Billing / Fees / Insurance

Making It Happen

Patti Carey, LAc

I had the pleasure of brunching with Marilyn Allen recently. We had a great time catching up on all that has happened since I graduated from Pacific College of Oriental Medicine (PCOM) in December 2001. When the discussion turned toward how I found my current practice situation, I shared my unique story, which reflects the timing and effort that was necessary to make my situation happen. Marilyn suggested I share my story to give others words of encouragement and direction. We both lamented about the lack of preparedness graduates seem to demonstrate, even with all of the classes and information available on how to create a practice. Hopefully, this story will reach someone who is in a dilemma about an upcoming graduation or practice.

I decided early in my studies that I wanted to live in the desert. I began looking for places to live: southern California, Nevada, Arizona, New Mexico, and the like. I talked with anyone who would listen, or who had ever been to, or lived in or around any desert community. During this time, I never lost sight of the fact that I needed a place where I would be happy with my environment and that could support me financially as an acupuncturist. By the time I'd progressed to my last year in school, my preference was to practice in the Palm Springs-Palm Desert area of California.

I began asking people if they knew anyone in and around Palm Springs or Palm Desert who might be willing to talk with me about moving there and setting up a practice. The people were kind and generous, offering names and phone numbers of other people they knew. I also searched the Web to look at housing, cost of living, population demographics, hospitals, real estate - anything that could give me a knowledgeable head start on my impending move. I searched for acupuncturists, physicians, chiropractors, massage therapists, psychologists - anyone who would be a potential contact for practice opportunities or referrals. I also had a friend who lived in Palm Desert and asked her to provide me with an old telephone directory - another excellent way to search for potential contacts.

One of the names I selected from a Web site was for a clinic that listed alternative medicine as its main practice. There were two names listed: One was an MD, the other a DO - both with the same last name. I assumed they were brothers, or coincidentally shared the name. It isn't often you find an MD and DO practice together, and the fact that the Web site listed treatments such as chelation therapy, anti-aging, natural hormone replacement, and nutritional supplementation made it seem like a good lead to pursue. After all, I thought, if they already offer alternative therapies, they might be interested in adding an acupuncturist to the practice. I had nothing to lose by pursuing it.

Typical of my business background, I approached the clinic with an introductory letter and resume. I explained who I was (an impending acupuncturist about to graduate) and offered to call within the next two weeks to talk about practice opportunities in the community, and to get a perspective on the feasibility of having an acupuncturist in the area. True to my word, I called two weeks later and made an appointment to speak with the MD by phone.

What was supposed to be a 15-minute conversation turned into an hour-long discussion. He asked to have lunch with me next time I was in the area, to which I replied that I planned on being in the desert in two weeks. (I hadn't really "planned" to be there, but a key rule in making contacts is to accept all invitations if there is the slightest hint that something positive could occur.)

Here's the "unique" part: At the end of our telephone conversation, the MD asked how I'd heard about the clinic. I told him I found it on his Web site. There was a slight pause; then he responded that he didn't have a Web site. On further questioning this oddity, it seems he never had a Web site, and wasn't a member of any local business organization or chamber that would have had a Web site on his behalf. After our conversation, I went online to find the site: Sure enough, it wasn't there. I've tried several times to find it, but to this day, it eludes me.

Another interesting event occurred just before my telephone conversation with the MD and involved my friend in Palm Desert. I had asked her to provide me with information related to practice opportunities. One day in school, she told me about a conversation she'd had with a woman she sat next to in church. When my friend mentioned to the woman that she was in acupuncture school, the woman recommended she talk to a physician at a clinic that specializes in alternative medicine. Sure enough, it turned out to be the same physician I had found on the Web site that didn't exist. Things were really beginning to get interesting!

Two weeks later, I found myself in a lovely clinic in Palm Desert. The physician and I hit it off beautifully. The facility was quite nice and in a great location. As it turned out, the MD was very supportive of bringing an acupuncturist into the clinic and the community. There were already three or four acupuncturists in the area, but he felt there was enough opportunity to support another acupuncturist. He occasionally used a part-time acupuncturist from the Los Angeles area, but he wanted someone in the clinic full time. This was sounding better and better.

The physician and I had several telephone conversations and a few face-to-face visits to discuss how to create a win-win situation for both of us. We agreed it would be best if I were an independent contractor (what I wanted all along). We shook hands on the last visit, and I committed to join the clinic after my board exams. I passed on my first try (whew!). Two weeks later, I moved to the desert; two weeks after that, I began my practice.

While waiting for my board notification and license, I offered massage therapy, nutritional and herbal consultation, and began setting up the office: getting business cards printed, ordering herbs and supplies, making brochures - all the "tools of the trade." I started seeing patients as soon as I received the letter stating I had passed the board and received my license. The physician and I had created a backlog of patients who needed or wanted acupuncture, and were just waiting for me to get my license. In my first month, I averaged 10 to 12 patients a week; in the second month, 15 to 19 patients; and in the third month, I surpassed that number. While this may not seem like a lot of patients to some new practitioners, I feel things have gone extremely well for me.

I have spent, and continue to spend, a lot of time meeting people in the community and joining various organizations (business, social, women's groups, etc.). Networking is the key to meeting people and becoming established in any community. It is a major part of any practitioner's life - even after filling a practice to capacity. Networking is as much a part of being a practitioner as needling and herbs, and is the foundation for my social and professional life.

When I attended the PCOM graduation ceremony in April 2002, I was surprised at how many graduates and soon-to-be graduates had yet to identify where they wanted to practice, or what kind of practice they wanted. Some were going to travel. Some said they were moving back home. Some simply said, "I don't know." Overall, few had any concrete plans to segue into practice. Several students commented how lucky I was, but the way I see it, luck had little to do with it. First, I believe that the universe - or God - provides us what we need and will guide us to where we can do the most good, especially with our medicine. However, I also know it requires taking action and effort on our part. My process started early in my educational career at PCOM: The actual searching and contacting began nearly a year before I graduated, and the final commitment for my practice wasn't made until August. So, it didn't happen overnight - it took time, but I had direction and focus.

Statistically, the actual number of acupuncture graduates who set up a practice is approximately 20 percent. I am sure there are good reasons why the other 80 percent don't practice, but I find it hard to believe that anyone would want to go through the grueling process of Oriental medicine school and not practice! I have a feeling that many are just too afraid to venture out to find that special place to practice. Don't be fooled: It's work getting set up and starting your practice, but what a great way to offer hope and healing to so many people.

Many communities would benefit greatly from having acupuncture as an alternative and complementary therapy. The key is to plan and take action early. Nothing is cast in concrete until you want it to be. Plans may shift and change before you make a final decision, but that's okay! At least you're opening doors.

Here are a few other thoughts about the process:

  • Start thinking about your future your first year in school. That's not too early! If you already know where you will live and practice, great. Just make sure you stay connected to that community. While your friends and family may be there to support you initially, they will be only a tiny part of your overall practice. You need to find out who the "movers and shakers" are in the community, make contact with them, and stay in touch.
  • At the beginning of your last year of school, focus on your selected residence and begin making visits to the community with the people you've contacted. Talk to everyone you meet to get information about the area. Whether you'll be practicing solo or with someone else, it's important to make connections early and nurture those connections before, during and after your move into practice.
  • If you're a little hesitant to make contact with strangers - something that's difficult for some of us - start by calling the chamber of commerce or the visitors bureau and ask for a relocation package. You can also go online and look for information about your community. Next, send out letters and make phone calls. Even if you've lived in the same place all your life, you need to be reminded of who's who, what's there, and what's coming down the pike.
  • Contact professionals who would be possible referral sources: chiropractors, massage therapists, energy healers, psychologists, physicians, nutritionists, hypnotherapists, sports trainers/therapists, health food store owners - the list goes on and on.
  • Remember, if you contact someone and they do not return your call, don't take it as a personal rejection. Several people did not return my calls. That told me they were not the people with whom I needed to connect. Several people I talked to actually discouraged me from moving to the desert. What really surprised me was that some of this discouragement came from other acupuncturists. I weighed their words carefully, and recognized that people are often afraid of competition, rather than embracing it and making it work to their advantage.
  • Remember to send thank-you notes to those people with whom you've had either a telephone conversation or a visit. It's a nice way to keep your name in front of them, and let them know you appreciate and respect their time. The value of good will generated by such small actions is priceless.
  • Decide what kind of practice you want and pursue it. Not everyone will enjoy working with an MD, in a clinic, or even with other acupuncturists. The key is to create your practice. Even if you are already an established massage therapist, or are working as an assistant in an acupuncture or other type of clinic, do not assume that once you become licensed all of your massage clients will become acupuncture patients, or that the acupuncturist(s) you work with are going to refer their patients to you. It's up to you to create your patient base.

The beauty of being an acupuncturist is that we are able to offer so much to our patients. The hard part is getting to that point. Whatever the situation, you have the responsibility to create your own practice situation, generate your own patients, and not rely on others to do the work for you - not your school, your marketing class, your family or your friends. They are just guides to help you along your path to becoming an Oriental medicine practitioner.

You'll be surprised at how the universe responds to your requests for help and guidance, but ultimately, it's up to you - and who knows? You, too, might encounter that special "unique" situation that's just right for you. So, make it happen!

December 2003
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