Guest guest Posted January 20, 2007 Report Share Posted January 20, 2007 Chris: This was great that you detailed all this for us. I have a few comments being a former business teacher myself. Now let me caveat this by saying I have not made the Fortune 500 myself as yet. I worked in the business world for 10 years (have an MBA), taught business, management and economics for 10 years after that, and as a small business person have a made a few mistakes and continue to learn. The " keeping overhead low " thing was told to me by a chiropractor when I first came out of school. I did not listen to him and got my own space at $1000/month, repainted, new blinds $2k. Two weeks later a tornado hit the town (hardley predictable since the last time it happened was 100 years ago.) It devasted a lot of buildings near mine but not mine. I was obligated to pay that rent for a year in a town that looked war torn. Everyone came to my house basically, which is where I stil am predominately. I went into a dr.'s office two days last year (and the phone rang). I am about to join a wellness center (still part time for starting rent of $320 (no lease) The doctor was $400 (a lease that was binding even when I left earlier - it was hectic in there). I do advertise and write an article every month (and it is effective) This is $85 - $125 per month. I do other advertising occassionally. Okay Chris, what I wanted to add to your comments is: I think you should cover that overhead faster. I think 19 patients is too hard of labor to put out for overhead alone. One easy way to do it is raise rates. $65 is very low. One of our practitioners in our area who is a " live off the land " person and treats in a trailer on a farm just raised her rates to $75. Mine are $85 and another practioner in town is $90. First treatments run $150 to $160. I do a history and a treatment on the first day, so it runs about 1.5. hrs. Usually people need treatment right away. Now I know someone who is playing an insurance game and charging those without insurance much lower rates and those with much higher than what I just quoted you. Frankly, I need to sleep at night. I do worry about not serving everyone and I think the answer to that is clinics like Andrea has formed when you treat a group of people in lounge chairs. Otherwise a personal service like ours is worth so much more .. Massage therapists in my area charge $75 (for their basic massage) and they go to school a year with a curriculum not nearly as demanding as ours. I like the Hawaian philosophy of community service, but my mechanic only accepts cash or check. Please take this in the spirit it was meant - to help. I struggle with these issues too. Anne -------------- Original message ---------------------- " Christopher Vedeler L.Ac. " <ckvedeler > Hi Trish, > > I teach practice management at PIHMA so this is a topic dear to my heart. > It seems that many of us acupuncturists drop the ball when it comes to the > business side of our practice. I wish all of us could be successful making > a good living doing what we love. > > Here are a few things I do to keep my overhead low - > 1) I work solo. I don't have an office manager. Save $20 - $30 thousand a > year or about $2500 a month. A $54 a month business line comes with > voicemail. I may loose a potential patient or two a month because I can't > answer the phone right away, but it isn't enough to justify a whole salary. > If I was much busier, I would need an office manager, but I just haven't > reached that point and I'm not sure I want to. I like keeping my patient > load between 25 and 30 patients a week for my own energy and sanity. > 2) I have a smaller office space. My rent is $1200 a month for 600 square > feet, which is pretty cheap for Scottsdale. > 3) I have two treatment rooms, but one of them was going un-used most of > the time since I only book one person at a time for a hour (the way I like > it). So I sub-leased the other room to a reiki practitioner, reducing my > rent effectively to $700 a month. I typically cover my rent within 2 - 4 > days of seeing patients. > 4) I target my marketing. I only spend money on marketing the produces > good results. This means that I track carefully where patients hear of me. > 5) My only other expenses are needles, herbs, office supplies and my phone > line. > > On a typical month my total overhead for a month is about $1200. At $65 a > patient I need to see about 19 patients a month to break even. I'm > currently seeing about 80 - 100 a month. That leaves a net income of about > $4000 - $5000 a month. While I won't get rich at that rate, it is a > comfortable living doing what I love and not being so busy that I burn out > (something very important to keep in mind!). I also teach 2 days a week at > the local acupuncture college supplementing my income an additional $800 a > month. > > Christopher Vedeler L.Ac., C.Ht. > Oasis Acupuncture > http://www.oasisacupuncture.com > 9832 N. Hayden Rd. > Suite 215 > Scottsdale, AZ 85258 > Phone: (480) 991-3650 > > > Chinese Medicine > Chinese Medicine On Behalf Of pippa258 > Thursday, January 18, 2007 6:35 AM > Chinese Medicine > Keeping Overhead Low > > > > >>I priced my services not only to be competitive with my fellow L.Ac.'s but > to make them available to more people. While most of my patients are from > within 10 miles of my office, I draw from the whole valley with several > patients willing to drive an hour or more one way to see me. I make a good > living (by keeping my overhead low) and am fairly busy. I've been in > practice for over 2 years.<< > Christopher Vedeler L.Ac., C.Ht. > > Hi Christopher, > > Can you detail what you do to keep your overhead low? > > Thanks, > Trish -- > Internal Virus Database is out-of-date. > > Version: 7.5.432 / Virus Database: 268.15.29/607 - Release 12/28/2006 > 12:31 PM > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2007 Report Share Posted January 20, 2007 Wow, I'm bowled over by the fees for acupuncture in your neck of the woods, Anne. Where do you live? I'm on Long Island, one of the more expensive parts of the country and fees here are around what I charge - $95 for a first, 1.5 hour visit, and $70 for follow-ups. I do offer reduced fees for retirees, teens and children. It's also important to me to keep about 25% of my treatment appointments available for those who can't pay my usual fee. Those treatments are at whatever price the patient feels s/he can afford and range from $40 down to nothing at all. That allows me to pay my bills and while still being of service to those who don't have much money. I also founded a free clinic in another town which offers Reiki, massage, chiropractic, acupuncture and yoga one day a week to those in need. It's totally staffed by volunteers. To those just starting out, I would say to really listen to the advice about keeping overhead low. Otherwise you're working to support a fancy office and, out of necessity, that's where your focus will be. When you think about overhead, it's good to also think about the overhead of your personal life. If you buy the fanciest car or the biggest house, that impacts your attitude about work. If you keep overhead low, you'll be more easily able to make a living and you'll be able to share your services more freely with those who can't afford your fees. I think paid advertising is pretty much a waste of money. About 2/3 of new patients at my office come in because another patient referred them to me and that's the best advertising in the world. Most people want a referral for something like acupuncture and patients who receive good care love to tell others about acupuncture. I've noticed that as soon as they start to feel better, many of my patients want to spread the word and will ask if acupuncture can help a different health challenge that's being experienced by someone they care about. After answering their questions, I give them a copy of " The Acupuncture Answer Book " (available from Dove Publishing) to pass on to that friend or relative. Bottom line in all of this..... I feel so lucky and so grateful to be able to do this work. I see the changes acupuncture and Chinese medicine make in people's lives and it feels great to be part of that. I also love the experience of getting to know so many amazing and courageous people. My patients teach and give me as much as I do them. To me, getting the money part of the program in balance is important only because it then allows me to focus on what's truly important and that's about compassion, service and joy. Peace, Liz Casey - anne.crowley Chinese Medicine Saturday, January 20, 2007 10:23 AM RE: Business Mgmt Chris: This was great that you detailed all this for us. I have a few comments being a former business teacher myself. Now let me caveat this by saying I have not made the Fortune 500 myself as yet. I worked in the business world for 10 years (have an MBA), taught business, management and economics for 10 years after that, and as a small business person have a made a few mistakes and continue to learn. The " keeping overhead low " thing was told to me by a chiropractor when I first came out of school. I did not listen to him and got my own space at $1000/month, repainted, new blinds $2k. Two weeks later a tornado hit the town (hardley predictable since the last time it happened was 100 years ago.) It devasted a lot of buildings near mine but not mine. I was obligated to pay that rent for a year in a town that looked war torn. Everyone came to my house basically, which is where I stil am predominately. I went into a dr.'s office two days last year (and the phone rang). I am about to join a wellness center (still part time for starting rent of $320 (no lease) The doctor was $400 (a lease that was binding even when I left earlier - it was hectic in there). I do advertise and write an article every month (and it is effective) This is $85 - $125 per month. I do other advertising occassionally. Okay Chris, what I wanted to add to your comments is: I think you should cover that overhead faster. I think 19 patients is too hard of labor to put out for overhead alone. One easy way to do it is raise rates. $65 is very low. One of our practitioners in our area who is a " live off the land " person and treats in a trailer on a farm just raised her rates to $75. Mine are $85 and another practioner in town is $90. First treatments run $150 to $160. I do a history and a treatment on the first day, so it runs about 1.5. hrs. Usually people need treatment right away. Now I know someone who is playing an insurance game and charging those without insurance much lower rates and those with much higher than what I just quoted you. Frankly, I need to sleep at night. I do worry about not serving everyone and I think the answer to that is clinics like Andrea has formed when you treat a group of people in lounge chairs. Otherwise a personal service like ours is worth so much more . Massage therapists in my area charge $75 (for their basic massage) and they go to school a year with a curriculum not nearly as demanding as ours. I like the Hawaian philosophy of community service, but my mechanic only accepts cash or check. Please take this in the spirit it was meant - to help. I struggle with these issues too. Anne -------------- Original message ---------------------- " Christopher Vedeler L.Ac. " <ckvedeler > Hi Trish, > > I teach practice management at PIHMA so this is a topic dear to my heart. > It seems that many of us acupuncturists drop the ball when it comes to the > business side of our practice. I wish all of us could be successful making > a good living doing what we love. > > Here are a few things I do to keep my overhead low - > 1) I work solo. I don't have an office manager. Save $20 - $30 thousand a > year or about $2500 a month. A $54 a month business line comes with > voicemail. I may loose a potential patient or two a month because I can't > answer the phone right away, but it isn't enough to justify a whole salary. > If I was much busier, I would need an office manager, but I just haven't > reached that point and I'm not sure I want to. I like keeping my patient > load between 25 and 30 patients a week for my own energy and sanity. > 2) I have a smaller office space. My rent is $1200 a month for 600 square > feet, which is pretty cheap for Scottsdale. > 3) I have two treatment rooms, but one of them was going un-used most of > the time since I only book one person at a time for a hour (the way I like > it). So I sub-leased the other room to a reiki practitioner, reducing my > rent effectively to $700 a month. I typically cover my rent within 2 - 4 > days of seeing patients. > 4) I target my marketing. I only spend money on marketing the produces > good results. This means that I track carefully where patients hear of me. > 5) My only other expenses are needles, herbs, office supplies and my phone > line. > > On a typical month my total overhead for a month is about $1200. At $65 a > patient I need to see about 19 patients a month to break even. I'm > currently seeing about 80 - 100 a month. That leaves a net income of about > $4000 - $5000 a month. While I won't get rich at that rate, it is a > comfortable living doing what I love and not being so busy that I burn out > (something very important to keep in mind!). I also teach 2 days a week at > the local acupuncture college supplementing my income an additional $800 a > month. > > Christopher Vedeler L.Ac., C.Ht. > Oasis Acupuncture > http://www.oasisacupuncture.com > 9832 N. Hayden Rd. > Suite 215 > Scottsdale, AZ 85258 > Phone: (480) 991-3650 > > > Chinese Medicine > Chinese Medicine On Behalf Of pippa258 > Thursday, January 18, 2007 6:35 AM > Chinese Medicine > Keeping Overhead Low > > > > >>I priced my services not only to be competitive with my fellow L.Ac.'s but > to make them available to more people. While most of my patients are from > within 10 miles of my office, I draw from the whole valley with several > patients willing to drive an hour or more one way to see me. I make a good > living (by keeping my overhead low) and am fairly busy. I've been in > practice for over 2 years.<< > Christopher Vedeler L.Ac., C.Ht. > > Hi Christopher, > > Can you detail what you do to keep your overhead low? > > Thanks, > Trish > > > > > > > -- > Internal Virus Database is out-of-date. > > Version: 7.5.432 / Virus Database: 268.15.29/607 - Release 12/28/2006 > 12:31 PM > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2007 Report Share Posted January 20, 2007 Liz: I am in a suburb of Washington, D.C. but I think suppy and demand dictates the rates also. In Columbia, MD there are hundreds of acupuncturists because the school is there. Baltimore is close by and there are a lot of healing practitioners there. Practtioners have reduced rates or joined insurance plans in Columbia to get practices going. Also if you see more than one person an hour, this may still give you a good living at $70 a treatment. I have heard all kinds of things around this Liz. I even went to a practice management group once with some colleagues of mine. They were real hard sell, set up orignally for chiropractors. I could not stomach this after a short while. On the other hand, people some how feel guilty about charging for what we do. My dentist gets paid well, my doctor gets paid well , my automechanic gets paid well. I have a neighbor that drives a Hummer and has all kinds of things - he is a manager at a car dealership (with a whole lot less training than acupuncturists) Yes, I feel priveleged to be doing what we do. I went to a hypnotherapist (with much less training than ours) in Baltimore. She charged me $85. She is good and I did not mind paying her. My acupuncturist in Columbia (who has a very established practice) also charges $85. Silver Spring and Bethesda can be a lot more. Bottom line (no pun intended). I think we have to do what we are comfortable with. Anne -------------- Original message ---------------------- Liz <lizzzrd > Wow, I'm bowled over by the fees for acupuncture in your neck of the woods, > Anne. Where do you live? I'm on Long Island, one of the more expensive parts > of the country and fees here are around what I charge - $95 for a first, 1.5 > hour visit, and $70 for follow-ups. I do offer reduced fees for retirees, > teens and children. It's also important to me to keep about 25% of my treatment > appointments available for those who can't pay my usual fee. Those treatments > are at whatever price the patient feels s/he can afford and range from $40 down > to nothing at all. That allows me to pay my bills and while still being of > service to those who don't have much money. I also founded a free clinic in > another town which offers Reiki, massage, chiropractic, acupuncture and yoga one > day a week to those in need. It's totally staffed by volunteers. > > To those just starting out, I would say to really listen to the advice about > keeping overhead low. Otherwise you're working to support a fancy office and, > out of necessity, that's where your focus will be. When you think about > overhead, it's good to also think about the overhead of your personal life. If > you buy the fanciest car or the biggest house, that impacts your attitude about > work. If you keep overhead low, you'll be more easily able to make a living and > you'll be able to share your services more freely with those who can't afford > your fees. > > I think paid advertising is pretty much a waste of money. About 2/3 of new > patients at my office come in because another patient referred them to me and > that's the best advertising in the world. Most people want a referral for > something like acupuncture and patients who receive good care love to tell > others about acupuncture. I've noticed that as soon as they start to feel > better, many of my patients want to spread the word and will ask if acupuncture > can help a different health challenge that's being experienced by someone they > care about. After answering their questions, I give them a copy of " The > Acupuncture Answer Book " (available from Dove Publishing) to pass on to that > friend or relative. > > Bottom line in all of this..... I feel so lucky and so grateful to be able to > do this work. I see the changes acupuncture and Chinese medicine make in > people's lives and it feels great to be part of that. I also love the > experience of getting to know so many amazing and courageous people. My > patients teach and give me as much as I do them. To me, getting the money part > of the program in balance is important only because it then allows me to focus > on what's truly important and that's about compassion, service and joy. > > Peace, Liz Casey > > - > anne.crowley > Chinese Medicine > Saturday, January 20, 2007 10:23 AM > RE: Business Mgmt > > > Chris: > > This was great that you detailed all this for us. I have a few comments being > a former business teacher myself. Now let me caveat this by saying I have not > made the Fortune 500 myself as yet. > > I worked in the business world for 10 years (have an MBA), taught business, > management and economics for 10 years after that, and as a small business person > have a made a few mistakes and continue to learn. > > The " keeping overhead low " thing was told to me by a chiropractor when I first > came out of school. I did not listen to him and got my own space at $1000/month, > repainted, new blinds $2k. Two weeks later a tornado hit the town (hardley > predictable since the last time it happened was 100 years ago.) It devasted a > lot of buildings near mine but not mine. I was obligated to pay that rent for a > year in a town that looked war torn. Everyone came to my house basically, which > is where I stil am predominately. I went into a dr.'s office two days last year > (and the phone rang). I am about to join a wellness center (still part time for > starting rent of $320 (no lease) The doctor was $400 (a lease that was binding > even when I left earlier - it was hectic in there). I do advertise and write an > article every month (and it is effective) This is $85 - $125 per month. I do > other advertising occassionally. > > Okay Chris, what I wanted to add to your comments is: I think you should cover > that overhead faster. I think 19 patients is too hard of labor to put out for > overhead alone. One easy way to do it is raise rates. $65 is very low. One of > our practitioners in our area who is a " live off the land " person and treats in > a trailer on a farm just raised her rates to $75. Mine are $85 and another > practioner in town is $90. First treatments run $150 to $160. I do a history and > a treatment on the first day, so it runs about 1.5. hrs. Usually people need > treatment right away. Now I know someone who is playing an insurance game and > charging those without insurance much lower rates and those with much higher > than what I just quoted you. Frankly, I need to sleep at night. I do worry about > not serving everyone and I think the answer to that is clinics like Andrea has > formed when you treat a group of people in lounge chairs. Otherwise a personal > service like ours is worth so much more > . Massage therapists in my area charge $75 (for their basic massage) and they > go to school a year with a curriculum not nearly as demanding as ours. > > I like the Hawaian philosophy of community service, but my mechanic only > accepts cash or check. > > Please take this in the spirit it was meant - to help. I struggle with these > issues too. > > Anne > > -------------- Original message ---------------------- > " Christopher Vedeler L.Ac. " <ckvedeler > > Hi Trish, > > > > I teach practice management at PIHMA so this is a topic dear to my heart. > > It seems that many of us acupuncturists drop the ball when it comes to the > > business side of our practice. I wish all of us could be successful making > > a good living doing what we love. > > > > Here are a few things I do to keep my overhead low - > > 1) I work solo. I don't have an office manager. Save $20 - $30 thousand a > > year or about $2500 a month. A $54 a month business line comes with > > voicemail. I may loose a potential patient or two a month because I can't > > answer the phone right away, but it isn't enough to justify a whole salary. > > If I was much busier, I would need an office manager, but I just haven't > > reached that point and I'm not sure I want to. I like keeping my patient > > load between 25 and 30 patients a week for my own energy and sanity. > > 2) I have a smaller office space. My rent is $1200 a month for 600 square > > feet, which is pretty cheap for Scottsdale. > > 3) I have two treatment rooms, but one of them was going un-used most of > > the time since I only book one person at a time for a hour (the way I like > > it). So I sub-leased the other room to a reiki practitioner, reducing my > > rent effectively to $700 a month. I typically cover my rent within 2 - 4 > > days of seeing patients. > > 4) I target my marketing. I only spend money on marketing the produces > > good results. This means that I track carefully where patients hear of me. > > 5) My only other expenses are needles, herbs, office supplies and my phone > > line. > > > > On a typical month my total overhead for a month is about $1200. At $65 a > > patient I need to see about 19 patients a month to break even. I'm > > currently seeing about 80 - 100 a month. That leaves a net income of about > > $4000 - $5000 a month. While I won't get rich at that rate, it is a > > comfortable living doing what I love and not being so busy that I burn out > > (something very important to keep in mind!). I also teach 2 days a week at > > the local acupuncture college supplementing my income an additional $800 a > > month. > > > > Christopher Vedeler L.Ac., C.Ht. > > Oasis Acupuncture > > http://www.oasisacupuncture.com > > 9832 N. Hayden Rd. > > Suite 215 > > Scottsdale, AZ 85258 > > Phone: (480) 991-3650 > > > > > > Chinese Medicine > > Chinese Medicine On Behalf Of pippa258 > > Thursday, January 18, 2007 6:35 AM > > Chinese Medicine > > Keeping Overhead Low > > > > > > > > >>I priced my services not only to be competitive with my fellow L.Ac.'s but > > to make them available to more people. While most of my patients are from > > within 10 miles of my office, I draw from the whole valley with several > > patients willing to drive an hour or more one way to see me. I make a good > > living (by keeping my overhead low) and am fairly busy. I've been in > > practice for over 2 years.<< > > Christopher Vedeler L.Ac., C.Ht. > > > > Hi Christopher, > > > > Can you detail what you do to keep your overhead low? > > > > Thanks, > > Trish > > > > > > > > > > > > > > -- > > Internal Virus Database is out-of-date. > > > > Version: 7.5.432 / Virus Database: 268.15.29/607 - Release Date: 12/28/2006 > > 12:31 PM > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2007 Report Share Posted January 20, 2007 Thanks Anne. I appreciate your perspective, especially coming from a business background. I am always open to learning and growing. I think the secret to a successful practice is to realize that your practice is an extension of you. Where you are strongest your practice will be strongest and where you are most challenged, your practice will be most challenged. My $1200 a month space is very, very nice (and quite a bargain for Scottsdale). I had a patent come in a few weeks ago and she brought her husband along. While my patient was on the table, he fell asleep in the recliner next to her. She told me yesterday when I saw her for a follow up, that she had never seen that before with him. My space sets the mood and establishes the foundation for the energy of my practice. It is not something I want to skimp on. Like Thomas said a few days ago, just keeping overhead low is not the path to success. We need to be smart where we put our money and Qi so our practice can thrive, but that doesn't mean not investing where it is important. For me, next to me, my space is the most important thing. I've been told I should raise my prices before, a few times by my patients. My philosophy is to provide a $100 treatment and only charge $65. When people feel they are getting high quality at a low cost they refer more and come back more. Think of Costco. I don't want the price of the first treatment to be a major barrier for someone with limited funds to see me and so I simply charge a flat fee of $65 for everything I do. At some point I may raise my prices, but for right now $65 seems to work well and I am making a decent living. I didn't get into this medicine to get rich (or to go bankrupt either). I was also very deliberate in the pricing of my services. It was based partly on local demographics and partly on my desire to make my services available to many more people than if I charged " Scottsdale prices " . As a result I have many patients drive over an hour through Phoenix traffic to see me. Also, at $65 a treatment many of my patients don't mind coming in every week (actually making me more money). At $75 or more that might become a barrier to some of them getting the full benefits of multiple treatments. However, that said, once I am as busy as I want for several months I may raise my prices to $75 for new patients. Growing a business is like walking a tightrope. One must consider so many variables to success and put up with a lot of fear. The most important thing in my opinion is to keep clear on my original vision for both who I am and what my practice is about and then take every action I make in light of that vision. When my vision gets foggy, my practice suffers. When my vision gets clear, the phone rings and I book out. I don't know exactly what process in the universe makes that happen, but it has happened enough times to me that I have no doubt about it. Christopher Vedeler L.Ac. Oasis Acupuncture <http://www.oasisacupuncture.com/> http://www.oasisacupuncture.com 9832 N. Hayden Rd. Suite 215 Scottsdale, AZ 85258 Phone: (480) 991-3650 Chinese Medicine Chinese Medicine On Behalf Of anne.crowley Saturday, January 20, 2007 8:23 AM Chinese Medicine RE: Business Mgmt Chris: This was great that you detailed all this for us. I have a few comments being a former business teacher myself. Now let me caveat this by saying I have not made the Fortune 500 myself as yet. I worked in the business world for 10 years (have an MBA), taught business, management and economics for 10 years after that, and as a small business person have a made a few mistakes and continue to learn. The " keeping overhead low " thing was told to me by a chiropractor when I first came out of school. I did not listen to him and got my own space at $1000/month, repainted, new blinds $2k. Two weeks later a tornado hit the town (hardley predictable since the last time it happened was 100 years ago.) It devasted a lot of buildings near mine but not mine. I was obligated to pay that rent for a year in a town that looked war torn. Everyone came to my house basically, which is where I stil am predominately. I went into a dr.'s office two days last year (and the phone rang). I am about to join a wellness center (still part time for starting rent of $320 (no lease) The doctor was $400 (a lease that was binding even when I left earlier - it was hectic in there). I do advertise and write an article every month (and it is effective) This is $85 - $125 per month. I do other advertising occassionally. Okay Chris, what I wanted to add to your comments is: I think you should cover that overhead faster. I think 19 patients is too hard of labor to put out for overhead alone. One easy way to do it is raise rates. $65 is very low. One of our practitioners in our area who is a " live off the land " person and treats in a trailer on a farm just raised her rates to $75. Mine are $85 and another practioner in town is $90. First treatments run $150 to $160. I do a history and a treatment on the first day, so it runs about 1.5. hrs. Usually people need treatment right away. Now I know someone who is playing an insurance game and charging those without insurance much lower rates and those with much higher than what I just quoted you. Frankly, I need to sleep at night. I do worry about not serving everyone and I think the answer to that is clinics like Andrea has formed when you treat a group of people in lounge chairs. Otherwise a personal service like ours is worth so much more .. Massage therapists in my area charge $75 (for their basic massage) and they go to school a year with a curriculum not nearly as demanding as ours. I like the Hawaian philosophy of community service, but my mechanic only accepts cash or check. Please take this in the spirit it was meant - to help. I struggle with these issues too. Anne -------------- Original message ---------------------- " Christopher Vedeler L.Ac. " <ckvedeler@access4le <ckvedeler%40access4less.net> ss.net> > Hi Trish, > > I teach practice management at PIHMA so this is a topic dear to my heart. > It seems that many of us acupuncturists drop the ball when it comes to the > business side of our practice. I wish all of us could be successful making > a good living doing what we love. > > Here are a few things I do to keep my overhead low - > 1) I work solo. I don't have an office manager. Save $20 - $30 thousand a > year or about $2500 a month. A $54 a month business line comes with > voicemail. I may loose a potential patient or two a month because I can't > answer the phone right away, but it isn't enough to justify a whole salary. > If I was much busier, I would need an office manager, but I just haven't > reached that point and I'm not sure I want to. I like keeping my patient > load between 25 and 30 patients a week for my own energy and sanity. > 2) I have a smaller office space. My rent is $1200 a month for 600 square > feet, which is pretty cheap for Scottsdale. > 3) I have two treatment rooms, but one of them was going un-used most of > the time since I only book one person at a time for a hour (the way I like > it). So I sub-leased the other room to a reiki practitioner, reducing my > rent effectively to $700 a month. I typically cover my rent within 2 - 4 > days of seeing patients. > 4) I target my marketing. I only spend money on marketing the produces > good results. This means that I track carefully where patients hear of me. > 5) My only other expenses are needles, herbs, office supplies and my phone > line. > > On a typical month my total overhead for a month is about $1200. At $65 a > patient I need to see about 19 patients a month to break even. I'm > currently seeing about 80 - 100 a month. That leaves a net income of about > $4000 - $5000 a month. While I won't get rich at that rate, it is a > comfortable living doing what I love and not being so busy that I burn out > (something very important to keep in mind!). I also teach 2 days a week at > the local acupuncture college supplementing my income an additional $800 a > month. > > Christopher Vedeler L.Ac., C.Ht. > Oasis Acupuncture > http://www.oasisacu <http://www.oasisacupuncture.com> puncture.com > 9832 N. Hayden Rd. > Suite 215 > Scottsdale, AZ 85258 > Phone: (480) 991-3650 > > > Traditional_ <Chinese Medicine%40> Chinese_Medicine > [Traditional_ <Chinese Medicine%40> Chinese_Medicine ] On Behalf Of pippa258 > Thursday, January 18, 2007 6:35 AM > Traditional_ <Chinese Medicine%40> Chinese_Medicine > Keeping Overhead Low > > > > >>I priced my services not only to be competitive with my fellow L.Ac.'s but > to make them available to more people. While most of my patients are from > within 10 miles of my office, I draw from the whole valley with several > patients willing to drive an hour or more one way to see me. I make a good > living (by keeping my overhead low) and am fairly busy. I've been in > practice for over 2 years.<< > Christopher Vedeler L.Ac., C.Ht. > > Hi Christopher, > > Can you detail what you do to keep your overhead low? > > Thanks, > Trish -- > Internal Virus Database is out-of-date. > > Version: 7.5.432 / Virus Database: 268.15.29/607 - Release Date: 12/28/2006 > 12:31 PM > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2007 Report Share Posted January 21, 2007 Chris, et al: Well I guess I will ignite another match. I am still on the crusade of we must be paid what we are worth. Chris, why would you give a $100 service and only charge $65. So people will feel they are getting a deal. I feel that way everytime I get treatment. My acupuncturist sees only one an hour for $85. I am thinking of going to two patients and hour or hour and 15 , and this tweeks my inner guilt. She is in a different location and her salary is not the main income. There are lots lof circumstances around these things. Anyway if she went to two an hour, I would book a double appt and pay double to see her. I also wish sometimes she left the room for 10 mins or so. I leave the room, but judge when to leave based on the patient. When there are two an hour you pretty much have to leave the room in a set range of time. Some schedule 1/2 hr., 1/2 hr., 45 mins when they are working with two rooms. My osteopath (in Annapolis MD) BTW is $198 per session ($300 for first one that is longer) which is 1 hr. He's hands on the whole time. He gives you a receipt to file. Has a waiting list of months unless there is a cancellation. There was a doctor in our town who discovered the efficency of electro acupuncture. She was booking 4 an hour at $90 and hour (this is when I was $75). I heard she booked a lady in her 80's that way, who knew nothing about acupuncture. That to me is crazy. So Chris, I do think you are providing a great service. You must realize that you also need to make a living. If there are patients who definitely need a discount, give them one, but limit the number of people in your practice like this. When one leaves, make room for another. Okay Chris again, I am sticking my neck out for your sake and those new students at the school. Anne -------------- Original message ---------------------- " Christopher Vedeler L.Ac. " <ckvedeler > Thanks Anne. I appreciate your perspective, especially coming from a > business background. I am always open to learning and growing. > > I think the secret to a successful practice is to realize that your > practice is an extension of you. Where you are strongest your practice > will be strongest and where you are most challenged, your practice will > be most challenged. My $1200 a month space is very, very nice (and > quite a bargain for Scottsdale). I had a patent come in a few weeks ago > and she brought her husband along. While my patient was on the table, > he fell asleep in the recliner next to her. She told me yesterday when > I saw her for a follow up, that she had never seen that before with him. > My space sets the mood and establishes the foundation for the energy of > my practice. It is not something I want to skimp on. Like Thomas said > a few days ago, just keeping overhead low is not the path to success. > We need to be smart where we put our money and Qi so our practice can > thrive, but that doesn't mean not investing where it is important. For > me, next to me, my space is the most important thing. > > I've been told I should raise my prices before, a few times by my > patients. My philosophy is to provide a $100 treatment and only charge > $65. When people feel they are getting high quality at a low cost they > refer more and come back more. Think of Costco. I don't want the price > of the first treatment to be a major barrier for someone with limited > funds to see me and so I simply charge a flat fee of $65 for everything > I do. At some point I may raise my prices, but for right now $65 seems > to work well and I am making a decent living. I didn't get into this > medicine to get rich (or to go bankrupt either). I was also very > deliberate in the pricing of my services. It was based partly on local > demographics and partly on my desire to make my services available to > many more people than if I charged " Scottsdale prices " . As a result I > have many patients drive over an hour through Phoenix traffic to see me. > Also, at $65 a treatment many of my patients don't mind coming in every > week (actually making me more money). At $75 or more that might become > a barrier to some of them getting the full benefits of multiple > treatments. However, that said, once I am as busy as I want for several > months I may raise my prices to $75 for new patients. > > Growing a business is like walking a tightrope. One must consider so > many variables to success and put up with a lot of fear. The most > important thing in my opinion is to keep clear on my original vision for > both who I am and what my practice is about and then take every action I > make in light of that vision. When my vision gets foggy, my practice > suffers. When my vision gets clear, the phone rings and I book out. I > don't know exactly what process in the universe makes that happen, but > it has happened enough times to me that I have no doubt about it. > > Christopher Vedeler L.Ac. > Oasis Acupuncture > <http://www.oasisacupuncture.com/> http://www.oasisacupuncture.com > 9832 N. Hayden Rd. > Suite 215 > Scottsdale, AZ 85258 > Phone: (480) 991-3650 > > > > Chinese Medicine > Chinese Medicine On Behalf Of > anne.crowley > Saturday, January 20, 2007 8:23 AM > Chinese Medicine > RE: Business Mgmt > > > > Chris: > > This was great that you detailed all this for us. I have a few comments > being a former business teacher myself. Now let me caveat this by saying > I have not made the Fortune 500 myself as yet. > > I worked in the business world for 10 years (have an MBA), taught > business, management and economics for 10 years after that, and as a > small business person have a made a few mistakes and continue to learn. > > The " keeping overhead low " thing was told to me by a chiropractor when I > first came out of school. I did not listen to him and got my own space > at $1000/month, repainted, new blinds $2k. Two weeks later a tornado hit > the town (hardley predictable since the last time it happened was 100 > years ago.) It devasted a lot of buildings near mine but not mine. I was > obligated to pay that rent for a year in a town that looked war torn. > Everyone came to my house basically, which is where I stil am > predominately. I went into a dr.'s office two days last year (and the > phone rang). I am about to join a wellness center (still part time for > starting rent of $320 (no lease) The doctor was $400 (a lease that was > binding even when I left earlier - it was hectic in there). I do > advertise and write an article every month (and it is effective) This is > $85 - $125 per month. I do other advertising occassionally. > > Okay Chris, what I wanted to add to your comments is: I think you should > cover that overhead faster. I think 19 patients is too hard of labor to > put out for overhead alone. One easy way to do it is raise rates. $65 is > very low. One of our practitioners in our area who is a " live off the > land " person and treats in a trailer on a farm just raised her rates to > $75. Mine are $85 and another practioner in town is $90. First > treatments run $150 to $160. I do a history and a treatment on the first > day, so it runs about 1.5. hrs. Usually people need treatment right > away. Now I know someone who is playing an insurance game and charging > those without insurance much lower rates and those with much higher than > what I just quoted you. Frankly, I need to sleep at night. I do worry > about not serving everyone and I think the answer to that is clinics > like Andrea has formed when you treat a group of people in lounge > chairs. Otherwise a personal service like ours is worth so much more > . Massage therapists in my area charge $75 (for their basic massage) and > they go to school a year with a curriculum not nearly as demanding as > ours. > > I like the Hawaian philosophy of community service, but my mechanic only > accepts cash or check. > > Please take this in the spirit it was meant - to help. I struggle with > these issues too. > > Anne > > -------------- Original message ---------------------- > " Christopher Vedeler L.Ac. " <ckvedeler@access4le > <ckvedeler%40access4less.net> ss.net> > > Hi Trish, > > > > I teach practice management at PIHMA so this is a topic dear to my > heart. > > It seems that many of us acupuncturists drop the ball when it comes to > the > > business side of our practice. I wish all of us could be successful > making > > a good living doing what we love. > > > > Here are a few things I do to keep my overhead low - > > 1) I work solo. I don't have an office manager. Save $20 - $30 > thousand a > > year or about $2500 a month. A $54 a month business line comes with > > voicemail. I may loose a potential patient or two a month because I > can't > > answer the phone right away, but it isn't enough to justify a whole > salary. > > If I was much busier, I would need an office manager, but I just > haven't > > reached that point and I'm not sure I want to. I like keeping my > patient > > load between 25 and 30 patients a week for my own energy and sanity. > > 2) I have a smaller office space. My rent is $1200 a month for 600 > square > > feet, which is pretty cheap for Scottsdale. > > 3) I have two treatment rooms, but one of them was going un-used most > of > > the time since I only book one person at a time for a hour (the way I > like > > it). So I sub-leased the other room to a reiki practitioner, reducing > my > > rent effectively to $700 a month. I typically cover my rent within 2 - > 4 > > days of seeing patients. > > 4) I target my marketing. I only spend money on marketing the produces > > good results. This means that I track carefully where patients hear of > me. > > 5) My only other expenses are needles, herbs, office supplies and my > phone > > line. > > > > On a typical month my total overhead for a month is about $1200. At > $65 a > > patient I need to see about 19 patients a month to break even. I'm > > currently seeing about 80 - 100 a month. That leaves a net income of > about > > $4000 - $5000 a month. While I won't get rich at that rate, it is a > > comfortable living doing what I love and not being so busy that I burn > out > > (something very important to keep in mind!). I also teach 2 days a > week at > > the local acupuncture college supplementing my income an additional > $800 a > > month. > > > > Christopher Vedeler L.Ac., C.Ht. > > Oasis Acupuncture > > http://www.oasisacu <http://www.oasisacupuncture.com> puncture.com > > 9832 N. Hayden Rd. > > Suite 215 > > Scottsdale, AZ 85258 > > Phone: (480) 991-3650 > > > > > > Traditional_ > <Chinese Medicine%40> > Chinese_Medicine > > [Traditional_ > <Chinese Medicine%40> > Chinese_Medicine ] On Behalf Of pippa258 > > Thursday, January 18, 2007 6:35 AM > > Traditional_ > <Chinese Medicine%40> > Chinese_Medicine > > Keeping Overhead Low > > > > > > > > >>I priced my services not only to be competitive with my fellow > L.Ac.'s but > > to make them available to more people. While most of my patients are > from > > within 10 miles of my office, I draw from the whole valley with > several > > patients willing to drive an hour or more one way to see me. I make a > good > > living (by keeping my overhead low) and am fairly busy. I've been in > > practice for over 2 years.<< > > Christopher Vedeler L.Ac., C.Ht. > > > > Hi Christopher, > > > > Can you detail what you do to keep your overhead low? > > > > Thanks, > > Trish > > > > > > > > > > > > > > -- > > Internal Virus Database is out-of-date. > > > > Version: 7.5.432 / Virus Database: 268.15.29/607 - Release Date: > 12/28/2006 > > 12:31 PM > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2007 Report Share Posted January 21, 2007 Hi Anne, Good questions and nice discussion. There is nothing wrong with seeing 2, 3 or 15 patients an hour and charging what every you want. I'm all for people getting paid what they are worth and more power to those who want to make six figure incomes as Chinese medicine practitioners. I'm just not one of them IF it means I have to feel rushed, over booked, over worked, or burned out. If I wanted that I would have gone to medial school (I almost did, until I found out the kind of life it entails). I intentionally designed my space to be quiet, tranquil and slow paced. Most of my patients appreciate it. One of the biggest issues facing our time is the price of medical care. It is getting absurd. Sure some doctors make very big salaries, but at what cost? Believe me, I'm about as far from a socialist as Donald Trump, but for myself I'm into living a life that as true to my calling as possible and I know and trust that as long as I stay true to my vision I will be taken care of financially. For myself, what my services are worth is only a small part of how I price them. Christopher Vedeler L.Ac., C.Ht. Oasis Acupuncture http://www.oasisacupuncture.com 9832 N. Hayden Rd. Suite 215 Scottsdale, AZ 85258 Phone: (480) 991-3650 Chinese Medicine Chinese Medicine On Behalf Of anne.crowley Sunday, January 21, 2007 11:35 AM Chinese Medicine RE: Business Mgmt Chris, et al: Well I guess I will ignite another match. I am still on the crusade of we must be paid what we are worth. Chris, why would you give a $100 service and only charge $65. So people will feel they are getting a deal. I feel that way everytime I get treatment. My acupuncturist sees only one an hour for $85. I am thinking of going to two patients and hour or hour and 15 , and this tweeks my inner guilt. She is in a different location and her salary is not the main income. There are lots lof circumstances around these things. Anyway if she went to two an hour, I would book a double appt and pay double to see her. I also wish sometimes she left the room for 10 mins or so. I leave the room, but judge when to leave based on the patient. When there are two an hour you pretty much have to leave the room in a set range of time. Some schedule 1/2 hr., 1/2 hr., 45 mins when they are working with two rooms. My osteopath (in Annapolis MD) BTW is $198 per session ($300 for first one that is longer) which is 1 hr. He's hands on the whole time. He gives you a receipt to file. Has a waiting list of months unless there is a cancellation. There was a doctor in our town who discovered the efficency of electro acupuncture. She was booking 4 an hour at $90 and hour (this is when I was $75). I heard she booked a lady in her 80's that way, who knew nothing about acupuncture. That to me is crazy. So Chris, I do think you are providing a great service. You must realize that you also need to make a living. If there are patients who definitely need a discount, give them one, but limit the number of people in your practice like this. When one leaves, make room for another. Okay Chris again, I am sticking my neck out for your sake and those new students at the school. Anne -------------- Original message ---------------------- " Christopher Vedeler L.Ac. " <ckvedeler@access4le <ckvedeler%40access4less.net> ss.net> > Thanks Anne. I appreciate your perspective, especially coming from a > business background. I am always open to learning and growing. > > I think the secret to a successful practice is to realize that your > practice is an extension of you. Where you are strongest your practice > will be strongest and where you are most challenged, your practice will > be most challenged. My $1200 a month space is very, very nice (and > quite a bargain for Scottsdale). I had a patent come in a few weeks ago > and she brought her husband along. While my patient was on the table, > he fell asleep in the recliner next to her. She told me yesterday when > I saw her for a follow up, that she had never seen that before with him. > My space sets the mood and establishes the foundation for the energy of > my practice. It is not something I want to skimp on. Like Thomas said > a few days ago, just keeping overhead low is not the path to success. > We need to be smart where we put our money and Qi so our practice can > thrive, but that doesn't mean not investing where it is important. For > me, next to me, my space is the most important thing. > > I've been told I should raise my prices before, a few times by my > patients. My philosophy is to provide a $100 treatment and only charge > $65. When people feel they are getting high quality at a low cost they > refer more and come back more. Think of Costco. I don't want the price > of the first treatment to be a major barrier for someone with limited > funds to see me and so I simply charge a flat fee of $65 for everything > I do. At some point I may raise my prices, but for right now $65 seems > to work well and I am making a decent living. I didn't get into this > medicine to get rich (or to go bankrupt either). I was also very > deliberate in the pricing of my services. It was based partly on local > demographics and partly on my desire to make my services available to > many more people than if I charged " Scottsdale prices " . As a result I > have many patients drive over an hour through Phoenix traffic to see me. > Also, at $65 a treatment many of my patients don't mind coming in every > week (actually making me more money). At $75 or more that might become > a barrier to some of them getting the full benefits of multiple > treatments. However, that said, once I am as busy as I want for several > months I may raise my prices to $75 for new patients. > > Growing a business is like walking a tightrope. One must consider so > many variables to success and put up with a lot of fear. The most > important thing in my opinion is to keep clear on my original vision for > both who I am and what my practice is about and then take every action I > make in light of that vision. When my vision gets foggy, my practice > suffers. When my vision gets clear, the phone rings and I book out. I > don't know exactly what process in the universe makes that happen, but > it has happened enough times to me that I have no doubt about it. > > Christopher Vedeler L.Ac. > Oasis Acupuncture > <http://www.oasisacu <http://www.oasisacupuncture.com/> puncture.com/> http://www.oasisacu <http://www.oasisacupuncture.com> puncture.com > 9832 N. Hayden Rd. > Suite 215 > Scottsdale, AZ 85258 > Phone: (480) 991-3650 > > > > Traditional_ <Chinese Medicine%40> Chinese_Medicine > [Traditional_ <Chinese Medicine%40> Chinese_Medicine ] On Behalf Of > anne.crowley@ <anne.crowley%40comcast.net> comcast.net > Saturday, January 20, 2007 8:23 AM > Traditional_ <Chinese Medicine%40> Chinese_Medicine > RE: Business Mgmt > > > > Chris: > > This was great that you detailed all this for us. I have a few comments > being a former business teacher myself. Now let me caveat this by saying > I have not made the Fortune 500 myself as yet. > > I worked in the business world for 10 years (have an MBA), taught > business, management and economics for 10 years after that, and as a > small business person have a made a few mistakes and continue to learn. > > The " keeping overhead low " thing was told to me by a chiropractor when I > first came out of school. I did not listen to him and got my own space > at $1000/month, repainted, new blinds $2k. Two weeks later a tornado hit > the town (hardley predictable since the last time it happened was 100 > years ago.) It devasted a lot of buildings near mine but not mine. I was > obligated to pay that rent for a year in a town that looked war torn. > Everyone came to my house basically, which is where I stil am > predominately. I went into a dr.'s office two days last year (and the > phone rang). I am about to join a wellness center (still part time for > starting rent of $320 (no lease) The doctor was $400 (a lease that was > binding even when I left earlier - it was hectic in there). I do > advertise and write an article every month (and it is effective) This is > $85 - $125 per month. I do other advertising occassionally. > > Okay Chris, what I wanted to add to your comments is: I think you should > cover that overhead faster. I think 19 patients is too hard of labor to > put out for overhead alone. One easy way to do it is raise rates. $65 is > very low. One of our practitioners in our area who is a " live off the > land " person and treats in a trailer on a farm just raised her rates to > $75. Mine are $85 and another practioner in town is $90. First > treatments run $150 to $160. I do a history and a treatment on the first > day, so it runs about 1.5. hrs. Usually people need treatment right > away. Now I know someone who is playing an insurance game and charging > those without insurance much lower rates and those with much higher than > what I just quoted you. Frankly, I need to sleep at night. I do worry > about not serving everyone and I think the answer to that is clinics > like Andrea has formed when you treat a group of people in lounge > chairs. Otherwise a personal service like ours is worth so much more > . Massage therapists in my area charge $75 (for their basic massage) and > they go to school a year with a curriculum not nearly as demanding as > ours. > > I like the Hawaian philosophy of community service, but my mechanic only > accepts cash or check. > > Please take this in the spirit it was meant - to help. I struggle with > these issues too. > > Anne > > -------------- Original message ---------------------- > " Christopher Vedeler L.Ac. " <ckvedeler@access4le > <ckvedeler%40access4less.net> ss.net> > > Hi Trish, > > > > I teach practice management at PIHMA so this is a topic dear to my > heart. > > It seems that many of us acupuncturists drop the ball when it comes to > the > > business side of our practice. I wish all of us could be successful > making > > a good living doing what we love. > > > > Here are a few things I do to keep my overhead low - > > 1) I work solo. I don't have an office manager. Save $20 - $30 > thousand a > > year or about $2500 a month. A $54 a month business line comes with > > voicemail. I may loose a potential patient or two a month because I > can't > > answer the phone right away, but it isn't enough to justify a whole > salary. > > If I was much busier, I would need an office manager, but I just > haven't > > reached that point and I'm not sure I want to. I like keeping my > patient > > load between 25 and 30 patients a week for my own energy and sanity. > > 2) I have a smaller office space. My rent is $1200 a month for 600 > square > > feet, which is pretty cheap for Scottsdale. > > 3) I have two treatment rooms, but one of them was going un-used most > of > > the time since I only book one person at a time for a hour (the way I > like > > it). So I sub-leased the other room to a reiki practitioner, reducing > my > > rent effectively to $700 a month. I typically cover my rent within 2 - > 4 > > days of seeing patients. > > 4) I target my marketing. I only spend money on marketing the produces > > good results. This means that I track carefully where patients hear of > me. > > 5) My only other expenses are needles, herbs, office supplies and my > phone > > line. > > > > On a typical month my total overhead for a month is about $1200. At > $65 a > > patient I need to see about 19 patients a month to break even. I'm > > currently seeing about 80 - 100 a month. That leaves a net income of > about > > $4000 - $5000 a month. While I won't get rich at that rate, it is a > > comfortable living doing what I love and not being so busy that I burn > out > > (something very important to keep in mind!). I also teach 2 days a > week at > > the local acupuncture college supplementing my income an additional > $800 a > > month. > > > > Christopher Vedeler L.Ac., C.Ht. > > Oasis Acupuncture > > http://www.oasisacu <http://www.oasisacu <http://www.oasisacupuncture.com> puncture.com> puncture.com > > 9832 N. Hayden Rd. > > Suite 215 > > Scottsdale, AZ 85258 > > Phone: (480) 991-3650 > > > > > > Traditional_ > <Chinese Medicine%40> > Chinese_Medicine@ <Chinese_Medicine%40> > > [Traditional_ > <Chinese Medicine%40> > Chinese_Medicine@ <Chinese_Medicine%40> ] On Behalf Of pippa258 > > Thursday, January 18, 2007 6:35 AM > > Traditional_ > <Chinese Medicine%40> > Chinese_Medicine@ <Chinese_Medicine%40> > > Keeping Overhead Low > > > > > > > > >>I priced my services not only to be competitive with my fellow > L.Ac.'s but > > to make them available to more people. While most of my patients are > from > > within 10 miles of my office, I draw from the whole valley with > several > > patients willing to drive an hour or more one way to see me. I make a > good > > living (by keeping my overhead low) and am fairly busy. I've been in > > practice for over 2 years.<< > > Christopher Vedeler L.Ac., C.Ht. > > > > Hi Christopher, > > > > Can you detail what you do to keep your overhead low? > > > > Thanks, > > Trish > > > > > > > > > > > > > > -- > > Internal Virus Database is out-of-date. > > > > Version: 7.5.432 / Virus Database: 268.15.29/607 - Release Date: > 12/28/2006 > > 12:31 PM > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2007 Report Share Posted January 22, 2007 Anne: Thank you, thank you, thank you!!!! Part of our difficulties in this profession is that many tend to undercharge for our services. If we do not value our services, how will anyone else. Lee Tritt, AP, OMD, Dipl. Ac.(NCCAOM) 321-961-6432 A LITTLE " NEEDLING " NEVER HURT ANYONE Chinese Medicine Chinese MedicineOn Behalf Of anne.crowley Sunday, January 21, 2007 1:35 PM Chinese Medicine RE: Business Mgmt Chris, et al: Well I guess I will ignite another match. I am still on the crusade of we must be paid what we are worth. Chris, why would you give a $100 service and only charge $65. So people will feel they are getting a deal. I feel that way everytime I get treatment. My acupuncturist sees only one an hour for $85. I am thinking of going to two patients and hour or hour and 15 , and this tweeks my inner guilt. She is in a different location and her salary is not the main income. There are lots lof circumstances around these things. Anyway if she went to two an hour, I would book a double appt and pay double to see her. I also wish sometimes she left the room for 10 mins or so. I leave the room, but judge when to leave based on the patient. When there are two an hour you pretty much have to leave the room in a set range of time. Some schedule 1/2 hr., 1/2 hr., 45 mins when they are working with two rooms. My osteopath (in Annapolis MD) BTW is $198 per session ($300 for first one that is longer) which is 1 hr. He's hands on the whole time. He gives you a receipt to file. Has a waiting list of months unless there is a cancellation. There was a doctor in our town who discovered the efficency of electro acupuncture. She was booking 4 an hour at $90 and hour (this is when I was $75). I heard she booked a lady in her 80's that way, who knew nothing about acupuncture. That to me is crazy. So Chris, I do think you are providing a great service. You must realize that you also need to make a living. If there are patients who definitely need a discount, give them one, but limit the number of people in your practice like this. When one leaves, make room for another. Okay Chris again, I am sticking my neck out for your sake and those new students at the school. Anne -------------- Original message ---------------------- " Christopher Vedeler L.Ac. " <ckvedeler > Thanks Anne. I appreciate your perspective, especially coming from a > business background. I am always open to learning and growing. > > I think the secret to a successful practice is to realize that your > practice is an extension of you. Where you are strongest your practice > will be strongest and where you are most challenged, your practice will > be most challenged. My $1200 a month space is very, very nice (and > quite a bargain for Scottsdale). I had a patent come in a few weeks ago > and she brought her husband along. While my patient was on the table, > he fell asleep in the recliner next to her. She told me yesterday when > I saw her for a follow up, that she had never seen that before with him. > My space sets the mood and establishes the foundation for the energy of > my practice. It is not something I want to skimp on. Like Thomas said > a few days ago, just keeping overhead low is not the path to success. > We need to be smart where we put our money and Qi so our practice can > thrive, but that doesn't mean not investing where it is important. For > me, next to me, my space is the most important thing. > > I've been told I should raise my prices before, a few times by my > patients. My philosophy is to provide a $100 treatment and only charge > $65. When people feel they are getting high quality at a low cost they > refer more and come back more. Think of Costco. I don't want the price > of the first treatment to be a major barrier for someone with limited > funds to see me and so I simply charge a flat fee of $65 for everything > I do. At some point I may raise my prices, but for right now $65 seems > to work well and I am making a decent living. I didn't get into this > medicine to get rich (or to go bankrupt either). I was also very > deliberate in the pricing of my services. It was based partly on local > demographics and partly on my desire to make my services available to > many more people than if I charged " Scottsdale prices " . As a result I > have many patients drive over an hour through Phoenix traffic to see me. > Also, at $65 a treatment many of my patients don't mind coming in every > week (actually making me more money). At $75 or more that might become > a barrier to some of them getting the full benefits of multiple > treatments. However, that said, once I am as busy as I want for several > months I may raise my prices to $75 for new patients. > > Growing a business is like walking a tightrope. One must consider so > many variables to success and put up with a lot of fear. The most > important thing in my opinion is to keep clear on my original vision for > both who I am and what my practice is about and then take every action I > make in light of that vision. When my vision gets foggy, my practice > suffers. When my vision gets clear, the phone rings and I book out. I > don't know exactly what process in the universe makes that happen, but > it has happened enough times to me that I have no doubt about it. > > Christopher Vedeler L.Ac. > Oasis Acupuncture > <http://www.oasisacupuncture.com/> http://www.oasisacupuncture.com > 9832 N. Hayden Rd. > Suite 215 > Scottsdale, AZ 85258 > Phone: (480) 991-3650 > > > > Chinese Medicine > Chinese Medicine On Behalf Of > anne.crowley > Saturday, January 20, 2007 8:23 AM > Chinese Medicine > RE: Business Mgmt > > > > Chris: > > This was great that you detailed all this for us. I have a few comments > being a former business teacher myself. Now let me caveat this by saying > I have not made the Fortune 500 myself as yet. > > I worked in the business world for 10 years (have an MBA), taught > business, management and economics for 10 years after that, and as a > small business person have a made a few mistakes and continue to learn. > > The " keeping overhead low " thing was told to me by a chiropractor when I > first came out of school. I did not listen to him and got my own space > at $1000/month, repainted, new blinds $2k. Two weeks later a tornado hit > the town (hardley predictable since the last time it happened was 100 > years ago.) It devasted a lot of buildings near mine but not mine. I was > obligated to pay that rent for a year in a town that looked war torn. > Everyone came to my house basically, which is where I stil am > predominately. I went into a dr.'s office two days last year (and the > phone rang). I am about to join a wellness center (still part time for > starting rent of $320 (no lease) The doctor was $400 (a lease that was > binding even when I left earlier - it was hectic in there). I do > advertise and write an article every month (and it is effective) This is > $85 - $125 per month. I do other advertising occassionally. > > Okay Chris, what I wanted to add to your comments is: I think you should > cover that overhead faster. I think 19 patients is too hard of labor to > put out for overhead alone. One easy way to do it is raise rates. $65 is > very low. One of our practitioners in our area who is a " live off the > land " person and treats in a trailer on a farm just raised her rates to > $75. Mine are $85 and another practioner in town is $90. First > treatments run $150 to $160. I do a history and a treatment on the first > day, so it runs about 1.5. hrs. Usually people need treatment right > away. Now I know someone who is playing an insurance game and charging > those without insurance much lower rates and those with much higher than > what I just quoted you. Frankly, I need to sleep at night. I do worry > about not serving everyone and I think the answer to that is clinics > like Andrea has formed when you treat a group of people in lounge > chairs. Otherwise a personal service like ours is worth so much more > . Massage therapists in my area charge $75 (for their basic massage) and > they go to school a year with a curriculum not nearly as demanding as > ours. > > I like the Hawaian philosophy of community service, but my mechanic only > accepts cash or check. > > Please take this in the spirit it was meant - to help. I struggle with > these issues too. > > Anne > > -------------- Original message ---------------------- > " Christopher Vedeler L.Ac. " <ckvedeler@access4le > <ckvedeler%40access4less.net> ss.net> > > Hi Trish, > > > > I teach practice management at PIHMA so this is a topic dear to my > heart. > > It seems that many of us acupuncturists drop the ball when it comes to > the > > business side of our practice. I wish all of us could be successful > making > > a good living doing what we love. > > > > Here are a few things I do to keep my overhead low - > > 1) I work solo. I don't have an office manager. Save $20 - $30 > thousand a > > year or about $2500 a month. A $54 a month business line comes with > > voicemail. I may loose a potential patient or two a month because I > can't > > answer the phone right away, but it isn't enough to justify a whole > salary. > > If I was much busier, I would need an office manager, but I just > haven't > > reached that point and I'm not sure I want to. I like keeping my > patient > > load between 25 and 30 patients a week for my own energy and sanity. > > 2) I have a smaller office space. My rent is $1200 a month for 600 > square > > feet, which is pretty cheap for Scottsdale. > > 3) I have two treatment rooms, but one of them was going un-used most > of > > the time since I only book one person at a time for a hour (the way I > like > > it). So I sub-leased the other room to a reiki practitioner, reducing > my > > rent effectively to $700 a month. I typically cover my rent within 2 - > 4 > > days of seeing patients. > > 4) I target my marketing. I only spend money on marketing the produces > > good results. This means that I track carefully where patients hear of > me. > > 5) My only other expenses are needles, herbs, office supplies and my > phone > > line. > > > > On a typical month my total overhead for a month is about $1200. At > $65 a > > patient I need to see about 19 patients a month to break even. I'm > > currently seeing about 80 - 100 a month. That leaves a net income of > about > > $4000 - $5000 a month. While I won't get rich at that rate, it is a > > comfortable living doing what I love and not being so busy that I burn > out > > (something very important to keep in mind!). I also teach 2 days a > week at > > the local acupuncture college supplementing my income an additional > $800 a > > month. > > > > Christopher Vedeler L.Ac., C.Ht. > > Oasis Acupuncture > > http://www.oasisacu <http://www.oasisacupuncture.com> puncture.com > > 9832 N. Hayden Rd. > > Suite 215 > > Scottsdale, AZ 85258 > > Phone: (480) 991-3650 > > > > > > Traditional_ > <Chinese Medicine%40> > Chinese_Medicine > > [Traditional_ > <Chinese Medicine%40> > Chinese_Medicine ] On Behalf Of pippa258 > > Thursday, January 18, 2007 6:35 AM > > Traditional_ > <Chinese Medicine%40> > Chinese_Medicine > > Keeping Overhead Low > > > > > > > > >>I priced my services not only to be competitive with my fellow > L.Ac.'s but > > to make them available to more people. While most of my patients are > from > > within 10 miles of my office, I draw from the whole valley with > several > > patients willing to drive an hour or more one way to see me. I make a > good > > living (by keeping my overhead low) and am fairly busy. I've been in > > practice for over 2 years.<< > > Christopher Vedeler L.Ac., C.Ht. > > > > Hi Christopher, > > > > Can you detail what you do to keep your overhead low? > > > > Thanks, > > Trish > > > > > > > > > > > > > > -- > > Internal Virus Database is out-of-date. > > > > Version: 7.5.432 / Virus Database: 268.15.29/607 - Release Date: > 12/28/2006 > > 12:31 PM > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 .. Now I know someone who is playing an insurance game and charging those without insurance much lower rates and those with much higher than what I just quoted you. Frankly, I need to sleep at night. Anne Anne, I couldn't help but respond to this as it is often misunderstood and misapplied. It's not an insurance game to charge " more " for insurance billings than for those who are paying " out-of-pocket " . Your real price is what is charged to insurance and to anyone else who is not going to give you payment that day of treatment. For example, let's just say for a return visit your price is $90. For the patient who pays the same day as service, a (legal) " payment same day of service discount " is applied. The amount of that discount is up to you, but I wouldn't recommend anything over 20%. So, that would make the cash paying patient charge of $72. Your time and energy and sometimes months of waiting (and calling repeatedly) is accounted for in your real (e.g., insurance) rate. Technically, a practitioner should offer this same discount to any insurance company that can pay their bill within 7 days. A note can be sent with billings letting them know of the savings that can reap by quick payment. There is nothing illegal or unethical about this practice. Many MD's and dentists, in my experience, offer this type of discount to patients as a thank you for eliminating a bunch of waiting and work. Consistency is key, however. When a person calls and want to know your prices, you must always respond by telling them your real (full) price and then inform them that you offer a ___% discount to patients paying the same day. You could say, " My price for return visits is $90, however I do offer a 20% discount to those who are paying out of pocket as long as payment for treatment is received the same day. " If patients want to be billed monthly, or can't pay until next week, the discount is forfeited. Just my 2 cents (but with a 20% discount, it would be 1.6 cents) :-) Barb -------------- Original message ---------------------- " Christopher Vedeler L.Ac. " <ckvedeler@access4le <ckvedeler%40access4less.net> ss.net> > Hi Trish, > > I teach practice management at PIHMA so this is a topic dear to my heart. > It seems that many of us acupuncturists drop the ball when it comes to the > business side of our practice. I wish all of us could be successful making > a good living doing what we love. > > Here are a few things I do to keep my overhead low - > 1) I work solo. I don't have an office manager. Save $20 - $30 thousand a > year or about $2500 a month. A $54 a month business line comes with > voicemail. I may loose a potential patient or two a month because I can't > answer the phone right away, but it isn't enough to justify a whole salary. > If I was much busier, I would need an office manager, but I just haven't > reached that point and I'm not sure I want to. I like keeping my patient > load between 25 and 30 patients a week for my own energy and sanity. > 2) I have a smaller office space. My rent is $1200 a month for 600 square > feet, which is pretty cheap for Scottsdale. > 3) I have two treatment rooms, but one of them was going un-used most of > the time since I only book one person at a time for a hour (the way I like > it). So I sub-leased the other room to a reiki practitioner, reducing my > rent effectively to $700 a month. I typically cover my rent within 2 - 4 > days of seeing patients. > 4) I target my marketing. I only spend money on marketing the produces > good results. This means that I track carefully where patients hear of me. > 5) My only other expenses are needles, herbs, office supplies and my phone > line. > > On a typical month my total overhead for a month is about $1200. At $65 a > patient I need to see about 19 patients a month to break even. I'm > currently seeing about 80 - 100 a month. That leaves a net income of about > $4000 - $5000 a month. While I won't get rich at that rate, it is a > comfortable living doing what I love and not being so busy that I burn out > (something very important to keep in mind!). I also teach 2 days a week at > the local acupuncture college supplementing my income an additional $800 a > month. > > Christopher Vedeler L.Ac., C.Ht. > Oasis Acupuncture > http://www.oasisacu <http://www.oasisacupuncture.com> puncture.com > 9832 N. Hayden Rd. > Suite 215 > Scottsdale, AZ 85258 > Phone: (480) 991-3650 > > > Traditional_ <Chinese Medicine%40> Chinese_Medicine > [Traditional_ <Chinese Medicine%40> Chinese_Medicine ] On Behalf Of pippa258 > Thursday, January 18, 2007 6:35 AM > Traditional_ <Chinese Medicine%40> Chinese_Medicine > Keeping Overhead Low > > > > >>I priced my services not only to be competitive with my fellow L.Ac.'s but > to make them available to more people. While most of my patients are from > within 10 miles of my office, I draw from the whole valley with several > patients willing to drive an hour or more one way to see me. I make a good > living (by keeping my overhead low) and am fairly busy. I've been in > practice for over 2 years.<< > Christopher Vedeler L.Ac., C.Ht. > > Hi Christopher, > > Can you detail what you do to keep your overhead low? > > Thanks, > Trish -- > Internal Virus Database is out-of-date. > > Version: 7.5.432 / Virus Database: 268.15.29/607 - Release Date: 12/28/2006 > 12:31 PM > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 That is quite illegal. Avery > Anne, > > I couldn't help but respond to this as it is often misunderstood and > misapplied. It's not an insurance game to charge " more " for insurance > billings than for those who are paying " out-of-pocket " . Your real > price is > what is charged to insurance and to anyone else who is not going to give > you > payment that day of treatment. For example, let's just say for a return > visit your price is $90. For the patient who pays the same day as > service, > a (legal) " payment same day of service discount " is applied. The > amount of > that discount is up to you, but I wouldn't recommend anything over 20%. > So, > that would make the cash paying patient charge of $72. Your time and > energy and sometimes months of waiting (and calling repeatedly) is > accounted > for in your real (e.g., insurance) rate. Technically, a practitioner > should offer this same discount to any insurance company that can pay > their > bill within 7 days. A note can be sent with billings letting them know > of > the savings that can reap by quick payment. There is nothing illegal or > unethical about this practice. Many MD's and dentists, in my experience, > offer this type of discount to patients as a thank you for eliminating a > bunch of waiting and work. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 Chinese Medicine Chinese Medicine On Behalf Of Dr. Avery Jenkins Tuesday, January 23, 2007 12:53 PM Chinese Medicine Re: Business Mgmt That is quite illegal. Avery > Anne, > > I couldn't help but respond to this as it is often misunderstood and > misapplied. It's not an insurance game to charge " more " for insurance > billings than for those who are paying " out-of-pocket " . Your real > price is > what is charged to insurance and to anyone else who is not going to give > you > payment that day of treatment. For example, let's just say for a return > visit your price is $90. For the patient who pays the same day as > service, > a (legal) " payment same day of service discount " is applied. The > amount of > that discount is up to you, but I wouldn't recommend anything over 20%. > So, > that would make the cash paying patient charge of $72. Your time and > energy and sometimes months of waiting (and calling repeatedly) is > accounted > for in your real (e.g., insurance) rate. Technically, a practitioner > should offer this same discount to any insurance company that can pay > their > bill within 7 days. A note can be sent with billings letting them know > of > the savings that can reap by quick payment. There is nothing illegal or > unethical about this practice. Many MD's and dentists, in my experience, > offer this type of discount to patients as a thank you for eliminating a > bunch of waiting and work. Subscribe to the new FREE online journal for TCM at Times http://www.chinesemedicinetimes.com Download the all new TCM Forum Toolbar, click, http://toolbar.thebizplace.com/LandingPage.aspx/CT145145 and adjust accordingly. Please consider the environment and only print this message if absolutely necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 I would like to hear more on this. Barabara thinks it is okay and Avery thinks it is illegal. I think chiros do the range of fees often. I always thought you had to charge everyone the same and could give someone a discount based on need. Is this different for different states? The insurance game I was talking about was charging insurance 200 per treatment and between the copay and the reimbursement practitioner got 95, was a member of the plan and was paid pretty well based on this. I know they don't charge everyone that - quite a lot less. Anne -------------- Original message ---------------------- " Dr. Avery Jenkins " <docaltmed > That is quite illegal. > > Avery > > > > > Anne, > > > > I couldn't help but respond to this as it is often misunderstood and > > misapplied. It's not an insurance game to charge " more " for insurance > > billings than for those who are paying " out-of-pocket " . Your real > > price is > > what is charged to insurance and to anyone else who is not going to give > > you > > payment that day of treatment. For example, let's just say for a return > > visit your price is $90. For the patient who pays the same day as > > service, > > a (legal) " payment same day of service discount " is applied. The > > amount of > > that discount is up to you, but I wouldn't recommend anything over 20%. > > So, > > that would make the cash paying patient charge of $72. Your time and > > energy and sometimes months of waiting (and calling repeatedly) is > > accounted > > for in your real (e.g., insurance) rate. Technically, a practitioner > > should offer this same discount to any insurance company that can pay > > their > > bill within 7 days. A note can be sent with billings letting them know > > of > > the savings that can reap by quick payment. There is nothing illegal or > > unethical about this practice. Many MD's and dentists, in my experience, > > offer this type of discount to patients as a thank you for eliminating a > > bunch of waiting and work. > > > Subscribe to the new FREE online journal for TCM at Times > http://www.chinesemedicinetimes.com > > Download the all new TCM Forum Toolbar, click, > http://toolbar.thebizplace.com/LandingPage.aspx/CT145145 > > > and adjust > accordingly. > > Messages are the property of the author. Any duplication outside the group > requires prior permission from the author. > > Please consider the environment and only print this message if absolutely > necessary. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2007 Report Share Posted January 24, 2007 In California, a provider may offer any type of discount to a patient as long as the provider has " reasonable cause to believe " that the patient is not eligible for insurance reimbursement and as long as the discount is not prohibited by any contract the provider might have with a third-party payer. California providers may also offer " prompt payment " discounts to third-party payers who pay within a specified time period. These prompt payment discounts are only applicable to health or medical claims and cannot be extended to individual patients unless the patient is ineligible for reimbursement as indicated above. In short, unless you have reasonable cause to believe that a patient does NOT have coverage for acupuncture, you cannot offer a discount of any kind. This is true even if a covered patient does not intend to file a claim for your services. As far as I know, California is the only state in the US that explicitly permits these discounts. --Bill. ============== California Business & Professions Code, Section 657: (a) The Legislature finds and declares all of the following: (1) Californians spend more than one hundred billion dollars ($100,000,000,000) annually on health care. (2) In 1994, an estimated 6.6 million of California's 32 million residents did not have any health insurance and were ineligible for Medi-Cal. (3) Many of California's uninsured cannot afford basic, preventative health care resulting in these residents relying on emergency rooms for urgent health care, thus driving up health care costs. (4) Health care should be affordable and accessible to all Californians. (5) The public interest dictates that uninsured Californians have access to basic, preventative health care at affordable prices. (b) To encourage the prompt payment of health or medical care claims, health care providers are hereby expressly authorized to grant discounts in health or medical care claims when payment is made promptly within time limits prescribed by the health care providers or institutions rendering the service or treatment. © Notwithstanding any provision in any health care service plan contract or insurance contract to the contrary, health care providers are hereby expressly authorized to grant discounts for health or medical care provided to any patient the health care provider has reasonable cause to believe is not eligible for, or is not entitled to, insurance reimbursement, coverage under the Medi-Cal program, or coverage by a health care service plan for the health or medical care provided. Any discounted fee granted pursuant to this section shall not be deemed to be the health care provider's usual, customary, or reasonable fee for any other purposes, including, but not limited to, any health care service plan contract or insurance contract. (d) " Health care provider, " as used in this section, means any person licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or licensed pursuant to the Osteopathic Initiative Act, or the Chiropractic Initiative Act, or licensed pursuant to Chapter 2.5 (commencing with Section 1440) of Division 2 of the Health and Safety Code; and any clinic, health dispensary, or health facility, licensed pursuant to Division 2 (commencing with Section 1200) of the Health and Safety Code. On Jan 23, 2007, at 4:26 PM, anne.crowley wrote: > I would like to hear more on this. Barabara thinks it is okay and > Avery thinks it is illegal. I think chiros do the range of fees > often. > > I always thought you had to charge everyone the same and could give > someone a discount based on need. Is this different for different > states? > > The insurance game I was talking about was charging insurance 200 > per treatment and between the copay and the reimbursement > practitioner got 95, was a member of the plan and was paid pretty > well based on this. I know they don't charge everyone that - quite > a lot less. > > Anne > -------------- Original message ---------------------- > " Dr. Avery Jenkins " <docaltmed >> That is quite illegal. >> >> Avery >> >> >> >>> Anne, >>> >>> I couldn't help but respond to this as it is often misunderstood and >>> misapplied. It's not an insurance game to charge " more " for >>> insurance >>> billings than for those who are paying " out-of-pocket " . Your real >>> price is >>> what is charged to insurance and to anyone else who is not going >>> to give >>> you >>> payment that day of treatment. For example, let's just say for >>> a return >>> visit your price is $90. For the patient who pays the same day as >>> service, >>> a (legal) " payment same day of service discount " is applied. The >>> amount of >>> that discount is up to you, but I wouldn't recommend anything >>> over 20%. >>> So, >>> that would make the cash paying patient charge of $72. Your >>> time and >>> energy and sometimes months of waiting (and calling repeatedly) is >>> accounted >>> for in your real (e.g., insurance) rate. Technically, a >>> practitioner >>> should offer this same discount to any insurance company that can >>> pay >>> their >>> bill within 7 days. A note can be sent with billings letting >>> them know >>> of >>> the savings that can reap by quick payment. There is nothing >>> illegal or >>> unethical about this practice. Many MD's and dentists, in my >>> experience, >>> offer this type of discount to patients as a thank you for >>> eliminating a >>> bunch of waiting and work. >> >> > > Quote Link to comment Share on other sites More sharing options...
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