decided to branch out, what were the benefits you saw for other dietitians to join your group practice?
For the dietitians I was going to bring on, they could also learn from working in a group practice. I found that there are brilliant dietitians working in the clinical setting, but they had no training in communicating and delivering nutrition services in a private setting. Working in a group practice, they get the training and can swoop in and see their clients, with all the leg work, is done for them.
What making the transition to work in a group private practice brings to my team:
- They develop nutrition counseling skills: as opposed to working in a clinical setting, counseling with clients over a period of time means building a relationship and supporting your clients in the long-term. This takes practice and time
- They gain marketing skills: marketing is definitely not something learned in educational training for dietitians, but is essential in private practice. Each of my team members need to learn how to market themselves to successfully build a client base.
- Provides additional income: working in a group practice provides additional income, as most of my team work other full-time jobs, and part-time see clients.
- Flexibility in their schedules: as a private practice dietitian, in general it allows you to have a flexible schedule, especially if you’re working part-time as a contractor.
What did it take for you to first get your practice off the ground?
For me, and this is probably not palatable or even healthy, I put my business first during year one. I sacrificed a lot of personal time, relationships, and affair. Perhaps full immersion into a start-up isn’t balanced, but I do think it’s a predictor of success in many ways. You have to want success badly. It’s not about the money. I would have pursued corporate dietetics jobs if it were about the money. It’s voracious internal ambition — I’m going to start a practice and I’m going to KILL IT and leave no stone unturned.
If you’re considering launching a group practice, you have to be prepared to be competitive, ambitious and you want to have to live and breathe it 100% for the first year. Even more, you have to want to be a positive role model to inspire the team that works with you, so that collectively you can grow the group practice.
How did you navigate the legal requirements in bringing on an additional contractor or employee?
First things first: please consult an attorney who specializes in employment and organizational law. You are a dietitian, not a JD/MBA/CPA. You’re going to mess something up, legally, if you attempt to do this alone, and you want to make sure you’re covering all of your bases. I am known for being annoyingly meticulous when it comes to protocol and procedures, so I hired everyone: a CPA, a business attorney, and a business consultant with an MBA.
We went through the legal and organizational process together: drafted up documentation, ensured I had the correct business entity, navigated the operational processes of bringing on an employee (and the software / accounting requirements needed therein), and much, much more.
Each of your contractors will have to sign an agreement, that is unique to your practice. Your attorney will help you draft this agreement, given your vision for your business. I also hired an IP law specialist for my branding, an attorney for the LLC set up, AND one who reviews all my contracts. To protect my brand and intellectual property, the IP attorney helped me set up systems and protocols that were unique to my process. Pro Tip: expect to spend $5-$10k as one-time set up fees
I continue to consult with my team of experts as needed. I recognize that I certainly don’t know everything. I have an MS in Dietetics, not Business. There are a lot of things you ‘pick up’ over time, but filing sales tax quarterly is not exactly intuitive.
What do you look for when hiring dietitians for your business? How do you determine “fit” for your business?
Hiring providers that are actually a fit for your vision and your business is incredibly important. I know you can’t define if someone is “sharp” — but my dietitians are SHARP. Yes, the RDN is a given. I also only hire RDs who have worked in a hospital for at least one year, because I had that position and respect it so deeply. I want to surround myself with folks who have been in the ICU at length, gone through rounds, and worked alongside the very sickest so they are equipped to treat the “well” folk we see.
You also need to have a service-oriented personality. You have to be charming. You have to be somewhat trained in various psychotherapeutic modalities that are necessary for the world of outpatient care.
My dietitians are rockstars. I am candid about time commitment both for clients, clerical work, and administrative team duties when they are hired. They are encouraged to be open and honest with me as I am with them. There is a LOT of respect and decency between us. We also have a heck of a lot of fun. They’re my teammates!
When managing your group practice, what steps have you taken to retain and empower your providers?
The culture of creating positivity and being decent and compassionate in all dealings is fundamental to a successful group practice. Although, we do have to talk a lot about being assertive, polite, and firm. I hold them to very strict standards in the way we interact with each other and with our clients. We encourage a VERY open communication pattern.
They never feel shy or embarrassed to ask or say something. We are ALL always learning from one another. I want them to feel like they have a lot of independence, but know I and the rest of the team are always there for support.
- Being human and compassionate with your staff
- Appreciate style, collaborative, open communication essential
- Opportunity to learn and grow — exposure to private practice
- Contractors versus employees
- They are part of my brand and be appreciative of their contribution
- Slow myself down, I’m a teacher & mentor — what do they get out of the experience?
Now that you’ve grown your team, what are the advantages that you continue to see being in a group practice?
It’s extremely fun to be with a fabulous gang of like-minded individuals. We all speak the same nutrition language. It’s never boring. I look forward to our staff meetings. We share resources, we feed off of each other, we are constantly learning from each other, we philosophize.
It’s like one big neverending informal but informative and enriching live CEU reel. Each client and experience is a learning opportunity not only for the individual RD but for the group. The RDs get to maintain clinical privileges and keep their toes dipped in that wild and academic clinical world, and then get to flourish and cultivate their different talents as magnificent private practice providers, but all the legwork, branding and business responsibilities are taken care of by me.
They get to be the chef and star of the show, rather than the sous chef/supporting actor doing the backend work (my job…) Working in a private practice renders well-rounded providers. Clinical is a revered realm and the foundation of our science as RDs, but private practice is almost another science/discipline, and practicing with private clients extends into becoming a better human in the world. It’s learning to engage correctly with other humans, and that’s a major life skill.
How does Healthie support you as your practice grows?
Healthie has made the growth process truly seamless. I simply don’t have time to onboard someone onto many different electronic platforms. Each dietitian has their own provider account within Healthie, but are part of our group organization. The dietitians navigate Healthie really well, and it allows me to keep eyes on everyone as a manager, as I retain permissions on the organization. We can share forms, calendars, client information and have all billing a processing done from our organization. It’s actually the easiest part of the practice with its “one stop shopping” appeal for all things including intake, billing, scheduling, charting, video, educating and logging.