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“Dear Dietitian: Eating Disorders, Private Practice vs Hospital Dietetics and Marketing”

We discuss eating disorders and our strategies on what we do and don’t do to support clients who see us as a result of an eating disorder. We also touch on our different methods if it’s just the client in the room, or if their parent or carers is with them during the consultation.

Private practice vs dietetics in a hospital setting. Peta shares why she chose to become a private practice dietitian in a hospital setting. Tyson also shares feedback from other dietitians and their responses to private practice vs hospital.

We share our tips on how we market ourselves as dietitians from what we look like, to how we communicate with clients and industry professionals plus more!

Total watch time: < 12 mins.

Full transcript:

Tyson: 0:02: Welcome to Dear Dietitian, where you ask questions and we answer them. This time, I’m going to ask the questions.

Peta: 0:13: It looked kind of creepy when you did that.

Tyson: 0:16: Because I’m excited.

Tyson: 0:19: Oh, I went out of focus a little bit, sorry about that. Alright, so question, when you are seeing eating sort of clients, do you have a particular strategy that, or approach, that you always take?

Peta: 0:40: A strategy in response to what?

Tyson: 0:42: So like, yeah, if the clientele comes in, is there a certain communication style? Is there anything that you ensure that you try not to say? Is there anything that you make sure you do say? Is there anything like across the board?

Peta: 0:59: Yeah. So I suppose a lot of it’s rapport building and initial gathering of data about what brought them here. What don’t I say? So really try to avoid the conversation around weight, directly gaining or losing weight. There’s a lot of different approaches as to how that should happen, whether the GP’s supposed to weigh the person, the psychologist, the dietitian. Generally for the most part because it’s out of my scope, I would never let them see their weight.

Tyson: 1:39: Out of your scope? Why?

Peta: 1:41: Depending on the methods. So some psychologists use a particular method where they get them to see the weight and they gradually become comfortable with the weight as being just a number or figure, it’s not something that they discuss their feelings and thoughts around it. Traditionally, and that’s a new thing, that’s actually an interesting concept, but I feel like it’s probably not my scope to be able then really get into that and I would obviously be referring them to see a psychologist at the same time. So yeah, I generally do a blind weight particularly early on when I know that they’re extremely uncomfortable with that figure, and I’m not there to be talking about their weight, because I’m there to be trying to improve their relationship with food, and trying to improve their nutrition. So I generally do a blind weight and avoid talking about it for the most part, particularly early on.

Tyson: 2:31: So when you do a blind weight, how do you respond to them going, “So what is it, tell me, is it good?”

Peta: 2:35: I don’t respond. They rarely ask that.

Tyson: 2:41: “Am I overweight?”

Peta: 2:43: Not with an eating disorder, they won’t say that, if it was somebody else without an eating disorder, absolutely, they would say that. Yeah, although they’ll be waiting for my response. So, it pretty much it’s just no response, it’s just, “Okay, no worries, step off the scales”, so no emotional response.

Tyson: 3:01: Do you find it hard sometimes to have no response? Like if you see a number on the scale? Or if you already just see by looking at them, that’s your response?

Peta: 3:12: Oh no, you can’t tell, it’s hard, hard to know. I’m sure I’ve had some sort of response and it’s probably facial, nothing that I say and I don’t find it difficult.

Tyson: 3:21: It’s a good thing she’s got an “RBF”.

Peta: 3:24: Yeah, that’s right, I’m practising on that, can you tell? So no, that will be the only thing that I do consistently for all of them, but each of them are extremely different, they all come in different reasons for why they’re here as well, and a lot of them have brought a parent, so that conversation can be really challenging, navigating that. I try to always talk to them, because the parent would generally be in there and so a lot of the time there’s that, you know, “She’s done that, she’s done this, she’s been doing these behaviours.” So it’s really difficult to make sure that you then don’t end up just having them a blind person in the room so I do try to engage them a lot in that conversation. Anything else I particularly do differently? So I don’t talk about a try-to-avoid, talking about food from an energy, calorie, protein point of view, and I rather try to just start to talk about food, and food for nourishment.

Tyson: 4:22: Do you do food for health, or just mostly just nourishment? Do you ever bring up the fact that they could die?

Peta: 4:31: Depends, sometimes, yeah. Some clients. Most of them have already, you know, depression, anxiety and even suicidal thoughts and even attempts. So, I guess that reality is there and I have had that conversation with plenty of people, but to be honest, doesn’t really matter for a lot of them, a lot of them are very high-strung, certainly very ambitious, and what about, you know, when it comes to themselves they don’t care. That is the true fact.

Tyson: 4:59: Okay, cool. Next question. So, why did you choose not to, or not interested in working in a hospital, as a dietitian?

Peta: 5:16: Oh yeah that’s easy.

Tyson: 5:17: Why?

Peta: 5:19: Because there’s no continuity. Particularly, not unless they’re chronically unwell. But even then, what I have to say in hospitals is probably bottom-feeder type thing, and generally people looking improve to their food and nutrition is not when they’re chronically unwell, so I find that our values, my value in particular was better suited for a community environment. I also didn’t like numbers, and traditional dietetic model is counting those numbers, and that is just not my thing. I have terrible handwriting, so writing into progress notes is, again, not a strength of mine. But look, to be honest. That’s my self reflection, but I wasn’t offered a position in a clinical, I didn’t want to move, and I don’t really have a passion to be anywhere. So, I just tried what I got offered first and on reflection, have never applied or gotten a clinical position, didn’t like supplements and all that sort of, doesn’t make my brain happy, so it’s just not a good space for me.

Tyson: 6:27: So many people apply for our practice job saying that, they don’t like hospital work because they didn’t get enough time with the client or that they feel like they’re not making a difference. But do you think it’s just the way you frame what you’re doing? Because obviously in private practice you actually have less time with the client sometimes.

Peta: 6:50: But yeah, I don’t think time is an initial, I just mean an ongoing…

Tyson: 6:56: Yeah, but I’m just saying to what new grads say, that they don’t really know anything else other than hospital and they go, “I don’t like that, I want to work in private practice because I’ll be able to see people more often.” It’s not always the case, I can see a Medicare client with a chronic disease, I’ll see them twice in a year and you’ll see them again next year.

Peta: 7:16: The other value is predictability in a hospital clinical setting which I get. You turn up each day, you have your list and that’s there, it’s already there, and you don’t have to work hard, and you know there’s no-show and if they’re not there they’re probably getting scanned or something and they’re gone. So that’s another reason why somebody might want a hospital clinical job. But I like all those differences. I guess that’s the main reason, deciding for me that was just the opportunity that didn’t present itself, but I’m glad. I really like bi-chemistry. So, you know, the changing…

Tyson: 7:51: So you like those numbers.

Peta: 7:52: Yeah I like to calculate them. I just interpret them, and they’re small numbers, I can deal with that. So I really like that sort of stuff. So really actually did have an interesting renal, and those various bits and pieces early on, and I probably could have made my place there, but again, didn’t happen. I’m happy.

Tyson: 8:15: Cool. Good. Another question.

Peta: 8:16: Hammering me today.

Tyson: 8:18: Well, you rarely get hammered. I’m usually the one individually. How would you market yourself?

Peta: 8:28: Very broad with your questions today, Tyson.

Tyson: 8:32: Well that audience is asking these broad questions.

Peta: 8:37: This is true.

Tyson: 8:39: Other than giving preamble like you tend to every single time.

Peta: 8:43: I like my preamble.

Tyson: 8:48: How would you market yourself?

Peta: 8:49: Well I do market myself. Okay do what do I do? What I look like is really important to that. So when I’m marketing myself, I make sure that what I’m wearing is at least, doesn’t have a rip in it, or it’s clean, it’s crisp, doesn’t require ironing because I don’t do it. You know, we do need to be seen as being relatively professional, clean cut, all of the above. Yeah. (That’s why you don’t go marketing yourself.) No, that’s true. It’s a real thing.

Tyson: 9:22: I do marketing! It’s just not too good with doctors, I’ve got to do full, long-sleeve, everything, button up.

Peta: 9:30: When I first met Tyson he was like, yeah, early on, he had these white, button-up shirts and he was sweltering.

Tyson: 9:37: I wasn’t sweltering. She just thinks, “God, is that like, choking you?” It’s called fashion, Wagga girl!

Peta: 9:44: I don’t know, it looked restrictive. I thought he was going to die!

Peta: 9:48: So what you look like, definitely really important. I don’t think taking a heap of resources and stuff to kind of throw at them is really valuable.

Tyson: 9:45: How you market YOURself. Not how do they market themselves. How do you market yourself?

Peta: 10:03 So, I tend to talk about what my interests are, what I’m good at, how long I’ve been practising as a dietitian, because that’s relatively valuable, particularly a lot of, you know, dieticians, probably early on there was a lot of new grads and certainly around here, so around here I do talk about my level of experience. I talk about our business and the collaborative approach that we have. I market myself as, so in terms of the skills and the things and the results that I get with clients so I would talk about, you know, things that I would do with clients, and then, you know, how my approach is better and different. I often ask them a little bit about clients that they see, what are their practices, who they’re referring to, and then I would use that to piggyback off why I’m better, I’m different, why I’m going to get better results. So a lot of it’s feedback from the GPs or the specialist, or whatever. But has to be really bouncing off conversation, I’m not just going to sit there and tell you why I’m good. So I often do lead in with a bit of discussion and just chatting and that, but I do tend to be very serious in those meetings. So, I try to have a little bit of light, particularly at the end or in between, otherwise it’s quite confronting and I’ve aware of that. But you only got a short space of time so you really got to make your mark really quickly. I probably talk too quickly, and I have on here. Been talking really quickly. But yeah, so, what do I look like, what do I have to say, my years of experience, what are my specialties, and why I’m better. There you go.

 

Over to you…

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