Grow Your Dietitian Private Practice by Tracking These Two Metrics with Liz Abel
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[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.
I'm Libby Rothschild, the founder of dietitian boss, a fellow registered dietitian and business owner. And in our podcast, I share some 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.
Libby: I'm here today with Liz Abel. Liz is a licensed nutritionist specializing in women's health. Her work centers on helping clients build self efficacy and heal their relationship with food. Liz's practical approach ensures women feel better fast. The experience clients have when working with Liz or anyone on her team in Nutrition Hive is one of personalization.[00:01:00]
Everything she and her team does puts the client at the center of the work. So whether the client is dealing with period problems, tummy troubles, loss of anxiety or general feeling of blah, they help. Liz holds two master's degrees, one in nutrition and integrative health and one in communication with an emphasis on behavior change.
She also provides clinical supervision to graduate students who are working towards their nutrition certification. Liz never misses a morning walk and loves exploring farmers markets.
Liz, I'm so happy to have you here today. I was wondering if you could talk a little bit about being a co founder of Nutrition Hive and what lessons you've learned.
And if you could also share a little bit about, talking to new dietitians because they struggle differently. They have different issues than more seasoned dietitians.
Liz: Absolutely. Libby, thanks so much for having me here. I'm so happy to be here with you. So, Yes, I am a co founder of Nutrition Hive, but it's not the first company I've started.
I actually had the privilege of starting a nutrition [00:02:00] practice three times. So if you ever think that what you're doing isn't working, I don't really believe in the word failure. I just look at it as building blocks. And so I've had a chance to start a practice in 2012, and then I formed an integrative health center in 2018.
And then now the third round is Nutrition Hive in 2021. So I've been at this for a little bit of time. So for new listeners on the phone, don't be scared by that but know that the path that you set out for yourself may find bends and turns and curves and that is okay. I think a couple of things like really bubbling it up.
The things that I have learned is everything takes longer than you think it will and people will surprise you. In both good ways and bad ways and the more that you can continue to be open and curious, it's really, really, really going to serve you. I'd be happy to share a couple of, like, my most important tips in getting [00:03:00] your business started.
Sure. That'd be good. Yeah, that'd be great. I remember, it took me a long time in my first practice before I was willing to outsource it. Some of the work, mostly the virtual administrative work and the billing work and the marketing work. I was afraid because that was money going out of my business checking account, and then I maybe also sensed that I was going to lose some control over it.
And I waited too long to outsource. And so I would encourage you to think about the things that you enjoy. And think about the things that you don't enjoy. And chances are the things that you don't enjoy are the things that you should outsource. So if you are not staying on top of your billing, or if you don't enjoy marketing, those things would be fantastic things to outsource. So I think that's a really good lesson and do it sooner than when you're comfortable, because for every, you know, they say a full time [00:04:00] clinician is going to spend approximately 20 to 25. client facing hours. And so if you think about a 40 hour work week, the balance of those 15 or 20 hours are going to spend on administrative work, marketing, billing, et cetera, et cetera, et cetera.
And so the more that you can Give to someone else who you're going to pay less money to than what you would bring in if you had an extra hour to see clients. So again, try to get rid of some of the stuff, pay someone to do five hours. Just imagine if you paid someone to do five hours of work a week and maybe they, maybe they are a 25 or 35 an hour job.
That's probably going to just be one or two clients. for you to have extra that week to make that up and it's going to lead to less burnout. It's going to lead to greater satisfaction. So that's one of my earliest advices for setting up your practice.
Libby: Yeah, that's fantastic. And that's especially true for us dietitians, right?
Because I would say the control issue tends to be a theme [00:05:00] even more than the issue of wanting to being concerned about your bank account. So I just wanted to ask you, do you have any examples from your past about what helped you let go and outsource or maybe a challenging situation that you overcame.
Liz: Yeah. So way back when the EMRs are a lot better now, they're integrated with our e dispensaries. Back when I started my practice, the EMRs did not have a lot of like a task feature to remind yourself, to contact your client who fell and broke their leg and just needed a month away to deal with whatever she was dealing with.
And there was only drop shipping for supplements. So you had to go in and order those, Supplements to make sure that they were then sent to the client and then you had to build a client for that So those are some examples of things that really were just like Drowning me so the client follow up making sure clients are getting their supplements They know how to order making sure if you're doing functional testing that they know how to order the test [00:06:00] that they understand what that looks like. Marketing it could be as simple as I might want to do You the middle part of this work, but I hired a virtual assistant who helped identify gynecologists in my area that were like, you know, 45 minute drive.
This is when I had an in person practice, still a 45 minute drive from me. And then I would look at their websites and identify the gynecologist that I thought would be a good fit for the types of clients that I wanted. And then the virtual assistant put together like a mailer.
I am old school. I like to touch things. And also this is pre COVID. And then we would send it out. And then, Reach out to them and we get on the phone with either the office manager or the doctor themselves. So that virtual assistant provided some of those marketing services, coordinating time for me if I needed to talk to someone, making sure clients didn't sort of just get lost if they were on the calendar, making sure that billing was happening.
So those are some of the things that I needed help with that were my favorite things to [00:07:00] do.
Libby: Yeah. And I love that your example also is you said that they helped you with some of the marketing, but you were still there. So there might've been one piece of you know, four part project. Like they helped identify and draft perhaps an Excel sheet for you, but then you were the one that went in and visited and You had to practice that discernment to find out who would be a good fit.
So I think that's an important lesson too, because sometimes we try to overload the VAs and have them do the whole project, and I think it takes skill for us to decide what small pieces can we tease out, and that's where I would encourage us dietitians to be patient with learning that delegation and outsourcing and all of that is a skill that can take some time.
Liz: I think that's a great point. And also, too, we now have AI, which is a tremendous source. Always, we have to reference everything, and sometimes AI products sound like AI wrote them. But it can be really helpful for even just brainstorming or generating loose outlines and things like that, because I had another assistant who did more of my marketing work later down the road, and I had a strong email list at the time, and so she would [00:08:00] write newsletters and things like that for me.
But she couldn't just write them without direction. So I think to your point, as the owner of the practice, you have to provide guidance, their job is not to do all of the thinking for you.
Libby: Yeah, absolutely. And for those who are more seasoned, what tips would you have for them in terms of business tips?
Liz: Yeah. Get a great bookkeeper.
Libby: Yeah.
Liz: Get a great bookkeeper. If you don't like spreadsheets or don't necessarily understand or want to understand measurements, find someone that really does. If that is your like kryptonite, there are people who love spreadsheets because what gets measured gets attended to.
And so for the more advanced practitioners, it's really going to be important to understand where are your clients coming from? Are they coming from search engines, are they coming from your social, are they coming from referrals? What does that look like? And the reason why that's so important is, if you ever wanted [00:09:00] to expand your business, if you ever wanted to hire another, you know, clinician.
You're going to know if you ever wanted to put marketing dollars in where that's going to be best. And also the other piece that's helpful is understanding how many new clients you need a year to maintain your business. So if you've been in practice for a while, there's a couple of measures that I would recommend that you understand.
And one is your retention rate. So when you get a new client on average, how many sessions do you have with them? Do you have them for 10 sessions? four sessions, 20 sessions. And what is also your average lifetime value of a customer? Because if you really, really were to scale a practice, you need to understand what is that the marketing spend, the cost to acquire a new client.
And so you want to balance the cost to acquire a new client with what their total lifetime value is. So you might be willing to spend a little bit more money. on a cost on a acquisition cost of a new client if they have a [00:10:00] higher lifetime value. And this other reason why I think this is really important just alone from the metrics and I'm sure some people's eyes just glossed over when we talked about that but those are just a couple of key metrics. You don't need many more. The other reason is clinician burnout is a thing. I've seen it with clinicians on my team. I've experienced it when I was seeing eight clients a day, four days a week. Like it was too much for me. I didn't enjoy that level of work.
I can see four or five clients a day and feel like that is like just my sweet spot. And so We know from experience that working with a new client who you've never met before, and then the first couple of sessions, you're we're building rapport, you're better understanding what's going on with them.
It takes more effort in my opinion, in the first couple of sessions than it does in session five, six, seven, eight, nine, 10. So there might also be less burnout and more professional satisfaction. If you can work with clients. With a longer retention rate. So that's the other reason I think that that data set is really important [00:11:00] and again, if your average retention rate is 10 sessions per client, you need on average two new clients a week to keep a full time practice of that 20 to 25 hours of client facing hours a week.
Libby: Yeah. And that's fantastic advice in terms of what to really focus on. So thank you for sharing that.
And then also in a group practices who are listening, you're going to need to know that as well for your clinicians because that rate If you managing multiple dietitians, it's going to be different per dietitian. Well, you might have a group practice standard, right? So you might want to have a percentage group for the group practice and then I don't know if you judge your staff on that.
Liz: We absolutely do look at it. And the other reason we look at it, it's not just as a stick? The carrot is we sit down and we talk with the clinicians and we understand when you have a new initial consult, tell me what your thoughts are.
Cause we get really good as clinicians. When someone walks into my virtual office now, I pretty much know how long are they going to stick around, right? Am I going to be working with them in a year from now? Are they going to do three? three [00:12:00] sessions and be done and, and things like if a client, I don't know who this client would be, but as an example, if a client only has like early hypertension and that's all they want to work on, that really might only be five or six sessions versus if you're working with someone who has recovery from eating disorders, if that's your specialty, or you're working with eating behavior or working with women's health and a myriad of symptoms, that's going to be a lot longer.
So we look at retention rates with our. each clinician and we talk about each new intake because I also don't want to burn out my clinician. I don't want my clinician to feel like, oh my gosh, here's a client that I think is probably only going to stick around for three or four sessions, but I got to get to 10 with them.
And it's painful and torturesome because there's plenty of other clients that they're going to have that are going to be up to 20. follow up session. So it's not just a stick metric. There is an understanding and that also helps us know where are those really good client leads coming from.
Because then we match the retention rate with the marketing effort. So we get to see clients [00:13:00] coming from this particular gynecologist referral. Wow, they really do a great job and they stay with our clinicians 10, 12, 15, 20 sessions. And we're going to continue to then maybe are there other gynecology offices that we could work to build relationships with because those seem to be really good clients for our clinicians.
Libby: So that was the next thing I was going say is do you have different retention rates for let's say insurance versus self pay and then it's great that you're looking at the metrics because I know that the argument for dietitians is well, you know, I need a better lead source, right?
Liz: Yeah, and insurance sometimes can be tricky and depending on what state you're in and what insurance provider you're contracted with because they have such different, right? rules for lack of a better word, right? So, you might have a great client who really would like more than three sessions, but that's all their insurance pays for and they don't have the financial resources to be able to pay for more and it can vary based on the condition that the client has.
Libby: So, let me ask you, I can say Liz, in my [00:14:00] experience working with dietitians, I do not see a lot of them looking at these metrics the way that you're explaining. Is your experience the same? And, what does your process look like in terms of who has ownership for looking at those metrics and holding the clinicians accountable?
Liz: So that's my responsibility. And we do have a client coordinator who does a fantastic job. And I've always had some variation of a client coordinator through all of my practices.
Again, that was that virtual assistant was one of the first things I hired a few years after I started my first practice. So I've learned over the years what skill sets a VA needs to match my skill sets, right? I think that's really important. Know where either is you're not so good at or you don't really like, or you feel like you spend a lot of churn in it.
So my client coordinator, she's amazing. She's been with us for over a year. She loves Excel spreadsheets more than I do, which really brings me joy because she is able to pull [00:15:00] together All of that data. So some of that data we look at on a weekly basis, just looking at trends and then but every month we have a comprehensive data read out of what is going on and then talking with the clinicians, talking to Meg Bowman, my co founder, who was a guest previously, she runs the marketing side of the business, and so we sort of just look at where do we need to change things, what levers do we need to pull, what's working, what's not working, etc.
Libby: I think that's so helpful and I recommend that practice for any business owner to have a weekly and a monthly appointment with yourself with your numbers. Of course, those numbers can depend on where you're at in your business, but thank you for, for sharing your behind the scenes.
Liz: And can I add one thing?
Libby cause you said something so important. Yeah. Make your, make your appointment with yourself and Even if you don't have the data yet, that's okay. Spend that 60 minutes trying to get your head around the data. It might take you six months or eight months before you figure out what data [00:16:00] you're looking at.
But the, the longer that we just ignore it, the longer it takes for us to see what's going on. And all these old adages around what gets measured gets attended to, and you're going to better understand your practice, which is going to allow for greater success in your practice Just both from a bottom line revenue dollar and your own Mental sanity by again making sure that you're working with clients that maybe aren't contributing to burnout
Libby: Absolutely, and for those who operate a group practice, you know similar to yours What would you say are the biggest mistakes that you suggest avoiding or maybe pitfalls that you think dietitians should be aware of?
Liz: If you are, if you are a cash pay practice, have packages. I hope probably everyone's already doing that. I had a cash pay practice and then I started accepting insurance. And so obviously you can't have packages with insurance. But all of a sudden I made less money. Because I was not, I lost the skill set or the skill set didn't translate of how do I talk to insurance based clients about what that continuity of [00:17:00] care is going to look like?
And it felt very much like laissez faire up to them. When do you want to come back? Instead of saying, I'd like to see you every other week for an hour and our work together is really important. probably going to take at least four or five months together, right? And so once I learned how to use that language, I set expectations because a lot of people maybe haven't worked in private practice with a clinician before, so they don't necessarily know what to expect.
And this is not an analogy I typically use with clients, but we can talk about it here. It's the same as if you're going to go to a personal trainer, seeing a personal trainer once a month for an hour, three times is probably not going to get the behavior change that we know is going to drive results, health related results.
So helping set expectations of what to expect is going to be really important. So that's probably one of the most important things from a group practice, I would say, is make sure that your clients know what to expect and what that's going to look like.
Libby: Yeah, that's fantastic. Setting expectations.[00:18:00]
So, thank you for sharing that. And I think that's, really helpful in terms of thinking about the personal trainer and really you steering the ship, which is the same advice I give for when you're trying to sell, right? You have to lead them and guide them. If you're laissez faire, then they're not going to sign up because if you leave it up to them, they don't know, especially because nutrition is still so unknown in general.
They're just going to say, well, my doctor sent me, if it's an insurance based or if it's cash they're going to need your direction, right?
Liz: Absolutely and I have one other idea too for group practices because this can get complex because I'm guessing anyone who's listening and it has a group practice likely still has a client load and it might be acting as a clinical director depending on the size of your group practice, maybe there's someone else in your practice that's doing that, but it's also acting as a clinical director. And also there needs to be time for chart audits. right? How are your clinicians charting? So I'm making sure that you have crystal clear guidelines that you understand not only what OpenNotes legally requires, but that if you have specific [00:19:00] obligations based on your insurance contracts.
What are they? Some of them are kind of like, you're like, what do I have to do? That's interesting. Okay. And so making sure that your note template for your clinicians, is consistent and mirrors all of those requirements. Then if you ever were to face an audit or a subpoena or something like that, that you have to do, you don't have to panic.
Libby: Yeah, that's that's that's helpful. And speaking of operations, I would say that's an operational concept, right? And I think that is one of the areas that you shine. Right. And then operations is all the talking spreadsheets and numbers. What is your particular role with Nutrition Hive? I know earlier we spoke to you being the one to do, to look over the metrics.
Where would you say you shine the most? And did you know, where you fit best as an owner? Or what happened to help you in on the craft you have now?
Liz: Yeah, thank you. So I'm a second career nutritionist. So I spent my first career managing projects, people's [00:20:00] budgets. So, my strength is to set strategy and then to operationalize it. And it's really fun. I like both worlds because when you start to get into the nitty gritty of operationalizing things, you can start to see very quickly where strategy might need to be. adjusted or changed or redirected. So I really like both strategy and operational things. And I've always known that about myself because I had nearly 20 years experience in another field. So managing people, managing budgets, managing projects, managing spreadsheets, that is how I fit into Nutrition Hive. I'm responsible for all of the HR related activities, minus the hiring. responsible for all the liaison with the bookkeeper and the accountant, the legal teams all of the operational things that fall into that. Sadly technology, not my strength, but that still all falls into my responsibility. Sure.
Libby: What an awesome background that you have. Have you noticed dietitians seem to lack these skills or what have you noticed in terms of working in the field?
Liz: [00:21:00] So I think that that's a great observation. A lot of people, when they come into doing clinical work, if they did have another job, even jobs that are, I remember talking to someone that worked for me. She used to be a manager at a huge restaurant, like, off of the mall. So, the volume of people, I don't even know how big her staff , it was. It was such a hard job and such a stressful job and it was like when she transitioned and finally then became a private practice clinician, it was like she wanted to forget all of that it seem like it applied and it does apply, you know how to manage people's schedules, you know how to manage people's schedules.
People, you know how to look at what is going on across the your whole unit and so let's translate some of what you know how to do and apply it to this field. It might look different in terms of the output, but this logic and the thinking [00:22:00] probably has some similarities. So I would encourage anyone who's had any other job to be like, are there any skills from that job that might apply or ways of thinking that might apply to how I'm running my practice now and chances are you're going to find more than maybe what you are willing to believe.
Libby: Yeah, I love that and that just takes some reflection and that can be really helpful to give yourself some confidence because we have so many skills we just might not be aware of them or we might not lean into them.
Liz: 100 percent and this is totally goofy and not everyone is going to do it but this is also where your BFF or your mom, they know you really well. And you could also just ask about like, what are your personality strengths too? Because that might also help shape what you're really good at, and maybe give you confidence again that something that you're naturally good at might be just kind of the way you were born at with it.
You maybe didn't have to hone it, but you take it for granted and you don't necessarily recognize it's a strength. And when someone else can point it out to you, you might be like, Oh, I am really good at [00:23:00] X, Y, Z. Let me see how I can build upon that.
Libby: I love that. I think that's really helpful advice and I don't think it's goofy.
I think it might just feel bit awkward, but really helpful. I've done that. I recommend that. I'm also a fan of personality tests, but I think asking people that, you know, what stands out about you and what some of your strengths are, or just reflecting on feedback you've gotten throughout your life and at jobs can be really helpful to identify, am I more of a team player where you'd like you mentioned before You're really good at strategy and execution implementation.
And so you're so aware of yourself and then you've obviously been able to help your businesses grow and play that operational role that is so needed. I know that's invaluable for your practice. And that leads me to my next question. I know that in talking to make your co founder, she talked about you running some experiments for nutrition in terms of insurance, and that caught my attention and that's why I asked Meg if I could get to know you and interview you as well. So can you share a little bit about what that means for for the listeners?
Liz: [00:24:00] Well, I don't know exactly what Meg meant by experiments, but I have had my share through the gauntlet of working with insurance companies, right?
So there was one time when I first started out my career, they owed me, one insurance company owed me over 10, 000. So being prepared, if you are going to go the insurance route, especially starting out your practice Gotta have a little money in the coffers to help cover or float any expenses that come in because it sometimes can be a delay to get paid.
So I think as we know, we can't talk about explicits of this insurance company and this state. Sure. Gives me the rate. We're not allowed to do that. So some of it has just been a learning of what is this, what is this panel? What have they offered to me in the past? Do we want to stay credentialed with Oh, This was a good insurance company in this state.
Let's try it in this other state versus this company is only ever does three, three sessions per. Her client and it's low pay. I'm just, I'm not going to do them. So there's a lot of [00:25:00] I'll say trial and error with understanding which insurance companies you want to get credentialed with it. And it
Libby: all goes back to the customer lifetime value, because you mentioned at the top of the interview that what you're looking at the two metrics you need to know, all right.
Retention, customer lifetime value. You want to understand. Where are people coming from and how do you get people who will stay with you for a while? And so if you're able to eliminate the panels that might not fit the best or the referrers that might bring you The, leads that don't really pan out as well that can help your staff prevent burnout as well as help you, improve client care and bottom, you know, the bottom line of the business.
And I think that, doing that is not something us dietitians are familiar with. That is a business skill and it, it's a business skill to conceptualize but to implement that as an operational skill, right? Because you have to really look at, you know, 80 20 in your business. What's working, what's not working, and you have to let go of the things that aren't. And I think for a lot of clinicians, they're not willing to do that. What do you think?
Liz: [00:26:00] Yeah, I would agree with you. A lot of clinicians aren't because again, they see money going out the window, and that makes them very uncomfortable. And I totally understand. I've lived that. I've been in those shoes.
What's really interesting about the insurance model is there's plenty of dietitians and nutritionists who decide to do this for themselves. Once you crack the code, it's not complex. The code changes sometimes. It's frustrating. It's irritating. There are a couple of great resources that are well known in our community that can provide training and I highly recommend those people.
I've always had a biller. I've always had a credentialer. I have never done any of that on my own because I personally have zero interest in doing it. Even when I first started my company, always hired someone, I've hired multiple people. It is hard to find a really good biller. Sure. It's really hard, but what that allowed me to do, because I no longer was spending time on getting frustrated with. Why a claim, one particular [00:27:00] claim from one individual on one Friday afternoon didn't get paid. It allowed me to see volume and patterns.
Libby: That's beautiful.
Liz: Yeah, and I think that's what was really helpful for understanding the decisions that I've now made around insurance for Nutrition Hive.
Libby: And I have to admit that earlier on in my career here at Dietitian Boss, helping dietitians grow their business, I thought insurance was a nightmare.
I was so against the idea of, oh my gosh, all these headaches, this learning curve. And the more that I learn about insurance, I see that it's just like any business model you choose. There are pros and cons. Would you say that you think it's worth it? I know you just mentioned there are resources and it's a language you have to learn and when you learn it, that learning curve becomes a little easier. Do you think it's worth it?
Liz: It's such a great question and I'm not going to give you a clear answer. You talk about what I think the pros and cons are of it. So One of the things I learned through insurance is how to have better boundaries because with insurance, if the client is not in front of you, you're not billing for that time.
Libby: Sure.
Liz: [00:28:00] Oh, if a client, wants to message you on the EMR and ask you a question, it got really easy to say, I'd love to talk about that with you in our next session. Whereas when I was a only cash pay. practice. I felt like, oh, these people were paying for such a boutique experience and therefore I would be spending all of this extra time responding to different things.
And so even though I charged more in my private practice than my average reimbursement rate, I would say my hourly rate was about the same because I didn't have good boundaries because I was responding to all of this concierge type of stuff. So that was the number one thing that insurance taught me.
And as part of going through all of these different changes, at one point in time, I had looked at my individual, client referrals. And I had over a hundred clients in one year that all came from referring partners that I knew had a personal, that I had a personal relationship with, that I had invested time in.
And so [00:29:00] I was going to say, you know what, I'm going to stop accepting insurance and everyone can submit super bills. I, again, I know what the out of network, benefits look like around my area for the primary insurance. And I said, at least people can get reimbursed. They're just going to do out of network billing. And so I was prepared to terminate contracts or let contracts expire. And I had one individual, and I remember it so clearly, she was one individual who wouldn't have been able to afford the cash pay for my services, even though she likely would have gotten reimbursed.
She just didn't have the money to put on her credit card to pay for my services. And I thought to myself, Am I really going to make so much more money in a private cash pay practice than I am going to take in an insurance if it's going to help people get the care they need? So, I made the altruistic decision that I'm going to keep insurance panels because it allows people to access the care more easily for what they really need. So that's then the pro of insurance. And do I pull my hair out? And do I scream? And I can't even tell you [00:30:00] all the things you know that can be, you know, the horror stories are true, but it allows people to access care. And so I don't think it financially, one is not better than another, unless you're living in a very, very, very affluent area but most of us don't. Sure. So that's why I like it.
Libby: Yeah. And thank you for sharing that. And I love that our listeners have the ability to practice discernment and make this decision for themselves in terms of if they want to take insurance or not. You know, that's a big question that dietitians ask at different stages of their career.
And I do think it's important to be honest and share your stories as well as, Hey, you might not get paid right away and having money to save in your business or to use towards expenses is a good lesson to keep in mind, right? That's smart.
Liz: And one of the other spreadsheets that I would encourage everyone to make you can probably get off of the Google template is make yourself a budget.
Libby: Yeah.
Liz: How much does your website hosting fee charge? Yeah. What are your state or village or country, county taxes? What does it cost [00:31:00] to renew your website? Professional license. In your state, how much does CEUs usually cost? Right? How much does your cell phone cost? How much does your EMR cost? How much does your computer cost?
Like all of those things that you need to run your practice. And the average, it can vary. I've seen it as low as five and as high as 10%. But I would say the average fee to have someone do your billing is 7%. Yep. So you can also factor in 7%. To your budget. And that'll help you determine how many clients hours do you need to work for the income that you want?
Libby: I think that's so practical. for sharing that. I love being able to share your mind and the way you think with the listeners. I think that you have such an incredible background. So for those of us that might not have the same background as you, or haven't yet Set an appointment with themselves to review the numbers are still trying to wrap their heads around key metrics in their business.
In addition to asking our friends and family, what traits about us stand out, right? You [00:32:00] mentioned that earlier. What do you think a dietitian can do to become more operational minded?
Liz: There are so many now. Terrific low cost or no cost. Courses, I think I just saw that was at Harvard that just like it was more specific to I think computer engineering, but there are Coursera.
There are so many free resources out there. I highly recommend that. And I believe, depending on your state and the CEUs that your state requires, some states allow for professional business development to count for a small number. So I just redid some CEUs for, for, and five, five CEs were allowed to be for that business building.
So there are probably business building CEs that you can find as well that could be really helpful and beneficial.
Libby: Yeah, and I would just go as far as to say if you're operating a business, whether it's, you're getting credit or not, like, you have to learn this stuff. Because you cannot operate a business if you don't wear all these hats.
Like, if you, you just can't. [00:33:00]
Liz: And there are also some scores. There's a not for profit that has in a lot of your big cities. I don't know if I have that right. Where they have essentially retired business people who help small businesses get off the ground.
Libby: problem with a lot of those is that they're very old school, so they don't understand.
I think that's helpful, but whether someone's running a virtual business, want to be lean I've, I that don't quite understand it is to run a business. are still the same. Score is a resource here in Dietitian Boss, we have resources for the listeners. I know you guys have resources. But in terms of what I would say to teach someone operations, and I know this might be a little bit obvious and people might not like this answer, but it's just to like do it and to be open to setting a percentage of your time, if you're looking at a pie chart, like think of your time in terms of what are you doing that is going to help you from an operational standpoint, which includes budget numbers, et cetera.
Liz: And I [00:34:00] love this because I think a lot of people when you're in business for yourself, you might suffer from a fixed pie mentality. The reality is there are enough people in this country. Who need nutrition services. We are not going to run out of people per dietitian nutritionist, right? So sure there is not a fixed pot There are plenty of people who need your services and so you are not in competition with every dietitian nutritionist out there
Libby: Yeah,
Liz: if you can find some build a mastermind group Bring your data sets together.
Talk about it. Maybe you need to be from different states. Maybe you need to be in the same state. I don't know, but there's nothing wrong with having a group of humans that are all sort of going through it. No one is supposed to be the expert, but you're, getting through it together.
You're bringing your data set, you're sharing, you're discussing, you're learning from each other. Again, because We're not in competition with each other. There's not every clinician is the right fit for every client. Sure. So we've got plenty of people to help. Let's see how we can help ourselves help more people.
Libby: I [00:35:00] love that. My last question here, Liz, before we wrap up would be, what is your philosophy on putting the customer first, but also achieving a profit?
Liz: Yeah. So putting the customer first is always an interesting idea because sometimes customers do not come first. My clinicians come first.
Libby: Yeah.
Liz: Okay. I have had to get on the phone a few times, not many, but a few times in the past few years to let a client know that we will no longer be providing services.
Libby: Yeah.
Liz: And the second that a clinician contacts me and asks me to do that, no problem. I'm going to do it because I have my clinicians back because I know them. They've worked with me. Again, it's only happened a couple of times.
So it's not like once a month a clinician is saying this client is not a good fit. No, it's been inappropriate language. It's been refusal to pay bills. It's been all sorts of ridiculous things where they're not going to be. the right fit for the business. And so the customer is right. until they're not.
So I just was looking at [00:36:00] someone else's cancellation policy. It was really interesting. So we have a cancellation policy. We give everyone a snow day because life happens, right? And, and life happens on our end too. We document if the clinician has an emergency too, so that it feels, it feels balanced.
And then we do bill for missed services. I saw recently someone's cancellation policy that if you cancel more than three times, just like no more, you don't get to use this service anymore. I'm not saying I would be that extreme because we're seeing these people on a regular ongoing basis. Life happens but I think getting crystal clear about where your boundary is, is going to help you decide. When the client is no longer, right?
Libby: Yeah, that's, that's really helpful. And I love that. And again, it goes back to looking at the bottom line of your business. And if you are there for your clinicians, then you're really focusing on teamwork and collaboration.
And obviously you have to look at the situation. But thank you for giving that particular example about what you saw with the cancellation policy and boundaries and all of that. And they're decisions we have to make as, as owners and practice [00:37:00] and see, What fits with our values? How do you reinforce it?
How do you train it? How do you have staff who's on board with it? And all of that stuff. As we wrap up today, this has been an absolute pleasure Liz having you on and sharing your brain and the great work that you do with your company. Is there any last words or anything you want to share with the listeners?
Liz: I'd love to let listeners know the other thing just briefly about me. My first career was in communications and behavior change. So one of the things that we excel at is behavior change at nutrition hive. And so much so that we've, we've taken our behavior change expertise and we now have a health coaching program called nested and it is targeted on behavior change and only credentialed wrong word, excuse me, licensed healthcare providers or like a healthcare provider seeking licensure are able to enroll.
So, unlike a lot of the other healthcare coaching program where they'll take anyone and everyone, we don't. We only focus on those people who are already healthcare providers and we believe that this [00:38:00] behavior change element is what also drives that retention rate, which is critical to your bottom line.
So, Nested Health Coach program could also be a great way, it does include CEs obviously could be a great way to help grow your bottom line by ensuring that your clients are sticking around for longer.
Libby: Amazing, and where can our clients learn more about that? We'll put a link in the show notes, do you want to also let them know where to find that information?
Liz: Yeah, nestedhealthcoach. com
Libby: Awesome. All right. And then as we wrap up today, Liz, if you want to just mention where people can find you and then our show notes, we'll have all of your information.
Liz: Yeah. The best place to find me is probably at nutritionhive. health nutritionhive. health. That's the best way to reach out to me and find me.
And thank you again so much Libby for your time today. I really enjoyed sharing my thoughts. I appreciate
Libby: it was an absolute pleasure. Thank you so much for spending time with us.
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