Latest / Nutrition Connection by Dr. Kristen Hicks-Roof / 50: Richard Erhart MS, RD, CNSC - HEALTH TECH / CLINICAL
Transcript
- Kristen Hicks-Roof PhD, RD: Welcome back to Nutrition Connection, the show where science meets storytelling. I'm your host, Dr. Kristin X. Roof, dietitian, researcher, and lifelong advocate of the role of nutrition, health, and wellness. Each episode, I sit down with dietitians and nutrition experts all across the food and healthcare landscape, leaders whose work touches nearly every aspect of our lives. So whether you're a student, a seasoned professional, or someone simply curious about food, nutrition, and health, this podcast is just for you. The views, thoughts, and comments on this podcast do not reflect those of my employer nor the employers of my guests. So I'm really excited to bring on a brand new connection of mine. have Richard Erhart. He is the founder of Intake IQ and also the clinical supervisor at St. David's Health Care. Welcome to the show, Richard. Richard Erhart: Thank you, Kristen. I really appreciate you having me on. I'm really excited to kind of just get our name out there and really excited to just kind of talk to you and yeah, just talk to the whole community. Kristen Hicks-Roof PhD, RD: When I know we interacted a little bit on LinkedIn, which really started this connection and it was kind of talking about when I was in a research study and I'm trying to really assess and understand 24 hour recalls and food frequency questionnaires. And so I'm excited to really dive into the software that you're developing, Intake IQ for health professionals to really leverage AI, but also be clinically smarter and to be able to be more efficient with our roles. So I really want to dive into there, but Let's start all the way back from the beginning. What inspired you, Richard, and made you want to become a nutrition professional in the first place? Richard Erhart: sure. This goes back to I was always an athlete ⁓ in early high school. So I was kind of always naturally just relatively healthy until about the senior year of high school. ⁓ And then I kind of quit sports and kind of got just we'll just say you know pretty overweight. ⁓ And so I was a you know researching a lot about health and nutrition and you know exercise and all these things. I got really into that. My mom was a nurse. ⁓ And so she was always saying like, Hey, always go into the health field. You always have a job. It's stable, you know, all these good things about it. ⁓ and so I, kind of. Meshed those are melted those two together, ⁓ found, know, a registered dietitian and you know, research what that was. And, ⁓ I ended up just pursuing that path early in my career. And, ⁓ you know, ⁓ ended up getting into a dietetic internship. I moved to California from Washington. ⁓ you know, lived a healthy lifestyle. I lost weight. You know, I saw the change that it made in me, ⁓ when I, a younger, you know, ⁓ kid. And, and so, you know, I was able to, at first it just started really in the kind of the weight loss realm. And then obviously as you go to school and get more involved, it evolves, you know, much into much more than that into the clinical world. So, ⁓ that's how I got to where I am today. ⁓ but yeah, that would mean that was kind of the roots of, of what made me go down this path initially. Kristen Hicks-Roof PhD, RD: I also think it's really interesting how you talked about you moved to California and you kind of started to develop healthier habits. I'm originally born from California, but I live in the Southwest region of the U.S. And when you go there versus, let's say you go to the South or the Northeast or even the Midwest, the lifestyles are so different and just like how people think and breathe. And that's a generalization. But it's really I think your environment and your surroundings do come so much into play that Richard Erhart: Yeah. Kristen Hicks-Roof PhD, RD: I don't think we really give it enough of how that can impact personal health, right? And nutrition is just one piece of that. ⁓ So let's talk about your journey. You wanted to become, or maybe you're just interested in sports nutrition. I think a lot of people in nutrition want to be aspired to be sports dietitians or in the athletic performance side. What kind of pivoted you into clinical and talk about your journey a little bit to where you are today. Richard Erhart: Here we go. Yeah, that was always an interest of me. I knew it was, ⁓ you know, the positions are much more rare, typically. ⁓ As fun as that would be, ⁓ you know, I think, you getting out of school, my internship ended up being heavily clinical. And one of the concentrations was critical care in my internship. ⁓ For reference, I moved from San Diego to Houston for my internship. ⁓ And so I did my internship with Sodexo, ⁓ really got into the critical care side and... ⁓ I'm really like a math brain, you know, like I love finance and numbers and all these things. And so, you know, like the critical care side is like really where I found that I thrive a lot. Custom TPN management, electrolytes and that sort of thing. I got a little taste of that in my internship. And then I kind of knew that out of, you know, I knew I was going to be starting in clinical with my first job with a reference from that internship. And everyone kind of always said, you know, that's where you get your you know, get your basis in clinical and then you can kind of go outwards from there, which I know not everyone does or needs to. ⁓ But at least that's where I got my start. And then that kind of, you know, my career trajectory just kind of went really just down the critical care path. I started in small ICUs at small hospitals where they really just needed coverage. So I got my bones early there ⁓ and then transferred to a bigger hospital where I got more ICU experience, different ICUs, neuro, CV. trauma and then, you know, eventually my manager is just like, hey, go get your CNSC, you know, career development. can, you know, can start teaching people, you know, because I enjoy teaching that. ⁓ And so that's really where I ended up was, you know, being kind of the campus TPN manager of a relatively large hospital of like all our new interns. ⁓ You know, all the newbies coming in, you know, I was kind of their intro into ⁓ custom TPN management there with the electrolytes and all that. ⁓ that was kind of the push for the CNSE. And then I was able to pass that in 2024. Kristen Hicks-Roof PhD, RD: Well, it's so funny that you talked about how you've built kind of that passion and career direction because oftentimes what you see is people going the opposite direction from TPN. I remember my TPN calculations in my graduate and internship and I was like, I want to go as far away from this as possible. This is not my jam here. ⁓ So I always think that's so fascinating that as dietitians, we kind of are all wired differently in a way that we can find our niche in different areas. Richard Erhart: Yeah. Yeah. Kristen Hicks-Roof PhD, RD: And I think you pointed out something that I also thought was really interesting. You talked about how your internship almost like opened your eyes a lot more to critical care and nutrition because I know a lot of students have asked me in the past like, ⁓ do I have to go to X internship or Y internship because they have whatever rotation? And my general feedback was kind of any any Richard Erhart: Yeah. Mm-hmm. Kristen Hicks-Roof PhD, RD: internship is a great internship and then obviously it would be great if you like know the sector you want to go in. But did you choose that internship in Houston because of the critical care or did you just so happen to be placed there? Richard Erhart: Mm-hmm. Um, I was lucky. So I was lucky to land a job as a diet tech for Sodexo, um, pre-internship. So I actually, you know, wasn't even able to get in the first time around, you know, despite me thinking I was pretty competitive. I only applied to a few select programs and it was a more competitive than I thought I was, you know, so, um, yeah, I ended up getting in a second time around and I had a lot more choice because Sodexo is a large company. They have a lot of different sites. My family was moving to Texas around, um, COVID times. ⁓ and so, you know, everything was a little weird. Everything was kind of online. ⁓ you know, it hard to get into sites, you know, if you were going to be depicting your own sites and, know, having to reach out and try to get into the sites. So the good thing about the Sodexo program is they have all those connections. There's no, you know, arranging, there's no reaching out to people trying to get placed. Like you're just placed there and you're good to go. It's all set up for you. So that's ⁓ how got to Houston. ⁓ I would move out there for family reasons, but I definitely think, ⁓ you know, be flexible with your internship options. ⁓ You might be surprised at what you find, like what you might like. ⁓ There's to be things that you think you would like and that you actually do not, and you for sure can rule that out as a career option. So ⁓ You know be open be flexible, you know, everyone for the most part is very young You don't really know necessarily what you don't know yet. So ⁓ You know just be humble learn a lot Be willing to take on multiple settings and things like that. And you know, I think you know, it'll work out Kristen Hicks-Roof PhD, RD: Yeah, well, and I think, you you had really great experience in your internship, which really gave you kind of that path and direction. So let's dive a little bit deeper than that. You are a clinical supervisor. You talked about how that's you got your CNSC and really love teaching and mentoring in the TPN space. Let's dive a little bit deeper into intake IQ. You're the founder of intake IQ. What is that? What made you see that gap and actually move forward with with creating that? Richard Erhart: Yeah, I mean, if you work in clinical, think every one of us has experienced like, man, you know, so a lot of these doctors, you know, are like, you other providers, like they haven't gotten very much nutrition education. You know, I think it's 20 hours. They might've increased it to 40 hours recently in their entire time in med school. And outside of that, it's pretty much just who they have in their internship. you know, I mean, as far as like, you know, a ton of doctors and residents who are super familiar with Aspen guidelines and how to initiate complicated nutrition support or sometimes just certain things like that, bowl is feeding J tubes, stuff where you come in over the weekend and you go, ⁓ no, I have to fix this. ⁓ It's not like they're doing it on purpose. They just literally aren't taught these things. It's just not touched on as much as they need to be. ⁓ You know, after seeing that enough, after having providers in rounds ask me like, Hey, what's this formula do again? Can we do this instead of that? Well, when would I use this one? When would I use vital versus pivot? Or can I do glucer enough there, you know, on pressers or, know, like they start asking these questions and they genuinely want to know. ⁓ I've done in services with, with providers and things like that. And it's, I just started seeing the gap. like, it would be great if we had, ⁓ something that could. teach not just new dietitians, but also providers and then also have like bedside support. And as I started to get into AI and technology, I realized the capabilities and the, least the potential of it. ⁓ The danger with AI, and we can get more into that later, is that you don't want it making decisions for you completely necessarily. ⁓ But, you know, if you have a domain expert that can kind of constrain those abilities and rein it in a little bit to where it's can only operate in this, you know, on this essentially guideline or this road, this roadmap. And if you can kind of rein that in a little bit and make it a little bit more targeted versus just typing a clinical question in the chat, GBT or Claude, you know, you're gonna get very results. Sometimes it's good, sometimes it's not so good, ⁓ you know, and so it's like, can we, is there some way that we could target this in our niche and give this to other providers and You know, I mean, we can talk for days about how, you know, dietitians, especially inpatient are so understaffed nowadays. And, ⁓ you know, you're expected to take larger and larger and larger patient loads on top of in services and going to, to quality meetings and all these things. And so it's like, how do we, where's the balance there? You know? And so that was the giant problem that I saw that's getting bigger by the day. And so I was like, well, well, maybe I can make something to fix that or at least help. ⁓ And so that's how that idea was born. Kristen Hicks-Roof PhD, RD: Well, and I liked how you talked about, you know, since my research was on educating health professionals on the importance of nutrition for well over 10 years, you hit spot on where you said, they want to know, they want to help, they want the best for their patients, but they don't know how to initiate it, what that might look like, what different formulations they can or cannot use, because you're right, they don't have extensive Richard Erhart: Yeah. Kristen Hicks-Roof PhD, RD: nutrition education across health professions that is not just, you know, just physicians, although typically those are your order prescribers. So there's definitely a gap here and I do like this. So if you were to like give a snapshot of what intake IQ is for any clinician who's listening, what is it and how does it help them in their clinical practice? Richard Erhart: For physicians and administrators, I always pitch it as this is up to date for clinical nutrition alongside with bedside support, or it's paired with bedside support. So I'm creating a comprehensive clinical library. It's expanding by the day. I'm having other providers where I'm not a specialty, I'm not a specialty, NICU dietitian or a PICU dietitian. ⁓ That is a totally different language from adults. And I know that I'm not qualified to vet all that information. And so, you know, I've, I've brought on people contributors, you know, ⁓ and hired some people to kind of take a look at some of the information and, expand that side of it as well. So it is comprehensive. It's not just adults. ⁓ and so, you know, that's what it's turning into is we have a giant clinical library. Like I said, that's growing by the day. ⁓ this is your static information, similar to up to date where you can look up guidelines, current practices. It is framed a little bit more for like practical use. And so that's where I see maybe the use case with new dietitians and dietetic internships is a lot of times you get general kind of case study questions, but you don't get there like really dip your toes in like, what is my internship going to be like until you're there? ⁓ And this is like real clinical, practical guidelines, work and recommendations for like how you would actually practice in the hospital. ⁓ It gives you lot of exposure to some of the medical information, the IV fluids, the different types of intravenous lipids and what the difference is between them all. I think it can really prepare not only new dieticians coming into their internship and their first job, ⁓ but I think then the bedside support side, which is the AI chat ⁓ that I was talking about, really it is not just chat GBT pasted into the website. There's a very, very extensive prompt for just purely adults and pediatrics that I have set up. And then we're working on NICU as well and some of the outputs there. But ⁓ this is for your provider. This is for your busy provider ⁓ that needs, you know, it's a Sunday night, the dieticians aren't on call, there's no dietician in sight, you have to come up with an order. ⁓ You know, that is what that purpose is for. Now it can also be a great function for a case study. or something like that. And I actually have two different modes on the chat output. So you can do brief for the busy providers who just need an answer to something or at least help with a decision. And then there's a detailed, which is like, hey, I'm in school, I'm learning, know, tell me where those sources come from. Is that Aspen? You know, is that from somewhere else, you know, et cetera. But ⁓ the whole point of the chat is to be, it's built by domain experts and it's harnessed by current clinical guidelines and research. And so that way you're not getting some of those crazy outputs that you would if you just were to type it into chat, GBT or Claude. And so I think that's where the future of AI tools is going, ⁓ is that, you know, it's not meant to replace us. It's meant to help us make decisions and learn. And so, you know, how do we do that in a safe, but also still adopt technology and be willing to, to, you know, modernize care, but at the same time, still be safe and make safe clinical decisions. So trying to meet that gap. Kristen Hicks-Roof PhD, RD: One, AI, I mean, it's so fascinating. If you've missed my episode with Raoul, I mean, he was so intriguing how he's talking about the different use cases of these technologies. And I think you're spot on in that it sounds like intake IQ is really this real-time support system. Rather than going back to your encyclopedia or your textbook and looking at different formulations, it's kind of like this is our nutrition up to date of practical guidelines. excited to see you take that adventure. So talk to me, what does your day to day look like? Because you're still a clinical supervisor at a hospital. And so how do you balance both and what does your day to day look like as you're taking off on this new adventure? Richard Erhart: Yeah, it's busy. Mm-hmm. ⁓ I do want to mention we do have a lot of calculators as well. you know, for dietitians that are already knowledgeable, they don't need the recommendations. They just need quick outputs. We got tons of tube feeding, Clinimix, IV fluid calculators, GIR, stuff like that. So that all comes with it. ⁓ But my day to day is busy. ⁓ You know, Monday through Friday, clinical supervisor, I'm ordering. ⁓ Because of staffing issues, I actually put away our supplements and our formularies and stuff too. So, ⁓ you know, receiving in that as well. So. Um, you know, typically eight to four, eight to four 30, eight to five is that's what I'm doing. Um, and then I kind of build intake IQ around there. So, um, you know, weekends after work, I have a young son, um, he's almost two years old. so, you know, most of the time I like to just go home, you know, with my wife and son and just kind of hang out with them as much as possible. So, um, but you know, early mornings, weekends, when I have time alone, um, you know, that's when I'm kind of. building intake IQ. Kristen Hicks-Roof PhD, RD: Yeah, it's kind of like a passion project. You know, that's kind of where this podcast lies too. I also, I have three little kids and it's a lot. You really want to make sure that you have that dedicated time towards your family. Plus you're working full time. Plus you have this endeavor that you really think that there's a value add there for clinicians or students or whoever it might be. So, ⁓ I think that's a point to people. Here's two case examples that you can do it. You just have to learn that work life balance for yourself and everyone's looks different. Richard Erhart: Mm-hmm. Yeah. Kristen Hicks-Roof PhD, RD: I'm kind of like you, Richard, like I'm up super early in the morning and I try and get a few things done. And sometimes at night, you know, before going to bed where most people maybe are watching TV or whatever, I'm hanging out with my spouse and I'm also, you know, maybe designing Canva graphics on my phone at the same time. So you kind of get like this multipurpose opportunity ⁓ when you are balancing almost two careers in a way, but one is emerging. So Richard Erhart: Mm-hmm. Mm-hmm. Yep. Kristen Hicks-Roof PhD, RD: You really talked about this tool as like an up-to-date and obviously as a TPN and a clinical supervisor, I think it's inherent that research really plays a critical role in everything that you do, right? Clinical practice guidelines. So I would love to hear your thoughts. Like, how do you think research really is involved in your day-to-day role? Richard Erhart: I mean, I think that's the engine that kind of drives everything. So, you know, I am, like I said, you know, there's a big difference between just typing something in the chat, GBT, and then knowing like, where are those outputs coming from? It could be pulling half the information from a random study somewhere from 1997. And it could be pulling the other stuff from the Aspen guidelines. Like you don't know, unless you ask. So, you know, that's really what drives it is like, okay, how do we... Everything that I'm building has to be and everything that I'm doing also in my daily practice, know, like we're kind of redoing a lot of our TPN policies here that are a little bit outdated. And so how do we build that all from the most recent Aspen guidelines? know, mean, this providers trust, you know, these kinds of organizations for their practice. And so they need to know that, you know, whether it's the outputs from an AI chat or whether, you know, what is their nutrition department doing, if an administration is concerned about policies and that sort of thing. ⁓ Where are these policies coming from? So everything has to be research and credible organization based. So without that, nothing really goes forward because you can't trust it. Kristen Hicks-Roof PhD, RD: Well, and it's so interesting. Like I've really gotten down this rabbit hole as I'm learning more about large language models and AI is how they're pulling information doesn't necessarily come from the most credible sourcing, right? Like you would think Aspen guidelines would be the primary driver if you're thinking about internal nutrition formulas. However, it could be, you know, Sally blue's blog and LinkedIn posts and all these other things where you're like, wait a minute, is that really the most appropriate? But Richard Erhart: Yeah. Mm-hmm. Yeah. Kristen Hicks-Roof PhD, RD: It's kind of, it's something that I think we need to continue to understand. And as health professionals and clinicians, like how are we making sure that our content and the content of not only the literature, but also practice guidelines are fueling the responses rather than random information from people who maybe don't have those skills, knowledge or credentials behind it. So. It's really interesting. And that's why you have tools like intake IQ or like up to date where you build this trustworthy machine and engine built on credible science, incredible recommendations. So that way they don't need to go and find all the original sourcing. So I really, I think that's something to be proud of, but it's also something that is needed in our field, especially as science is ever changing and recommendations change, right? Like all the time. Richard Erhart: Yeah. Yeah. Mm-hmm. Kristen Hicks-Roof PhD, RD: why you have to keep on top of different clinical needs or recommendations. So what's been your favorite so far? I mean, you've kind of grown the ladder in the clinical setting and now you're jumping off on your own endeavor, but what's been your most favorite or something you're most proud of in your career so far? Richard Erhart: Yeah, I think in one of the things that got me thinking, you know, in more of the business side of nutrition is ⁓ it started with malnutrition at my old hospital. We were able to launch the new initiative. We were able to ⁓ increase compliance with diagnosis, like up to 95 percent. ⁓ So the MDs were matching our diagnosis and also the number, you know, increased massively of actually like identifying malnutrition. getting a diagnosed and MD note and then actually getting that coded for reimbursement. ⁓ So that was a huge thing that kind of opened my eyes to, as RDs we're always talking about compensation and how can we be more involved in the health team and how can we get seen by administration and all these things, right? And so that was one area where I was like, well, this would be a great opportunity to, malnutrition is that area. And so, ⁓ not only building that into a tool, it's like just, you know, every day into our hospitals in a management setting, you know, like that, speak the language of, you know, like other units and things, because, you know, this is the language that's going to be spoken and, you know, your quality meetings and, ⁓ and things like that. So, you know, that's how you really kind of get integrated in that system. And, and I think that's ⁓ really important for us, you know, ⁓ as a, as a profession. ⁓ I think that's probably one of the ⁓ most important things that I've done is play a in that. ⁓ And I think that me, ⁓ that manager, ⁓ specifically prepared me pretty well for my role now. ⁓ And ⁓ just ⁓ really ⁓ kind pouring into me a bunch of knowledge, you know, ⁓ as clinical RDs, don't see the management side. ⁓ And so, ⁓ you know. It's really important for our managers, clinical managers, to really represent our field and really treat the RDs, blow them well, and prepare them for what's to come. Kristen Hicks-Roof PhD, RD: When I think what you talked about, how you could actually show the return on investment or the ROI as a clinical dietitian, especially with malnutrition, like that's something that I've been trying to push our profession as well is no matter what fields you're in, if you're in research and education and clinical and private practice and media, how do you add a return to the greater industry? Right? So like if you're in a hospital setting, in order for us to have more respect and more inclusion on healthcare teams, we have to show you the value add towards the patient. That may be reduced length of stay, improved clinical outcomes, ⁓ more billing and coding opportunities, right? And so until we show those types of like measurable dollar associated outcomes, I don't think we're gonna go that direction. I know I presented a webinar with Great Valley Publishing the other day. Richard Erhart: No, I agree. Kristen Hicks-Roof PhD, RD: on the physician-dietician relationship and how we really have to show value in your individual setting. And then my dream job would be like, hey, Richard, you're showing value at your hospital? Publish that data. Present it at FENCY. Go to some of these conferences where now all of a we can populate the literature of saying, wow, when dieticians were on a critical care unit, Richard Erhart: Mm-hmm. Mm-hmm. Kristen Hicks-Roof PhD, RD: they reduced length of stay, they brought in X number of dollars because of the malnutrition diagnosis, right? And that all of a now your little win turns into this bigger win that we as a profession can then use to be a data source as to why we're really good. Would you agree? Richard Erhart: Yeah, no, absolutely. And then, I mean, that's not even touching on the, you know, getting ready for discharge, like good interventions versus bad interventions by us can totally, like you said, obviously delay their length of stay. But I mean, readmission data too. I mean, how many people go to inpatient rehab and then come right back because they're malnourished and weak and they just functionally can't do it or home health, vice versa. ⁓ So, I mean, I think that's all data that just hasn't been quantified yet. And I think if we can quantify that and show it ⁓ to the decision makers, you I think that not only promotes our field and gets us more involved in clinical care and, ⁓ you know, which is all things people want, but it helps patients. I mean, these are, we're not diagnosing patients that don't have malnourished. Like these are people who are malnourished. We just aren't getting credit or reimbursement or anything back from it where, you know, we're just treating and we're not getting anything for it. And so it's like, you know, it can. you know, like this is is good for the profession, you know, it's good for the patients, it's good for us, and it's good for the physicians. So, ⁓ you know, it just needs to be communicated. And I think it's starting to I'm starting to see more content on it, and more education on it. But it really is kind of this still feels like some almost like an emerging field, you know, I've been in a bunch of different hospitals, and it's, you know, it is totally variable, you know, where you go. ⁓ And so I think it's this emerging field that's One thing I focus on and kind of like pitch with Intake IQ is like, hey, help drive this malnutrition initiative in your hospital. ⁓ And so, you know, I think all these things can be extremely helpful. And like, of course, you know, everybody wants a little bit more compensation. you know, if you can show that, hey, I saw a post on LinkedIn the other day, you know, ⁓ per dietitian, you know, ⁓ they were generating almost 150,000 of reimbursement, you know, per dietitian. you know, and if the dietician is getting paid 50 or 60, like that doesn't really match up. So, you know, if you're showing this value, then, you know, you will be rewarded for it. And like you said, like, what is the value that we're bringing? Like this is the value of what's communicated. Kristen Hicks-Roof PhD, RD: What I think we know it as dieticians and nutrition professionals, we're like, I see patients not being readmitted because I'm not going back to see them. I see patients happier and healthier and improve strength and mobility, whatever it might be. But that's all what you see, right? Like we need to be documenting, charting, and then presenting that data in the masses to be able to really move administrators and really move the profession overall. Richard Erhart: Mm-hmm. Kristen Hicks-Roof PhD, RD: I think there was a lot of room to improve it. I like how you said it's emerging, which is sad. We're in 2026 and it's emerging, but I think we've been doing it all along and now we're finally collecting the data because we're like, ⁓ clearly we need to show value in terms of like a benefit beyond just we know they're doing a really good job. And I think that's for, I mean, if you've listened to any other episodes across the podcast, you know, whether you're in the food industry or if you're in supplements or if you're in clinical or if you're in private practice, like we always are showing this. But why are we not learning it in school? Like I think that's something that we also need to be thinking about. If you're an educator, like we need to be integrating what ROI means and how we measure it across these different nation sectors to really make sure that as they become dietitians or whatever field they go into, they realize that they can not only provide the services and help the patients, which is our number one. Richard Erhart: Yeah. Kristen Hicks-Roof PhD, RD: but then they also are benefiting the bigger picture because everything in the end of the day is about money, right? And your hospital is there to, you know, process money and help patients in the meantime. But so what tips or recommendations or advice would you give someone who maybe is interested in, you know, clinical supervisor type role and or maybe interested in like health technology and making that leap of faith to be able to Richard Erhart: Yeah, absolutely. Kristen Hicks-Roof PhD, RD: really fill a gap in something that you may see in your facility. Richard Erhart: Yeah. ⁓ tips for, mean, really for me, for leadership, it is, you know, don't just wait for somebody to come to you or for you to, you know, hopefully have that experience, like constantly be seeking knowledge and wisdom. So, ⁓ whether it's somebody you respect that you want to be like in your facility, whether that's outside of life too. mean, I think that's an all things, ⁓ you know, seek that wisdom from, I They can be leaders in other industries. You know, they don't have to be leaders in as a dietitian and they can be and that's great. ⁓ and I've had those and then I've also just observed, you know, leadership is a lot of times just general qualities. And so, you know, and, something that can be learned too, you know, that's, that's one thing too, is I've seen so many people just kind of say, well, this is just kind of the way I am. And it's like, you can learn a lot of these skills and it may be uncomfortable, but, you can, you know, I mean, I was very much an introvert. previously back when I was in high school and you I am definitely not so much anymore. ⁓ you know, like you can learn these things and you can learn these skills and you can, if you admire it, then you can become that. You just need to learn from somebody and practice those things. you know, it just requires a lot of work. And so ⁓ I would say always be have open ears, always be listening, always be willing to ⁓ just take on ⁓ you mentors, I think is probably the most important thing in whatever you want to do. And then do what you love because that is really, I think where you get the, that's where I always, I get the fire behind everything that I'm doing is, you know, that's why I love intake IQ is like, love the software space. love business. I love numbers. I love, you know, all these things. And so, you know, like that's what's really gets me going, you know, is, being able to take what I do as a supervisor and then apply that into a totally different area and kind of see, get to see that come to life. ⁓ you know, so that's for me, that's like, what does it for me? But you just have to find that for you. Like, what does that thing for you? I think you had mentioned it's research for you, you know? ⁓ And so it's, you know, for everybody, it's going to be a little bit different. There's a lot of different personalities as dietitians. And so, you know, lean on that, find something you love, and then just learn it. Kristen Hicks-Roof PhD, RD: What I think is such good advice too of like follow your passions and your passions will guide you to all the different career fields that we have in nutrition. if you've listened to any episodes on this podcast, you can see how diverse our fields are. And so I think that is something I remember when I was an academic and I used to tell students like obviously try new things, right? That you maybe didn't know like you moved to Houston and you. Richard Erhart: Mm-hmm. Kristen Hicks-Roof PhD, RD: went in a clinical heavy internship, which you were maybe hesitant or unsure that that's the direction you wanted to go. So sometimes it's yes to things that are out of your thought process, that that's in your zone or in your bubble. I think it's some of that. then all of a sudden you're like, I'm putting all my passions into one. Right. You talked about how you love numbers and you love business, but you also love the clinical side. And it's like intake IQ is this convergence of all of those. And it's really just your passion and now you found this gap to be able to fill the passion. So I think it's really good advice there. And I loved how you also talked about mentors because I don't think any person is successful in the career path that they are. And they couldn't name one mentor that, you know, made a profound impact on them. So I think it's an opportunity for us to continue to seek mentors, but also be mentors. So if you are Richard Erhart: Mm-hmm. Kristen Hicks-Roof PhD, RD: middle career or later in your career, like making sure that you're devoting at least some time, it may not be a big chunk of time, but at least some time to really guide, support, inspire, and mentor that next generation who want to pursue especially niche and diverse career paths, or starting your own health technology. That's not easy. You had to likely get mentorship and guidance to be able to go that direction. Richard Erhart: Yeah, no, it wasn't easy to start learning all that. yeah, I mean, think that's the other thing is just really be open to different possibilities. that's one thing that I always struggled with was like, okay, well, I guess my options are clinical or outpatient or food service. And it's like, no, there's dietitians. I email one for our shipping and receiving. It's like, there's a dietitian who does shipping and receiving for a company. There's sales reps. clinical liaisons, there's clinical informatics if you like IT, there's endless possibilities, including starting your own business if you really wanted to do that. And it's not, like I said, it's not just private practice, there's a bunch of other gaps that need to be filled by somebody, and somebody will eventually, and so why not be you? Kristen Hicks-Roof PhD, RD: Yeah, no, think you bring a lot of good advice and, you know, I'm kind of, when I was interested in starting this podcast, it was kind of like, I've been on a lot of podcasts before, but I didn't know what it was going to be like on here. So every day I'm learning. I mean, there's new things. like, the other day I was on a podcast and someone had like a disclosure form and I was like, that's really smart. I never thought about, I need a disclosure form, you know? And so I think you can learn as you go to that. Richard Erhart: Mm-hmm. Yeah. Kristen Hicks-Roof PhD, RD: you can kind of absorb. You talked about having those open ears and just listening and being curious. And I do think that's a way that you can help to realize that there's gaps and then do something that makes you uncomfortable, especially if it's something you're passionate about. Okay, my favorite question. If you had a crystal ball, what do you think is coming next in nutrition, Richard? Richard Erhart: I think technology is a big part of it. That's why I'm doing what I'm doing is because I see that wave coming ⁓ and it's coming quick. ⁓ And so, you know, it's like, don't know what that looks like. I don't know what that's going to be like. I mean, I think most of it is kind of because it is so new, it's kind of limited to the EMRs and charting and the, you know, it's starting there, but eventually it will make it out to our niche. And so, you know, I think that's probably, you know, like really modernizing the industry is going to be the wave that's coming next. ⁓ And so that's why I kind of wanted to get ahead of it. like, again, you know, why not you? So, you know, try it. If you fail, it's okay. And just try to get ahead of it and see what that looks like. ⁓ you know, I think it's really important for the clinicians and not just for our domain, but really for any. domain, whether it's respiratory therapy or physical therapy or you're an NP, ⁓ know, really having a role in the development of those softwares. You know, like I think that we need to put clinician brains behind a lot of this technology. Otherwise, like we've seen count. I've seen a lot of LinkedIn, you know, content about just like the safety of AI and like, how do we really, we need to, everyone was excited and started implementing all these things and then they realized, oh wow, okay, this actually isn't as smart as we think it is. Like, you know, this is not replacing us, obviously. Like, this is something we need to harness and control and, you know, have safety guidelines and build control with. you know, like I said, I think it can be effective in the right setting, but it's like, you know, we need providers to build those guardrails. And we need us, like the brains behind it, the research to still fuel all that. Kristen Hicks-Roof PhD, RD: When to me, I feel like the clinicians and the nutrition experts almost helped to bridge this gap, right? So you have all this, AI is great about just content. And content is awesome, right? We know as educators, you can always teach something. You could teach anything you want to your patient, but you also need to bridge this gap of where is the patient or the community member or the clinician or whoever it might be. Richard Erhart: Yeah. Mm-hmm. Mm-hmm. Kristen Hicks-Roof PhD, RD: where are they in their baseline knowledge and then where are they able to learn or change behaviors? And so you really have to bridge this gap. And I think that the same goes for AI technologies. Like, yes, of course you're gonna have, you know, the food industry and the pharmaceutical industry and the agriculture industry. Like every industry is gonna adopt AI. And they've already been, begin adopting it. But how do we make sure that a nutrition expert sits at the crux of it? so that way they can translate it into practical, into real life guidance that would make sense for a patient, right? Because sometimes what gets spit out of AI like sounds good in theory and then you're like, wait a minute, like that patient can't eat that food or that doesn't make any sense for that cultural diet or whatever it is. And you're like, okay, this is a great idea but I gotta start back from ground zero because that is not appropriate. And especially I feel like in the clinical space when you are Richard Erhart: Yeah. Yeah. Kristen Hicks-Roof PhD, RD: you know, potentially life saving in like an ICU where you can't necessarily, you know, really overdo certain vitamins or minerals, or you could actually, you know, contribute to a heart attack or something like that. I mean, that you, can't really rely on some of these technologies for something very critical at this time. Richard Erhart: Mm-hmm. Yeah, it's really important. Yeah, it's just, it's, you know, it's really, it's really early. Like you really still need clinicians to be behind this and be like, Hey, well that doesn't make sense. I mean, there's, there's been several times where it's like, you know, you push back on something like on Chad GBT and it's like, ⁓ yeah, good point. You're right. And it's like, okay, well that would have been bad if you just took it, took its advice. And so, you know, it's like, how can we best build something that is still useful, but you know, it's modern, it's useful, but it's not. you know, like we need to still be in charge of everything. Kristen Hicks-Roof PhD, RD: love that you gave that example, Richard, because it was so funny. The other day I was I was ideating a concept of a speaking presentation. I'm like, give me some ideas of people who might be good co presenters in this area. a researcher got populated in there. And then I was like, wait, that researcher like they passed away. And so like, I looked it up because I wanted to confirm and then I got back and I went to like Chad GPT. And I was like, actually, that researcher is not Richard Erhart: Nah. Kristen Hicks-Roof PhD, RD: able to do it, they had passed away and it's like, oh, thanks for the feedback. And I'm like, wow, this is crazy. if I would have just taken it straight on, you know what I mean? Like that is not So Richard, Richard, thank you so much for the conversation. If you like the, like the conversation, make sure you like, subscribe, leave a review, but most importantly, check out the next episode because every episode I bring out a different dietitian or nutrition professional to share their story and give you tips and advice on how to be successful in that career. Richard Erhart: ⁓ ⁓ ⁓