Dietetic Career Spotlight on Sharon Lechter Smalling, Texas Medical Center, Private Referral
By SARAH KOSZYK, MA RDN on SEPTEMBER 11, 2018
Sharon Lechter Smalling, MPH, RD, LD, has always loved nutrition. But her career has had ups and downs and she’s learned to turn opportunities into new jobs, successful growth, and reinventing her career. Read on to learn more. – Sarah
What attracted you to the field of nutrition and dietetics?
My father had several bleeding ulcers starting when I was 1 year old due to stress at work. Others get high blood pressure. He got bleeding ulcers. As a result, he followed a very strict bland diet most of his life. My mother often cooked two meals at night, one spicier or perhaps a fried food, and his with less spice and baked or broiled. I was a Daddy’s girl and I loved to cook so it was always fun for me to cook something tasty and not bland that he would enjoy. And that’s it…that’s how I decided to be a nutrition major. Little did I know I would have an automatic minor in biology/chemistry.
Your Job Title?
Clinical Dietitian Specialist IV
Company you are with now?
Memorial Hermann Hospital – Texas Medical Center
Describe a typical (or not so typical) day-in-the-work-life for you?
My typical day starts with providing individual medical nutrition therapy to patients in our Cardiac/Pulmonary Rehab programs or privately referred patients. It just depends on the day, as our CR and PR patients exercise on specific days of the week. Most MNT takes 1.75 hours and then there is the charting to do. For our Cardiac Rehab patients, we do advanced lipid blood testing and I am the one who explains their results to them. Before seeing them, I put together a table that helps them understand which labs were abnormal, what risk factors they have that could cause it, and what the effects are of these particular labs. For private patients, I am sent the referral, last clinic note, and pertinent labs for the patient to review prior to them coming in. I try to review all patients for the day before the first one gets there as often they are truly back-to-back. The rest of the day is spent charting, perhaps calling the patients for the next week to confirm appointments, re-arranging patient appointments per request, answering emails, returning calls, and doing media requests (Facebook live events, TV, print media, etc). I speak for national, state, and corporate entities, so putting a presentation together can also be part of the day. I have dietetic interns/students from 3-6 months a year, so if one is there, I am working to help them grow and learn each day. I always have a few projects in the works and spend time on those as well. Currently, I am working with the Central Scheduling staff, who recently moved to a centralized location, to update the procedure for scheduling all outpatient nutrition consults in all of the facilities/hospitals in our system (I believe 5 of them) who offer outpatient nutrition services. I am working with our IT dept to have the nutrition survey used in Cardiac Rehab be computerized. And with SCAN (Sports, Cardiovascular and Wellness dietetic practice group). I have been part of a task force updating a nutrition survey that currently is being validated. We will, due to a request from AACVPR, suggest this survey be one approved for use nationally by cardiac rehab programs. Of course, there are also Quality Improvement processes that are currently being reviewed, evaluated, and suggestions made for changes.
How did you get your current job in dietetics?
After 5 years at my first job in Fort Worth, Texas, I was a part of some layoffs. I had actually been promoted to an administrative position from the clinical area when the layoffs were announced. I had the choice of bumping the last person hired and returning to the clinical area (as basically the job I had was being abolished) or taking severance pay and leaving. I loved the last person hired and she had some personal issues at the time, as well as being a single mom. I just couldn’t do that to her. I was single and realized I could truly move to wherever I wanted to go so, to the surprise of management, I submitted my letter to take the severance pay and move forward! It was a hard decision as I truly loved all the RDs I worked with. After numerous interviews I chose to move to Houston to work at Hermann Hospital to begin their outpatient nutrition services. I was there (which is really ‘here’ as Hermann merged with Memorial Hospital system 25 years ago) for 3 ½ years when, NOT AGAIN, my job was being abolished! I cried the first time and I cried this second time. Of course, I felt like, “what is wrong with me!” I had to keep reminding myself it was the job, and not me, being abolished. Then, like the first time, I realized I had to move forward and make lemonade again from this new set of lemons that had been handed (or should I say, thrown) at me. Luckily, the Director of the University of Texas School of Public Health internship program wanted to hire dietitians for her students to work with. Thus, I never missed a day of work and left Hermann one day to start at UT the next, taking my private referrals with me. Two and a half years later my phone rings and it is my Hermann manager asking me to come back! Why would I do that??? You let me go! Long story short she convinced me to come back and I have been there almost 28 years, ‘this time around’ as we like to say! I developed the nutrition aspect for our cardiac rehab program and have been the only dietitian since its inception. I also revitalized the private referral side of the business. A few years ago, we began Pulmonary rehab and I developed the nutrition portion of that program as well. The media events have just developed over time and I have gotten to know our marketing and PR team very well such that I can even pitch topics for our blog or a Facebook Live event.
What skills were you born with and what skills have you learned along the way?
I think I was always a caring person (my mom said I cared more for the dolls that weren’t quite as cute and sometimes a little ragged than the new ones I had) and have always loved teaching others (my dolls learned everything I learned in school that day; my favorite ‘toy’ was my chalkboard). Plus, I have always been that person who asked ‘why’…which drove my parents crazy I am sure. I set very high standards for myself and always wanted to make the best grades (my brother was 10 years older than me so it was the only way I could compete with him; I always won!). I have learned that it is good to set the standard high but not to get so upset when you just don’t quite make it. I have learned to have more patience and to realize its not so important to make sure people know everything, but to help them move that direction at a pace that works for them. Our marketing and PR team have taught me so much about how to do media interviews. I wish I would have had a class in school to prepare me for this aspect of my job, but then again, I was actually very shy and it is doubtful I would have signed up! I think I also have a trait of being insightful and able to ‘read’ a person within a few minutes of meeting them. I have to be careful though to realize my first impression may not always be right, but most of the time it is!
What advice do you have for others wanting to be just as successful and fulfilled as you?
Just go for it!!! Often it is others who see things in you and offer you opportunities you might not have thought of for yourself. (This happened to me with the media events; I basically got thrown into it one day as no one else was available)! And if something is a passion, take the time to learn about it and seek ways to become involved. Be involved with your city professional organization. Stay with that involvement or venture out to state organizations or even with a national dietetic practice group. Those I have met working with SCAN are just the most amazing people and I wish I had done it sooner. (And yes it was a friend/colleague who was active that pushed me to begin volunteering or I might never have done it). When along the road, lemons get tossed your way, cry or scream or do whatever is necessary, but never, ever doubt yourself or your abilities. You will come back stronger and better for it. I know. I did. And the job opportunities were better as well.
I was told many years ago by a professor/mentor, after I had to ask her to write yet a 5th reference letter for me and inquired what I might be able to do for her, that the only way to repay those who spent countless hours training me was to train the next generation. At the time, she asked me to never say no when asked if I would mentor a student. And I have fulfilled my promise to her, with the exception of I could not due to vacation or otherwise not available. I ask the same of my interns and it is such a great feeling when I see them at meetings and they tell me how much they love having students.
If you could be paid for your job with something other than a paycheck, what
would it be?
Seeing everyone I work with prosper and have the outcomes we intended them to have. From the patient successful with weight loss or bettering their A1c or CHOL level, to the student/intern who lands their dream job, and a co-worker who lives out their passion.