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> >prescribing. I sometimes feel compelled to reassure my

> >patients that I don't make much on the products I sell but I

> >would feel much better about just writing the prescript like

> >MD's do.

>

 

From what I have read on the threads here, everyone last one of you deserves

to make a profit on whatever it is that you do. I don't know what type of

thought process would even make you think for an instant that you needed to

reassure some patient that you weren't " making much " on what you sell. Why

shouldn't

you " make much? " Even if you charged what you would consider an exorbitant

fee for the herbs, you most likely would not match the prices that are charged

for the newer pharmaceuticals.

 

What is wrong with profit or even vast success in practice?

 

Guy Porter

 

 

 

 

 

 

 

 

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>Misha Cohen wrote:

>In my clinic, I have seen 4 people an hour for close to

twenty years.

As of one year ago, I have hired a co-practitioner and we

see 4 to 6

per hour.

We use all modalities of chinese medicine--acupuncture,

moxa,

cupping, massage,

loose herbs, pill herbs, nutritional consults and develop

treatment

plans which are

often for use with Western and other referring

practitioners.

Our front office is also our herb room--we carry many pill

herbs and

have about 550

loose herbs in stock--so the herb dispensing area is right

at the

front desk, This

nade it easy to cross-train the front desk people and the

assistants

to put together

herb formulas.

I hope this is somewhat helpful.

Yours, Misha

 

 

Misha,

Sounds like yours is the kind of practice I'd like to work

in. Brava! (550 herbs!) I'm glad there are people like you

in our field building such full-service, team-run clinics.

It think it's hard to build such a practice in a small

conservative city like my own but . . . maybe someday.

Marian

---

Outgoing mail is certified Virus Free.

Checked by AVG anti-virus system (http://www.grisoft.com).

Version: 6.0.734 / Virus Database: 488 - Release Date:

08/04/2004

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Guy,

 

 

 

This is of course one opinion. I think Todd's point about what MD's cannot

legally do and what naturopathics are recommended to do are the ethical

standard for healthcare. You may disagree, but the point is that you charge

for the service and not the supplement because it is real easy to recommend

things that the patient does not need. But hey it is all a matter of

perspective, like what is wrong with making a profit by exploiting migrant

workers, etc etc. And BTW - I think that with healthcare picking up most of

the cost for P-Drugs, if you prescribed herbs (i.e. about $80 a month) you

are most likely going to be more expensive then what the patient pays for

all their drugs. Include in 1 supplement app $30. you have $110 / month.

That is not cheap. But I stick by the ethical decision to not make profit

from herb sales.

 

 

 

-

 

 

 

_____

 

DrGRPorter [DrGRPorter]

Sunday, August 22, 2004 6:22 PM

 

Re: Re: patient load

 

 

 

 

 

> >prescribing. I sometimes feel compelled to reassure my

> >patients that I don't make much on the products I sell but I

> >would feel much better about just writing the prescript like

> >MD's do.

>

 

From what I have read on the threads here, everyone last one of you deserves

 

to make a profit on whatever it is that you do. I don't know what type of

thought process would even make you think for an instant that you needed to

reassure some patient that you weren't " making much " on what you sell. Why

shouldn't

you " make much? " Even if you charged what you would consider an exorbitant

fee for the herbs, you most likely would not match the prices that are

charged

for the newer pharmaceuticals.

 

What is wrong with profit or even vast success in practice?

 

Guy Porter

 

[Jason]

 

Guy,

 

 

 

This is of course one opinion. I think Todd's point that, what MD's cannot

legally do and what naturopathics are recommended not to do are the ethical

standard for healthcare. You may disagree, but the point is that one

charges for the service and not the supplement (in house) because it is real

easy to recommend things that the patient does not need and make $$$ - This

protects the patient. But hey it is all a matter of perspective, like what

is wrong with making a profit by exploiting migrant workers? Nothing right?.

And BTW - I think that with healthcare picking up most of the cost for

P-Drugs, if you prescribed herbs (i.e. about $80 a month) you are most

likely going to be more expensive then what the patient pays for their

drug(s). Include in 1 supplement approx $30. you have $110 / month. That

is not cheap. But I stick by the ethical decision to not make profit from

herb sales.

 

 

 

Finally, Patient's in my experience respect you greatly when you tell them

this. Many have been from practitioner to practitioner selling them every

supplement under the sun, knowing that these practitioners are making pure

profit from them. They are not happy about this and have expressed this to

me many times. I would be curious if you told every patient upfront that

you are making 100% profit off of the herbs that you are selling them. Many

would not care, I assume because they are getting better, but I bet many

would think twice. Just curious what they would say..

 

 

 

-

 

 

 

 

 

 

 

 

 

 

 

 

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Sorry about the previous post (below), my rough draft somehow got attached

to the top of the email, please disregard and check out the bottom portion.

 

 

 

-JB

 

 

 

_____

 

[]

Sunday, August 22, 2004 9:14 PM

 

RE: Re: patient load

 

 

 

Guy,

 

 

 

This is of course one opinion. I think Todd's point about what MD's cannot

legally do and what naturopathics are recommended to do are the ethical

standard for healthcare. You may disagree, but the point is that you charge

for the service and not the supplement because it is real easy to recommend

things that the patient does not need. But hey it is all a matter of

perspective, like what is wrong with making a profit by exploiting migrant

workers, etc etc. And BTW - I think that with healthcare picking up most of

the cost for P-Drugs, if you prescribed herbs (i.e. about $80 a month) you

are most likely going to be more expensive then what the patient pays for

all their drugs. Include in 1 supplement app $30. you have $110 / month.

That is not cheap. But I stick by the ethical decision to not make profit

from herb sales.

 

 

 

-

 

 

 

_____

 

DrGRPorter [DrGRPorter]

Sunday, August 22, 2004 6:22 PM

 

Re: Re: patient load

 

 

 

 

 

> >prescribing. I sometimes feel compelled to reassure my

> >patients that I don't make much on the products I sell but I

> >would feel much better about just writing the prescript like

> >MD's do.

>

 

From what I have read on the threads here, everyone last one of you deserves

 

to make a profit on whatever it is that you do. I don't know what type of

thought process would even make you think for an instant that you needed to

reassure some patient that you weren't " making much " on what you sell. Why

shouldn't

you " make much? " Even if you charged what you would consider an exorbitant

fee for the herbs, you most likely would not match the prices that are

charged

for the newer pharmaceuticals.

 

What is wrong with profit or even vast success in practice?

 

Guy Porter

 

[Jason]

 

Guy,

 

 

 

This is of course one opinion. I think Todd's point that, what MD's cannot

legally do and what naturopathics are recommended not to do are the ethical

standard for healthcare. You may disagree, but the point is that one

charges for the service and not the supplement (in house) because it is real

easy to recommend things that the patient does not need and make $$$ - This

protects the patient. But hey it is all a matter of perspective, like what

is wrong with making a profit by exploiting migrant workers? Nothing right?.

And BTW - I think that with healthcare picking up most of the cost for

P-Drugs, if you prescribed herbs (i.e. about $80 a month) you are most

likely going to be more expensive then what the patient pays for their

drug(s). Include in 1 supplement approx $30. you have $110 / month. That

is not cheap. But I stick by the ethical decision to not make profit from

herb sales.

 

 

 

Finally, Patient's in my experience respect you greatly when you tell them

this. Many have been from practitioner to practitioner selling them every

supplement under the sun, knowing that these practitioners are making pure

profit from them. They are not happy about this and have expressed this to

me many times. I would be curious if you told every patient upfront that

you are making 100% profit off of the herbs that you are selling them. Many

would not care, I assume because they are getting better, but I bet many

would think twice. Just curious what they would say..

 

 

 

-

 

 

 

 

 

 

 

 

 

 

 

 

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I am glad to hear that even the " more established " practitioners of

CM have a hard time managing both patient load, care and business.

As solitary, new practitioner in an underserved area, a lot of my

time is spent just educating the patient in the idea of wellness,

dietary habits, exercise and stress management - all of which seem

to have contributed to some very tangible early results.

 

From there acupuncture becomes my primary CM thrust - I include

moxa, cupping, estim and massage where necessary. Only after a

minimum of 3 visits do I turn to herbal therapy. This is for

multiple reasons.

 

1. It allows both the patient and me time to delve into the Chief

complaint - so many chronically ill patients have succesfully

ignored many of their complaints for so long that they are unable to

give an accurate picture of their disease - which can easily cause

an erroneous diagnosis.

2. It helps builds a trusting relationship

3. It allows time for me to research available (non-chinese

language) sources relating to their disease and the pathomechanisms

and build a more patient specific herbal formula, generally a KPC

classic as a basis with appropriate modifications.

 

The limitation of time certainly curtails too much sophistication in

formula design, however even the simplest modifications seem

worthwhile.

 

I find Sundays are the best day to develop formulas. There are no

phone interruptions and the desire to enjoy some of the weekend is a

great concentration tool.

 

While I agree with some of Marilyn Allens suggestions that to make a

business profitable you have to have multiple income strains, I also

firmly believe that time management, patient management

(expectations particularly) and the business of marketing,

networking and administration are all essentials to a thriving

practice. Non of which contribute an income strain - all of which

however cost time and money.

 

As with most health care professionals, we receive very little

training in the business side of running a practice. I compare

notes with many chiroprators, physical therapists and physicians and

they all lament the lack of business training.

 

One thing however that is essential - Write a business plan. It

forces you to declare your intentions - and manage your goals. Do

you need 30 patients a week, or 90 to achieve your financial goals?

Do you need to bring in additional income strains to supplement.

What kind of practitioner do you want to be.

 

If you practice acupuncture solely, you can probably see 3 patients

per hour - if you have a front desk person. You can increase the

number more if you have an assistant.

 

If you want to specialize in herbs then that patient number has to

drop and so your rates must go up. If you prescribe herbs can you

justify a 250% markup? Yes - you have to if this is your primary

treatment focus.

 

All of the above business decisions though demand that you as a

practitioner determine what kind of practice you want. We can all

become mediocre practitioners, who dabble - but it requires a plan

and a drive to excel. By establishing the plan upfront, you then

have a measuring stick which can help redirect you if you fail to

make your goals.

 

Kayte Halstead

 

 

 

 

, " Jill A. Likkel "

<jilllikkel@h...> wrote:

> , " Marian Blum "

> <marianb@r...> wrote:

> >

> > After 5 years, I'm revisiting the question of what type of

> > practice to have: specifically, numbers of patients seen per

> > hour and quality of care. I know many acups see 2 or more

> > people per hour. I would like to hear from anyone who does

> > this who is able to include herbal prescribing (custom?) and

> > modalities such as moxa and cupping. How do you do it? What

> > are the logistics? I

> . Have any of you delved

> > into these issues and since come to a happy resolution you'd

> > like to share?

> >

> > Marian

>

>

> Marian,

> I also have been in practice for five years. I work in a multi-

> disciplinary clinic (we have 9 practioners) where I have one room

> that is mine all the time and I share another room 1 1/2 days a

> week. This way I don't have to pay rent when I am not using the

> room. Usually I can get caught up with refills on the single room

> days. When it is not my doubled day and a half I can fill the

> formula(granules) easily. I also can manage to get out formulas

> usually on the doubled day because I haven't trained every patient

> to take herbs yet. But sometimes patients just have to pick them

up

> the next day. They usually don't mind.

> It would be helpful if my pharmacy was closer to my rooms. I have

to

> run up and down the stairs many times a day but I suppose it saves

> on gym fees.

> Our office does have a wonderful office manager that makes sure I

> get the notes about so and so needs herbs etc. She also collects

the

> $ and gives patients reciepts and books appointments.

> Occasionally it gets a little crazy and I have to stay late or get

> in early but I make up for this by being strict on my rule of only

> working four days a week, and an hour and a half lunch break. But

I

> really like having at least some doubled days. I'm not sure I'd

> want to do it all the time. And yes, I do moxa, cupping and gua

sha

> as needed.

> I also take insurance clients so I have a biller that picks up the

> superbills and attends to all the follow-up and phone calls. I

tried

> to do it myself(for a year and a half) but I was working to hard

at

> things I don't enjoy.

>

> In our town each practitioner has their own pharmacy.

> What do you and others think about having pharmacies(like

chinatowns

> in larger cities) instead of each practitioner having their own?

>

> Jill Likkel

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I think we deserve to make money on all aspects of our practice. However, there

are some

who make their business out of keeping their patients in the dark. One very

successful

practice repackages all of their patents into weekly plastic bags of $27 each.

Which

conveniently exactly fits into one slot of their insurance billing (but not for

herbs, you

figure it out). The patients think they are getting a special formula made in

the office by

these practitioners. And these are not the type of clienele who is going to

prowl around

Chinatown. So does one deserve to charge $27 for maybe $3 of patents? But as I

say this

is a very successful practice and this and other techniques work for them.

 

Also I have been to some practitioners who insist I need hundreds of dollars of

supplements and I have patients who come to me after having been to these

practitioners.

I question those that see their practice as selling these supplements. As one

bragged to

me, " I only charge the standard for acupuncture but each of my patients walk out

with at

least $200 in supplements. " Combine this with muscle testing or hair analysis or

any

number of " tools " and I see a loss of integrity.

 

 

Allow me to vent a little about the problem with Marilyn Allen in that she comes

from a

chiropractic model and I don't think she realizes the difference betweens the

two practices.

Which would be that we have a tradition that one can or should adhere to. It is

a rather

complete medicine (with caveats). Our practice is not an opportunity to create

" multiple

income streams " On the other hand I've read some of Honora's articles and think

she is

very good. I've taken to heart one article about giving something away free once

in awhile.

Which I often do with a $4 patent. Why try to make the extra 2-5 bucks when a

freebie

builds good will?

 

Just some thoughts.

 

doug

 

 

, DrGRPorter@a... wrote:

>

>

> > >prescribing. I sometimes feel compelled to reassure my

> > >patients that I don't make much on the products I sell but I

> > >would feel much better about just writing the prescript like

> > >MD's do.

> >

>

> From what I have read on the threads here, everyone last one of you deserves

> to make a profit on whatever it is that you do. I don't know what type of

> thought process would even make you think for an instant that you needed to

> reassure some patient that you weren't " making much " on what you sell. Why

shouldn't

> you " make much? " Even if you charged what you would consider an exorbitant

> fee for the herbs, you most likely would not match the prices that are charged

> for the newer pharmaceuticals.

>

> What is wrong with profit or even vast success in practice?

>

> Guy Porter

>

 

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Doug wrote:

 

> I think we deserve to make money on all aspects of our practice. However,

there are some

> who make their business out of keeping their patients in the dark. One

very successful

> practice repackages all of their patents into weekly plastic bags of $27

each. Which

> conveniently exactly fits into one slot of their insurance billing (but

not for herbs, you

> figure it out). The patients think they are getting a special formula made

in the office by

> these practitioners.

 

I think this is despicable. Another very successful practice I know even

puts the little black pills in tiny plain brown paper bags, so they look

even more exotic.

 

 

Julie

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In a message dated 8/24/2004 4:03:55 PM Central Standard Time,

writes:

 

> One very successful

> practice repackages all of their patents into weekly plastic bags of $27

> each. Which

> conveniently exactly fits into one slot of their insurance billing (but not

> for herbs, you

> figure it out). The patients think they are getting a special formula made

> in the office by

> these practitioners. And these are not the type of clienele who is going to

> prowl around

> Chinatown. So does one deserve to charge $27 for maybe $3 of patents?

 

I am not familiar with the situation you describe, but if you are implying

that there is something wrong with how the practitioner bills insurance in this

instance, then they should be prosecuted. There just isn't an excuse.

 

I also agree that this practice of repackaging is deceptive. And the fact

that it is overcharging is evident by the fact that the situation you describe

relies on deception, in that the patients think the herbs are something other

than what they are.

 

On the other hand, I sold patents to patients at a markup, and made no

pretense. I often let them know that they could go to our little Chinatown here

in

St. Louis and find them for themselves if they wished. My point is (and perhaps

it is my wood like personality that draws wood like patients) that I saw no

need to gain trust by telling them how little I made, rather I gained trust by

telling them what the herbs would do and by letting them see very earnest and

intense effort on my part, if not actual results. :)

 

In my experience, people are okay with the doc making a darn good living as

long as they feel that they have been listened to, cared for and that the doc

has extended himself earnestly and diligently during the rough times.

 

In about 17 years of practice, I had two people who bought their own herbs.

Hundreds of others were explicitly glad that I went through the trouble and did

not complain about the markup. Tens of people complained about the prices.

Some people who needed free care and would exchange something (cleaning,

artwork, filing) in exchange were given care for barter, and everyone who said

that

they just couldn't afford it was referred to a student clinic where they could

get the work done without charge. And of course, the good karma freebie is a

great thing.

 

I have coached more than one good practitioner about their practice when they

complained that they just weren't making it financially. In almost every case

I thought the guy was a better doctor than I was. So when I would talk to

them about their problem, I know it would sound as if I was just in business to

make money. But what was actually happening was that I was trying to balance

their proven inability to make money with some more business like thinking. To

an outsider it would sound harsh or self interested. But underlying that was

the intent that the practitioner needed to be making money and had to see their

healing practice as a business entity. Or else they would end up working at

Home Depot.

 

I don't know who Marilyn Allen is, but is it possible that this is what is

happening when she talks? Is it that she sees in front of her a few dozen people

who so deserve to make some money but are stuck seeing four patients a day

(six on a tough day) and apologizing for even charging for the herbs they had to

personally order, inventory and decoct?

 

I never meant that there was any reason to defraud, fool or dupe anyone. I

have had the experience of having some pretty serious health problems beyond the

reach (?) of Chinese medicine and when I see what kind of care I get from

allopaths, it makes me sicker to think that good herbalists aren't making

$150,000 per year.

 

Guy Porter

 

 

 

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Doug - I agree completely - the first practice is " Marketing a

Solution " - much like a " Happy Meal " - when you look at what is

really in the bag - the nutritional value is about 50c. However,

the intrinsic perceived value to the kid and hence parent is worth

$$ - the kid eats and the parent get's peace and quiet. Instant

gratification.

 

The 2nd practice is a front for supplementation and actually like a

Gin & Tonic - should really be called Tonic & Gin. However, they

have defined their field of business..They are selling

supplementation.

 

As far as Marilyns model goes - as I mentioned in my prior post -

the lack of business, marketing and positioning training is common

to Chiropractors too. They however, have had a few more years to

create an ABC for new practitioners with simple revenue streams like

pillows, seat cushions etc. They are much more limited by the bones

of the body as to how they can diversify, so a cookie cutter store

front is a revenue generator.

 

We have the " opportunity " to follow a very similar model - we can

easily make it work - any healing modality offers the potential for

feel good supplements and basic capitalism. I don't believe that the

tradition of TCM precludes or negates a money making enterprise.

 

Honora's freebies to generate good will and patient return are after

all not altruistic. The patient returns, they pay for another

treatment, replenish herbs and get to talk about how wonderful

acupuncture is at the next church meeting or golf foursome. That

generates the revenue and WOM advertising - in my book an awful lot

better than paying $50.00 for a pillow that is really uncomfortable

and wrecks at least 2 nights of sleep.

 

Either way - it comes back to my point of defining what type of

practitioner you are, what type of practice you want, writing a

business plan and setting attainable milestones.

 

Kayte

 

 

 

 

 

 

, " "

wrote:

> I think we deserve to make money on all aspects of our practice.

However, there are some

> who make their business out of keeping their patients in the dark.

One very successful

> practice repackages all of their patents into weekly plastic bags

of $27 each. Which

> conveniently exactly fits into one slot of their insurance billing

(but not for herbs, you

> figure it out). The patients think they are getting a special

formula made in the office by

> these practitioners. And these are not the type of clienele who is

going to prowl around

> Chinatown. So does one deserve to charge $27 for maybe $3 of

patents? But as I say this

> is a very successful practice and this and other techniques work

for them.

>

> Also I have been to some practitioners who insist I need hundreds

of dollars of

> supplements and I have patients who come to me after having been

to these practitioners.

> I question those that see their practice as selling these

supplements. As one bragged to

> me, " I only charge the standard for acupuncture but each of my

patients walk out with at

> least $200 in supplements. " Combine this with muscle testing or

hair analysis or any

> number of " tools " and I see a loss of integrity.

>

>

> Allow me to vent a little about the problem with Marilyn Allen in

that she comes from a

> chiropractic model and I don't think she realizes the difference

betweens the two practices.

> Which would be that we have a tradition that one can or should

adhere to. It is a rather

> complete medicine (with caveats). Our practice is not an

opportunity to create " multiple

> income streams " On the other hand I've read some of Honora's

articles and think she is

> very good. I've taken to heart one article about giving something

away free once in awhile.

> Which I often do with a $4 patent. Why try to make the extra 2-5

bucks when a freebie

> builds good will?

>

> Just some thoughts.

>

> doug

>

>

> , DrGRPorter@a... wrote:

> >

> >

> > > >prescribing. I sometimes feel compelled to reassure my

> > > >patients that I don't make much on the products I sell but I

> > > >would feel much better about just writing the prescript like

> > > >MD's do.

> > >

> >

> > From what I have read on the threads here, everyone last one of

you deserves

> > to make a profit on whatever it is that you do. I don't know

what type of

> > thought process would even make you think for an instant that

you needed to

> > reassure some patient that you weren't " making much " on what you

sell. Why shouldn't

> > you " make much? " Even if you charged what you would consider an

exorbitant

> > fee for the herbs, you most likely would not match the prices

that are charged

> > for the newer pharmaceuticals.

> >

> > What is wrong with profit or even vast success in practice?

> >

> > Guy Porter

> >

> >

> >

> >

> >

> >

> >

> >

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These words could have been typed on my keyboard. Amen from me.

 

 

Mark

 

 

-

<DrGRPorter

 

Tuesday, August 24, 2004 8:24 PM

Re: Re: patient load

 

 

>

> In a message dated 8/24/2004 4:03:55 PM Central Standard Time,

> writes:

>

> > One very successful

> > practice repackages all of their patents into weekly plastic bags of $27

> > each. Which

> > conveniently exactly fits into one slot of their insurance billing (but

not

> > for herbs, you

> > figure it out). The patients think they are getting a special formula

made

> > in the office by

> > these practitioners. And these are not the type of clienele who is going

to

> > prowl around

> > Chinatown. So does one deserve to charge $27 for maybe $3 of patents?

>

> I am not familiar with the situation you describe, but if you are implying

> that there is something wrong with how the practitioner bills insurance in

this

> instance, then they should be prosecuted. There just isn't an excuse.

>

> I also agree that this practice of repackaging is deceptive. And the fact

> that it is overcharging is evident by the fact that the situation you

describe

> relies on deception, in that the patients think the herbs are something

other

> than what they are.

>

> On the other hand, I sold patents to patients at a markup, and made no

> pretense. I often let them know that they could go to our little Chinatown

here in

> St. Louis and find them for themselves if they wished. My point is (and

perhaps

> it is my wood like personality that draws wood like patients) that I saw

no

> need to gain trust by telling them how little I made, rather I gained

trust by

> telling them what the herbs would do and by letting them see very earnest

and

> intense effort on my part, if not actual results. :)

>

> In my experience, people are okay with the doc making a darn good living

as

> long as they feel that they have been listened to, cared for and that the

doc

> has extended himself earnestly and diligently during the rough times.

>

> In about 17 years of practice, I had two people who bought their own

herbs.

> Hundreds of others were explicitly glad that I went through the trouble

and did

> not complain about the markup. Tens of people complained about the prices.

> Some people who needed free care and would exchange something (cleaning,

> artwork, filing) in exchange were given care for barter, and everyone who

said that

> they just couldn't afford it was referred to a student clinic where they

could

> get the work done without charge. And of course, the good karma freebie is

a

> great thing.

>

> I have coached more than one good practitioner about their practice when

they

> complained that they just weren't making it financially. In almost every

case

> I thought the guy was a better doctor than I was. So when I would talk to

> them about their problem, I know it would sound as if I was just in

business to

> make money. But what was actually happening was that I was trying to

balance

> their proven inability to make money with some more business like

thinking. To

> an outsider it would sound harsh or self interested. But underlying that

was

> the intent that the practitioner needed to be making money and had to see

their

> healing practice as a business entity. Or else they would end up working

at

> Home Depot.

>

> I don't know who Marilyn Allen is, but is it possible that this is what is

> happening when she talks? Is it that she sees in front of her a few dozen

people

> who so deserve to make some money but are stuck seeing four patients a day

> (six on a tough day) and apologizing for even charging for the herbs they

had to

> personally order, inventory and decoct?

>

> I never meant that there was any reason to defraud, fool or dupe anyone. I

> have had the experience of having some pretty serious health problems

beyond the

> reach (?) of Chinese medicine and when I see what kind of care I get from

> allopaths, it makes me sicker to think that good herbalists aren't making

> $150,000 per year.

>

> Guy Porter

>

>

>

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> I think this is despicable.

 

I don't know about " despicable, " but it is illegal under DSHEA as well

as unethical/unprofessional. (Part of the definition of a profession

as opposed to a trade is the existence of professional ethics.)

 

If you really are concerned about this, you should report it to your

Board of Acupuncture Examiners (if you have one), Department of

Regulatory Agencies, Board of Medical Examiners, Department of Health

& Human Services, or whoever regulates the practice of acupuncture &

CM in your state. You should also report this to your state

professional association whether or not the offending party(ies) are

members. Even consider writing a column about this for your local

newspaper's Health edition. (Most papers have such an edition once a

week). My point being, don't just lament this practice to others " in

the choir " but take responsibility to do something to change it. A

profession (as opposed to a trade) is supposed to be self-regulating

and self-enforcing.

 

Bob

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-

" Bob Flaws " <pemachophel2001

 

Wednesday, August 25, 2004 10:04 AM

Re: patient load

 

> I don't know about " despicable, " but it is illegal under DSHEA as well

> as unethical/unprofessional. (Part of the definition of a profession

> as opposed to a trade is the existence of professional ethics.)

>

> If you really are concerned about this, you should report it to your

> Board of Acupuncture Examiners (if you have one), Department of

> Regulatory Agencies, Board of Medical Examiners, Department of Health

> & Human Services, or whoever regulates the practice of acupuncture &

> CM in your state. You should also report this to your state

> professional association whether or not the offending party(ies) are

> members. Even consider writing a column about this for your local

> newspaper's Health edition. (Most papers have such an edition once a

> week). My point being, don't just lament this practice to others " in

> the choir " but take responsibility to do something to change it. A

> profession (as opposed to a trade) is supposed to be self-regulating

> and self-enforcing.

 

OK, I will consider doing something like this.

 

Julie

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, " Mark Reese " <tcm2.enteract@r...>

wrote:

 

> > In my experience, people are okay with the doc making a darn good living

> as

> > long as they feel that they have been listened to, cared for and that the

> doc

> > has extended himself earnestly and diligently during the rough times.

 

That is indeed true, but if the bulk of your patient population has always been

financially

strapped, it is a different matter than for those whom cash payments of a few

hundred

dollars a month are no problem. I have no problem with how anyone makes a

living. The

wealthy and middle class and insured certainly deserve healthcare. However so

do the

poor. I have been motivated for years to deliver my services to those who

cannot afford to

pay on their own. In this population, there is great suspicion of being ripped

off until one

develops that trust and rapport you mention. One of the trick with new patients

is not to

slam them with a huge herb purchase at once. Work with them, gain their trust

and slowly

make recommendations. However sometimes patients need herbs right away on their

first

visit, yet are vocally expressing concern about finances. If they react with

verbal concern

over the bill, I do sometimes feel the need to let them know that the herbs are

not

something I make money on.

 

The comfort of people with others making money has a lot to do with whether they

make

money themselves or feel constantly ripped off and abused by life (now don't get

me

wrong, I am not saying all or even most of these folks are accurate in their

characterizations of why life has screwed them, this is just the way it is). I

think such

patients are often reassured by knowing the person working on them is doing a

job, being

paid a salary and not personally profiting or losing in any way from herbs sold

or not.

That the only reason have to tack an additional charge onto their bills is

because it is in

their best interest. Sure, after you know someone, they trust you, but certain

folks are not

that trusting on first encounters, especially if they feel they have already

been run through

the ringer one too many times. This is never an issue for me with established

patients.

 

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While I agree that every practitioner deserves to make money on what

they do, I think the point being made is that too many practitioners of

all stripes are attempting to 'swell the bill' by giving substances to

patients that they probably don't need, or too many substances at one

time. When one is not making a profit, practitioner integrity is

assured.

 

There is probably a happy medium somewhere.

 

 

On Aug 22, 2004, at 5:21 PM, DrGRPorter wrote:

 

> From what I have read on the threads here, everyone last one of you

> deserves

> to make a profit on whatever it is that you do. I don't know what type

> of

> thought process would even make you think for an instant that you

> needed to

> reassure some patient that you weren't " making much " on what you sell.

> Why shouldn't

> you " make much? " Even if you charged what you would consider an

> exorbitant

> fee for the herbs, you most likely would not match the prices that are

> charged

> for the newer pharmaceuticals.

>

> What is wrong with profit or even vast success in practice?

>

> Guy Porter

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