Business Mgmt/successful practice

January 20, 2007

i agree with a lot of what's been said on this stream and have appreciated

the openness of those participating in this discussion.

in particular, as chris and anne have eloquently described, we have the

ability to make a comfortable living and lifestyle in this profession.

there are quality of life rewards for doing what we do: loving our jobs,

ability to change the lives of others qualitatively for the better, being

able to put in our mind and spirit into our work, the challenge and rewards

of practice and curing diff to tx conditions. on that note, may i add that

most of us don't consider practice 'work', it's a joy, and as some have

said, privilege to do what we do. i think we all feel this way in our

profession, and few other professions can boast of this.

to me, successful practice are these things, and the success/cure rate of

patients. none of this includes the idea of six figure incomes, a

definition of successful practice that i find offensive.

and on that note, may i add that many times colleagues in my area will ask

me how i'm doing, hedging around at what the number of patients is that i'm

seeing, and whether or not 'it's slow right now'. why are they not instead

asking about my interesting cases, any stunning successes/cures of late,

that type of thing?

my 2 cents,

kb

On 1/20/07, anne.crowley <anne.crowley wrote:

>

> 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 <lizzzrd%40optonline.net>>

> > 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 <anne.crowley%40comcast.net>

> > To:

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>

> > 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<ckvedeler%40access4less.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.oasisacupuncture.com

> > > 9832 N. Hayden Rd.

> > > Suite 215

> > > Scottsdale, AZ 85258

> > > Phone: (480) 991-3650

> > >

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>

> > >

[Chinese Medicine <Traditional_Chinese_Medicin\

e%40>]

> On Behalf Of pippa258

> > > Thursday, January 18, 2007 6:35 AM

> > > To:

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>

> > > 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

> > >

January 20, 2007

Hi Kath,

--- " "

wrote:

> me how i'm doing, hedging around at what the number

> of patients is that i'm

> seeing, and whether or not 'it's slow right now'.

> why are they not instead

> asking about my interesting cases, any stunning

> successes/cures of late, that type of thing?

Because they have too much fear maybe? Because they

practice acupuncture but they don't read the tao teh

ching or meditate often enough? I recall so many

concerns being voiced over " competition " in the

neighbourhood where I work (we had a group clinic).

I've never felt the competition. Maybe it's because

I'm missing something, but I tend to believe that it's

because we have competition when we are not filling

our " niche " (pronounced " neesh " everyone). We will

have plenty of competition when our mind is in the

wrong place and we are competing for the supposed

" best spot " .

On the other hand, if we have enough insight to fill

our role, and believe or see that we have a function

and we are being _asked_ to fulfill that function,

then I believe this competition disappears.

As I wrote earlier, when I try to force my business,

the whole thing drops like a stone. When I leave it

alone and just do what I am good at, it floats easily,

and my patients themselves act as a barometer for how

much I should charge. When I've been told to raise my

prices to a certain level enough times, I raise the

prices by half of the proposed increase. That way

nobody can _really_ complain. And I am happy to say

that although I've got some overhead problems to work

out, I make a great deal of money.

Bye for now,

Hugo

_________

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January 21, 2007

This has been a great discussion, one of the best I remember on the

TCM list. I've often wondered how others promote their practice,

manage their overhead, and determine their prices. I am gratified to

see that many other practitioners have a similar philosophy and

experience to my own over my many years in practice, and are

'sticking to their guns'.

On Jan 20, 2007, at 12:28 PM, Hugo Ramiro wrote:

> Hi Kath,

>

> --- " "

> wrote:

>

> > me how i'm doing, hedging around at what the number

> > of patients is that i'm

> > seeing, and whether or not 'it's slow right now'.

> > why are they not instead

> > asking about my interesting cases, any stunning

> > successes/cures of late, that type of thing?

>

> Because they have too much fear maybe? Because they

> practice acupuncture but they don't read the tao teh

> ching or meditate often enough? I recall so many

> concerns being voiced over " competition " in the

> neighbourhood where I work (we had a group clinic).

> I've never felt the competition. Maybe it's because

> I'm missing something, but I tend to believe that it's

> because we have competition when we are not filling

> our " niche " (pronounced " neesh " everyone). We will

> have plenty of competition when our mind is in the

> wrong place and we are competing for the supposed

> " best spot " .

> On the other hand, if we have enough insight to fill

> our role, and believe or see that we have a function

> and we are being _asked_ to fulfill that function,

> then I believe this competition disappears.

> As I wrote earlier, when I try to force my business,

> the whole thing drops like a stone. When I leave it

> alone and just do what I am good at, it floats easily,

> and my patients themselves act as a barometer for how

> much I should charge. When I've been told to raise my

> prices to a certain level enough times, I raise the

> prices by half of the proposed increase. That way

> nobody can _really_ complain. And I am happy to say

> that although I've got some overhead problems to work

> out, I make a great deal of money.

>

> Bye for now,

> Hugo

>

> ________

> All New Mail – Tired of unwanted email come-ons? Let our

> SpamGuard protect you. http://uk.docs./nowyoucan.html

>

January 21, 2007

Hi All,

There are only a couple of other acupuncturists in my town, one of whom I went

to school with and grew up here, and another who went to school in Phoenix. The

former is quite busy, and has been since she opened up here a year before I

graduated. Having grown up here with her father as a former mayor, she came

back to a town in which everyone already knew and loved her. She is so busy,

that when she gets a calls from new clients who need a treatment immediately,

she refers them to me because she is booked way in advance. The other

acupuncturist has become a friend, and we trade treatments with each other. She

has the high-dollar office in a brand new building with build-outs that cost her

$14k (neither she nor I can imagine how it cost that much), and she's very

consumed with making ends meet. She was formerly a busy massage therapist, and

her husband a building contractor for many years locally, so her practice also

soared soon after opening.

I'm a newcomer to this valley, here only 2 years. This means I don't have the

vast connections and networks established that both of these women do. This was

also true when I was in practice initially in San Diego. I have come to believe

being known in your community is quite possibly the biggest factor in building a

successful practice. Being a quiet and shy person by nature, I build

connections slowly, but it is happening here. I do get referrals from my

patients. But I also receive by far the largest number of new clients from my

ad in the phone book. It's a small in-column ad, 3/4' high. I only got 1 call

per year out of my phone book ad in San Diego, so regional mentalities do indeed

differ between the big cities and small, rural towns, as I was taught in an

advertising class at the local Small Business Development Center. Their

classes, by the way, are open to all small business owners and potential

business owners, and are an inexpensive gold mine of

valuable information. I highly recommend them to those already in business and

wondering about the " business " : side of their practice, and also to students

before graduating. There's lots of stuff to be learned that I never heard in

any practice management class - and I've taken a few.

Back to your question Kath, the acupuncturist I trade sessions with and I have

established a nice professional rapport. She's only in practice a year, and has

lots to learn, and makes some observable treatment errors that I remember making

also as an intern and newbie. But her training is different from mine, and so

we also have alot to learn from each other. One of the things we have started

doing is meeting monthly to discuss complicated or stubborn patient cases.

Another thing we do is substitute for each other at the addiction treatment

centers we each work at, when one of us needs to be somewhere else. In

addition, she is looking in to starting a NADA community-style treatment setting

in a local psychiatric center that is starting a new residential program, and

she has asked me to partner in this, dividing the treatment days between us.

I am learning alot from her about the benefits of having a colleague

relationship and working together and collaboratively, instead of viewing her

and all other acupuncturists as my competition, and having the mindset that if

they're " succeeding " faster than I am, then there must be something wrong with

me. We each grow and thrive in our own timeframes and according to the bounty

of our qi and other essential substances, and whatever life challenges we also

have. One of my challenges, having fibromyalgia, has been to be mindful not

only of my financial overhead, but also of my overhead in terms of energy

expenditure. While I am not disabled by the fibro like I was at one point

before acupuncture school (and this was the deciding factor in my part-time,

extended attendance) I have always had to keep a close eye on this, even more so

than my cash output. These are other things to consider, that I have never

heard discussed in any practice management or business

management class, but are an essential part of the equation: what we have to

bring to building our business or practice in terms of abundant personal

resources other than money. And yes, I do keep a very low overhead. This is

the first time I have my own office, a funky room in what used to be

Cottonwood's first hospital back in the 1930's. Owned by an osteopath, he rents

out what used to be the patient suites to individual practitioners while keeping

a wing for his own practice. My room is in the former maternity wing, and all

the doors are extremely wide to accommodate the old guerneys that were large and

cumbersome. I am the only acupuncturist amidst many massage therapists,

counselors, life coaches, one naturopath, and the osteopath and his nurse

practitioners. Though it sounds like a sort of collective, the truth is, we

rarely see or talk to each other. In fact, today we will be having our first

potluck since I started renting there in October of 2005. We

rarely offer each other referrals (I think I refer to them more than they refer

to me, but whether patients follow through on referrals is another question

entirely), Perhaps I will raise this as a topic for discussion today.

The number of patients I see weekly still varies greatly, is on the small

side, and increasing noticeably from year to year, and I use yearly increments

as measurements instead of months, because the seasonal tourist economy here

varies greatly with factors such as weather and the cost of gasoline - my first

year, summer was my busiest season, and the second year, which was much hotter,

it was quite slow, while winters are predictably slow and this winter so far is

much better than last, which was quite frightening financially. I have some

growth ideas in mind, such as my next office having 2 treatment rooms and making

those rooms available part-time to a different kind of practitioner because I

don't have the desire or qi to work full-time. My rent is $325 per month. My

cell phone, which I use for my business phone, costs $66.96. My only other

business expenses are the materials I use in my practice, and I keep it simple.

The debts I accumulated as a student and

early practitioner, and the student loans I have yet to begin paying off are

the other major expenses, and I cannot afford a luxurious lifestyle.

If I could have my ideal life, however, it would look quite different. Being

self-employed for the first time, and in a profession I am passionate about has

not changed one iota the fact that I simply do not enjoy working - at all, in

any form. I never have, and I suppose I never will, now that the parameters

have changed and I have more say-so in what I do and how I do it. And I have

worked in a very wide variety of jobs and professions in my life. I am

concluding now, in my 51st year, that I simply did not come into this life in

order to work, but to play. I need alot of variety, fun, and flexibility to be

happy. That said, I do enjoy the relationships I have with most of my patients,

and derive great satisfaction from helping them, and also enjoy the mental

challenge of sorting things out. But given my druthers, I'd druther not do it

at all. I'd druther be outside playing. All the time! And I am doing some

creative thinking in this past year as to how I can

make that happen, while receiving an income far more substantial than any I've

ever had from any job. I'm tired of being resentful about having to work in

order to " earn a living " . I'd druther be independently wealthy and afford to

fund clinics where other people do the " work " . I want to have a glorious life

of " time off " .

" " wrote:

and on that note, may i add that many times colleagues in my area will ask

me how i'm doing, hedging around at what the number of patients is that i'm

seeing, and whether or not 'it's slow right now'. why are they not instead

asking about my interesting cases, any stunning successes/cures of late,

that type of thing?

my 2 cents,

kb

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January 21, 2007

But given my druthers, I'd druther not do it at all. I'd druther be outside

playing. All the time! And I am doing some creative thinking in this past

year as to how I can

make that happen, while receiving an income far more substantial than any

I've ever had from any job. I'm tired of being resentful about having to

work in order to " earn a living " . I'd druther be independently wealthy and

afford to fund clinics where other people do the " work " . I want to have a

glorious life of " time off " .

AB:

i've heard you for the past few years i've heard you expound on the

difficulties of making a practice work, financially. given this comment, it

strikes me that energetically, this is the main barriar for you: you really

don't want to practice, you want to play. i read a quote recently about

billionaires like Donald Trump. they don't consider work, 'work'. they put

in 80+ hour 'work' weeks because they are doing what they love and living

their passion. they work rather be putting together power-deals than on the

golf course or sitting at a dinner party. (acutually, so would i, the

latter 2 activities don't interest me much, but you get my drift).

not sure how long you've been at it in AZ. i found after the 4y mark,

things got easier and i felt like i was over a hump. getting new patients,

and practicing was less and less a struggle and more and more joy and living

my passion.

kb

On 1/21/07, < wrote:

>

> Hi All,

>

> There are only a couple of other acupuncturists in my town, one of whom I

> went to school with and grew up here, and another who went to school in

> Phoenix. The former is quite busy, and has been since she opened up here a

> year before I graduated. Having grown up here with her father as a former

> mayor, she came back to a town in which everyone already knew and loved her.

> She is so busy, that when she gets a calls from new clients who need a

> treatment immediately, she refers them to me because she is booked way in

> advance. The other acupuncturist has become a friend, and we trade

> treatments with each other. She has the high-dollar office in a brand new

> building with build-outs that cost her $14k (neither she nor I can imagine

> how it cost that much), and she's very consumed with making ends meet. She

> was formerly a busy massage therapist, and her husband a building contractor

> for many years locally, so her practice also soared soon after opening.

>

> I'm a newcomer to this valley, here only 2 years. This means I don't have

> the vast connections and networks established that both of these women do.

> This was also true when I was in practice initially in San Diego. I have

> come to believe being known in your community is quite possibly the biggest

> factor in building a successful practice. Being a quiet and shy person by

> nature, I build connections slowly, but it is happening here. I do get

> referrals from my patients. But I also receive by far the largest number of

> new clients from my ad in the phone book. It's a small in-column ad, 3/4'

> high. I only got 1 call per year out of my phone book ad in San Diego, so

> regional mentalities do indeed differ between the big cities and small,

> rural towns, as I was taught in an advertising class at the local Small

> Business Development Center. Their classes, by the way, are open to all

> small business owners and potential business owners, and are an inexpensive

> gold mine of

> valuable information. I highly recommend them to those already in business

> and wondering about the " business " : side of their practice, and also to

> students before graduating. There's lots of stuff to be learned that I never

> heard in any practice management class - and I've taken a few.

>

> Back to your question Kath, the acupuncturist I trade sessions with and I

> have established a nice professional rapport. She's only in practice a year,

> and has lots to learn, and makes some observable treatment errors that I

> remember making also as an intern and newbie. But her training is different

> from mine, and so we also have alot to learn from each other. One of the

> things we have started doing is meeting monthly to discuss complicated or

> stubborn patient cases. Another thing we do is substitute for each other at

> the addiction treatment centers we each work at, when one of us needs to be

> somewhere else. In addition, she is looking in to starting a NADA

> community-style treatment setting in a local psychiatric center that is

> starting a new residential program, and she has asked me to partner in this,

> dividing the treatment days between us.

>

> I am learning alot from her about the benefits of having a colleague

> relationship and working together and collaboratively, instead of viewing

> her and all other acupuncturists as my competition, and having the mindset

> that if they're " succeeding " faster than I am, then there must be something

> wrong with me. We each grow and thrive in our own timeframes and according

> to the bounty of our qi and other essential substances, and whatever life

> challenges we also have. One of my challenges, having fibromyalgia, has been

> to be mindful not only of my financial overhead, but also of my overhead in

> terms of energy expenditure. While I am not disabled by the fibro like I was

> at one point before acupuncture school (and this was the deciding factor in

> my part-time, extended attendance) I have always had to keep a close eye on

> this, even more so than my cash output. These are other things to consider,

> that I have never heard discussed in any practice management or business

> management class, but are an essential part of the equation: what we have

> to bring to building our business or practice in terms of abundant personal

> resources other than money. And yes, I do keep a very low overhead. This is

> the first time I have my own office, a funky room in what used to be

> Cottonwood's first hospital back in the 1930's. Owned by an osteopath, he

> rents out what used to be the patient suites to individual practitioners

> while keeping a wing for his own practice. My room is in the former

> maternity wing, and all the doors are extremely wide to accommodate the old

> guerneys that were large and cumbersome. I am the only acupuncturist amidst

> many massage therapists, counselors, life coaches, one naturopath, and the

> osteopath and his nurse practitioners. Though it sounds like a sort of

> collective, the truth is, we rarely see or talk to each other. In fact,

> today we will be having our first potluck since I started renting there in

> October of 2005. We

> rarely offer each other referrals (I think I refer to them more than they

> refer to me, but whether patients follow through on referrals is another

> question entirely), Perhaps I will raise this as a topic for discussion

> today.

>

> The number of patients I see weekly still varies greatly, is on the small

> side, and increasing noticeably from year to year, and I use yearly

> increments as measurements instead of months, because the seasonal tourist

> economy here varies greatly with factors such as weather and the cost of

> gasoline - my first year, summer was my busiest season, and the second year,

> which was much hotter, it was quite slow, while winters are predictably slow

> and this winter so far is much better than last, which was quite frightening

> financially. I have some growth ideas in mind, such as my next office having

> 2 treatment rooms and making those rooms available part-time to a different

> kind of practitioner because I don't have the desire or qi to work

> full-time. My rent is $325 per month. My cell phone, which I use for my

> business phone, costs $66.96. My only other business expenses are the

> materials I use in my practice, and I keep it simple. The debts I

> accumulated as a student and

> early practitioner, and the student loans I have yet to begin paying off

> are the other major expenses, and I cannot afford a luxurious lifestyle.

>

> If I could have my ideal life, however, it would look quite different.

> Being self-employed for the first time, and in a profession I am passionate

> about has not changed one iota the fact that I simply do not enjoy working -

> at all, in any form. I never have, and I suppose I never will, now that the

> parameters have changed and I have more say-so in what I do and how I do it.

> And I have worked in a very wide variety of jobs and professions in my life.

> I am concluding now, in my 51st year, that I simply did not come into this

> life in order to work, but to play. I need alot of variety, fun, and

> flexibility to be happy. That said, I do enjoy the relationships I have with

> most of my patients, and derive great satisfaction from helping them, and

> also enjoy the mental challenge of sorting things out. But given my

> druthers, I'd druther not do it at all. I'd druther be outside playing. All

> the time! And I am doing some creative thinking in this past year as to how

> I can

> make that happen, while receiving an income far more substantial than any

> I've ever had from any job. I'm tired of being resentful about having to

> work in order to " earn a living " . I'd druther be independently wealthy and

> afford to fund clinics where other people do the " work " . I want to have a

> glorious life of " time off " .

>

> " " <acukath <acukath%40gmail.com>> wrote:

>

> and on that note, may i add that many times colleagues in my area will ask

> me how i'm doing, hedging around at what the number of patients is that

> i'm

> seeing, and whether or not 'it's slow right now'. why are they not instead

> asking about my interesting cases, any stunning successes/cures of late,

> that type of thing?

>

> my 2 cents,

>

> kb

>

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January 22, 2007

Hi Kath,

I think you're absolutely right. My practice, both of them, actually, since I

was in San Diego for 2 years prior to Arizona, only helped me see that the

problem wasn't working for someone else, or having a set schedule, or having no

autonomy on a job, and having my independent practice was an attempt to resolve

these issues. Now that they're resolved, I still wish I didn't need to work,

but I do need to support myself, and yes, that is a big barrier to being

" successful " . I've always found interesting aspects to all the different kinds

of work I've done, but never liked the activity of working. It continues to be

a big conflict for me.

I've been in practice in Arizona for 2 years. It does get better financially,

and I want this to continue to improve as I figure out what to do about my main

concern at this point, my happiness. As I said, I am doing some creative

thinking in this area, and I may do something entirely different with my license

once I figure it out - something other than seeing one patient after another in

an indoor office and doing ongoing care. I'm thinking outside of the box. When

I get it put all together, I'll let you all know. I imagine it will take

another 1-1/2 to 2 years.

Andrea Beth