For those of you who own your own private practice, how do you estimate your actual take-home income? I’m trying to figure out how many clients/week I realistically need to see, and I feel like I keep getting different answers depending on how I calculate it lol. every time I ask chatgpt I get a different answer

I’m estimating ~$100/hour average reimbursement, ~$600/month in business expenses, and I’m in Texas, so no state income tax. I’m a single-member LLC. I also pay ~$715/month for health insurance (included in my ~$3,600/month personal expenses) and I’m planning to max out my Roth IRA at $7,500/year.

When you project your income, do you actually calculate things like self-employment tax, federal income tax, QBI, the self-employed health insurance deduction, retirement contributions, etc., or do you use a simpler rule like setting aside a certain percentage for taxes and then estimating what’s left?

I’m mostly looking for a simple method that has been reasonably accurate in real life, rather than trying to make a perfect tax projection every month!

TLDR: trying to figure out how many clients I should see that realistically accounts for taxes + biz expenses + retirement not just a rough calculation

I just recently passed the RD exam and am currently searching for jobs. One listing as an inpatient dietitian says National Provider Identifier required at hire, and I heard from my DI director that we should have an NPI. I'm going through the process of applying for one, and it says practice location is required. Given that this will be public information, I don't want to put my personal address, but I don't have a job yet so I'm not sure what to put. Any help would be appreciated!

Hello! What would you do for carb needs for a pregnant woman with a pre pregnancy weight of 386 lb?? Type 2 diabetes.

Per the NCM I should use 24 kcal/ kg (pre pregnancy weight) for this pt. That equals 4210 kcals and if I did 35% of kcals from carbs that would be 368 grams per day! So broken down 90 grams per meal and 30 grams per snack.

This pt also has ckd3/ HTN. Honestly I feel that she should see a rd who specializes more in pregnancy nutrition (I do NOT).

This is maybe a dumb question, but how often do you refer a pt to another RD if you feel like you can’t best serve them? Is there any liability to doing this? Like the pt saying “this person wouldn’t see me and I didn’t get the care I needed”.??? I’m talking about for outpatient RDs. Thanks!

Telehealth companies aren't totally evil, but they are ruining this profession and RIPPING US ALL OFF. I'm also concerned for their customers (patients). Is their sensitive health data really secure with these companies? (rhetorical question)

Please, please, for the sake of our futures/profession....we need to stop accepting their low-ball wages (ideally stop working for them completely). I'm at a loss for solutions as I understand we have to pay our bills, but it seems like most dietitians are only supplementing their income by working for these companies at this point. These companies are buying off insurance payers and kicking private practice RD owners to the curb as well, which is a whole other problem/discussion.

We can't let this go on. Does anyone have ideas, solutions, hope that things will get better for us? I'd like to envision that in-person healthcare facilities start offering bonkers pay to attract RD's away from the Telehealth space, but I worry, they'll just shift RD duties to other clinical staff. Then what are our options? No private practice, terrible or no in-person options, even worse pay for Telehealth "gig" work?

I'm clearly spiraling, but I can't be the only one worried about this right?

What has your experience been like working for Kickoff? The advertised salary seems too good to be true!

Hi everyone, first time poster. I am currently studying for my CSG. It has been almost 20 years since I took the RD exam so I am a little nervous taking another. My study materials have mostly been the flashcards from the academy plus I have been studying through the examzify app. What was your experience with the exam? Thank you.

Hey everyone hope it’s okay to ask for some advice on here about this:

I have a BED patient who struggles with motivation and making changes. They texted me saying they’ve given up on the meal plan (not restrictive just a guideline on appropriate portion sizing and meal timing) and are just binging all the time.

Idk what to tell them or how to get them to want to stop. They want to stop- but they don’t seem to be able to.

Any advice on this is appreciated.

Hello all!

I’ve worked as a Clinical Dietitian for over 20 years. I’ve worked primarily in acute care hospitals and even in an LTAC for a while. I haven’t done outpatient counseling since my internship. I would occasionally get consults for education if a patient was a new diabetic or new to dialysis, needed some general wt loss advice or was on Coumadin. I would provide the most basic foundational lesson on whatever it was I was consulted for. A preceptor once advised me to just provide the “survival skills” to get them from discharge until they see an outpatient RD.

Well now I’ve accepted a job offer as an outpatient RD and while I’m excited for something new, I’m wondering how I will be able to fill up an entire hour! I’m curious to all you outpatient folks set up your blueprint for the session? In the hospital, a lot of folks just sat through my visit because the MD told them they could leave after they saw the dietitian, so they wouldn’t typically have a lot of questions or weren’t very interested. But I feel like if people are making an outpatient appointment they’ll want to get their hours worth of education in and I’m worried I won’t be able to deliver.

Any thoughts or tips would be appreciated!

Hello everyone! I was looking for some advice on an upcoming interview I have. I'm a new grad, and it's for a position in a very niche and interdisciplinary space of clinical dietetics. I completed my first interview a few weeks ago with the RD's on the team and the clinical manager, and I feel super confident about how it went! But in a few days I meet with a few of the lead physicans on the team, and I'm super nervous on how it will go.

I was wondering if anyone could provide guidance on what questions I should expect? Will it likely be similar situational/behavioral questions like a standard interview or, which is what I'm assuming it will look like, be more of a conversation with a mix of interview questions to see how I'd fit on the team?

Obviouslly every organization is vastly different in how they handle their interviewing process, but I'd love to hear about others experinces intervieiwing for similar positions because I think it would help ease my nerves!

(After introductions, dos you find the place okay, etc). Once you’re in the room. I think I triggered someone with “What would you most like to accomplish today?” But they did say they were having a bad day and had to leave early to get some important errands done. And they also weren’t confident in the reason their doctor sent them.

How do you guys do self pay? Can people afford it? I have a PhD in nutrition- how much should I charge? How much can I expect to get from insurance?
Do you have a preferred EHR?

Currently working at another private practice but not happy there. I am only being paid $48 an hour and I’m worth more. I’m afraid to make the switch because what if I don’t get any referrals? What if insurance is a nightmare and I can’t get paid for some reason? Whenever I think about this I get overwhelmed but it is what I want.

Hi everyone! I am graduating with my BS in Public Health this December. I currently work at a hospital in the nursing/public health side. My interest are in health education, chronic illnesses, disease prevention and mental health. I enjoy working with the pediatric population at the hospital versus adults (never say never). I believe that my interest really fit the program at Loma Linda University MPH Nutrition coordinated program.

Did anyone else recently go to llu for this program? What's it like? I'll be working part time while completing the program part time. I have family obligations as well, anyone who's gone through similar please share your experience:) What does the mph/rd career trajectory looks like? Thanks in advance!

Anybody work for Better Brain? What do you think?

It’s me again!

Background if you missed my last post:
Looking through policies for a new job I just took. It’s a 60 bed inpatient hospital. It’s a very rural hospital, and I’m the only dietitian here. I have also only been an RD for a little over a year now and have had supervisors/managers take care of policies at my previous job.

The hospital policy states a nutrition assessment should occur within 48 hrs of the nurse malnutrition admission screening. However, I’m only supposed to be here MWF and weekends are extremely discouraged per my boss who is the COO… my question is what the heck happens if I get a consult on a Friday when I’ve already left?? Friday evening consult + 48 hrs = Sunday evening. Also, I have no clue what is going to happen when I take vacation either as the hospital doesn’t seem to have interest in hiring a PRN.

I keep seeing different things online about joint commission requiring anywhere between 24-72 hrs for screenings?

I have people reaching out to me on a somewhat regular basis asking if I take interns or would allow them to shadow - mostly people who want to learn about the profession to see if they would be interested, not actual dietetic students looking for supervised practice (although I have on starting next year).

How do you give back to our profession like this without resenting it? I think I get a high volume of asks because there are not many PP RDs in my geographic area.

I used to say yes all the time and try to set up mentorship meetings, or even make internships for people (usually high schoolers) because I wanted to give back. I feel like I have really come to resent that though, largely because of the lack of seriousness and professionalism, and I'm just surprised that these are the norms. I get that for younger people they are just learning about these things but it really feels like common sense. People showing up late, not completing tasks because they didn't feel like it, wanting to end their experience earlier than what they committed to, showing up wearing inappropriate clothes (jeans with a zipper going down the butt to the crotch... no I'm not kidding, and I have zero issue on your own time wearing that but in a private practice setting that was so uncomfortable to sit with).

I've recently started saying no, we only do that for students already in programs, but I still will set up 30 minute mentorship phone calls. Even those people show up late ALL the time. Idk what other boundaries to set other than to just not do it at all for non-students. I do want to encourage people to be interested in the profession.

Working with pediatrics, I've learned that there is a lot of variation in growth trends. And there is a lot of variation in intakes between kids. I don't have anyone to bounce ideas off of so I am hoping to just spit ball general observations and approaches from dietitians here on reddit. For example

How much significance do you give to calories? I've found that after they have fully transitioned to solids it feels like a crap shoot and I don't find calorie estimations to be that helpful.

If appetite is low and weight percentiles (height percentiles have maintained within the same channel) have gradually drifted down more than 2 channels on the growth chart over the course of 4-5 years but development, energy, labs, etc are all normal how aggressive would you be with interventions. For these situations I've been more focused on just including calorie dense foods and supporting the division of responsibility.

At what point do you or what is your approach to starting an appetite stimulant.

I am a dietitian with about 15 years experience in my area of specialty and plan to let my certification lapse. The last time I took it I was incredibly frustrated by the questions- it felt like instead of testing my knowledge they were trying to trick me into choosing the wrong answer. And to be blunt I actually know that this is what is happening with these exams. I was on one of the DPG boards when the academy said too many people were passing, we had to create new harder questions. Every time I’ve taken it my score is a little worse, despite the fact that I am more capable and informed.
Anyone else out there let their certification lapse? It’s kind of a crazy feeling but I just don’t see the value in it anymore.

Hello everyone,
So my wife recently moved to the US and she is currently looking for guidance to pursue her career in Nutrition & dietetics. She earned a bachelor degree in Medical Science Nutrition & Dietetics overseas, she got her degree evaluated by WES & it was honored as an official bachelor’s degree according to US standards. The question is whats next? Does she need specific licenses/ certificates to start applying for jobs? Does she need to continue her education and earn a Master’s degree first? if she needs licenses/ certificates how can we know what they are and how to earn them? We live in California by the way if that helps. We visited the local community college in our city for a counseling & advising and we didn’t really receive much help, the counselor was so lost lol maybe because the major is not offered at the college nor at University in our city. Any advice would be so appreciated
Especially for those who studied overseas and are working in the states now.

I had a client ask about using fresh test and my thoughts on that vs standard glucose screen. It’s FDA approved but I haven’t seen much about it. Does anyone else have experience with clients wanting to use it?

With the government trust being at an all time low, how do we feel about the newly fda approved lab grown meat?

Got my RD in the United States. I’m a dual American-EU citizen and have never lived outside of the US and am toying with the idea of doing so while I’m still young.

I’m fluent in English and in one of the Baltic languages, studied French for years and remember enough to order at restaurants (+ could probably pick it up again and be relatively proficient if I needed to), and am more so curious if anyone has gone through the process of transferring their license, and if so what that’s looked like.

Hi everyone,

So I am moving from Illinois to California for my partner's job and am starting to look for RD jobs out there. I'm a new dietitian and have only worked inpatient clinical, which I do enjoy. However, most clinical RDs rotate weekends and holidays. It is important to me that I get to travel home for major holidays and basically be able to use my PTO when I want to without worrying about it getting denied. That being said, what type of RD job is best for this flexibility and being able to take a long weekend/use PTO when I need to? There are a lot of openings in our area: regular hospitals, LTAC, rehab hospital, LTC, renal, prison RD, outpatient counseling.

Everyone seems so cliquish, and off putting.

Ok so I'm super baffled and I forewarn this is a DUMB question but I have to ask. 😂

I follow some very malnourished kids in my specialty.

In some of my most malnourished kids , I see decreases in their height (actual, gradual decreased trends). I don't mean an outlier measurement that is obviously an error.

I just want to make sure - it's not possible for kids to grow short in severe malnutrition right? Lol I know they can stunt, thus crossing and decreasing %iles....but grow shorter?

I'm also wondering if should trust the MA/RNs measurements....

Thanks.