[00:00:00] If you're looking to grow your business as a registered dietitian, you've come to the right place. If you're not sure what to do or what steps to take next so that you can create flexibility and freedom in your life, then you're going to learn a lot from tuning into our podcast here at Dietitian Boss.
[00:00:17] I'm Libby Rothschild, the founder of Dietitian Boss, a fellow [00:00:20] registered dietitian and business owner. And in our podcast, I share the highs and the lows, and I talk all about how to grow your business. Get it started. And I interview our clients to date. We've had over 200 interviews from clients who share their journey on our podcast dietitian boss.
[00:00:37] Libby: Hello, and welcome to today's episode, where I'm going to talk [00:00:40] about client care, meaning how you see a client or patient words that I'm going to use interchangeably before, during and after their appointment. What are your processes? What are the things you're thinking of? And how can you standardize your care so that you can provide excellent care and also make sure that you're saving [00:01:00] time so that you prevent burnout as a practitioner.
[00:01:03] Libby: So as a dietitian, whether you want to do full virtual, a hybrid of virtual in person, or in addition to offering consults and single sessions, you might want to offer group programs and sell digital products such as eBooks and courses. Now, whatever your journey is in running your business, [00:01:20] you're going to need to understand the concepts of what to do before, during and after a consult or an appointment.
[00:01:26] Libby: And this goes true for whether you're doing a package or a group. Meaning you have somebody that signed with you for a duration of time, like 36 months or longer, or you're doing a single session, or maybe you've sold someone a bundle of sessions. So you know, they're going to be with [00:01:40] you and maybe the support between the actual sessions varies depending on how you've packaged your services.
[00:01:47] Libby: Now I talk about that in depth in terms of how do you package your services and other episodes. So. Make sure to check out our podcast over on dietitian boss on all available platforms for a podcast stream. But today I want to talk more [00:02:00] about what you think about doing, going through the process of before, during, and after your appointments.
[00:02:05] Libby: So we're going to be talking about how to save time and how you can improve patient care by thinking through what you're doing now, or if you're thinking about starting your business, what you want to have in mind for creating great processes in your business. What are you [00:02:20] thinking about before here? Now, why this is so important in terms of thinking before, during, and after a client is because you want to provide excellent care to all your clients. You want your clients or your patients to be so happy that they're referring all Other friends to you, or if you got them through insurance, maybe they're telling their provider like their doctor.
[00:02:38] Libby: So your doctor is more likely [00:02:40] to refer more patients to you. So whether you're looking for referrals for cash pay or referrals for insurance or just happy customers in general, because as dietitians, we want to provide excellent service. You're going to want to think through how you can provide a good standard of care.
[00:02:55] Libby: And keep in mind how you can be efficient. I want to mention that you can't be efficient with your [00:03:00] workflow, meaning your process from start to finish until you just get started and start doing it. So it might be a little sloppy at first. It might be more tedious and you might not be saving time as you're getting started.
[00:03:11] Libby: But with time, I want you to listen to this episode and pull out a couple pieces of information or tips that you can apply. So let's [00:03:20] first break down preparing for an appointment. That would be the before section of this podcast was broken down into three parts, right before, during and after. So you're going to want to review client information.
[00:03:30] Libby: Now, for those of you listening, you're probably thinking, Oh, I already do that. But I want you to think about what process you have in mind. Do you allocate a certain amount of minutes to your schedule day of, [00:03:40] or do you pad that into the appointment where the client might see you at, let's say at noon, but do you do it?
[00:03:45] Libby: Start it yourself the appointment at 1150 or 1155 or do you take your morning and let's say 20 to 30 minutes, depending on how many patients you have on your schedule. You're looking through and preparing for those appointments or those sessions. I know it can be hard to do well ahead of [00:04:00] time because people do cancel, but I want you to keep in mind that thinking about reviewing their information and how do you review their information can help you provide a better standard of care.
[00:04:10] Libby: So this is going to include reviewing their intake forms. Hopefully they're filling those out, their health history, even if it's brief and any previous notes that you've made, I would say, think about [00:04:20] where you've gotten that client from, have they made an inquiry? Are they from a doctor's referral? Are they referred from friends and family?
[00:04:26] Libby: So you want to kind of dig into how they learned about you and what information can you gather about this person so that you can be prepared to provide excellent care and assessment. You want to familiarize yourself with their background and that can help you tailor your session to their [00:04:40] needs. And you want to be listening and practicing active listening.
[00:04:43] Libby: And you can do a better job with that when you're more aware of who you're going to be spending time with, you also want to think about setting up your space. So this is where you can take a moment and check in with yourself. Are you offering online in person or hybrid consultations? So if you are doing a hybrid, you probably have a process for online and in [00:05:00] person, meaning online, you're going to want to be, have a background free of distractions.
[00:05:04] Libby: Thinking about having an environment that's safe and peaceful. So staying away from all the sounds, if you can, and if you're having an issue with noise, you're going to want to try to figure that out. Do noise cancellation, wear your headphones, think about the mute button, find a way to have a peaceful [00:05:20] space and also think about ergonomics, making sure that you're comfortable, especially if you're doing session after session all day.
[00:05:26] Libby: So your computer is at the right height of where your eyes gaze and your window is faced. Appropriately to where your desk is. I'm going to talk all about that in a future episode about setting up your workspace. But I just want to mention that ergonomics is really important, both for in person and [00:05:40] online.
[00:05:40] Libby: Well, if you're in person, you want to think that your consultation space is organized and welcoming, and you want to have a clean and professional environment. You can also think about your brand colors. If you already have your brand colors, you want to think about how you're creating a certain style and environment that's welcoming.
[00:05:55] Libby: If you're, if you're not quite there yet, just think about professionalism to have a positive [00:06:00] impression with your clients. And now, of course, this might be a little bit boring, but you want to think about a pet policy or child policy or late. Policy, meaning how do you feel about people bringing in animals to the office and children?
[00:06:13] Libby: And what do you have that documented in terms of when that scenario happens? Now, late policy is really important because it happens to [00:06:20] all of us. So how do you handle late and cancellations? And that should be written into the terms and conditions when you first sign on a client, and that would be before they even scheduled a session.
[00:06:30] Libby: So common mistake would be not reviewing client information thoroughly, and that can lead to an unprepared or less effective session thoroughly. Again, you want to look at the health intake forms. You want to think about [00:06:40] where did this client find you? Or how did they land on your schedule? And that might help you gather some data so that you can be better prepared to provide excellent assessment and motivational interviewing, right?
[00:06:50] Libby: Coming into that session with empathy. So, 1 thing, an actionable item that can help you would be to create a checklist of key items to review before each appointment and ensure that your [00:07:00] space is ready and comfortable and that can help you start the session with confidence. And maybe you do feel really amazing about the assessment piece, but you still need to brush up on your counseling skills.
[00:07:11] Libby: So. Counseling skills still counts as part of being ready for that appointment. So you might want to brush up on some tactics to help you ask more open ended [00:07:20] questions, make sure that you are making people feel comfortable and you're creating client centered environment for your patient. Now, the next phase that we want to move on to would be during, right?
[00:07:29] Libby: Conducting an appointment. So this is during the session. So the first thing you want to think about is how do you structure your sessions? Now, this might depend if you're working with insurance, you're doing one session, [00:07:40] or if you sold somebody multiple sessions, or if you're working in a long term package.
[00:07:43] Libby: This can also depend if whatever you sold involves between support communication. I will say as a standard, you can adjust this with time and experience and feedback, but you do want to start with a warm welcome and an outline of the agenda. You can always ask, how does that sound? Did you have anything else [00:08:00] in mind?
[00:08:00] Libby: Or here's what I'm thinking. Let's say that the patient's name is Jane. Hi, Jane. Here's what I'm thinking for our session. Here's what I normally do with clients. How does that feel? Did you have anything else in mind right? And that's going to help set the tone and expectations and make the client feel valued, especially if you use motivational interviewing and you're [00:08:20] asking and you're making the session client centered and you're asking their opinion in an open ended question.
[00:08:24] Libby: So not yes or no, but you're asking them to elaborate more. You want to follow a structured format if possible, like reviewing progress and then discussing current issues and then setting a goal. And if they don't know how to set a goal, or you're struggling with setting a goal, and you can take a moment to peel back [00:08:40] something at a level that they're meet them where they're at.
[00:08:42] Libby: So, if they say they don't know what to do, that's where you can kind of go back to the session notes and say, well, this is what we've discussed today. And If they don't want to set a goal, then you can talk more about what they might want to think about for the next time. But you do definitely want to follow that structure of reviewing the progress, [00:09:00] current issues, and then goal setting.
[00:09:02] Libby: And if you let them know that is how you conduct sessions, that's a great way for them to know what to expect. And that might mean. Based on depending on the person where they're at in their journey, they might spend more time discussing current issues than setting a goal or more time setting a goal than current issues.
[00:09:17] Libby: And that's okay. If that distribution changes per client, [00:09:20] but at least you have a baseline to work off of, then that can bring confidence. Of course, if you have your own way of doing this, and you don't agree, and you have a different flow for your patients, let us know. And we'd be happy to discuss other options or interview another dietitian so that she or he can share what they do.
[00:09:36] Libby: Now, the next step I suggest for during a session would be [00:09:40] effective communication that includes active listening and clear communication, which are essential ingredients in terms of creating a successful session. So open ended questions are going to help you understand their concerns and provide actionable advice.
[00:09:52] Libby: So you want to stay away from yes, no questions and keep the conversation focused to ensure that they feel heard and understood, [00:10:00] such as how did that make you feel? Or can you tell me why you're bringing that up now? And then you want to document key information. So, of course, taking notes during the session is something we all know to do, but capturing the details that are important can feel challenging, especially if somebody is very chatty, or if you're multitasking, you're trying to provide a great assessment and get [00:10:20] comfortable with telehealth while practicing motivational interviewing.
[00:10:23] Libby: That can feel like a lot. And so I want to remind you that using AI, artificial intelligence, is an awesome opportunity that will help you capture important details Where you can still focus on patient care. So there is charting tool AI that is linked with practice [00:10:40] better, who we definitely recommend.
[00:10:42] Libby: So if you go to the show notes and use an affiliate code that we've listed over at dietitianboss.com, you can use our affiliate code to try out practice better. So practice better is an electronic medical record system where you can chart on your patients and they have an integrated AI tool that is safe.
[00:10:58] Libby: An ethical that [00:11:00] allows you to record the notes or create notes from the session. So that can save you some time and energy and pick up and capture the important details. Now, you can't just use any AI, because, of course, you might be aware that there are ethical implications. So you want to make sure if you are using AI and it's not through, let's say, practice better, which we [00:11:20] recommend that you are using something that's approved for charting and HIPAA compliant, because right now, anything put into AI is not necessarily private.
[00:11:28] Libby: So make sure you're using a tool that is HIPAA compliant and safe. Another pitfall, in addition to not pulling the key or relevant data from the session into the notes, which would be not staying [00:11:40] on track with the session agenda or not documenting keynotes, which can impact the effectiveness of your follow ups.
[00:11:45] Libby: So, what you want to do is use a structured appointment template, which you can also get from going digital and you can create a appointment template on something like practice better or a similar electronic medical record system. And that can guide you in your sessions and keep your notes organized.
[00:11:59] Libby: So not only are [00:12:00] you telling patients at the top of the agenda, here's the flow and that I wanted to use today. How did you feel about that? But you're also keeping to that flow because you're looking at your electronic medical record system and this, Example practice better.
[00:12:13] Libby: And you're following that template step by step. Now, I will again stress that there's variability. So some of your [00:12:20] clients might be spending more time talking about goals where other clients might be spending more time processing client issues. So there will be some variability for how long you stay on each section or quadrant of the template.
[00:12:32] Libby: But it's a great place to start to standardize your care. And if you're using a I charting, that's going to not only speed up the process and help create [00:12:40] streamlined process for your clients, But you won't have to worry about which information are you capturing that is relevant because that's what the tool will do for you.
[00:12:47] Libby: And then you can really focus on practicing motivational interviewing and meeting the client where they're at. So, I would suggest a structured appointment template that can help guide and ensure and keep your notes organized and that can ensure overall important [00:13:00] aspects that you have detailed out. So, if you're not using the AI, like a charting tool, that's approved and HIPAA compliant, then, you want to make sure that you have some template that will allow you to create the notes and type them up, in a way that's streamlined.
[00:13:15] Libby: So, remember, nothing is going to be using technology if technology is HIPAA compliant and [00:13:20] approved, so we are big fans of using AI over here at Dietitian Boss. So we definitely suggest that, but if not, have a template as much as you can for whatever you're doing and for gathering information. Now, in terms of after the last phase of this three part section today for what you do before, during and after client visits, you want to update the [00:13:40] record.
[00:13:40] Libby: So I know it's tempting to not update records immediately, but thinking about updating your notes and any action items is super important. So, again, you want to make sure that you're reading the charts as soon as possible is helpful. Again, if you're using AI that can do it for you, but you still have to read over and approve and wrap up that session.
[00:13:55] Libby: So if you have a lot of open notes and open sessions, and you're going to start to forget things and the [00:14:00] accuracy is going to diminish and to provide great patient care, it's ideal if you can leave a few extra minutes or a few moments at the end of a certain hour or after X amount of sessions to wrap them up and make sure that you've reviewed the, the charts and that they're good to go.
[00:14:13] Libby: You also want to send follow up communication. So sending a follow up email or message to summarize key points from the session, [00:14:20] can be helpful. And again, if you're using AI that can help assist in doing follow up, you still want to review whatever the AI generates, but that's going to help save some time and reinforce the client's commitment.
[00:14:32] Libby: So that's going to help give you both clarity on what to do and expect next in your relationship. Then there's billing and administrative [00:14:40] tasks, which can depend if you're insurance based or not. And. You might have heard, and I will reiterate that handling those tasks promptly can help decrease overwhelm.
[00:14:49] Libby: For example, if you're just starting out, or you're not full time, or you're not overwhelmed, or you don't have a biller, let's say, if you're taking insurance, you probably want to handle the billing the same day or the next day. And [00:15:00] if you're doing cash pay, you're going to want to make sure you're on top of invoices.
[00:15:03] Libby: Et cetera, on a very regular basis because they pile up and they can be really overwhelming. So you want to ensure that invoices are sent out and payments are tracked and that you have the necessary documentation Complete for however, you're receiving pay whether it's cash insurance panels or a combination [00:15:20] The common pitfalls can be delaying follow up communication or neglecting administrative tasks, because administrative tasks can feel not as important as the actual session, but that's not true as administrative tasks are important.
[00:15:34] Libby: They just feel a bit monotonous for some of us, and that can also lead to missed opportunity. So you definitely want to [00:15:40] create space in your calendar to have that communication with. Clients and make sure that you're following up with billing or, anything that has to do with invoices. So what I recommend is setting aside time after each appointment or every few appointments, if not every appointment, let's say every three appointments.
[00:15:57] Libby: So that might be a longer lunch break or some [00:16:00] type of, you know, block per day to send out follow up communication and complete billing tasks. So when you establish a routine that'll help ensure that the tasks are handled efficiently, and then you want to create effective workflow so that means standard procedures. And this happens a little bit more down the line.
[00:16:16] Libby: If you're already consistently seeing a lot of higher [00:16:20] volume of patients, you're going to want to establish standard workflows for managing appointments. So that's going to include preparing for sessions, conducting them and handling follow ups. So if you're listening to this and you're already doing everything, but not AI, then you definitely want to incorporate AI with your process.
[00:16:36] Libby: But if you are not already thinking about each step of the process, [00:16:40] then you want to start there. So typically we think about improving our standard procedures after we have done the process several times, and that can help you streamline and ensure consistency when it comes to client care. And also you can help you with saving time, right?
[00:16:55] Libby: And that's where I talked earlier about templates and asking similar questions that can really [00:17:00] create that standardization when it comes to client care. Now, you also want to think about using project management tools. Of course, you have to make sure everything's HIPAA compliant, or that you're honoring HIPAA laws, but consider using project management tools that can help track client appointments.
[00:17:13] Libby: You might notice that your EMR, like Practice Better, takes care of that. So you don't need anything separate, but it will depend on how you [00:17:20] set your practice up and what else you're offering in terms of services and products in your business. Here at Dietitian Boss, we use Asana and have been for years, and we love using Asana for our workflow.
[00:17:30] Libby: And a lot of our clients do use similar project management tools, but we also have other clients that just use their EMR like practice better, and that works for them just [00:17:40] fine. So think about your unique situation. Now, in terms of common pitfalls, you might be aware that not having a clear workflow, for example, process of what to do in a very common situation that can lead to disorganization and missed appointments.
[00:17:53] Libby: And that's not good. Cause you're losing out on helping people as well as income. So it's important to have a system in place, even if that system is still [00:18:00] in process of getting sorted out. Right? If you don't have that system completely dialed in, you still want to have something in place to manage client interactions smoothly and give yourself some grace, knowing that you can improve that process with time and repetition.
[00:18:14] Libby: So create and document your standard operating procedures, meaning what do you do regularly for client [00:18:20] management? So if you do use project management tools to track and manage your tasks and appointments Efficiently, that's great. Or if you're using your EMR that gives you an opportunity to project manage within the EMR, then you want to think about how does that workflow look and what can you do to improve it?
[00:18:36] Libby: Now, you also want to think about managing clients, billing and payments. So [00:18:40] setting up a billing system. So you want to implement a billing system to handle client payments and track invoices. You want to ensure that you have clear policies for payment terms and methods. And that goes back to what we talked about earlier with late cancellations.
[00:18:52] Libby: Late policies and cancellations and reschedule policies, and you want to have all of that in your terms and conditions or contract [00:19:00] when somebody first signs with you when someone before they book an appointment. Right? And then you want to track your payments. And this again goes into admin where you can pad in this time regularly in your schedule.
[00:19:09] Libby: So tracking payments means you're regularly tracking your payments to ensure that invoices are paid on time. On time, you can set up reminders for overdue payments and follow ups as needed for your clients. And you can make [00:19:20] sure that you're regularly reviewing your expectation for income and the reality.
[00:19:24] Libby: And this can be a little tricky when it comes to insurance because they can pay out later. So you just have to have some type of a tracking tool to make sure, you know, when you're getting paid. So a common mistake when it comes to billing and tracking payments to be not having clear billing system, which can lead to payment [00:19:40] delays and financial stress.
[00:19:41] Libby: So, I would suggest choosing a reliable billing and invoicing system that integrates with your client management software, which is really easy because a lot of the softwares out there, especially when we recommend practice better has integrated billing and invoicing systems. So, it's really just setting up your technology, and then you want to regularly review and reconcile your payments to [00:20:00] ensure accuracy.
[00:20:00] Libby: In conclusion, effective client management does involve careful preparation, but flexible preparation because it can depend on how smooth you feel with how long you need to review clients information and how you set up your day. Right? If you have 5 or 7 appointments. It's going to look different than if you have one or two appointments per [00:20:20] day.
[00:20:20] Libby: And if you're five years in, that's going to look different than if you're newer at seeing client sessions, or if you've just switched to virtual, there's going to be a learning curve as well. You want to structure your appointments. I gave an example of how you can do that and streamline how you structure appointments with your templates integrated into your electronic medical records system.
[00:20:39] Libby: You also want to have [00:20:40] some thorough followups and something that can help with that would include using the AI. Now that can mean you're using an AI system. Note taking chart charting that's integrated with something like practice better or there are other softwares out there as well that do the same job, but they have to be HIPAA compliant.
[00:20:56] Libby: So you definitely want to make sure you're doing your homework and looking at the technology you [00:21:00] have. Now, if you're not using technology yet, I would suggest using practice . And you can go to our website to find our affiliate code over on the show notes for this episode at dietitianboss.com.
[00:21:09] Libby: Now, by establishing clear workflows and managing administrative tasks efficiently, then you're going to enhance our client interactions streamline your practice. Thank you for joining today's [00:21:20] episode and we have another episode coming out about managing your office space.
[00:21:23] Libby: So I hope that you are going to tune in and listen to that one that will be airing soon. Thank you so much.
[00:21:29] Looking for support to grow your dietitian business or even get started, I invite you to join the library, our monthly affordable membership that shows you exactly what to do every [00:21:40] step of the way so that you can create the business of your dreams. Not sure if it's the right time, the membership gives you an option to.
[00:21:47] Go at your own pace. We have modules, a roadmap to show you exactly what to do and monthly live calls, as well as new content that we release every single month based on requests inside of the library. We [00:22:00] have four stages of business. So whether you come in getting started or you want to enter the membership and grow or scale your business, we have the appropriate resources for you.
[00:22:08] And our team, including myself available to answer your questions, head on over to dietitianboss. com and check out the library today. We'd love to see you there.
