Finding Independence in Private Practice

When I started as a dietitian, I was working per-diem at a hospital. I always covered for other dietitians, coming in to see their patients for a day. Every day, I’d do something different. One day I’d work in oncology, the next day in the ICU, and the next day in general medicine. It provided me with great experience, but left me feeling frazzled and unsettled. I’d see more than twelve patients per day. There wasn’t much time to talk with clients and help them make real health changes.

My hours at the hospital became inconsistent, so I started to look for other jobs. Private practice felt intriguing, and I liked the idea of being my own boss. I thought I’d just do it on the side to supplement my hospital job. As my private practice schedule filled up, I found myself not wanting to work at the hospital anymore.

I started my practice in 2014 and left my hospital job officially in June of 2016.  

Finding the right EHR

Before finding SimplePractice, my practice was chaotic. I used three different systems — one for scheduling, one for charting, and one for billing. Clients filled out paper intake forms, and I then had to transfer all of that information into my charting system as well as my billing system. It confused my patients to schedule in one platform and then receive messages from me in another one. It sounds ridiculous now when I think about it.

I spent at least half a year trying out different platforms. My schedule was full, all of this admin work piled up, and I had to stay up late at night to get all of it done. I accepted the free trials of as many different EHRs as I could find. I Google’d EHR, EMR, and nutrition platforms. I searched in various dietitian Facebook groups for different platforms other people were using. I wanted to see what the flow was like.

• Was it intuitive?
• Did it feel clunky on my end?
• What was the patient experience?

These were the questions I asked. I wanted to log into one platform to do everything. I couldn’t find EHRs that incorporated billing, claims, and ERAs at a reasonable price. Ones that did were geared toward doctors and wanted pretty exorbitant money to submit claims within the platform.

I heard about SimplePractice in a mental health group, but didn’t consider it at first because I assumed it wouldn’t work for me. Then, I met a dietitian using SimplePractice and was very happy with it. Once I discovered it streamlined the intake, charting, and billing process, I was sold.

I utilize Telehealth by SimplePractice quite a bit. The connection is more consistent than with my previous Telehealth provider. Telehealth is super handy. About 20% of our appointments at Dandelion Nutrition are Telehealth. Clients can meet with me while they’re at work, at home with their kids, or even out on a hike. I can tell people that it doesn’t matter if it’s snowing out or if they have a cold. As long as they can hop on their phone or a computer, we can still have our appointment. That’s one way I save clients from having to pay for a late cancellation.

The insurance decision

If I could go back to the beginning and give myself advice about insurance, it would be to get peer support from people who have been there and done that. In my journey to get credentialed, I had a ton of questions, so I spent hours and hours Google-ing and on the phone with insurance companies. There was a lot of trial and error.  There were so many questions I could have just asked someone who had been through the process before and they would have known right away.

Even after accepting insurance for a few years, I still felt like I regularly had questions and couldn’t find the answers. It shouldn’t be so hard. I wanted to share what I learned with other dietitians and also provide a resource for myself to ask questions. That led to the formation of my Facebook group — Insurance Credentialing and Billing for Dietitian Nutritionists.

The most significant benefit of accepting insurance is that it gets people in the door. My practice grew a lot faster because of it. My area in Seattle, Washington has excellent coverage for nutrition. When clients find out they won’t owe anything or sometimes just a co-pay, I think they’re much more likely to schedule that initial appointment.

Insurance billing at a reasonable cost is what sealed the deal and made me ultimately decide to go with SimplePractice. Other platforms had cool features, but none of them made insurance billing so easy. That piece was going to save me the most time so I could devote my time and energy to helping clients instead of billing them.

The freedom of group practice

I love being my own boss and the flexibility it provides. I don’t want to spend my time doing needless tasks. I want to focus all of my attention on helping patients achieve amazing results.  

When I found out I was pregnant, I didn’t know what I was going to do for maternity leave. Being a single mom by choice, there isn’t a second income. My practice was built on my time. That was a big obstacle I had to overcome. I did that by hiring employees; expanding the practice out to be a group so that while I was on leave, my clients were staying in the practice rather than being sent elsewhere and I was still earning some income.

My goals as a dietitian and practice owner have changed a lot this year since I have a baby now. Before finding SimplePractice, I was able to stay up late at night and finish things up, and now I just can’t do that. My biggest goal right now is streamlining my processes so that I’m not worrying about work when I’m with my kid.

Know your worth

I wish I’d recognized the value of what I offer early on. I ended up working with a business coach who helped me see the value of my services. People care about not passing noisy, smelly gas during a work meeting. They care about getting the eczema on their arm to calm down so they can feel confident in a tank top. They care about not having a migraine keep them from enjoying a weekend with their kids. I package my services a little bit differently, focusing on efficiency now so that I can get clients better results.

Regarding advice for professionals looking to manage their own practice better, I’d say to them when you’re getting started, set things up as if your practice was full. I tried doing everything on the cheap, but by the time my practice was full, those cheap systems didn’t serve me at all. They actually inhibited my growth. I also didn’t have time to research systems and make the changes. I wish I had started out with better processes in place.