Ep 114 4 MORE things the NHS taught you that are secretly costing you clients

If you've ever found yourself thinking, "I'm doing everything I can to grow my private practice... so why aren't more clients enquiring?" you're certainly not the only one.

I speak to dietitians every week who are brilliant clinicians but feel frustrated that their business isn't growing as quickly as they'd hoped. They're posting on social media, updating their website, attending CPD events and working incredibly hard. Yet enquiries still feel inconsistent.

The interesting thing is that the problem often isn't your knowledge or your qualifications.

It's the habits you've carried with you from the NHS.

Now, before you panic, these habits aren't bad. In fact, they're probably the reason you're such a fantastic dietitian. They helped you provide safe, evidence-based care and become someone your patients could trust.

The challenge is that the same habits don't always serve you when you're trying to build a business.

I know because I had to unlearn many of them myself.

When I started building my nutrition business alongside my NHS role, I found myself second-guessing everything I posted online, squeezing business tasks into tiny pockets of spare time and feeling uncomfortable talking about my services.

Looking back now, I can clearly see that it wasn't a marketing problem.

It was an identity shift.

Here are four NHS habits I regularly see holding dietitians back and what to do instead.

 

1. You're not following up with potential clients

This is probably one of the biggest opportunities I see.

In the NHS, if someone doesn't attend an appointment, you document it and move on. You certainly don't keep contacting them. You're trained to respect patient autonomy, and rightly so.

But business works differently.

When someone enquires about working with you, they're rarely saying "no".

More often they're saying "not yet."

Life gets busy. They need to discuss it with a partner. They have another question. They become distracted by work, children or simply forget to reply.

Without a follow-up process, those enquiries quietly disappear.

I've seen dietitians sign several new clients simply by checking back in with people who had already expressed an interest in working with them.

That's not being pushy.

That's providing support and making it easier for someone to make a decision.

Something to try

Create a simple follow-up system.

If someone says they'd like time to think after a discovery call, let them know you'll check back in a few days. Put a reminder in your diary or client management system and follow through.

You might be surprised how many new clients are already sitting in your inbox.

 

2. You're treating your business like a hobby

This one feels very familiar to me.

When I was building my business alongside the NHS, I'd fit work into the gaps.

A little bit before work.

An hour after the children were in bed.

A quick task while dinner was in the oven.

Sound familiar?

The problem is that businesses rarely grow consistently when they're built around whatever time happens to be left over.

In the NHS, someone else creates your structure. Clinics are booked. Rotas are written. Targets already exist.

When you become self-employed, that structure disappears overnight.

No one tells you when to work.

No one decides your goals.

No one sets your income targets.

That's both exciting and uncomfortable.

The biggest shift happened for me when I started treating my business as though it were a job I'd been hired to do.

I blocked out dedicated business development time, decided exactly what I would work on and started setting monthly, quarterly and annual revenue goals.

Everything became much calmer.

And much more predictable.

Something to try

Protect business development time in your diary exactly as you would protect a clinic appointment.

Not client admin.

Not emails.

The work that actually grows your business.

 

3. You're waiting until everything is perfect

If I had a pound for every dietitian who has rewritten an Instagram caption ten times before posting it, I'd probably be writing this from a beach somewhere.

(With Dustin the Labradoodle happily digging enormous holes nearby.)

Perfectionism is incredibly common amongst health professionals.

We're trained to be precise because accuracy matters.

That makes perfect sense when you're working clinically.

It becomes a problem when it stops you showing up online.

I remember worrying that another dietitian would spot something I'd written, disagree with it and somehow I'd end up in serious professional trouble.

Looking back, those fears seem wildly exaggerated.

At the time, though, they felt very real.

The result?

I stayed quiet far longer than I needed to.

The truth is your future clients don't expect perfection.

They're looking for someone who understands them, communicates clearly and gives them confidence that they're in safe hands.

Perfection isn't what builds trust.

Consistency does.

Something to try

Set yourself realistic deadlines.

When the deadline arrives, publish.

Not because it's perfect.

Because it's good enough to help someone today.

You can always improve it next time.

 

4. You're educating instead of marketing

This is probably the most common dietitian marketing mistake I see.

Many dietitians create content that's packed with brilliant information.

It's evidence-based.

Helpful.

Accurate.

People save it.

But nobody enquires.

Why?

Because information alone doesn't create connection.

People don't choose to work with you simply because you know more than everyone else.

They choose you because they trust you.

That trust comes from hearing your stories, understanding your values and seeing your personality.

Some of my highest-performing content isn't educational at all.

It's the posts where I've shared my journey, the mistakes I've made or the lessons I've learned building my own businesses.

Those are the posts that start conversations.

Those are the posts that generate enquiries.

Education is important.

But connection is what moves someone from "that's interesting" to "I'd love your help."

Something to try

Before you publish any piece of content, ask yourself two questions.

Would I say this to a friend who was struggling?

And is there a clear next step if someone wants my help?

If the answer to either question is no, your content probably needs a little more warmth, personality or direction.

 

Growing a Dietitian Business Means Becoming a Business Owner

One of the biggest mindset shifts I had to make was recognising that I wasn't leaving behind my clinical identity.

I was adding a new one.

Business owner.

That identity comes with different skills.

Different ways of thinking.

Different habits.

The wonderful thing is that every single one of these habits can be changed.

You can become more comfortable following up.

You can create structure that works around your family rather than the other way round.

You can publish before everything feels perfect.

And you can create content that builds genuine relationships instead of simply sharing information.

None of that changes the brilliant clinician you already are.

It simply helps more people find you.

And isn't that why you started your business in the first place?

 

Ready to Grow Your Dietitian Business?

If you're tired of piecing together advice from social media, trying to work everything out alone and wondering why your business isn't growing as quickly as you'd hoped, I'd love to help.

Inside Accelerate, I help dietitians and other regulated health professionals build profitable businesses that fit around their lives, not consume them. Together we work on both the practical strategies and the mindset shifts that make sustainable business growth possible. Find out more here https://www.sarahalmondbushell.com/yes

Because building a successful business isn't about becoming someone different.

It's about giving yourself permission to think differently.

And that changes everything.

 

The Master Plan:

Helping you build the business of your dreams. Get your 22 point step-by step workbook here: https://www.sarahalmondbushell.com/master-plan

 

Connect with me:

Website: https://www.sarahalmondbushell.com/

Instagram: https://www.instagram.com/dietitiansinbusiness/

Facebook: https://www.facebook.com/dietitiansinbusiness

Facebook Group: https://www.facebook.com/groups/beyondtheclinicbusiness

YouTube: https://www.youtube.com/@BeyondTheClinicPodcast

 

Episode transcription:

Most dietitians have no idea how much their old NHS habits are keeping them stuck in their private practice and affecting their ability to get clients. And the last episode that I did on this was one of my most downloaded ever, which tells me that this is something that so many dietitians like you are struggling with. There are so many habits, beliefs and ways of thinking that we develop in the NHS that makes us

excellent clinicians, but those very same habits can make building a successful private practice so much harder than it needs to be. They keep us from fully putting ourselves out there in the online world, from charging properly and doing the things that you need to do in order to actually grow a client base. And the tricky part is most of the time you don't even realize they're there because they've become part of how you operate.

and part of your professional identity. I know this because I've had to unlearn so many of these habits over the years and I see them show up time and time again with the dietitians that I work with inside Accelerate. The good news is once you spot these habits, you can start changing them and often that's when business starts feeling easier. As I said, back in February, I recorded an episode called

four NHS habits that are quietly killing your business. was episode number 94, I'll link to it in the show notes. And it ended up becoming one of the most downloaded episodes that I've ever done. My DMs were full of messages from dieticians saying things like, my goodness, I do all of these. And well, this explains why I've been so stuck. So I knew there was so much more to say on this.

And in today's episode, I'm going to be sharing four more NHS habits that could be secretly costing you clients and slowing down your business growth. And my guess is at least one of them is something that you're doing right now without even realizing. So if you've been feeling like you're doing all the right things to get clients and grow your private practice, but you're still not seeing the results you want, this episode is for you.

Now the first NHS trained habit could that could be costing you clients every month is well, it's a biggie and it's actually not following up with potential clients. Now, if you think about it in the NHS, if a patient doesn't attend an appointment, you might send a DNA letter and you just move on. You don't chase them. You don't check in to ask if they still want support. Following up can feel like you're hassling someone really.

You're trained to respect patient autonomy and in that NHS setting, it makes total sense. People need to be in charge of their own healthcare. You would never dream of ringing a patient and saying, you missed your appointment that I booked for you. Shall I rebook you? And then following up again if they didn't respond to that one. After all, most NHS dieticians are far too busy for that. But in business, it's a completely different story.

And that's why this habit ends up costing dietitians a huge number of clients. In the marketing world, it's often cited at 80 % of sales happen in the follow-up. The reality is most people don't book straight away. The people who inquire but don't book immediately are not saying no, they're saying not yet. They're usually still deciding they're mulling over the pros and cons.

Or they need more information. Perhaps he didn't fully answer their question or they haven't yet asked what's truly holding them back. Or they're just busy and they've been meaning to come back to it. Or they simply forgot because life got in the way. So if you don't follow up, you're leaving clients and income on the table every single month. I actually spoke about this in episode 108, where one of my clients went from a really quiet month

to signing five new clients in the space of a few days. And what made the difference wasn't a big marketing push or a new campaign or a fancy strategy. It was just going back to the people who'd already shown an interest in working with him and following up with him properly. And it was just a short check-in to reopen the conversation, remind them of their original inquiry and see if they needed any questions cleared up.

After doing this follow-up, he got five new clients sign. It's really interesting how when we move into business, that instinct suddenly gets labeled as pushy when actually it's just care. Because if someone has taken the time to inquire about working with you, they're already telling you something. They need your help. And it's your job to make sure that they've got the information that they need, that their questions are answered and that they feel supported in making a decision.

So the fix here is actually really simple. Make sure you have a follow-up system. So after a discovery call, if someone says, need to think about it, don't leave them to get back to you. Say, no problem, I'll check in with you again on Monday. And then a few days later, follow up and again, if needed. Set a reminder in your phone or your client management system for every single person who doesn't say yes immediately.

so that you don't lose clients simply because there was no follow-up in place. Because if you're not following up with every client who tells you they need to think about it on a discovery call, there's a very high chance that you're losing clients every single month without even realizing it.

Now, habit number two I see all the time is treating your business like a side project or a hobby. In other words, not really running your business like a business and not having a proper structure behind what you're doing. And the reason this happens is, well, it's really understandable because in the NHS, you're not really responsible for creating a structure for yourself. You've got a rotor telling you when you're working.

You've got clinics booked in your diary with a start and an end time. You've also got things like targets and some trusts even have KPIs that are already set for you. So you don't actually have to decide what success looks like in advance. But in business again, it's a very different story. Suddenly you've got to create your own structure. You have to define your own targets, including your revenue targets. And this is where a lot of dietitians get a bit stuck.

What usually happens is you work when you can. So instead of having proper focused business time, maybe you squeeze in a few tasks into the gap between school runs or your NHS days, or maybe you end up thinking about your business and different ideas in your head while you're off doing other things, but never actually focus on it properly or execute anything fully. And that's why it can sometimes feel like you're working all the time.

but you're not actually getting anywhere. Now, it's important you recognize that this isn't a discipline problem. It's not that you're lazy or you're not motivated enough. It's just that you've never really been taught how to create your own structure or how to define your own targets or revenue goals.

You've been trained to work inside the system rather than build a system for yourself. And that shift is actually one of the biggest and hardest changes when you move into business. I know firsthand how hard it is to adjust into this mindset. When I first started my private practice, I was juggling building my children's nutrition business alongside my NHS work. And in the beginning, it was very much something that I squeezed in whenever I could. Those 5 a.m. starts were real.

There was no real structure behind it. But then I made an intentional decision to start treating it like a real business and not a side project. So I started time blocking specific hours for business tasks, not seeing clients, the building of the business and deciding in advance what it was that I was actually going to focus on and when. I also started setting really clear revenue targets for the month.

the quarter and the year. So I actually knew what I was working towards. And I finally stopped feeling like I was constantly trying to play catch up and I actually started seeing my income grow with a lot more predictability. So my advice to you would be treat your business like a job you've been hired to do. So start setting yourself concrete hours, even if it's just five hours a week.

and decide exactly what business tasks you're going to get done in those hours, that's not client related time and it is not client related admin. It's your business development time. So put business development time in your diary and protect it like the way you'd protect a clinic slot. Because remember, if you treat your business like a hobby and squeeze things in when you can, it's going to pay you like one. So get intentional with your time.

and get intentional with what you actually want your business to be able to achieve.

Okay. Habit number three is something that I think you'll definitely relate to. It's something most dieticians struggle with actually. And it was definitely something I struggled with, particularly when I was starting in business. It's this idea of needing everything to be perfect before you can actually hit publish or post. Maybe you hold back from posting on social media because you're worried you might say something that's slightly inaccurate or that someone from your old NHS department might see it and judge you.

That fear of what if I say the wrong thing or what if someone reports me is really, really common. And I can 100 % relate to this. In the early days of starting my nutrition business, there was a period of time when my mind was running wild with fear about being visible online. And as ridiculous as it sounds now, at the time it felt very, very real. I genuinely thought that if I posted something wrong or said something slightly outdated, I would get reported.

I remember thinking then would be another dietitian watching my content, sitting, waiting, ready to pick it apart. I even worried I was going to get reported to the HCPC and receive a letter saying I wasn't fit to practice. So, yep, I was full on spiralling into the worst case scenarios over a simple Instagram post. And you know what? Because of that, I held myself back for a very long time.

didn't want to go live. didn't want to talk about my office properly. I didn't want to put anything out there unless I was 100 % certain that it was perfect because somewhere along the line, I had linked visibility with risk. And the interesting thing is that fear wasn't really about social media. It was my NHS conditioning. It was that deep conditioning of don't get it wrong, be clinically precise.

and don't say anything unless you are absolutely 100 % sure. Now, if you think about it in clinical practice, we're trained to be careful, we're trained to be precise because we're working with real people with real conditions. And of course that comes with real risks. So you learn to be cautious, you learn to be evidence-based and be very, very sure before you say anything out loud. And that is perfect. But what happens over time?

is that careful, safety-led mindset starts slowing you down when it comes to business. So instead of just openly sharing your nutritional advice and your opinions and your views, your brain starts going to, is this 100 % up to date? Have I missed some new research on this? Could someone interpret this the wrong way? You're also then thinking about an old colleague or a very senior dietitian, perhaps, who might be watching and calling you out.

And the problem is this can result in you massively holding back in your content. And people don't build trust with overly cautious, generic watered down content. They connect with trust and they connect with someone who actually sounds like they believe what they're saying. And it doesn't just show up in clinical content either. You'll see in other areas of your business too, like spending weeks or even months perfecting your website before setting it live, for instance.

So how do you actually break out of this habit? Well, first and foremost, remind yourself really consciously that you are a regulated healthcare professional with experience and you know what you're talking about. That doesn't go away just because you're saying it online and not in the NHS. Secondly, I'd recommend separating clinical work from business work in your mind.

because they're not held to the same standard, even though it can feel like they are. Give yourself permission to be imperfect in your business work. Done is better than perfect. And when it comes to things like your website and your social media, your first offer, your first email sequence, you know what? Done is better than perfect there too. I want you to launch it. I want you to learn from it and I want you to improve it next time.

Practically, one of the most powerful things you can do is start setting real deadlines for everything you create in your business. And then when that deadline arrives, you don't make excuses. You just get it out there into the world. And even if it feels like it could be better, even if there's still a few tweaks you'd make if you had more time, just get the blooming thing out there.

Now, last but not least, habit number four, and this is one that catches so many of us out because on the surface, it looks like we're doing everything right. So you might be posting consistently and sharing super valuable, super useful information, but nobody's really inquiring or buying. And the reason is often because you're essentially documenting information instead of marketing your services. Because in the NHS, that's what you've spent years doing.

you're trained to educate, to explain and to communicate clearly, accurately and professionally. In the NHS, you're writing clinical notes, you're writing care plans, discharge summaries, and everything is designed to inform and communicate facts. But in business, as much as it's great to give nutritional advice, if that's all you're doing, you end up with posts that are genuinely helpful, but they don't create connection, they don't create desire, and they don't create a clear next step.

for someone to take. So people might read your content, they might learn something from it, even save it, but they never actually think, I want to work with this person. Remember, people don't buy from the most qualified person. They buy from the person they feel most connected to. And connection comes from stories, personality, opinions, vulnerability, not from perfectly polished tips.

The data from my content proves this too. My posts around my personal stories from building my nutrition business consistently outperform my purely educational content by five times. In the NHS, you're also used to writing for other healthcare professionals and not for the person actually needing the care. So sometimes it can be hard to switch into writing in a way that actually connects with a person that you're trying to help.

I

I guess the thing you've got to remember is the person reading your content isn't another clinician analyzing the accuracy of your nutritional guidance. It's someone scrolling on Instagram at 9 p.m. probably whilst watching something on Netflix, feeling frustrated with their problem, wondering if they should finally do something about it and if you're the person that can help them. And that is a completely different context. So here's what I want you to do.

For every piece of content you create, ask yourself two simple questions. First, would this sound like something I'd say to a friend who's struggling with the same thing that my client is dealing with? If the answer is no, then it probably needs softening or simplifying or sounding more like you. And secondly, is there a clear reason for someone to take action after they've read this? Because ideally you want every piece of content to have some kind of call to action.

an invitation or a next step. Otherwise, it's just information. And if you're just giving free information with no pathway to buy, you honestly don't have a business.

So the biggest takeaway from this episode is these habits aren't flaws in you. They're simply NHS trained ways of working that made you a brilliant clinician, but they're likely shaping how you show up in business and potentially losing you clients without you even realizing it. So if you've recognized yourself in any one of these habits today, that's good because you can't change what you don't see. But once you do see it, you can start to act differently.

You can start following up instead of losing inquiries. You start intentionally creating structure in your days instead of squeezing your business into the gaps. You start pressing publish, even if something isn't yet perfect. And you start posting content that actually connects with your dream clients, not just educate them. Now, if you're thinking I can see those habits in myself, but I don't really know how to change them. Well, this is exactly the kind of work we do inside Accelerate.

Because Accelerate isn't just about giving you practical strategies for getting clients, it's also about helping you actually build the confidence to show up, to step into your role as a business owner and start making decisions from that identity instead of your NHS trained one.

The doors to Accelerate are currently open, but they're closing this Thursday and then I'm heading away for two weeks. At the moment, you can join on the silver tier, which is our most accessible, low cost entry point into the program, or you can apply for a spot on gold. Now, I know there's lots of business coaches out there who can show you how to get clients, but as a dietitian and business coach, I go that one level deeper because I truly understand.

because I truly understand the mindset that you have that's holding you back and the very unique challenges that come with moving from the NHS into private practice. I've been where you are. I've had the same fears and the same doubts, and I've also built a multi-six-figure business on the other side of that. And now I want to show you how to do the same thing. To join Accelerate, Silver, before the doors close or apply for a Gold Spot,

Follow the link in the show notes of this episode. Bye for now.