How Much Does a Dietitian Cost?

How Much Does a Dietitian Cost?

Detoxifying vegetables and fruits

Whether you are a client, referring practitioner, or an insurer it can be confusing to determine the appropriate cost to consult with a dietitian. So, to help you in your decision-making process, we compiled some research into the rates that Registered Dietitians (RDs) charge in Ontario.

How Much Does A Dietitian Charge?

The College of Dietitians of Ontario indicated that “RDs should ensure that their billing practices are accurate, transparent and reflective of the dietetic services provided. Charging a fee that is excessive for the dietetic service provided could be considered professional misconduct. While the College doesn’t have fixed charges or specified maximum fees for dietetic services, at some point a high fee can become excessive. Charging a very high fee becomes particularly concerning where a client is financially vulnerable or incapacitated”.

The Consulting Dietitians Network of Dietitians of Canada provided an updated fee guidelines report for private dietitians in Ontario in 2019. In the province of Ontario, the average hourly rate for nutrition assessments was $125 an hour (range was between $60 and $199 an hour) with hourly rate follow-ups at an average $122 an hour (range of $60 to $199). For Toronto specifically these rates were higher with an average of $139 an hour for an assessment and $119 an hour for treatment. It is important to note that these were provided in 2019 and it is anticipated that these rates are likely higher now given inflation.

We also interviewed 6 dietitians currently practising privately in Ontario including clinicians from Toronto, Ottawa, Owen Sound, and Thunder Bay. They all indicated the average private rate that they charge is $150 an hour, although they indicated that in their experience in their industry the private rate ranges from $120 to $180 an hour.

Insurance or Benefits Coverage for Dietitian Services

Dietitian’s services are insurable in Ontario. Many extended health benefits programs and other plans such as Blue Cross for Veterans Affairs will cover the cost of a dietitian. Each individual plan is different, so it is best to check-in with your insurance or benefit provider for more details.

How Much Does A Dietitian Charge In The Motor Vehicle Accident (MVA) Industry

For individuals that have been involved in a motor vehicle accident (MVA) there are additional tasks, forms, travel time, report writing and communication amongst the rehabilitation team required. Thankfully, dietitian’s services can be covered by your auto insurance following an MVA.

Registered Dietitians are not listed in Financial Services Commission of Ontario’s (FSCOs) professional fee guidelines, the government organization that oversees the auto insurance industry. The amounts payable by an insurer related to services not covered by the Guideline are to be determined by the parties involved.

In short, relating to motor vehicle accidents there are no fee guidelines identified by FSCO for Registered Dietitians. As a result, most dietetics providers in this industry tend to follow guideline fees that are similar in disciplines and qualifications such as occupational therapists, physiotherapists and registered nurses; which have similar education, salaries and private rates. Based on the FSCO guidelines for these disciplines Dietitians adhere to the $119.92/hour for cases involving catastrophic injuries (CAT files) and $99.75/hour for cases involving non-catastrophic injury (non-CAT files) These are the same rate for occupational therapists (OTs) and Physiotherapists (PTs).

The National Occupational Classification (NOC) lists Registered Dietitians in Major Group 313, one group above Occupational Therapists and Physiotherapists (Major Group 314), one group below Chiropractors (Major Group 312). Based on NOC’s classification of Registered Dietitians in relation to other Regulated Health Professionals, the $99.75/hr or $119.92/hr fees for a Registered Dietitian practicing in Ontario in the MVA industry are more than reasonable, if not a minimal, fee to charge.

Further, in reviewing an Independent Evaluation report dated November 2020 for a motor vehicle accident client by Dynamic Functional Solutions, an Independent Medical Evaluations company, the Dietitian Elke Sengmueller, B.A.Sc., RD recommended that the hourly rate for dietitian services in the MVA industry should be $125 an hour.

Summary

It’s important to take into account a Dietitian’s industry and insurance coverage options when determining the cost to consult a dietitian. Whether you are seeking a dietitian to address personal health concerns, are a professional hoping to refer a client for complimentary care, or are in the insurance industry seeking additional information about cost, we hope the above helps you make an informed decision!

If it’s right for you, we welcome you to book now with Koru Nutrition or to make a referral.

 

    The Inspiration To Research And Treat Spinal Cord Injury

    The Inspiration To Research And Treat Spinal Cord Injury

    A Personal Note From Kylie James

    For those who don’t know me, I’m Kylie James, a Certified Nutritionist and the founder of Koru Nutrition. It’s a question that comes up often enough, so thought it would be nice to take some time to share why I became interested in Spinal Cord Injury (SCI).

    In August 2009, my then 11-month-old nephew became a C3-C4 incomplete quadriplegic as a result of medical negligence. Cooper had undergone surgery to address an extradural hematoma in his spine, but the treatment team failed to recognize his worsening symptoms following surgery, which led to the build-up of pressure on his spinal cord injury resulting in his ultimate injury.

    My sister and her husband were told that he would not be able to use his hands or legs and would be living with a tracheostomy for the rest of his life. Obviously, this was devastating for my family.

    Life for my nephew and family have been tough. Fortunately, he was able to get off the tracheostomy but morning and evening routines are busy with catheters, tube feeds, making special meals, suctioning, and enemas. They also require special vans, wheelchairs and various other adaptive devices. Basic activities such as popping around to a friend’s house is difficult as homes are not accessible.

    In primary school, it was tough for Cooper to try to make friends as so many activities involved sports and physical activities which he could not do. Thankfully, Cooper discovered Power Chair Football and at the early age of 9 he made the New Zealand power chair football team, competing in various tournaments against Australia. He has been voted “most up and coming athlete” and was the second highest goal scorer in New Zealand!

    In the photo above Cooper is pictured with his brother and my daughter.

    Cooper is now 14 years old and has just started high school. When he grows up he wants to be a sports commentator, coach, or design houses.

    To hear more about Cooper’s life now, check out the video below that I filmed with him:

    Naturally, after my nephew had his injury in 2009, I desperately started researching any kind of resources I could to help my family. I was an occupational therapist and a nutritionist, so I felt I must be able to help somehow.

    I had seen a student at my nutrition school that was in a wheelchair and reached out to connect with her and learn about her experience with spinal cord injury. It turns out that we were both working in the auto insurance field and a friendship quickly developed.

    We would often meet up to discuss nutrition as it relates to brain injury and spinal cord injury and realized that there was very limited literature out there on nutrition with spinal cord injury. With this in mind we decided to embark on writing a book to pool together all the resources and studies that related specifically to nutrition and SCI. We applied to the Americans Veterans of America for a grant and won it!

    Over the next 2 years we read many articles and researched secondary health complications that SCI individuals are prone to, foods and supplements that would be the best fit for their condition and developed recipes that were easy to make and cost effective to support specific health issues.

    If you’re interested in how nutrition can support those with SCI, check out Eat Well, Live Well With Spinal Cord Injury:

    Once we finished the book, we began attending various conferences presenting on the topic of nutrition spinal cord injury. One of the things that we found in researching and writing the book was there was limited studies specific to nutrition and SCI. So, part of our goal was to inspire research in this area!

    Joanne Smith and I have now completed 3 studies together. The first two were at Brock University on the impact of inflammation on mood following an SCI and the other on the impact of cytokines on the body in relation pain in individuals with SCI. Our latest study was just recently published, and took place at Maryland University on the impact of aquatic exercise and nutrition on cardiometabolic function.

    I’m so excited to share our most recently published study!

    If you, a client, or someone you love is managing life after a spinal cord injury – we’d love to be of support! Send me an email to [email protected], call us at 1-855-386-5678, or schedule your consultation here.

    Expectorant Soup

    Expectorant Soup

    Two Glasses with Detox Green Smoothie

    This recipe is designed to support individuals with respiratory illness.

    In the last couple of years, most of us have been affected, or had friends and family members affected, by the prevailing respiratory illness responsible for the pandemic. 

    So, we wanted to share this recipe for an Expectorant Soup that can help support the body through respiratory illness.

    We all know that soup is a perfect meal choice when sick because it helps us meet our fluid needs (which increase during illness) and is generally easy to digest. But, this meal in particular contains the three vegetables that help promote drainage of mucus from your lungs.

    Specifically, carrots, leeks, and chili pepper are known as expectorants, which help clear mucous from the upper and lower airway. Additionally, the garlic contained in this soup is not only an expectorant herb, but also has anti-viral properties! Plus, the chili peppers not only have expectorant qualities, they may also help your recover from a fever faster. This is a powerhouse combination of ingredients!

    Above helping meet your fluid needs, providing expectorant vegetables, and containing immune system supporting herbs – this recipe also contains 304% of your daily serving of Vitamin A, a vitamin that supports our immune system functioning.

    The next time you or someone you love is under-the-weather, we suggest making up a large pot of this healing soup. Stay well! 

    Expectorant Soup

    Soup is a perfect meal choice when sick! This dish, in particular, contains three vegetables that help promote drainage of mucus from your lungs.
    Prep Time 5 minutes
    Cook Time 30 minutes
    Total Time 35 minutes
    Servings 4 servings

    Ingredients
      

    • 1 tbsp Extra Virgin Olive Oil
    • 1 Leek thinly sliced
    • 6 Carrots peeled and sliced
    • 1 Chili Pepper thinly sliced
    • 2 cloves Garlic crushed or chopped
    • Pinch of Salt
    • 3 cups Chicken Stock low sodium
    • 1 tbsp Pasley finely chopped

    Instructions
     

    • Heat oil in a large saucepan over medium heat, cook leek until soft, approximately 4 to 5 minutes.
    • Stir in carrots, chili pepper and garlic and season with salt.
    • Cook until carrots are soft, approximately 8 to 10 minutes.
    • Add chicken stock and bring to a simmer.
    • Cook 10 to 12 minutes.
    • Puree half the soup in a blender until smooth.
    • Stir puree into remaining soup.
    • Garnish with parsley.

    Notes

    Nutritional information per serving:
    Calories - 102
    Sugar - 5g
    Proteins - 5g
    Carbs -  12g
    Fats - 5g
    Fibre - 3g

    Mushroom Millet Porridge

    Mushroom Millet Porridge

    Two Glasses with Detox Green Smoothie

    So many of us are used to super-sweet breakfasts like pancakes, muffins, pastries, or sugar-cereal. This savory Mushroom Millet Porridge is a comforting change-of-pace.

    This porridge uses millet instead of oats to provide a hearty texture and slightly lower glycemic index. Millet is rich in dietary fibre. Most of the fibres in millet are “prebiotic” in nature, meaning they help to feed the good bacteria living in our guts. Supporting our gut microbiome can help improve mood, reduce stress, keep bowel movements regular, and even reduce the risk of colon cancer!

    This meal also has a full serving of vegetables in each bowl. The majority of North American’s are greatly under-consuming vegetables, so slipping in a serving with the first meal of the day may help you reach the minimum recommended 7-8 servings a day. 

    Mushrooms, specifically, can be quite therapeutic in nature. Using a medicinal mushroom variety such as reishi can provide additional health benefits. Reishi is adaptogenic, which means it can help our body manage stress. (1) Is there a better way to start the day than by priming your body and mind to gracefully manage what comes?

    Spring onions (also called green onions or scallions) are part of the allium family, which also includes garlic, leeks, and chives. Onions are rich in B-vitamins, such as B6 and folate. These vitamins are important to keep our minds sharp, boost energy, manage stress and keep our metabolism running well. (2)

    So, if you’re looking for a more savory way to start your day… look no further. With all the various benefits these ingredients bring to the table (pun intended), this porridge is a fabulous way to “break your fast”!

     

    1. https://www.healthline.com/nutrition/adaptogenic-mushrooms  
    2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3648704/  

     

      Mushroom Millet Porridge

      So many of us are used to super-sweet breakfasts like pancakes, muffins, pastries, or sugar-cereal. This savory Mushroom Millet Porridge is a comforting change-of-pace.
      Prep Time 5 minutes
      Cook Time 25 minutes
      Total Time 30 minutes
      Servings 2 Servings

      Ingredients
        

      • ½ cup Fresh Mushrooms sliced
      • 1 cup Millet soaked overnight
      • 2 Spring Onions Sliced
      • Salt to taste

      Instructions
       

      • In a small bowl, pour boiling water onto the mushroom slices. Let sit for 5 minutes. Drain and set aside.
      • In a medium sized pot, add 2.5 cups water and the millet. Bring to boil on high heat.
      • Reduce the heat and simmer for approximately 20 minutes until the millet is fully cooked. Add more water if needed.
      • Fluff the millet with a fork. Then add salt and mushrooms. Cook together for 5 more minutes on low heat.
      • Portion into bowls. Add chopped spring onion to garnish. Enjoy!

      Notes

      Nutritional information per serving:
      Calories - 119
      Sugar - 2g
      Carbs - 23g
      Fat - 2g
      Protein - 4g
      Fibre - 3g

      Top 5 Strategies To Help Manage Stress

      Top 5 Strategies To Help Manage Stress

      Detoxifying vegetables and fruits

      Stress is an all too common problem in the 21st century. Throw a pandemic with lockdowns and online schooling in the mix and it is no wonder our stress levels are through the roof! It is hard to remain optimistic when the future is so unknown. There’s potential new variants lurking around the next corner, and the ability to plan vacations or just to “get away” might feel like an impossible dream. 

      Work-life balance can be a struggle as well and finding time to manage the workload and stress load can be tough. We know how you feel. We’re all in this craziness together!

      That’s why we are providing you with some strategies to help you manage your stress and regain some balance.

      #1 Brain Dumping

      Are you someone that struggles to get to sleep at night? Do you find your brain cannot shut off? Is your mind endlessly going over all the things that you need to do tomorrow, this week, and this month?

      To help take that burden off we suggest brain dumping!

      Have a pen and paper beside your bed. Before going to sleep at night, write all those thoughts or tasks that you have on to the paper. Basically, you are transferring the storage of important information from your brain to the paper – giving your mind permission to shut off and go to sleep.

      #2. Find Your “Energy Robbers” And “Energy Givers”

      This is an important step in helping to get back your energy and happiness.

      Write a list of all the things and people that give you energy, happiness or pleasure – even if you haven’t done or seen them for a while. Then, in another column write down all the activities and people that take your energy or are detrimental to your health (whether it be physically, emotionally etc.)

      Once you have completed the list make steps to engage in those positive activities and people more often during the week!

      For the “energy robbers” there are a few ways to reduce their load. First, you may want to look at changing the situation. For example, can you trade childcare with a friend so you both can have some time for self-care? Another option is to look at how can you change yourself to adapt to the situation. For example, if you were getting more sleep would you be able to better perform and manage your work during the day? Lastly, you can look at leaving or avoiding the situation altogether. For example, maybe your book club is no longer bringing you joy and it is time to search for a new hobby.

      #3. Switch Out Your Coffee

      You might be shuddering at the fact that you have to give up your morning cuppa. If stress and fatigue is an issue, you may be desperately relying on more than a few cups of coffee to get you through the day. But excess caffeine consumption can actually contribute to stress and fatigue – and even adrenal exhaustion.

      Excess caffeine intake can contribute nervousness, irritability, insomnia, “restless legs,” dizziness and subsequent fatigue (Haas, 762). A study published in the American Journal of Psychology looked at 1,500 psychology students and divided them into four categories depending on their coffee intake: abstainers, low consumers (one cup or equivalent a day), moderate (one to five cups a day), and high (five or more cups a day). The moderate and high consumers were found to have higher levels of anxiety and depression than the abstainers, and the high consumers had the greatest incidence of stress-related medical problems, as well as lower academic performance (Holford, 2013)

      Instead, you can swap your coffee for green tea, which might be a better option. Firstly, it does have a bit of caffeine (just not as much as coffee) to help give you a “pick me up”. But it also has the amino acid L-theanine which has a calming effect on the mind. The compounds within green tea can also help facilitate weight loss which often can be an issue for people that are stressed as the stress hormone cortisol can contribute to weight gain, especially around the belly. 

      #4 Start Your Day With A Balanced Breakfast

      We get it, this seems like a basic thing to do. But, you will be surprised at how many people struggle to eat breakfast – especially a balanced one!

      Balancing blood sugars is so important for managing stress and energy levels. If you are able to consume balanced meals throughout the day this will go a long way to provide a steady flow of energy and promote a calm and balanced mood.

      If you skip breakfast or rely on a bagel or doughnut from a drive-through, or consume toast with jam or sugary cereals; then you create a blood sugar spike. And what goes up (our blood sugar, in this case) quickly comes crashing down. When blood sugar crashes your body naturally produces cortisol to help raise blood sugar back up. The problem is if we are stressed, we usually have too much cortisol running through us so the last thing we need is more.

      Try incorporating the following breakfasts:

      These are all much better options to help keep your blood sugars balanced. 

      #5 Explore Herbal Supplements

      There are many herbs that have been shown to help us manage our stress. One such herb is Ashwagandha. This herb helps support cognitive functioning, critical reasoning skills and thinking; which all become negatively affected when we are under stress and trying to function with our foggy and overwhelmed brain. This herb has a calming effect on the body and helps to modulate cortisol levels; meaning it’s beneficial whether your levels are too high or too low.

      Siberian Ginseng is another herb that helps support and rejuvenate adrenal function, increase resistance to stress, normalize metabolism and regulate neurotransmitters; which all help to modify the stress response. Studies showed it improved absorption of B-vitamins and helps reduce vitamin C loss – these key vitamins are crucial in supporting the adrenal glands and are used up quickly in the body when we are under stress.

      Licorice root helps to restore cortisol balance. It also provides antioxidant support, stimulates blood circulation and boosts the immune system – which often becomes depressed or compromised when we are stressed. This is why we often get run down and sick when we are stressed out.

      If you are going to explore herbs as part of managing stress, please speak to your health practitioner first. Herbs can be contraindicated with certain medications or health conditions, so it’s best to seek qualified advice before starting new supplementation.

      Summary

      Stress is an exceedingly common problem in our society and achieving a balance can sometimes seem impossible. That said, if not dealt with it, stress can lead to a variety of secondary health issues.

      But by incorporating some simple strategies such as having a balancing breakfast every morning, switching out your coffee for green tea, drinking more water, supplementing with herbal support, brain dumping at night to stop ruminating thoughts, and engaging in activities that give you energy and pleasure – then you are off to a good start!

      If you would like more support in this area to help manage high stress levels, rebalance your diet, or begin a supplementation protocol, then please reach out to us. We would love to help.