How to Start a Nutrition Private Practice: One Pediatric Registered Dietitian’s Story

March 14, 2024   |   Health Coach

Building a private nutrition practice as a registered dietitian (RD) practice isn’t easy, but it’s rewarding and much-needed. 

Although nutrition is at the heart of every area of healthcare, booking an appointment with an RD can prove challenging. Most licensed RDNs work in health systems, where appointments are booked months in advance. 

Starting a new nutrition private practice, either as a side hustle to your hospital job or full-time, can give you a more flexible work schedule as you provide valuable services to your community.

Betsy Hjelmgren, MS, RDN, CSP, LDN, is one of only a handful of pediatric dietitian private practice owners in the Chicago area. Like many business women with families, she started Feed to Succeed in 2008 as an alternative to the 9-to-5 commute and to keep her license active. 

Today, she and two other dietitians help children with everything from picky eating and eating disorders to nutrition for medically complex cases. 

Benefits of starting a private RDN practice

Appointment availability

Where Hjelmgren practices in the Chicago area, there’s a long waitlist for an appointment with a hospital-based dietitian –– as long as 4- 6 months. Appointment slots are booked back to back and can be rushed. Once you get in, it’s difficult to schedule a follow-up appointment. “There’s a real barrier to seeing a dietitian in a hospital system,” says Hjelmgren.

With three dietitians available at Feed to Succeed, new patients can get an appointment within two weeks and schedule follow-up appointments as needed. Urgent matters are handled even faster.

Flexibility in methodology and practice

Besides a flexible schedule, owning your practice allows providers to take ownership of their methodology. While large health systems can be slow to change, a private practice owner can adopt new methods based on the latest research.

“One thing I’ve learned through my practice and as a consumer of other healthcare is that hospital providers are tied to following a certain set of procedures and practices dictated by large health systems,” says Hjelmgren.

For example, when research showed that carefully formulated real food blends are healthier than formula blends for some children with a gastrostomy tube, Hjelmgren could recommend this option to families long before children’s hospitals in the area did the same. 

“I’m the most effective by being out on my own. I’ve been able to practice according to my training instead of somebody else’s fear or comfort level,” says Hjelmgren.

Continued nutrition support after aging out of early intervention

Many Feed to Succeed clients come from early intervention (EI). Once children age out of EI, some of them still need nutrition support, especially when they have pediatric feeding disorder

Feed to Succeed can support clients’ needs for as long as they need help. This can be through regular appointments or periodically when an issue arises.

More support for achieving positive outcomes

Nutrition patients tend to come and go in a hospital setting. Private practice affords RDNs more time to build relationships and provide follow-up support. “I’ve been able to work with families long term and develop a relationship that has led to seeing more successful outcomes,” says Hjelmgren.


Tips for setting up your practice

Providing patient care is the easy part of owning a private registered dietitian practice. Becoming a business owner takes time. “We’re not trained in business when we’re trained to do nutrition. And, like many of us, it’s not my personality to put myself out there,” says Hjelmgren.

Stepping into the role of CEO is something Hjelmgren has learned through experience. “We’ve changed it a lot over the years, and I’ve learned some lessons the hard way and in good ways,” she says.

Accepting insurance makes it easier to grow

One decision every new private practice owner makes is accepting insurance. In the early days, Hjelmgren only accepted private pay. As her ambition grew, she needed to accept insurance to grow her practice. “When I networked with physicians, the first thing they asked me is do you take insurance,” says Hjelmgren.

Referral marketing is easier than online marketing

In the early days, Hjelmgren built referral relationships by visiting pediatric practices. Once she works with a patient, she stays in touch with their other providers. This helps her reinforce existing partnerships. “They get to know your style, and they get to see your successes if you’re staying in communication with them,” she says.

EI is also a strong referral source because you are on their list of available providers once you work with EI patients.

Set aside time to work on your business

Hjelmgren sees patients four days a week and sets one day aside to work solely on the business.  “What I’ve learned about running a private practice is that I need to have my patient and business admin time defined and separate,” she says.

Find an insurance partner to support your growth

Registered dietitians and nutritionists both need professional liability insurance –– whether you’re working in a health system or a private practice. It doesn’t happen much, but there have been times over the years when something made me worried about liability,” says Hjelmgren.

Having the right insurance partner offers peace of mind.

Finally, Hjelmgren advises anyone who wants to build a private nutrition practice to go for it. “It’s harder than you think it’s going to be and more rewarding than you think it could ever be.”

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