What You Need to Know to Start a Dietitian Private Practice

I was listening to a podcast this week (how I start every sentence lol) on how the obsession with productivity keeps us from living the life we want, and it really struck home. The podcast focused on the importance of receiving and how so many of us move from one achievement to the next, without taking the time to acknowledge and appreciate what we have accomplished.

This is completely accurate for me. I am terrible at taking a minute to stop and reflect on the progress I have made and accomplishments I have achieved, as I am so focused on moving on to the next goal or target. However, with the one year anniversary of launching my private practice, which coincides with the one-year anniversary of the Covid-19 pandemic I am making a concentrated effort to reflect on the past year. What a ride! 

I officially launched my private practice just over one year ago on March 4^th, 2020. A week before Covid-19 was declared a global pandemic, and three weeks before I returned to working in a hospital as an inpatient RD from maternity leave. So, pretty well perfect timing.

I can’t believe how much I have learned over the past year. My business has gone through a name change, two websites (the first of which I paid to have developed, the second which I developed myself with guidance from my amazing aunt) and changed from a sole proprietorship to an incorporated business. On top of the website design, I have fumbled my way through the business and legal side of things – accounting, invoicing, scheduling, incorporation, insurance, compliance regulations etc. Working full-time in health care, having a toddler, planning a massive renovation and launching a business in the same year has been stressful, exhausting and exciting. 

Overall, I am so grateful I made the decision to finally start this business, which I have dreamed about starting since the beginning of my career. I have made so many connections, formed amazing partnerships, and worked with so many dedicated and inspiring clients over the past year. I honestly can’t wait to see what the next year brings.

When I started researching the process for starting a private practice, I was discouraged that I could not easily find resources outlining all of the necessary steps to get started, as well as additional factors to consider. I wanted to write this article to provide guidance for RD’s in the same boat as me – interested in launching a practice but unsure where to start! So here it is, my Guide for Starting a Dietitian Private Practice. 

Note: as I am based in Ontario, Canada some of the regulations I reference are province-specific. The steps I discuss are relevant to all dietitians, however they may require tailoring slightly to your specific province or state. 

Lastly, it can feel very overwhelming when you are getting started, so focus on crossing off one step at a time and you will be ready-to-launch before you know it! 

This is just a high level overview of the steps required to launch a private practice, in no particular order. I plan on building on this guide and doing a series of ‘dietitian business’ articles where I go further in-depth on many of these steps, so keep an eye out for those articles and let me know if you have specific questions! 

Guide for Starting a Dietitian Private Practice

Step 1: Choose a Name

The first step, but one of the most difficult! Your primary consideration will be whether or not you want to use your own name for the business name, or use a completely separate name, ideally something that resonates with your practice and target audience. 

There are pros and cons associated with either option. For example, if you have a long-term vision of expanding your business beyond a private practice, or want the option of hiring employees or other dietitians to work under you, than choosing a name that isn’t your own makes sense. Additionally, if you want to sell products or differentiate yourself from your ‘brand’ than choosing a different name is a good option.

On the other hand, using your own name for the business can help to establish a more personal connection for clients with you and your brand. And it’s easy, since you already know your name!

Step 2: Register your business: Sole proprietorship vs Incorporated Business

Generally speaking, I would recommend launching your private practice as a sole proprietorship, and transitioning to an incorporated business when you have established profitability and the benefits outweigh the upfront costs. 

Registering your business as a sole proprietorship is a straightforward process that you can complete yourself, generally in less than an hour, and at minimal cost. If you are in Ontario, follow this link to search for, register ($60), renew, change or cancel a business name:

Benefits of sole proprietorship: 

• Simple and quick to register, affordable
• Provides more flexibility to make changes to your business
• Straight-forward banking. You can continue to use your personal bank account (if you choose) and you do not need to complete a separate tax return for a sole proprietorship (simple addition of a T2125 form to report professional income as well as your business expenses)

Incorporating your business

Incorporation means changing the format of your small business into a registered corporation. A corporation is considered a separate legal entity and therefore a significant advantage to incorporation is that is protects your personal assets. Incorporating your business can also bring authority and legitimacy to clients and consumers, and make the process of collecting payments and accessing loans and capital from different sources easier. Brand building and marketing can also be easier. Additionally, there can be tax benefits to incorporating, depending on how you pay yourself (salary vs dividends) and other factors. 

However, the process of incorporating your business is significantly more costly and time-intensive than registering a sole proprietorship. I would strongly recommend hiring a lawyer to navigate this process for you in order to ensure it is done properly (things like Articles of Incorporation and share structures were beyond my knowledge!). In my experience, the process of using a lawyer was straightforward and significantly reduced stress. The process took several weeks to complete and cost ~$2000 in my experience.  

Step 3: Choose a Client Management/Charting Software

This step is a MUST, and one that I made the mistake of launching without. A secure client management system is an invaluable resource, and it also ensures you are meeting college guidelines. The client management platforms listed below are compliant with PIPEDA (Canada) and HIPAA (US) privacy requirements.

These programs offer so much more than just secure charting. They also include client scheduling, invoicing, secure video conferencing and collecting payments. Using a client management software system is an amazing way to keep yourself organized! They also allow for sharing documents directly with clients 

Here are some popular client management platforms: 

• Healthie
• Practice Better (Affiliate Link)
• Jane

I use Practice Better and have been very happy with it. In addition to covering all of my charting and invoicing needs it allows me to share documents and messages with clients in real time, and for clients to input accurate food journals directly into the app for review on a regular basis. You can also use Practice Better to easily create and run through programs (including Evergreen!).

Step 4: Liability Insurance  

It is a college requirement for dietitians to have appropriate liability coverage. Additionally, you need to ensure that your liability insurance policy covers virtual care if you are providing virtual services. 

The College of Dietitians of Professional Liability Insurance Coverage Requirements state: 

A member engaging in the practice of dietetics shall maintain professional liability insurance coverage with the following characteristics:  

a. The minimum coverage shall be no less than $2,000,000 per occurrence. 

b. The aggregate coverage shall be no less than $5,000,000. 

c. The deductible shall be no more than $1,000. 

As a dietitian in Ontario, you can obtain liability insurance through one of the following:

• Dietitians of Canada (DC) offers liability insurance for its members. The DC insurance meets the College By-Law requirements. Contact DC for more information. If you are outside of Canada, consult with Prolink (DC’s insurance provider) to confirm whether they cover dietetic practice in the country where you are practicing. 
• A private insurance company. To explore your options, search online for “Ontario dietitian professional liability insurance”.
  • As I am not a member of DC, I did not qualify for the Prolink insurance policy, even after contacting Prolink directly to attempt to purchase private insurance coverage. I found the process of obtaining liability insurance through a private company somewhat challenging. In the end, I obtained quotes from two companies that were able to provide appropriate liability coverage: Zensurance and BMS. 
  • Note: I had to obtain a custom coverage package rather than using their more standard Allied Health package as the aggregate coverage was not high enough in the standard coverage.

Step 5: Virtual vs In-Patient

One of the first questions to answer when considering which services you will offer, is to determine how you will be providing your services. Will you be offering exclusively virtual services, in-person services, or a mix of both? 

To me, the decision to offer exclusively virtual services was a no-brainer, even prior to the pandemic. However, my situation may be different than yours as I was always planning on running my private practice as a side-business in addition to my full-time hospital position, so I was not overly concerned with appealing to 100% of potential clients and am not dependent on income from my private practice. 

If you choose to operate an in-person practice, you will need to consider the location of your practice. Will you provide services from a home office, rent an office space, or attempt to join a pre-established clinic (like a doctor’s office or physio clinic). Joining a pre-established practice may allow you to grow your clientele more efficiently, with reduced effort needed to market your services. 

On the other hand, there is increasing acceptance of virtual services. With the pandemic, online practice is becoming the new norm, even for health care services. Previously, there may have been concern related to patient experience or quality of virtual services, however in my experience virtual care offers a lot of benefit to both the client and the provider without any sacrifice of quality or experience. 

Benefits of Providing Virtual Services: 

• Lower overhead and startup costs. Rent is expensive, not to mention other expenses such as utilities, office supplies, and furniture. Particularly when you are launching a new practice and haven’t established profitability, it can be daunting to take on high costs associated with opening a physical location.  
• Less travel – for both you and the client! This improves efficiency and can save a significant amount of time in your day. 
• Convenience and flexibility – for both you and the client! 
• Increased access to care for clients. By providing virtual services, you open up access to a much broader group of client across your entire state/province – and potentially internationally. This means more opportunities for clients, as well as providing remote clients better access to services. 

Step 6: Determine Services Offered and Pricing

Once you have determined how you will be providing your services, you need to decide on what services you want to provide (i.e. packages vs individual sessions, group sessions, online courses, specialized services such as custom meal plans) and price your services.

Here are a few things to consider: 

• Packages vs Individual Sessions
  • Lifestyle change does not happen overnight. And one of the biggest benefits of working with a dietitian on an ongoing basis is the accountability factor. In order to provide value to your clients, ideally they are achieving results, which generally means ongoing follow-up and monitoring and adjustment of goals and interventions. 
  • Experiment with different package options. Consider time-frame (1-month, 3-month, 6-month packages) as well as number of sessions offered. Additionally, having a dietitian readily available to them for answering quick one-off email questions can be invaluable. Clearly communicate exactly what is included in each package and the benefit. 
  • Lastly, will you provide a free 15-minute discovery call? This can be appealing to clients who are wanting to connect with the right provider before committing to a package. It can also allow you to determine whether the client is a good fit for you and your expertise, or whether you should refer them to a different RD. However, be mindful that if you offer a free discovery call, some clients may try to take advantage of you and get a few answers to their questions without booking a paid service. 
• Pricing
  • Review college suggestions, google local private practice dietitians/other health care professionals. 
  • Price your services fairly based on market standards, but I would avoid providing a discounted rate to appeal to more clients. It undervalues your skills, and you will feel resentful over time. Additionally, it can certainly be done, but I would avoid changing pricing too often. You are better off pricing your services appropriately from the get-go, rather than increasing prices every few months as you gain confidence and clients, which can be frustrating to clients.  
  • Know your value! Don’t undervalue yourself in order to appeal to a wider range of clients. 

Step 7: Define Your Target Population

This step can seem slightly counterintuitive, especially when you are first launching your private practice and want to appeal to a wide variety of clients. I completely understand how appealing it is to want to target a very broad audience in order to increase the numbers of clients and referrals you receive. However, I would caution that the opposite is usually true. By defining a target audience or establishing a ‘specialty’ you actually provide credibility to your skills as an expert. It is very hard to be an expert in a very wide variety of conditions. 

Think of it this way. If I were a client wanting to seek out advice and custom recommendations for my IBS, I would go to a gut health/GI dietitian, I wouldn’t go to a general dietitian who likely isn’t an expert in this area. Additionally, by listing 10-20 (or more!) conditions/areas of ‘expertise’ you are setting yourself up for a LOT more work! It means you need to stay up-to-date on all of those areas, develop resources for all of those conditions, and be prepared to compete with specialist dietitians in those areas. Lastly, there are probably a few specific areas of practice that appeal to you that you are actually interested in. Why wouldn’t you want to specialize in an area of dietetics that you love and are passionate about! In my experience, I still receive plenty of referrals from clients in areas that I don’t list as specialties, and I see most of them. I work in a community hospital on four different units (ICU, medicine, stroke and mental health) so I am used to working with a very broad patient population and feel qualified in most areas of dietetics. However, if you receive a referral for a client in an area that you aren’t comfortable with, or that you simply don’t enjoy – don’t hesitate to pass along that referral to a colleague! Taking on clients outside of your scope, or areas that you don’t enjoy working with, won’t serve you in the long run.   

Step 8: Review Compliance Regulations 

Another very important step. Prior to launching your private practice, take time reviewing your regulatory college requirements to ensure you are compliant with all regulations. 

Examples of things to review: 

• Health information and record keeping requirements 
• Consent requirements
• Where you are allowed to practice (i.e. provincially, nationally or internationally) 
• Liability insurance
• Annual dues and college requirements 

When in doubt, contact a representative from your college and ask them questions! In my experience, I have always received prompt and helpful advice. They are there for you as a resource! 

A few notes: 

• In Canada, certain provinces require licensing in order to see clients within those provinces (Ontario, BC, Alberta and PEI). It may be an option to provide nutrition coaching, rather than practicing dietetics as an RD, to clients from outside your college. However, I would recommend clarifying this directly with your college before offering any nation-wide or international services.
• Ensure you are obtaining informed consent from your client for services, prior to initiating care. Create a consent form and post it on your website, as well as providing the form to all clients on initiation of services. Many of the client management software systems I discussed above provide consent form templates that you can use. Note: if you are providing virtual services, ensure your consent form covers virtual services and telehealth. 

Step 9: How Will You Track Taxes/Invoices/Payment/Expenses  

Once you have determined pricing for your services, you need to set up a system for getting paid!

A few questions to consider: 

1. How will you send invoices?
   1. The client management software systems mentioned above have invoicing and payment capabilities integrated. You can also use a separate accounting software system such as QuickBooks to send invoices. 
2. How will you collect payment?
   1. The client management software systems mentioned above provide the ability to integrate payment directly into the system. There are several other options such as accepting e-transfer, stripe, square or PayPal for payment. You can also use a separate accounting software system such as QuickBooks to receive credit card payment or Apple Pay right from the invoice.
3. Will you use a personal bank account, or setup a business account?
   1. I would recommend setting up a separate business account in order to separate your business and personal income. This can be super helpful to stay organized when tax time comes.  
4. How will you track expenses and tax write-offs?
   1. There are two options. Either you can track your expenses manually, hold onto receipts and create a spreadsheet for yourself to stay organized or you can use an accounting software system. Having a separate business account where you collect all payments and pay for all business expenses can help a lot to stay organized, and a separate accounting system may not be necessary. However, in my experience there are benefits to using an accounting software system which improve efficiency, such as directly uploading expense receipts, linking to your bank accounts and properly tracking and categorizing expenses. 

I use both an accounting (QuickBooks) and a client management (Practice Better – affiliate link) system. Although using both may not be necessary, as there is a lot of overlap in services they provide, for me the relatively minimal payment is well worth the increased efficiency. I use Practice Better to book and schedule clients, complete secure video sessions, provide access for clients to input food journals and for secure and confidential record keeping. I use QuickBooks for all accounting needs: invoicing, accepting payment and tracking and managing expenses.  

Step 10: Marketing

The last step, but very necessary to build your clientele and business! There are so many options these days for marketing your services. Choosing which methods to use, the amount of time you spend on marketing, and any financial commitments are completely your choice. You can always start with minimal marketing and invest more time and resources as you build your business.  

You have two primary options for basic marketing of your services; a website and social media. In my opinion, you should start with both, especially if you are hoping to grow your business. 

• Website
  • A website provides credibility, and is still the most valuable tool for clients to find you online. The majority of clients will find you through a search engine such as Google by searching something such as “gut health dietitian London, Ontario” etc. It is important to have proper SEO (search engine optimization) in place on your website to ensure you are searchable! 
  • A website allows you to list all services and pricing information in a way that is easily available to clients. 
  • You can post blogs, recipes and relevant research articles on your blog to help build your credibility and allow visitors to form a more personal connection with you – and make them more likely to book your services! 
  • You can add booking links to your website, and even collect payment through your website. 
• Social Media
  • Primary options: Instagram, Facebook, LinkedIn
  • Younger clientele may search and find you through social media instead of using a search engine to find your website
  • Posting regularly to social media allows you to build an online presence and connect with potential clients and other health care providers. 
  • Create business profiles on social media rather than personal profiles, which offer benefits such as being able to review insights and promote posts to reach a wider audience. 

Update: I can’t believe it’s been 3 years since I wrote this article. All of the above stands true as essential first steps in launching your private practice. The single biggest piece of advice I can give is just to start! It is not going to be perfect, and it doesn’t need to be – you will learn as you go. My biggest regret will always be not starting sooner. I have learned so much over the past 4 years since launching my practice. We are now a team of four dietitians providing virtual and in-person services at our clinic on campus at Western University. During this time I have had two babies, hired and grown a team, experimented with various paid marketing tools, completely revised my website, significantly expanded our services, incorporated the business and more. I have learned so much! As a result, I am now offering 1:1 dietitian coaching to help you get started on launching your private practice. There is no commitment and coaching is booked by the hour. I often help RDs get started on Practice Better, work on developing services/packages and pricing, creating forms, automating processes, invoicing, dealing with insurance claims etc.!