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  • Writer's picturePaige Smathers

51: How I Became a Registered Dietitian & What it's Like to be in Private Practice

If you’re considering a career in dietetics, listen to this episode to get some questions answered! In this episode, I take on frequently asked questions about how to become a registered dietitian as well as what it’s like to be in private practice.

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Hey everyone, welcome back to another episode of Nutrition Matters. I’m Paige, your host, and I want to take some time today to talk a little bit about becoming a registered dietician, and to talk about what I do in my private practice.

Now before you think “why is she talking about herself? That’s not that interesting”, I want to explain why. I agree, it’s not all that interesting to me either, but I have a local university here in Salt Lake City, the University of Utah, there’s some class that the professor keep assigning the students to find people in the community who are doing work that people in the class are interested in, and they request to interview me all the time. There’s certain times of the year where I will get literally three or four emails per week saying “can you answer these 15 questions for me?” or “can I come in to your office and talk to you for an hour about what you do?”. I used to try to really try to sit down and take the time to talk to people individually, but I’ve just gotten to the point with what I do where I just need a space to refer people to when they approach me with wanting to interview me, or when people who find me or know about me somehow and want to hear more about what it’s like to become a registered dietician. I’m creating this podcast episode as a way to have a place to refer those people. So listen on if you’re interested. If it sounds super boring, wait til the next one comes out!

So I’m just gonna take some time and talk about my journey to become a registered dietician, and it’s a little different than normal - I’m just going to be talking to myself. Some of you have listened back to that episode where I talked about being 14 years old, sitting in Career Day in High School, and listening to a registered dietitian talk about what she does for work. It was really then in that moment that I kind of decided “you know what? I think that’s what I wanna do”. It was interesting - I always thought maybe I’ll change my mind, maybe I’ll not wanna do this in the end, and I was open minded about having a different attitude, but for some reason, I just ended up continuing to fall more and more in love with that idea.

So I applied to various universities and made sure that they had a Didactic Program in Dietetics, which if you’re in High School listening and you’re looking into colleges, that’s what you want to look for in your Undergrad. Some of you might already have done school and are looking at Graduate Programs, so that’s a little bit different. There are Graduate Didactic Programs in Dietetics, and there are Undergraduate Programs. So I’ll explain - while I’m telling my story, I’ll intersperse some details throughout.

So I made sure that the schools that I applied to had those Programs and then I just fell more and more in love with it, and finished school and then when you’re done with your Didactic Program in Dietetics, you have to apply to an internship, and you complete usually a year where you do various rotations to get a good feel for what it’s like to work in all the various aspects of the world of nutrition. So you do a food service rotation, you do a clinical rotation, you do some outpatient things, and you also do community nutrition, which is kind of public health - usually it takes place in the WIC office - working with the Women Infants Children government-run program, and then the clinical setting is in the hospital. Typically you have the opportunity to do some type of outpatient rotation. For me, I did a rotation at a dialysis clinic, which was a lot of fun! I really really enjoyed that.

So the next thing after an internship is you have to pass a test called the RD Exam. Basically it’s just the biggest test you’ll ever take in your life, and you study like crazy, and then you have a huge party when you pass! I actually got a job right out of my internship, so I was not an official RD (Registered Dietitian) yet.

This maybe is a good opportunity to explain the difference between a nutritionist and a Registered Dietician. So the term “dietician” is a regulated term, so it is protected - you’re not allowed to call yourself a dietitian unless you are one, unless you’ve gone through these steps that I’ve been talking about here. The term “nutritionist” is an unregulated term, so really anybody can call themselves a nutritionist, whether or not they have those credentials or they’ve gone to school for it. So my official title is “Registered Dietitian Nutritionist”, and our governing agency allows us to call ourselves either “Registered Dietician” or “Registered Dietitian Nutritionist”. I choose to call myself “Registered Dietitian Nutritionist” because I think most people in the everyday regular world understand what a nutritionist is a lot more than a dietician. So I wanted my title to be more intuitive for people who were finding me or looking at what I do, or looking at my credentials. I wanted people to have a good idea of what that was. So that’s why I choose to go by the credentials “RDN”.

So, I got a job right out of school in a hospital setting, and I then, I think it was about 6 weeks later, I passed my RD exam. I think you have within a year (don’t quote me on this!) to complete that exam. It might be 6 months, I can’t remember the exact rules there. So I passed the test, got a job, loved it - I worked in a hospital setting, it was a great experience. I learned a lot about physicians and how things work in the medical world, and insurance and social workers and all kinds of really really great opportunities.

A few years later, I was approached by my boss to have an opportunity to switch roles from the inpatient world - the hospital setting - to the outpatient world. So this new job that I got was a lot more counselling-based, and I was working with people who needed educations for nutrition. So when there was a new diagnosis of coeliac disease or diabetes - oh and that’s one thing I didn’t mention earlier, sorry - I was also trained in the inpatient setting to be a diabetes educator. I never got my credential officially but I was trained, so I went around and taught people in the hospital setting about diabetes, and that was a really great experience, I learned a lot there. So in the outpatient setting, that skill really transferred over and I worked a lot with diabetics, with pregnant women, I taught classes, I worked with people with eating disorders. I got a lot of exposure to that different setting where all of a sudden, I’m building these relationships, I’m learning about people, I’m able to follow up with them, and I really found that that continuity, that relationship building, was just way right up my alley. I loved getting to know people and working with them on a personal level rather than just when they’re drugged up in their hospital bed and not really able to think or listen. I really enjoyed the outpatient setting because it was so, so different.

So eventually I transitioned into starting my own private practice, and that’s where I am today! So people often ask me what I love most about being in private practice. Well, I absolutely love the - I know this is so cliche - but I feel very free to do the things that I want to do. Such as this podcast! No one’s really paying me to do this, this is sort of my effort, like I’ve told you before, putting out as good information as possible, and reaching out to a community at large to try to help in areas that I can and I feel like I can really make a difference. So that’s so fun. In the hospital setting, sometimes I felt a little bit tied down by policies or rules or expectations where I didn’t really feel the freedom to think outside the box. I love that in private practice I’m able to take on any freelance writing I want to do, or do a podcast, or create an online course, or do all kinds of different things that are just new and different and exciting. I’m really able to dream big and think big, which is so so fun. I love obviously being my own boss and making my own schedule. I work quite a bit - it kind of ebbs and flows as I take on more projects outside of counselling and working with clients one-on-one. But I get to choose when I work, I get to take vacations when I want to. That is just incredibly amazing and something I’m really, really grateful for. I love being able to think outside the box, I love being able to have my own schedule, I love being able to have my own little space and do my own little thing.

One of the things that’s been really hard about being in private practice is that I get approached by a lot of people who want me to jump on board with what they’re doing. So some people, there’s been various practitioners in my area who have said “hey, come on our team” or “join this practice” or whatever it might be. There’s been various opportunities that have popped up throughout the years that kind of seem tempting. Like “ooh, that would be a way more secure job”, or “that would be reliable income”, etc. But what’s been hard but also really nice is just as I’ve stuck to what I feel is right and true to who I am, I’ve just continually found the right situations for me. Part of what’s hard is that I have to say no a lot, I have to have some boundaries when I get requests to do various things, whether it’s have someone come on my podcast that I can tell has never listened to it and they’re just trying to promote a product, or have someone approach me who wants me to join their practice but I don’t really agree with their philosophy. I’ve had a lot of chances and opportunities where I just have to sort of say no, which is a hard thing sometimes to do. But I’m getting better at it. So that’s been hard but also good, because as I’ve stayed true to my philosophy and what feels good to me, I’ve just really found this space where I’ve felt comfortable and I feel like I’m doing good things and feel like I’m staying true to myself, so that’s awesome.

One of the very hardest things about being in private practice is that everything I do in my practice is sort of an extension of who I am. So I take it very very seriously and I sort of see it as - when I’m working with an individual, if they are not happy with what we’ve done together, or if I get a negative review somewhere, if I get an email from someone who’s upset about something I’ve done… That rejection of a client that doesn’t come back after the first session, or of someone sending me an email that they’re upset with me about something… I’m admitting some vulnerability here by saying “I’m sensitive”. It’s hard to take that rejection or that criticism. Part of it’s just because I take this so seriously and it’s just an extension of who I am and I’m trying my very very best, and it’s hard to not take it personally when things happen along those lines. But, I really think I’m making some improvements there, and as I grow and become who I want to be, I think there’s a lot of things that I’ve seen myself get better at. That’s one of them - kind of taking some of those things in stride and recognizing that my approach and my personality and who I am just won’t be right for every single person. So that’s probably one of the difficult things, but definitely an opportunity to grow, always.

So a lot of people ask me about what a typical day looks like for me. I have an office, as I mentioned, so a typical work day depends on the day of the week, but I have classes that I teach. I teach a class every single week on Wednesday mornings, and then I have clients typically most of the day. I see anywhere from 4 to sometimes 8 clients in a day. That’s the majority, the bulk of my day. If I ever get a cancellation or something along those lines, I always have side projects that I’m working on. I have a couple of contacts with corporations, so I sometime will start working on some of the tasks I have to do for that. Or I have freelance writing to do. Or right now, I am in the process of building an online course, so that’s taking up a tonne of my time right now. So a typical day is kind of, come into the office, meet with people, have appointments sometimes, and obviously answering a lot of emails and sometimes phone calls, interspersed with little bits of freelance writing. Sometimes I check in on social media and see “oh have I not posted for a while”, or I plan blog posts or articles, things like that. So there’s really always something to do. But again, everything I take on is something that I feel is aligned with who I am and what I do, which then makes it fun and not as much of a drag.

Lately, since I’ve been building this online course, I’ve been working a lot in the evenings, as well as on Saturdays and things like that, just to get caught up on all the work I have to do, which is why this podcast has taken a little bit of a back seat, because I’ve just been so crazy busy. But a typical day is meetings, appointments with people, networking with other professionals - I’ve a weekly meeting I go to with other eating disorder professionals locally, which is awesome. Just lots of work one-on-one with people, plus little projects here and there.

So I’d say if you’re thinking about becoming a Registered Dietitian Nutritionist, I’d say go for it! I think it’s a wonderful field, there’s really amazing people within it. I’ve made a lot of great friends just through what I do professionally, I love it. One thing that a lot of professors warned us about in school was that you don’t make a whole lot of money, which is definitely true. When I look at what an inpatient dietitian makes working full time and having to work weekends and holidays occasionally or regularly, and then I look at what a teacher’s salary is, it sometimes ends up being pretty similar. So if you’re in it for the money, it might not be a great idea! Although private practice is different and you can kind of scale it and make it what you want it to be. I’ve found a lot of financial freedom in starting my own private practice. Obviously I work a lot - I have a lot of things on my plate, so to speak. But again, it’s all stuff that I love and feel passionate about, so it feels a little less like a drag and more like a fun learning opportunity or an exciting puzzle to solve to see how I can best meet this person’s needs or whatever.

I absolutely love what I do, and I would recommend anybody who is thinking about it to definitely give it a go and see what you think. I think it’s just a fantastic world of opportunity. One thing that a lot of people do complain about in school is that they didn’t realise how scientific the study of nutrition is, and how chemistry-based it is. I think the chemistry courses in college do tend to kind of shy some people away or scare people off! So if chemistry is not your thing, you might want to consider taking a different route perhaps. But if you love helping people, if you love the idea of working with people to improve their lives in whatever way that means for them, I think it’s great - I would definitely recommend it.

If you’re thinking about starting a private practice and you’re already a dietician, or if you’re looking at starting your private practice when you become one, I just have a few things to say about that to help you recognize if it’s the right choice for you. I would definitely recommend having the chance to work under an organization for a while before you commit to being on your own, just because I think there’s such great learning opportunities that can be had when you are under the umbrella of somebody else paying for your training and helping you learn the things that you need to learn to be the best clinician possible. I know there are very successful, wonderful, knowledgeable and insightful dietitians who started private practice right after school, but I just know for me personally it was really helpful to give me that experience and to also just help me feel really confident in a counseling setting. I would definitely recommend that if any of you are on the fence or wondering about that.

Part of what makes being in private practice in particular really difficult, but also really fun, is the fact that you have to wear all kinds of hats. You have to be an accountant - definitely you hire one, but you still have to keep track of all your expenses in a very organized way. You have to be a marketer, you have to be a writer, you have to be inventive and creative on social media. You have to learn to be very compassionate and be a therapist - you’re gonna see a lot of tears and you’re gonna deal with a lot of emotions and a lot of really sad situations. You also have to be a lawyer and watch out for all of the legal implications of what you’re doing. Not to mention the fact that you’re a dietician and you have to keep up on your nutrition knowledge and stay current on studies and on trends and things like that. On the one hand it’s super fun because you’re never bored, you’re always having to put on a new hat and become a new professional and learn and learn and learn, which is so fun for me. But I think a lot of times, it might not be the right career move for every different personality. You have to be not afraid to learn how to say no, you have to advocate for what you need. You need to not be afraid to take payment from people - I know sometimes it can be really awkward, especially in the beginning, having prices and expecting people to pay you! There’s just so many elements of being in private practice that are fun but definite learning opportunities and can be kind of difficult. So those are just some things that I would add in here about what it’s like being in private practice in particular and what are the pros and cons there.

I apologize that this is a little discombobulated and unorganized - I’m kind of just talking here to myself, which is definitely a lot harder than interviewing someone else and listening to their wisdom! One question I get a lot from students is “how do I balance work and home, or work and family life?”. One of the things that I’ll say just on a personal level, I like for me personally, that I am a better mom because I’m able to have this creative outlet, this intellectual outlet, and I absolutely love being a mom - it’s just a wonderful thing in my life. But I also love the ability to come, be in my own space, have my own office, and work really really hard at stuff that excites me and that is fun for me. I feel like this balance between being a mom and also being a professional business owner-type person is a really good balance for me personally. So for me, it’s just a really great balance and something that I’m really grateful that I have the opportunity to do both of those in my life.

That’s typically the questions that I get about my journey to become a Registered Dietitian and where I am now, and what I love about it and what’s hard about it. If you have questions about the field, if you would like to find out more information, I’m going to link to a few of my favorite dietitian blogger blog posts about their journey to become a Registered Dietitian, just so that you can see. One person that I’ll link to went back to school later on in life. Actually, I think both of the things I’m going to link to, they actually had a degree and then went back. A lot of them documented a lot of the process of being in school and talking about the internship, and taking the RD test. So if you’re in that boat or if you’re thinking about it, or if you’re in the middle of trying to finish your schooling to become a dietitian, you might want to check those out, it might be interesting to you.

If you’re thinking about it, I wish you all the luck and I’m so glad that you listened in today, and I wish you the best!

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