[00:00:00] Some of the private practitioners thought that they need to untrain themselves from their university study to then retrain in the private practice domain. And I guess that tells us something about the work of private practitioners, which we don't have a lot of evidence on and now we have more on, but the work is, is a bit different.
[00:00:16] We still have those, we need to have strong clinical skills. There's a huge cancelling aspect of private practice, that's really important and obviously you're wearing a business hat as well.
[00:00:30] Welcome to How to Build a Profitable Nutrition Business. If you love nutrition and you love helping people and you want to be in the game long enough to keep doing that, then this is the podcast for you. Let's get into it.
[00:00:44] Today's guest is the amazing Jennifer Donnelly. Jen is a dietician and PhD candidate at Swinburne University. Jen has undertaken some really exciting research that looks at how prepared new graduates are for private practice and how that can impact the industry. If you're a [00:01:00] nutrition professional passionate about the private practice landscape, then this is an episode you're not going to want to miss.
[00:01:05] Let's get into it. Welcome back to another episode of How to Build a Profitable Nutrition Business. Today I'm really excited to have a guest who is Jennifer Donnelly, who is a lecturer in the Masters of Nutrition and Dietetics at Swinburne University. And Jen has just completed some research which is very much needed in the private practice space for nutrition.
[00:01:25] And Going through the research, Jen, I'm sort of speaking ahead of the questions here, but I wished I was you, like, being able to talk to all the dieticians in this research was just fascinating and I've loved reading what you've found and the findings, so I'm really excited to get into it today, so thanks for coming on.
[00:01:43] Thank you so much for having me on, Chris. And I just want to also thank you for the exceptional work you do in this podcast. Our students actually benefit from the expertise and knowledge that's shared through this podcast. So thank you so much for that. Oh, awesome. Thanks for saying that, Jen. It's good to know that people are out there [00:02:00] listening other than my mom.
[00:02:01] Actually, my mom doesn't listen. They are. So let's go into the origins. What motivated you to look into this area, this really important topic? Yeah. So I'll take you back a bit. So I, so I started my career as a medical laboratory scientist. So I trained a bachelor of applied science, laboratory medicine. I did a diploma in business frontline management at the time because I had an interest in business and leadership and management.
[00:02:28] I thought maybe one day I'll use it. Okay. So I worked for about eight years or so in the UK and Australia, and then a bit of a health issue came up and I had to change careers. But behind that, I was feeling like I wanted to work directly with patients and clients. So it was something that was burning there anyway, which, which was a good thing.
[00:02:48] So I did a graduate certificate of human nutrition and then a master of dietetics. I was a mature age student. When I trained, we didn't have any exposure to private [00:03:00] practice that I can recall. We certainly didn't do any business training, no placements, very minimal cancelling education at the time. This was about 11 years ago when I finished.
[00:03:11] And I needed, you know, regular income, so I was looking for a hospital job. Like everyone else, I guess, not everyone, but many, um, that the trend at the time was to go into hospital. And that didn't happen for me straight away. It did happen down the track. And I, silly, I thought maybe all these transferable skills might give me, might look good on paper to a future employer in the hospital.
[00:03:36] It was really fortunate that I obviously had good clinical knowledge from my previous career as a medical scientist. It wasn't previous, I actually maintained working as a scientist at night. On the evening shift for a good probably 3 or [00:04:00] 4 years. post graduating as a dietitian. So the road was not easy.
[00:04:04] I built my private practice up, worked in multiple clinics, but eventually I really just needed a stable income. I had a young family, all the expenses that come with that. And so I continued to pursue the clinical work. So I, at one stage I was driving to the country for five hours to work in a rural hospital in the hope that I would get a job in the tertiary, um, Sector in Melbourne, which I did very quickly, but striving to the country working in private practice and working nights as a medical scientist.
[00:04:36] It was a bit in a young family. And a young family. So it's a bit hectic. But I got there in the end. Um, I have been able to maintain a private practice work throughout my clinical work. And then once I, you know, worked for some time in the hospital environment, I was looking for something different work.
[00:04:54] I worked as a clinical trials coordinator with St. Vincent's Hospital Melbourne, a fabulous department [00:05:00] there, a cardiothoracic surgical research team, and really honed in on my research skills. And then I thought, well, maybe I can do a PhD. Maybe that's possible for me. So I had the opportunity to do some teaching work.
[00:05:16] With Swinburne, which is a dream, it's something that I always wanted to do and it's such a privilege. But then the beauty of doing a PhD in private practice dietetics is that our students benefit from that real time translation of research. So the work that I do in my PhD gets translated to our students in real time.
[00:05:41] So I think that is extraordinarily rewarding, but I guess the other aspect is that the issues that I faced with the lack of training that I had for private practice appeared to be anecdotally still there 11 years later. There is and was a [00:06:00] perception that preparation for graduates into private practice is.
[00:06:05] still inadequate. So I wanted to explore that in my PhD and see if we could find some answers. So that's really a long story, but that's the reason why I decided to do a PhD this space. I can't think of anyone better to do this PhD listening to your backstory there. Some business training for a start, but someone that really Was in the trenches early on trying to build a private practice to feed their family, essentially.
[00:06:28] So it's, I agree. I had a similar experience. It's like at uni, I think we might've had one or two lectures about business. It wasn't much, we recommended a book to read. In fact, is my memory of it, at least. Hit us a while ago now, but it was then I worked in the hospital setting and then four years later went into private practice.
[00:06:50] And essentially I was a new grab when it come to private practice because I was blind to it. It was like, and the hospital setting was actually detrimental for me. I found Because the hospital setting you had more [00:07:00] time, there wasn't, you wanted good outcomes for your clients, but a lot of it was bedside, so there wasn't the follow up as much, and there wasn't that pressure to get results for your clients and make sure they were really sensing value out of your consults.
[00:07:13] I found my hospital experience, I had to quickly get out of that, to be honest, I had to really quickly adapt and change and then get a private practice mindset going to make it workable. Yeah, I think that's something that came out of our study was not just experience in the clinical setting, but also the training some of the private practitioners felt that they need to untrain themselves from their university study to then retrain in the private practice domain.
[00:07:39] And I guess that tells us something about the work of private practitioners, which we don't have a lot of evidence on. And now we have more on, but the work is, is a bit different. We still have those. We need to have strong clinical skills. There's a huge cancelling aspect of private practice that's really important, and obviously you're wearing a business hat as well, so [00:08:00] you need to know how to run a business to be successful.
[00:08:03] Yeah, absolutely. And it was, for me, it was, like you say, you needed both. And where I set up our private practice, I needed to be a generalist dietitian too, like you needed. Because any business coming through the door, you wanted to make sure you were doing no harm and providing value for the client. But you needed to be across everything clinically then at the same time.
[00:08:22] Keep the lights on and make the business run. Jen, what were some of the things you found through the research that some of the skills or attributes that were missing in the training that would really benefit new grads coming into private practice? Yeah, so just to give you a bit of background on the study.
[00:08:38] So we interviewed 16 experienced private practitioners across Australia. We completed semi structured interviews and we looked at all workforce development aspects, right from training all the way to when private practitioners leave the profession, if they had or hadn't left the profession and why. But I guess some of the key elements [00:09:00] or probably the biggest theme is what the private practitioners reported that were underprepared for practice as a new grad.
[00:09:05] And obviously that's similar to our stories. But in terms of that, it was the same sorts of things. Business training was very minimal to non existent. They had very little exposure to private practice. There might've been a half an hour lecture or a two hour lecture where some. Someone came in to speak about private practice.
[00:09:25] Even cancelling skills was an area that wasn't very strong in their education and preparation as well. And very few had private practice placements and if they did it was generally self sourced. So the students had to go out and find their placement and it might have been only for a shorter period of time as well, so maybe a couple of weeks at most.
[00:09:47] So these were key gaps in their training from their perception. Yeah, it's interesting. I, and I could be wrong here. I, my memory of placements was that the [00:10:00] universities do remunerate the hospitals in some capacity for placements. Is that correct? Yeah, so in some states, definitely. Yes, they get renumerated.
[00:10:10] It's not a lot, but it's definitely a little bit. Not a lot, but I'm thinking as a business, as a private practice, there's a revenue opportunity. I always enjoyed having students and I found most clients were okay with a student coming on board. So I'm thinking placements in private practice, is that landscape changing?
[00:10:31] So we are exploring that at the moment in the work that I'm doing, so I'll be able to get back to you on more of that down the track. But there are definitely a lot of challenges to having students in private practice, which universities are definitely trying to navigate. Certainly, some universities do have private practice placements.
[00:10:53] We don't at this stage, but it's something that we're We really want, we're just trying to look at how to make [00:11:00] that work because obviously we have our competency standards that our students need to meet to graduate. We have accreditation standards that our courses are accredited by. All of these factors need to be considered and I think in the study as well, what came out was, it was a bit of a mixed view on, uh, students in, uh, private practice placements.
[00:11:24] So some were very supportive and did, uh, have, uh, students in one to two week placements. Um, but some did talk about aspects of client burden. And how can we charge a person? a client and have a student present. There's also some limitations around funding as well. Some of the health insurance, they don't actually provide funding for students to be in a consult.
[00:11:54] So there are a few challenges, also the duration of placements as well, because a [00:12:00] lot of our placements at university sort of range from five to 10 weeks. So just navigating. some of those elements, which, but as I said, it's very front of mind and something that we're actively looking at. And we'll be open to if anyone's got any ideas and willingness to take on students, please let us know, obviously.
[00:12:19] It's an interesting topic because I've been in some chat groups where even the mentoring side of it, some of the dietitians feelings there are about being remunerated for giving up an hour a month when they're in private practice to mentor. And some of these dietitians were taking on four students because it's a, it's a, requirement in the APD program for someone to do some mentoring for 12 months, but there's no remuneration for it.
[00:12:44] And I don't know where I sit there. I can see their point of view, but I also see it as giving back to the profession. But yeah, it's an interesting topic, particularly when you factor in placements as well. Yeah, I think it's a challenge. And I think there's obviously talk of aspects [00:13:00] of internships or micro credentials as well, better support for graduates going into private practice, whether the APD provisional program is adequate, it's all under discussion.
[00:13:13] That being said, though, like, we do have a subject called entrepreneurial dietetic practice in our course. So, we cover things like entrepreneurial mindset, we get our business school to help us teach some business finance, our students hear from private practitioners around billing models and models of practice, we delve into marketing, social media, we're bringing in some more media training this year, we talk about health insurance systems, so there's a lot more from our university perspective.
[00:13:43] We have a. We have a more than we had. We're always building on that though. And we, so that's a semester equivalent, whether we need more than that is something that we need to explore. Um, but you spoke to Sophie Horton some time ago, one of our [00:14:00] graduates, and she's She's doing really well in private practice in sports, dietetics as a new graduate.
[00:14:06] So that's a good sign. She had multiple mentors, so not just one. So I think that's really important for our graduates to have multiple mentors, particularly when they are going out into private practice. So you might have a business mentor and you might have. The private practitioner, you might have someone in the clinical setting.
[00:14:22] So I think that's a very important factor for graduates to consider. It's not just one mentor. Consider having multiple to support you and having a network of people around you. And this is no disrespect to other universities because I don't, I haven't looked into the course curriculum of the other universities for 15 years but Swinburne seemed to be at the forefront when it comes to private practice and I would hope that other universities are providing something at least similar because I was going to say that interview I had with Sophie and we were talking about the Swinburne course and it sounded amazing.
[00:14:59] I [00:15:00] wish we'd had something like that when I was going through university. Yeah, so we are doing some work to look at the curriculum across the country. I can talk about that in the future, perhaps, but I know that it's definitely front of mind for many universities. So I think it's not just Swinburne. I think universities generally are really acknowledging the fact that we actually have 30 to 50 percent of our graduates entering private practice.
[00:15:24] So we need to ensure that their training is adequate. Um, do you, do you have any data about, and sorry to put you on the spot with this cause you might not have it, but. Like, in terms of the, the volume of graduates coming out now compared to say a decade ago, because I know there's a lot more universities on board compared to when I graduated, so we've got 30 to 50 percent going into private practice, but has the volume of graduates increased as well?
[00:15:52] I think the volumes definitely increase. I don't have specific numbers, but there's obviously a lot more courses. I know when I studied, there was only two courses in Victoria [00:16:00] and now there's, I think, five or five or six. So, um, quite a few more here just in Victoria, let alone the rest of the country. So there's definitely, there's more courses than ever before.
[00:16:11] Yeah, right. So that 30 to 50 percent that are going into private practice, I know you looked into the research and there were particular reasons why someone might land in private practice. Did you want to discuss that? Yeah, so I guess we are seeing, and again, there's not any particular evidence at this point in time, but we observationally observing that our students are coming into the courses wanting to go into private practice.
[00:16:35] So that's a good thing. So their mindset is in the private practice space. And whether that's. from social media or nutrition being a really big area of interest to the public, generally speaking. So that's something to consider. But then there's also our graduates that perhaps obviously the workforce is highly competitive and getting jobs is extremely challenging.
[00:16:59] So [00:17:00] sometimes they are entering obviously via default. So in this Um, in my study, obviously, we had that, we had our experienced private practitioners talking about the fact that they, some had the intention of going to private practice, others ended up because they couldn't get a clinical job and so ended up by chance.
[00:17:21] Others, I think, also. Ended up in private practice later on, like yourself as well, where they found a niche, they found a gap in services. So they were working in the clinical environment and they found a gap in the service delivery and very smartly took that as an opportunity to build a business around filling that gap.
[00:17:44] So I think that's. Pretty amazing. And obviously that's the whole idea of working in private practices. We want to take the burden away from the tertiary sector. Lena Brake is a fantastic example of that, isn't she? The food feeding dietician. So that was [00:18:00] born out of necessity, wasn't it? Absolutely. The brilliant, brilliant mind.
[00:18:04] And there's others as well, though. There's others as well that we interviewed. So yeah. Yeah. I don't know about you, Jen, but I, I loved private practice, and loved private practice compared to my time in the hospital. And I had a great team at the hospital, worked with amazing people, but I love the innovation side of private practice.
[00:18:23] Where we're bound by evidence, but then the rest of it's up to us. You know what I mean? Like you can provide services, and I just love that. I think, yeah, I mean, I don't know about you, what's your experience with your, what you thought about private practice? Oh, absolutely. Because I worked in private practice before moving into the clinical environment, and admittedly I did move quite quickly into the clinical environment, but not completely.
[00:18:48] It was some time before I worked full time, but definitely things like my cancelling skills were well developed and that really helped me in the clinical environment to build connections. [00:19:00] quite quickly. So I think, and you're making decisions on the run as well in private practice, you have to be good at building connections and developing plans that work well for the patients as you go.
[00:19:11] So I think there are a lot of benefits from. Private practice. But I guess something that came out of our study is that I think what I found really inspiring speaking with the private practitioners in the study was that incredible entrepreneurial mindset that they had, the incredible work ethic that goes into private practice.
[00:19:33] I don't really think we fully appreciate how much work private practice is. And running a business. I'll also the drive to succeed and find the answers. So leaving no stone unturned. I think that's really was really inspiring because they obviously had a lot of challenges given that they weren't fully prepared for private practice in their training.
[00:19:57] So they had to. Work it [00:20:00] out. So whether that was through networking and mentoring and serendipitously meeting people that helped them, but also that drive and passion and motivation and the desire to help and the desire to grow their businesses as well and often with huge challenges. So we had private practitioners talk about driving hours to gain volunteer experience.
[00:20:24] We talked to practitioners that had been bankrupt, but then rebuilt their business and were booming. We met private practitioners that had sold their business with enormous success. So they had statewide, nationwide, and even international businesses. So I think these are some of the things that we don't talk enough about in our profession, but these are enormous.
[00:20:46] and achievements, uh, that we should be really proud of. Well, you identified in the research that need for adaptability or some resilience, which I think is, is a really important asset to be taken into private practice. But [00:21:00] talking about those serendipitous moments that you mentioned, it's, I, I think with private practice, You're on all the time.
[00:21:07] Your mind never switches off when it comes to your business. Yes, you've got a family and everything else, but if it's a hospital job, and I'm speaking from my experience, I finish work at a certain time and I can then switch off and not think about it mostly until the next day. Whereas when it's your business, you're open to opportunity all the time.
[00:21:26] So you're always thinking and always on thinking about your business, which opportunities then come from, don't they? Absolutely. I think the work ethic is, is something that really I get excited by. I think it's just so inspiring. Some of them are working at 16, 20 hour days. And that's not ideal, obviously, but it's business.
[00:21:46] It is what it is. And the people that work in this space, all credit to them. Yeah, yeah, 100%. I always have said I'd rather do 12 hours for myself than 8 hours for someone else. Because it's, and [00:22:00] it's just that you get to see, you enjoy the fruits of your labour a lot more in terms of seeing the outcomes of the business thrive.
[00:22:05] And I think that also that's something that our generation coming through are quite attracted to, the flexible nature of being self employed. Obviously. needing to understand the work that goes into that. But this day and age, particularly post COVID, people are looking for more opportunities to make their own hours and work for themselves or develop their own.
[00:22:29] Yeah. A hundred percent that you've got that flexibility, particularly when you've got a young family, you can go to the kids parades or whatever it may be. Yeah, no, it does offer that. Jen, with new graduates coming through into private practice, what did the research identify? Like, I'm thinking as a new grad just starting a practice, and I think of my experience, the type of service I provided, and even the, the charging, like I, I initially would charge a gap on private clients and then, but all the children, concession card and aged pensioners [00:23:00] would, I would bulk bill.
[00:23:01] And then what I found is that there was only about 30 percent of my clients. It's coming from Medicare from doctors that I was actually charging a gap. So I just started bulk billing everyone and then my business kind of exploded, but that doesn't mean the profit was there. It wasn't until we built our privates and DVA and NDIS sort of clients that we started to become more profitable.
[00:23:21] But with new grads starting, is there that sense that they shouldn't charge much or are they undervaluing their services because they just lack that confidence? What did you find with that? So I guess, so this was an interview with experienced prior practitioners who are Many of them employing graduates.
[00:23:39] There is a feeling that's happening that graduates are undervaluing and undercharging. I guess I can only speak from Swinburne's perspective in the sense that we are definitely changing that mindset in the sense that we get, we actually had Jodie Sheridan come in and talk about billing models and we are demonstrating to [00:24:00] the students that there is places for bulk billing and concession rates and all that sorts of things.
[00:24:05] But in terms of business sustainability, we need to charge hours and they're doing five, five, six years of training to become dietitians. So we are experts in the field. We do a lot of university training, so we really. focus on that message of valuing your worth and coming out as graduates and charging accordingly.
[00:24:28] But being mindful, obviously there are places for bulk billing, as you mentioned. So I, well, in my experience, I'm seeing graduates coming out and charging appropriately. That's something that's shifting now from our education, but across the board, it's, I don't have the evidence at this point in time to tell you that's happening across the board.
[00:24:50] Um, Jim. Yeah. Okay. That's good. It's can certainly be an issue. And the other factor with that then is if someone is, is seeing a [00:25:00] dietitian that may not provide the service they expect, then it can undervalue the service as well. And then put people off the field of dietetics on doing some side research at the moment, which is not, it's not official research.
[00:25:15] So I'd love to talk to you about it, but it's about the, I've just got a questionnaire. questionnaire that I've sent out as widely as I can. And it's actually about that value perception of people's experience with seeing nutritionists and dietitians and naturopaths and even personal trainers. What are the things that they received and what was their average cost and what was their rating in terms of a sense of value.
[00:25:37] And so it's really interesting to see some of the feedback come from that. I like, I'm still collating the data, but maybe you and I can talk about that at another time. Definitely. That sounds like a brilliant study, Chris, so we should definitely talk. I probably should have got your mind behind it to really fine, fine tune the questions.
[00:25:54] But anyway, it may be a stepping stone for further research down the track. So Jen, [00:26:00] I appreciate your time. I'm just going to ask you one more question and this is just to wrap up. Okay. So from all of the research that you know, you've put together in this really important area, if you could implement one change moving forward for our profession, what would it be?
[00:26:15] I think we just need to continue to build in the relevant training for our graduates, um, moving into private, students moving into private practice. I think we need to keep building on that across the country. So not, you know, Yeah, we're, we're doing our bit, but we need to be adding more in ourselves. We need to diversify our placements as well.
[00:26:39] Exploring, we are exploring that at the moment, but I think that is something that we need to be looking at in deep detail so that we can offer the experiences that are relevant to the jobs that our graduates are entering. So that's, they're probably from an academic point of view, they're the key areas that we're working on for sure.
[00:26:59] Well, [00:27:00] I mean, it's just reassuring for me to know that the next generation of graduates coming through are certainly being directed in the right way. So that's a big thank you to Swinburne and yourself, Jen, for commencing this research and doing further research in the future. Thank you so much for having me on.
[00:27:17] Now, Jen, if anyone wants to follow you on LinkedIn, is that okay if we put your profile in there? And that way they can keep up to date with all the research that you're putting out. Absolutely. Thank you so much. All right. Thanks, Jen. Nice. Have a good day. Bye. Do you find this podcast valuable? There may be other nutrition professionals out there will also.
[00:27:36] If you like, share and subscribe, it's going to help other nutrition professionals make an impact on the world, just like you. Thanks.
