Employing a Registered Dietitian Nutritionist at Physiotherapy Associates of Georgia

Kelsey Higgins, Steven Pham, Michelle Giang

Georgia State University
Abstract
The purpose of this study is to determine the
feasibility of hiring a registered dietitian nutritionist
(RDN) as a part of Physiotherapy Associates of Georgia.
Population: Current Physiotherapy Associates of
Georgia clients from 27 clinics in and around Atlanta, as
well as RDNs in the southeastern United States who are
members of the Academy of Nutrition and Dietetics.
Design: Longitudinal case report. Outcome measures:
Based on responses from clients and RDNs, we will
analyze client interest in various nutrition issues, type of
programs to implement, clinician annual income,
reimbursement rates, need to travel, and experience of
RDN.

Methods
We designed an anonymous and voluntary one page
survey consisting of questions related to nutrition interest.
Our goal was to distribute them to Physiotherapy
Associates clients from 27 of their clinics across Georgia.
Basic demographic information was asked such as sex and
age range, as well as whether or not they had medical
insurance. The remaining questions pertained to interest in
nutrition counseling/services and if they were willing to
travel to receive these nutrition services. Finally, we
inquired whether or not the individual has ever seen an
RDN and the types of services that would appeal the most
to them.
We designed an anonymous and voluntary online
survey created on www.surveymonkey.com Our intention
was to distribute them to RDNs around the southeast via email. Questions included information about workplace
setting, amount of patients seen per day, employment
status, income, and billing and reimbursement.

Description of Services
Goal: To improve dietary habits to shorten recovery time.
The RDN will provide guidance in setting goals, expert
evidence based nutrition advice, and services tailored
towards multiple audiences.
Services offered: Individual nutrition assessments, followup consultations, family nutrition counseling sessions,
monthly group nutrition seminars, and continuing education
courses (CEUs).
Requirements of RDN:
1. Bachelors degree in a nutrition-related area
2. Completion of a didactic program in dietetics
3. One year of experience in clinical outpatient dietetics
4. Certified and licensed as an RDN in Georgia
This is a full-time position with eight and a half hour work
days, Monday through Friday. Seven of these hours will be
billable time spent with clients. The other time will be spent
in meetings, training, presentations, traveling, and for lunch.
The RDN will rely on the experienced billing team employed
at Physiotherapy Associates to bill for nutrition services.

Marketing Plan

Discussion

Internal Marketing
The RDN will make phone calls to existing clients informing
them of the addition of an RDN, types of services available, and
how the client will benefit. The RDN advises clients to contact
their healthcare provider to determine if a physician referral is
necessary to receive medical nutrition therapy (MNT). Literature
outlining RDN services and benefits will be available in clinic
waiting rooms. The RDN will provide nutrition education to
physical therapists in the clinics through lunch-and-learns and
continuing education seminars.

With internal and external marketing efforts, we hope

to raise awareness concerning the importance of nutrition
therapy in health management among Physiotherapy
Associates clients. A portion of our mission is to provide a
holistic approach in the recovery process tailored to align
with the clients goals. The RDN will serve as the nutrition
expert utilizing the most current, evidence based research to
equip the client with skills to make sensible food choices and
eating habits. Working with Physiotherapy Associates
existing billing department, we will educate staff regarding
the appropriate diagnosis codes. In addition, we will identify
codes available for clients who exceed their annual allotted
visits, but wish to continue receiving medical nutrition
therapy.
After consulting with stakeholders and discussing their
productivity requirements, we anticipate to incorporate seven
billable hours during an eight and a half hour work day. One
hour is designated for marketing, travel, projects, and
presentations. Following the success of incorporating
nutrition services to physical therapy, we foresee the
demand of RDNs to rise. Not only will clients expect
accelerated recuperation while Physiotherapy Associates
gain a revenue stream, an interdisciplinary team can be
created among referring clinicians to enhance understanding
amongst each discipline and provide quality patient care.
MNT will decrease length of recovery and optimize health
outcomes in clients currently receiving physical therapy.

External Marketing
Physiotherapy Associates marketing team will utilize social
media to promote the availability of nutrition services. The
marketing team will promote MNT to healthcare professionals.
Flyers will be disease-specific and include corresponding
insurance reimbursement codes. Community outreach will be
accomplished through presence at health fair booths, open
enrollment fairs, 5Ks, seminars, and other health-focused events.
The use of a bioelectrical impedance analysis device will attract
attendees to assess, and then discuss, their body composition
and its relation to disease risk.

Results
Physiotherapy clients are primarily above the age of 46 and almost
all of them have some form of health insurance. Many of them have
never seen an RDN before and are not willing to travel to a different
location for nutrition services. Popular nutrition interests found in this
group were weight management and general health. Individualbased counseling was the preferred counseling style.
A majority of the RDNs work interprofessionally with other
health professionals. On average, they saw four to six patients per
day in the outpatient setting. They primarily work full-time (40-60
hours per week) and earn between $50,000 and $70,000. Most of
them bill for their services in 15 minute increments, using a variety
of reimbursement codes.

Physiotherapy Pilot Locations for Nutrition Services:

Dunwoody, Peachtree City, East Cobb, Buckhead

Return on Investment and Salary

8.5 hour work day (8AM 4:30PM w/ hour break)
7 billable hours spent with clients
1 hour miscellaneous (meetings, training, presentations, travel,
research)
Projected Daily Net Revenue = $700

References
1. Morris DM, Kitchin EM, Clark DE. Strategies for optimizing
nutrition and weight reduction in physical therapy practice: the
evidence. Physiotherapy Theory & Practice (PHYSIOTHER
THEORY PRACT. 2009 Jul; 25 (5-6): 408-23.
2. Heuer AJ, Geisler SL, Kamienski M, Langevin D, O'Sullivan
Maillet J. Introducing medical students to the interdisciplinary
health care team: piloting a case-based approach. Journal of
Allied Health (J ALLIED HEALTH). 2010; 39 (2):76-81.
3. Registered Dietitian Salary in Atlanta, GA http://www.indeed.
com/salary/q-Registered-Dietitian-l-Atlanta,-GA.html
4. Dietitian Salaries in Atlanta, GA http://www1.salary.
com/GA/Atlanta/dietitian-salary.html