The private practice sector has seen a dramatic increase in dietitians in recent years. The total number of Accredited Practicing Ditetitians (APD’s) working full-time or part-time in private practice listed with the Dietitians Association of Australia (DAA) increased from 772 in 2007 to 868 in 2011. This sector currently represents 29% of the total DAA membership (Ball, Larsson, Gerathy, Hood & Lowe, 2013). 

Brett Parker, a second year Nutrition and Dietetics student at Griffith University on The Gold Coast, decided to try and find out exactly what the world of Private Practice Dietetics was really like, and what attracts dietitians to this sector. Brett contacted two private practice dietitians on the Gold Coast. The first, Kelly Bright APD, Sports Nutritionist & Exercise Physiologist, is the proprietor in her own business, and the second, Janita Averay, APD works at Marie-Claire O’Shea Dietitans within a team of 4 private practice dietitians.

1. Firstly why did you decide to become a private practice dietitian? 

Kelley: “I originally studied as a naturopath on the Gold Coast. Later, I realised I wanted to branch out into sports nutrition, so I went to Southern Cross University in Lismore and studied exercise science. I then worked in that industry for a while at Armadale University running the university sports program and then outdoor education for about 5 years at Golden Door Health Retreat and Camp Eden running the fitness programs. I then went back to Griffith to do my Masters in Dietetics. 

Personally I did not find (being in a hospital setting during university practical’s) particularly rewarding. I didn’t feel as though I was being as effective as I wanted to be and I didn’t feel I was using all the skills I had learned.  So, when I graduated (as an APD) I went to work for Amanda Clark at Great Ideas in Nutrition on the Gold Coast for about five years. I really learned a lot there and “cut my teeth”.  Amanda taught me everything to be able to go out own my own, which is what I decided I really wanted to do. I then went out and found my current spot and thought to myself “this is perfect”. I have been here for 4 years now.

Janita: “The opportunity to utilise a large range of the skills I learnt at university is just amazing. In one day I might see a fussy toddler, a newly diagnosed Coeliac, a Diabetic and someone for weight loss! It is always a lovely surprise to see who might walk through the door next. I love being able to specialise in a range of areas and the challenge of keeping up to date with all areas of clinical nutrition. I also love the flexibility of choosing my own hours and working in range of different environments.”

2. What is different between working in Private Practice vs working in a hospital setting?

Kelley: “I did my hospital prac at Tweed Hospital and my food service prac at John Flynn hospital. That was my only experience. I think it is a great starting point to learn the ropes, but it is very different to what I am doing now. I think it really comes down to the ability to connect on a regular basis with your clients, whereas in a hospital setting you would see them once, maybe twice and you really aren’t making much of an impact on their lifestyle. Even as an outpatient you might see someone once and you would never see them again. 

Janita: “In my opinion, the flexibility of private practice is a stand out. I choose my working hours, my breaks, my holidays, my working days and locations.  

The variety of work is another significant difference.  Our occasions of service and our case mix far exceed those of our hospital peers. And in QLD with our ‘changing’ public sector, private practitioners are called on more and more to provide acute post hospital care, further adding to our variety”.

3. Could you please describe a typical day?

Kelley: “I work Monday to Friday (and generally) I can elongate people to fit from 7:30 in the morning till 5:30-6pm at night. I also do a day a week of Veteran’s Affairs. I usually get in around 6:30am and spend half an hour reviewing the clients I have for the day (before I start seeing anyone). I might slot in one of my Veteran’s Affair’s visits (If there is a cancellation or a gap). I also see doctors (to maintain referrals). I have aligned myself with the psychology practice across the hall and once a week we go to another medical centre and we take lunches for the doctors and introduce ourselves. I also do one day a fortnight at another medical centre. I am not really sure why I do that, but it just seems to be a habit I have gotten in to over the last few years! I think it is just for a change of scenery! I don’t take any set breaks, so if I have a couple of cancellations I’ll zip downstairs and grab something to eat, but I can go a day, get in, put my head down and just see as many people as I can. Oh yes, and by the end of the day, there is a stack of bookwork that I have to enter in!”

Janita: “We do a fortnightly cycle that includes aged care work, medical centre work, food service work, CPD, meetings with reps, nutrition presentations and more. Every day is different!”

4. How do you find clients?

Kelley: “I was very lucky to walk into a medical centre that has an incredibly good referral base. That really was just luck because there are many dietitians working in medical centre’s where there isn’t a lot of work being generated. Aside from referrals and speaking with doctors, I get a lot of word of mouth clients, which I think is really important. If you do a good job the word disseminates. I also get a lot of other referrals from this area as I am not located inside of the medical centre. As far as they are concerned, I am just in the building; I don’t have a connection with another medical centre. This really helps my business.”

Janita: “The bulk of our patients are referred by GP’s”.

5. How many hours do you spend at work, or typically in a working week?

Kelley: “I work Monday to Friday. Generally I get in at 6:30 in the morning and start seeing clients from 7:00-7:30 in the morning till 5:30-6pm at night”. 

Janita: “The working week can vary from dietitian to dietitian. In our team, we often work up to 40 hours per week, however some of us choose to work a 4 day week only, while others choose to have a later start and some like half days so they can go to the gym or enjoy the wonderful Gold Coast. Flexibility… it’s great!”

6. What advice would you give for a student considering a career in private practice (as in, what could they do during their degree to give themselves the best chance of success for getting into the industry or starting their own business)?

Kelley: “Previous work experience. Again from my own background, I would recommend get as much work experience as you can and preferably from a variety of backgrounds. If you are interested in private practice, try and work for a week in a practice. I was really lucky that I spent a few weeks with Julie Albrecht after I graduated. Also having a previous work history shows that you have a good work ethic. If you want to do (as in, start your own) private practice, make sure you work for a good private practice dietitian, learn the ropes, learn what to do before you go out on your own, but then again, you may decide you don’t want to go out on your own. It is really hard! I would certainly not recommend (establishing your own) private practice unless you are prepared to do long hours, and put yourself out there to generate work. Otherwise I would recommend that you work for someone else or work in a public setting.”

Janita: “From a clinical point of view; students should take the opportunity to learn as much as possible while they are studying at university! We see patients for anything and everything in private practice, so to have an excellent knowledge base is essential.

It would also be important to understand the role of the dietitian as part of the allied health team, get familiar with the dietitians working in the community where they are working and start to build relationships/network with health providers in the area.”

7. If you were looking to hire a new graduate, what sort of qualities would be most valuable to you? For example: university grades / qualification, any related experience, personal attributes, volunteering experience and so on.

Kelley: “I think determination is key. If someone says “no” to you (regarding work experience), you ring them back a month or so later and try again. You have just got to be really determined and really want to work in the place you are contacting. When you are young you don’t have anything greater than anybody else except your level of determination to not take “no” for an answer”. 

Janita: “As well as an excellent knowledge base, the ability to communicate well and build relationships/trust with both patients and the health team is essential.  We look for dietitians that show an eagerness to learn, attention to detail and a friendly manner.

Developing relationships with other health providers is essential, so we look for someone who loves the Gold Coast and is willing to or has made this their permanent home. Unfortunately, unlike other positions, locums are not so attractive to us in private practice”.

 

References:

Ball, L., Larsson, R., Gerathy, R., Hood, P. and Lowe, C. (2013), Working profile of Australian private practice Accredited Practising Dietitians. Nutrition & Dietetics. doi: 10.1111/1747-0080.12015