Making Private Practice Work: Part IV

In earlier articles of this series I stressed that your practice is a business and while there are some things unique to being an acupuncturist, basic business principles still apply. One of the most basic business principles I want to cover is that of your accessibility. How accessible are you and your services? The more accessible you are, the easier it will be to grow your practice. Another way of thinking about improving your accessibility is to think in terms of reducing the number of obstacles that prospective patients must overcome to make use of your services. More obstacles mean less accessibility and a greater degree of difficulty growing your practice.

Perhaps the No. 1 issue of accessibility is regarding your hours of operation. What days/hours are you open for business? I am often struck by the hours I see acupuncturists listing on their websites. Many show their hours of operation as being a few hours a day on some days and different hours on others with odd days of being open and closed. Some of those with such a mixed bag of days/hours may be doing so because they have multiple offices or other part-time jobs and this might be unavoidable but just know that irregular hours adds obstacles. If you can't be open normal business hours, at least try to make your hours of operation easy to remember like having the same hours Mondays, Wednesdays, and Fridays and then different hours Tuesdays and Thursdays, etc.

I was surprised to learn just how much limiting my hours reduced my patient-load when I cut back from five full days a week to four. I began working one day a week with the insurance company I consult with. I had been in practice over 10 years and had a very stable patient-load seeing 55-60 patients a week being open Monday through Friday. I began to close my office on Wednesdays thinking it would be no big deal to squeeze my patients into four days instead of five. Although it took a few months, my patient-load went down to just below 50 a week; almost a 20 percent reduction for reducing my hours by 20 percent. I went back to five days a week a year later and it took me six months to get my numbers back up to around 60 per week. If I could experience such a drop-off even after 10 years of steady practice, think of how much limited hours can stunt the growth of a budding practice.

The next issue of accessibility is regarding your office itself. Is your office easy to find and in a neighborhood that won't scare-off some patients? Do you have adequate parking and accessibility for those in wheelchairs or frail, elderly patients? If it is physically difficult to get into your office, you will lose some possible patients.

Another extremely important aspect of your accessibility involves financial accessibility. Are your rates so high as to make it difficult for most people to afford your services? Nothing is a touchier subject than fees for services and that is too broad a subject to cover thoroughly here. I do want to make the point, however, that relatively lower fees can greatly expand the pool of prospective patients able to access your practice. In addition to limiting the “sticker shock” higher fees can cause, charging less per treatment allows your patients to afford more treatments and this can greatly improve success rates leading to more referrals. Of course there is a balance that must be struck between charging too much and charging too little, but you should do everything you can to consider if you can find that balance point with lower fees.

In addition to the rate of your fees there is also the issue of how your fees are paid. Do you accept insurance, checks, and credit cards? I didn't accept credit card payment for the first 15 years and realized once I made that change what a mistake it had been. Like the broader issue of fees, the question of accepting insurance is too complex to cover well in a short article, but I do want to touch on this as it relates to the subject of accessibility. I frequently hear acupuncturists lament how hard it is to deal with insurance and it makes me cringe. These are people who have learned such complex subjects as modern anatomy, physiology, and medical terminology in addition to systems steeped in ancient Yin/Yang philosophy, learning about hundreds of acu-points and often hundreds of herbs and dozens of formulas. Learning how to deal with insurance is not difficult compared to those other subjects if one gets the right kind of training and approaches the subject with a positive attitude.

I also hear people being encouraged to have their patients pay upfront and then give them a super bill that the patient can turn in to their insurance company to receive reimbursement. While super bills certainly make things easier on the practitioner, it does present an obstacle to the patient. Some people do not have the money to pay up front while waiting to get paid back from their insurance company especially if they need several treatments over weeks of time. Insurance can bring a vital income stream to a growing practice. Those who say it is too much trouble never learned how to manage it well. Yes, it has downsides and yes, it is a hassle, but first learn how to do it well before you decide if it is worth it or not.

And lastly, another aspect of accessibility has to do with how well you help people understand the nature of the services you offer. Most people have no clue how acupuncture works and what it can and cannot do for them as I tried to emphasize in my last two articles. As the number of acupuncturists continues to rapidly grow, it will only be through attracting new patients that have never had acupuncture before that newer practitioners will be able to earn a living. This being the case, the task of explaining acupuncture will continue to be vital to acupuncturists for years to come. I spent many years refining my explanations on thousands of people who had never had acupuncture before and feel certain it is a big reason I have had such a stable practice over the last 25 years. I encourage you to review my previous articles and do all you can to improve the way you explain acupuncture and your services to the public.

I am not suggesting that no one can be successful if they limit their accessibility in any way. Some get away with it, but the failure rate among acupuncture practices is too high and there seems to be a widespread disconnect with some basic business realities like the more obstacles you create for prospective patients to access your services, the more difficult it will be to build a successful practice. Once your practice is on a firm foundation with a steady patient-load, refined operational procedures, etc., you will then have the luxury to decide if you want to reduce your hours, stop accepting insurance, raise your rates, and so forth. Until you reach that level of security you should worry about how to make things easier for your patients rather than how to make things easier for yourself. As always, good luck.