I’ve had the opportunity over the past few months to do a bit of outpatient counseling as a dietitian. I always thought I would love to one day be an outpatient dietitian so it has been a great hands-on experience actually being able to work in that role. What I have learned is that being an outpatient dietitian is A LOT different than how I imagined from my dietetic internship, so I wanted to share my experience with you.

Because I primarily work as an inpatient dietitian, I am going to compare the two to illustrate their similarities and differences. I hope you enjoy

Job description

Inpatient dietitian: sees patients who are admitted to the hospital. Job responsibilities include assessing patients for nutritional risk, managing tube feedings and parenteral nutrition and providing inpatient diet educations for chronic diseases.

Outpatient dietitian: counsels patients from physician / provider referrals. I think the outpatient dietitian position fits the stereotypical dietitian role… you know, the one where everyone thinks you make people a meal plan type role. You are making appointments with patients and they are coming to visit you in the office.

Specialties

Just like an inpatient dietitian, an outpatient dietitian can specialize in different areas such as diabetes education, renal, GI, pediatrics or weight loss. I think whether you are a general dietitian or specialize in something really depends on the size of your facility. A dietitian at a small facility is going to see a little bit of everything, whereas an RD at a large facility is probably going to see a specific type of patient.

Schedule

If you ever hear that outpatient is really hard to get into as a dietitian, it might be because of the schedule!

Inpatient dietitians have to work weekends, sometimes later evening hours and take call.

An outpatient dietitian will typically work regular office hours, Mon-Fri from 8-5. I’m sure there are facilities out there that might offer later hours or Saturday counseling, but I think the traditional schedule is considered to be the norm. No holidays!

Day-to-Day Schedule

As an inpatient dietitian, I organize my schedule as I see fit. I will prioritize my patient list and see patients with the most pressing issue first. Unless an emergency comes up, I can pretty much go throughout my day as I please. I could see all of my patients in the morning and chart in the afternoon, or I could see a few patients here and there and chart as I go along. I can usually stop to eat lunch whenever I am hungry, answer the phone when it rings, speak to someone who stops by my office, etc.

An outpatient dietitian is operating on a set schedule. At some facilities, an administrative assistant might schedule your patients and at others you might be able to schedule your own. Either way, I have an entire schedule of appointments already made for me for the entire day. Appointments usually take 30-60 minutes each.

This took a lot of getting used to for me! One time I had back-to-back outpatients and was really hungry for lunch, but I had to wait 2 hours to eat. Also, if something comes up like a webinar or meeting or something and it’s last minute, then I usually have to skip it when I’m working outpatient. I’m sure these types of things are really no big deal when you work outpatient 24/7, but they are things that I didn’t really think about until I came across them.

Talking vs. Charting

Okay, I had to put this in here!! Outpatient involves so.much.talking.

Inpatient dietitians will stop by a patient’s room and chat with them and/or their families. Sometimes conversations are more involved, but I would say the typical visits are 5-15 minutes. The real work comes after the conversation with the patient has ended. Then it’s time to put in orders and chart.

An outpatient dietitian spends a LOT of time talking and counseling. My first time working outpatient involved 5 hours of appointments. That is a lot of talking! Once the patient leaves your office, most of the work is done aside from a brief chart note.

Seeing Progress

Okay, so as an inpatient dietitian, I KNOW my job is important. There are plenty of studies out there that show that nutritional status in the hospital can affect readmit rates and patient outcomes when they are discharged.

But it’s something completely different to really be able to see how your expertise can help someone… and this is where outpatient is really cool and rewarding. If I see a patient on a regular basis then I get to know them as a person. I share in their happiness and feel sad for their failures. I really feel invested in helping them! There is no greater feeling than to see someone take your advice and follow up with you in a month to see tangible results- weight loss, lower blood sugars, feeling better, etc. I have received many sincere thank yous from these patients and it’s great.

Which is Better?

Working in both settings just reaffirms my thoughts that there are SO many opportunities for dietitians out there. Everyone has their niche. If you are really into counseling, like working a regular schedule and want to feel invested in your patients’ successes then outpatient might be a good fit for you. If you like being on the go, seeing new faces each day and don’t mind working on the weekends then maybe inpatient is a good fit for you.

Have a great day!!