Guest guest Posted February 18, 2006 Report Share Posted February 18, 2006 The average american has negative savings right now. However a good number have equity in their homes. Unfortunately luxury expenses and even basic needs are often being financed from this equity. At the same time, the California housing market is crashing. Homes are staying on the market much longer than a year ago. There is a huge inventory. For example, if I wanted to sell my condo in SD today, I would likely take a $40K loss after all expenses were figured in. So the question for those in the field of alternative medicine is how are your prospective patients going to be able to pay their fees and buy their herbs once they have used up their equity and the foreclosures begin? Insurance covers only a small number of patients for a small number of visits and herbs are rarely covered at all. Being forced to give limited service and cheap (and thus often ineffective) herbal rx, your results will be poor and your word of mouth will suffer. I am hard pressed to see how anyone just starting out or still in school can ever anticipate making more than 35K per year in the next ten years under this scenario. I may be wrong, but there is a lot of denial in this field. I urge those who are not too heavily invested in their careers to find others who have been out for a while or even longer and see if you can get them to come clean on what they actually earn. Many, many folks have privately conceded to me that they barely get by even ten years after graduating. Yet due to ego on one hand and business sense on the other, most folks will claim otherwise in a public setting. If your potential patient base finds out you are not making a decent living, they will be loathe to use your services. Either you are no good at what you do or you might be gone very soon. Either way, not a good health investment. Someone remarked to me the other day, " well, so an so lives in a big mansion, etc. " . All his examples were of folks who had been in the biz for 20 years. It is then when it occurred to me that the profession as it stands is somewhat like a pyramid scheme. The folks on the top of the pyramid are the long time practitioners and the schools. The long time folks are benefitted by the appearance of a thriving profession and abundant cheap or free labor in the form of students seeking mentors. The schools rake in profits by charging high tuition, which is easily covered by students in the form of student loans, which they assume they will pay off soon after graduating. Again, find some honest folks like me who will tell you that in my best years, I made 60K and see little possibility of ever paying off my student loans. I know for a fact that the majority of recent grads are pretty much in the same straits. Then those who fail in practice are told it is because they don't know how to run a business. Perhaps, perhaps not. But you can't squeeze blood from a rock. If the patient base has no disposable income, no amount of slick marketing will part them from their cash. Besides, is that what you want to do anyway? Persuade anyone and everyone that they need your services, regardless of their actual need? I'll admit I could have made a bit more in the boom years of the 90's if I was willing to sell my soul this way, but its not boom time anymore. People talk about breaking out of your comfort zone and approaching people on line in a supermarket to sell them the goods. I can tell you that if anyone ever tried to sell me anything on line at a supermarket, I would rip them them a new one right then and there. It is the most reprehensible thing I can imagine. Why not just take your traveling snake oil show on the road? No, the only solution involves a twofold approach: 1. do research to prove what you do works. insurance companies are not going to cover acupuncture services unless it is evidence based. 2. work for the creation of some sort of universal health coverage that recognizes the benefits of preventive and alternative care so the impoverished souls of america can actually procure your services. For those who are dedicated to the field and want to see it develop into the future, this is the path to take, not the road of slick marketing tactics. If this profession goes down that slippery slope, not only will most folks end up broke anyway, but the credibility of the filed will be forever tarnished and the opportunity to accomplish the two goals above will have come and gone. don't believe me? Try and find a real friend, ply them with alcohol and get them to admit the truth about their incomes and debts. Web/Online Coordinator Adult Degree and Graduate Programs Prescott College http://www.prescott.edu Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 19, 2006 Report Share Posted February 19, 2006 Hi Todd et al, I agree with everything you said about the sad reality of making a living with our profession. Before I offer a solution I'm allowing myself one shot at school owners. Having gone through one school and taught at two others, I'd sooner make out with a rattlesnake than shake hands with a school owner. I recommend to anyone willing to shake hands with a school owner that you count your fingers immediately afterward. While running a not-for-profit sliding fee scale OM clinic I thought of a way to give access to the mainstream public without insurance. (The clinic had operated for about a year by September 11, 2001 and securing funding at that point was futile and that's the end of that story.) The idea is to create an OM delivery system completely independent from the existing heatlh care system. Here it is. -Assemble a group of OM providers with some kind of geographic such as distribution over an area where employees of a client company live.or proximity to the work sites. -Assemble accounting, bookkeeping, and marketing/sales staff and a OM provider to be medical director. -Billing, collection and distribution of fees will be done by the afore-mentioned. This will simplify and make more trustworthy the administration of the programs for both client businesses and providers -Offer OM services to businesses on a basis designed for each. For instance, the employer could have the services available to all or some of its employees. The employer could bear 20% or 50% or 100% (whatever) of the cost with the employee making up the balance. Employee family members could be eligible for services or not. Services could be only occupational health type such as on the job injuries or the gamut of what OM can provide. The employer can limit the number of visits (to be negotiated by the marketing staff) -DO NOT offer fees based on capitation. OFFER FEES BASED ONLY ON SERVICES RENDERED AND PRODUCTS DELIVERED. Businesses are either already paying a fee based on the legalilzed gambling of risk analysis or they have avoided the cost by not purchasing a monthly premium based policy. -Begin marketing with industries that have high musculo-skeletal injury rates. These injuries have high direct and indirect costs. Some examples are businesses that employ mechanics, concrete finishers, warehouse workers, those with significant numbers of employees who suffer repetitive motion injuries like real estate agencies and law firms. I consulted a lawyer and know for a fact that this isn't insurance but a price structure and method and the burdens of running an insurance company do not apply. Selling points for this setup are pretty apparent, especially to a marketeer This isn't " a million dollar idea " but it will provide a decent living for those involved. It won't do that overnight but after a sustained marketing effort. But that effort will be done by marketing pros and not OM providers who can devote the time they save to billable patient care hours. BTW, I'm not interested in arguing the merits of this idea. I will discuss how to make it work though. I'm putting it out in the wind for any and all who can see its potential and are disposed to capitalize on it. I'm not doing it for two reasons, 1) I'm a clinician not a businessman, and 2) I finally found someone to give me a job as an acupuncturist. JOE Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2006 Report Share Posted February 20, 2006 Luckily i am one of those that have been around for more than 20 years but i do feel sorry for many new graduates. > > I find this very disheartening as I prepare for the national boards (hopefully it will be offered in june) and graduation in August. This is my second career at the age of 45. I gave up the big admin job in Western medicine to follow my heart, only to find that I'm on a dead end road......????? Please tell me it's not all doom and gloom and that my time,money and dreams have not been wasted. Jean Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2006 Report Share Posted February 20, 2006 Joseph, I've been saying for years that we need to somehow develop alternative structures within our profession to the present insurance/ HMO/PPO scenario. You've offered a nice plan, but like you, I am a clinician/scholar, not a businessman. I hope others in our profession will develop these tools sooner than later. On Feb 19, 2006, at 10:11 AM, Joseph Balensi wrote: > Hi Todd et al, > > I agree with everything you said about the sad reality of making a > living > with our profession. Before I offer a solution I'm allowing myself > one shot > at school owners. Having gone through one school and taught at two > others, > I'd sooner make out with a rattlesnake than shake hands with a > school owner. > I recommend to anyone willing to shake hands with a school owner > that you > count your fingers immediately afterward. > > While running a not-for-profit sliding fee scale OM clinic I > thought of a > way to give access to the mainstream public without insurance. (The > clinic > had operated for about a year by September 11, 2001 and securing > funding at > that point was futile and that's the end of that story.) The idea > is to > create an OM delivery system completely independent from the > existing heatlh > care system. Here it is. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2006 Report Share Posted February 20, 2006 I don't feel that joining the Chinese medical profession should be gloom and doom at all. While I agree with Todd that sometimes the game resembles the'pyramid scheme' he describes, I think the problem is a combination of wrong emphasis in educational institutions along with a general lack of self-esteem in the profession. You have entered a noble profession, one based in 2000 years of application to a large portion of humanity. It is a great medical system, relieves much suffering, and this can only bode well for its future, if we can get past the unfair economic advantages given to biomedicine by insurance companies and the media. A little self-confidence goes a long way. Along with dedication, study and practice practice practice. I wish you luck and success, On Feb 20, 2006, at 3:54 PM, Jean wrote: > Luckily i am one of those that have been around for more than 20 > years but i do feel sorry for many new graduates. >> >> > > > I find this very disheartening as I prepare for the > national boards (hopefully it will be offered in june) > and graduation in August. > > This is my second career at the age of 45. I gave up > the big admin job in Western medicine to follow my heart, > only to find that I'm on a dead end road......????? > > Please tell me it's not all doom and gloom and that my > time,money and dreams have not been wasted. > > Jean > > Chinese Herbal Medicine offers various professional services, > including board approved continuing education classes, an annual > conference and a free discussion forum in Chinese Herbal Medicine. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2006 Report Share Posted February 20, 2006 I guess its easier out of CA Oakland, CA 94609 - Jean Monday, February 20, 2006 3:54 PM Re: earning a living Luckily i am one of those that have been around for more than 20 years but i do feel sorry for many new graduates. > > I find this very disheartening as I prepare for the national boards (hopefully it will be offered in june) and graduation in August. This is my second career at the age of 45. I gave up the big admin job in Western medicine to follow my heart, only to find that I'm on a dead end road......????? Please tell me it's not all doom and gloom and that my time,money and dreams have not been wasted. Jean Chinese Herbal Medicine offers various professional services, including board approved continuing education classes, an annual conference and a free discussion forum in Chinese Herbal Medicine. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 23, 2006 Report Share Posted February 23, 2006 can I forward some of your comments to my local (Australian) acupuncture forum? I'm not sure if this is that relevant as they are mostly talking about acupuncture and not herbs, but here are some hopeful signs coming out of the UK in terms of National Health Service funded treatments: http://www.acupuncture.net.au/podcasts/ -Li On 2/20/06, <alonmarcus wrote: > > I guess its easier out of CA > > > > > Oakland, CA 94609 > > > - > Jean > > Monday, February 20, 2006 3:54 PM > Re: earning a living > > > Luckily i am one of those that have been around for more than 20 > years but i do feel sorry for many new graduates. > > > > > > > I find this very disheartening as I prepare for the > national boards (hopefully it will be offered in june) > and graduation in August. > > This is my second career at the age of 45. I gave up > the big admin job in Western medicine to follow my heart, > only to find that I'm on a dead end road......????? > > Please tell me it's not all doom and gloom and that my > time,money and dreams have not been wasted. > > Jean > > Chinese Herbal Medicine offers various professional services, including > board approved continuing education classes, an annual conference and a free > discussion forum in Chinese Herbal Medicine. > > > > > > > Quote Link to comment Share on other sites More sharing options...
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