Governor Gavin Newsom has retracted the proposed budget cuts to the Medi-Cal acupuncture program for low-income Californians for the 2024-2025 budget year. This decision marks a significant victory for health care providers and advocates who have long championed acupuncture as a vital component of comprehensive medical care.
Peer Points: From The High Seas to a Booming Practice
When licensed acupuncturist Kerry Boyle Jenni was working aboard 30 cruise ships, she learned to navigate the world of patient care and was inspired to build a practice that would thrive on land. The lessons overseas as a sales and revenue manager of acupuncture, managing all services and sales of acupuncture and herbs on board proved to be pivotal to her overall success in the years that followed when she began to build her practice from scratch. Today, Jenni owns and operates a private practice, an acupuncture clinic with three acupuncturists and two support staff in Vermont.
The practice has been extremely successful and she sees approximately 100-150 patients come through her doors every week. She shares her success by having a practice run as a 50/50 partnership with another acupuncturist, Joshua Singer, MS, LAc.
The two have managed to integrate acupuncture within their community hospital in a number of ways, including the oncology department. Jenni took some time to talk to us about her unique background and experiences in developing an intentional integrative practice with primary care physicians and her local hospital, as well as what it takes to succeed in the world of acupuncture today and through a partnership.
AT: Can you tell us how working aboard a cruise ship helped you develop the skills you needed to build a practice?
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KJ: The most important skills I gained were public speaking and the ability to successfully educate patients. Being comfortable with pubic speaking came after many on board lectures and is something I now use all the time. Learning how to educate the patient in a short time, a.k.a. "the elevator pitch" where you are able to have an interaction in the time of an elevator ride, has proven essential. I used to answer "how does acupuncture work" in the time it took to go from deck 2 to 7, now I use the same explanation at dinner parties, on lines at the grocery store, everywhere. People want clear, short answers and it takes practice to be able to deliver them. Fortunately, people unfamiliar with acupuncture tend to have similar questions, including how does it work, does it hurt, and how many treatments will I need. If we can develop confident and clear answers to these common questions it will serve us well. I had an opportunity to engage with a whole new community of 2,000-3,000 people every 2-3 weeks and essentially build a new practice every cruise. There was a lot of opportunity to practice these questions and engage with lots of personalities. This has proven very helpful for a comfortable bedside manner in my practice.
AT: Tell us about going from an acupuncturist aboard cruise ships to being a successful business owner. What are some of the important steps you took?
KJ: The hardest part was deciding where to live and open a practice. My husband is from Switzerland and we considered living in Europe. I was concerned my lack of fluent German or French would be a major problem for opening a practice. Since he is fluent with English and his career in hospitality allowed for flexibility, we chose the U.S. We weighed the pros and cons of where in the U.S. to live based on chances for practice success. Having gone to school in Seattle at Bastyr, I knew I had a network of providers there and support system of teachers. We consider a number of other places including Miami and New Jersey, but settled on Vermont for quality of life and opportunity for practice success. A large portion of our profession is based on the West Coast, where there are lots of successful and established practices. There are other parts of the U.S. that would benefit greatly from more acupuncturists. I would highly recommend finding a community that is not already being served with acupuncture and develop a practice there.
AT: How did you decide to get into practice with another acupuncturist instead of being completely independent?
KJ: The decision was born out of opportunity. A new medical doctor and employee of our local hospital had completed Dr. Weil's integrative medicine fellowship and was introducing the concept of integrative medicine to our community. He was building a team of independent providers to work under one roof and wanted more then one acupuncturist. My partner, Joshua Singer, and I had a mutual desire to create authentic integration within the Western medical community. We had known each other from participation in our state's acupuncture association and respected each other's education and experience. We were both very excited for the opportunity to work within an integrative clinic. When we discussed the details of independence versus partnership, it seemed most in line with our philosophy of integration to be a partnership. We genuinely wanted to provide patients with access to more then one acupuncturist and to collaborate on care.
AT: How has working with another acupuncturist in a 50/50 setting contributed to your overall success as practitioner?
KJ: The greatest benefit is as a clinical resource to each other. It is incredibly helpful to have another acupuncturist, one that is committed to your success, available for case reviews. Our patients benefit for both convenience of scheduling, Josh offers early mornings and Saturdays and I offer late afternoons and evening, and expertise. I frequently refer a complicated internal medical issue to Josh for herbal formula recommendations while he equally sends a patient with a stubborn migraine to me for acupuncture with craniosacral therapy. Having a partner also allows me to take vacation time without guilt and to call out sick when I really need to stay home. Our patients know we are a partnership and although they may be used to seeing one of us regularly, there has never been an issue with being seen by the other due to an unexpected event. I believe it is also a benefit as we present ourselves to physician groups. I think a sense of commitment to each other, to our practice, to our community, is conveyed through our partnership practice.
It was also very helpful financially as we started the clinic to split all over-head. At the beginning, we rented a small space with two exam rooms and an office together. In order to maximize our revenue, we adjusted our schedules to never work the same hours and always ran two rooms. When we reached a point where we were totally maxed out with available appointments, we renovated an office space to suit our needs with four times the square footage.
AT: What advice would you give other practitioners who are looking to team up with another acupuncturist?
KJ: A partnership could be a perfect match, or it could not. My responsibilities on cruise ships included management of about 30 acupuncture clinics and some of those were run as partnerships of two acupuncturists. I've seen the beauty of complementary providers working in harmony and the agony of two people forced to try to find a common ground when there was none. I had a teacher at Bastyr over 10 years ago have us write down where we wanted to be in 10 years and include a lot of details about how many hours we wanted to work, how many patients per week, how much money did we want to make, etc. I think independently evaluating your own wants like this and then come together with your lists and see if it's a match. And just to note, I recently found my list from over 10 years ago, and believe it or not my practice as it is now is incredibly similar to my manifestation list.
One more thing to note, have a business contract with a partner prepared by an attorney. It's a lot easier to think about how to disband a business when things are good then if they are not.
AT: When it came time to market yourself as an acupuncturist in your community, how did you go about doing this?
KJ: Marketing our practice is an ongoing project, no matter how busy we are. Even during periods where our schedule is full with a waiting list, we have a dry erase board in our back office with a large section that says "marketing ideas." As a team, we're always on the look out for new opportunities. I keep my eyes open for free publications around our community and contact them with an idea for an article geared for their market about how acupuncture may help their readers. We do a lot of expos and outreach events, where we always have a "sign up for our newsletter" list or raffle off a complementary treatment. We attend wellness events at local businesses where we offer workshops about acupuncture. We celebrate AOM day annually where we offer massage, tai chi, acupuncture and TCM snacks. We write a column in our local newspaper about natural health, focusing on Chinese medicine. We also regularly donate acupuncture treatments for local businesses fundraising events. In general, I am thinking about community outreach every single day and everywhere I go.
AT: As an acupuncture business owner what are some mistakes you made early on?
KJ: I was so lucky to learn my mistakes on someone else's dime, as the saying goes. When I worked on cruise ships, the program was in its infancy. We were developing marketing ideas for on board use by trial and error. If something didn't work, we had a whole new community of cruisers the following week to try a new angle. For example, we decided showing images with needles in the face was not positive for patients concerned about needles. Now the Steiner program is mature and the marketing is ironed out. I think as a provider some of mistakes we make in our early years are all about boundaries. It's incredibly important to have clearly defined boundaries, as they will constantly be tested.
AT: As an acupuncturist, what is the latest trend in your practice that you think is affecting the way acupuncturists do business these days?
KJ: I think the integration of acupuncture within hospitals is the next step for our profession. That will undoubtedly affect the way we do business. For example, we recently created private labels for Chinese herbal formulas for our practice with the intention of creating a brand that blends with this evolution. We wanted to recommend herbs to patients with names on them they could comprehend based on their symptoms and labels that were clean and clear and not full of imagery. I deeply respect the traditions and culture behind our medicine, but I also recognize the benefits of blending into a new medicine here in the West. We as licensed acupuncturists have the potential to profoundly affect this new paradigm of healthcare if we are pliable enough to allow for integration. I caution against rigidity and recommend engaging with other healthcare providers, legislatures and our communities to make our voice heard about how we are an essential part of the future of healthcare.
AT: You've managed to integrate acupuncture within your community hospital in a number of ways, including the oncology department. Can you tell us about your experiences in developing an intentional integrative practice with primary care physicians and the local hospitals in your area?
KJ: I think our successful blend into our local hospital, including hospital privileges, on-site treatments for employees, and regular oncology department shifts was created out of our willingness to meet both the care providers and administration on their level. Josh and I take pride in our western medical education and use it to speak the providers' language. Even if they respect our concepts of Qi and Yin and Yang, they need Western medical terminology in order to go to the board of directors of their hospital and recommend inclusion of care. I do not believe it is the responsibility of the doctors to translate our medicine, I believe it is ours.
My experience has been medical providers of all types are educated on the benefits and effectiveness of acupuncture and are looking for us. I live in Vermont where the community is liberal in general, so maybe my experience is skewed. But it seems everywhere I look the benefits of acupuncture are being touted. Gone are the days of talking until blue in the face about "it works!" Even "how does it work" has been answered now. There are providers out there looking for confident acupuncturists who can represent them well when they refer out. Connect with them, be confident and speak their language. I highly recommend seeking out the medical doctors who have an interest or certification in acupuncture, they already know it works. They are most likely too busy in their practice to provide acupuncture treatments and are looking for an acupuncturist to refer to.
AT: In your practice, what are the most common health issues you are seeing these days?
KJ: Our practice is general health; we do not specialize. That said, about 30 percent of my patients are OB/GYN. We work well with the OB/GYN departments of the hospital and our local midwives and receive referrals for breech positioning, morning sickness and back pain in pregnancy. We also have some overflow from our work in the oncology department and see a number of patients with side effects from chemotherapy. But the majority of our practice is pain management. It's well known acupuncture treats pain very well. Our community, and many others nationwide, has an issue with opiate addiction and many providers are trying to avoid prescribing opiates when they can. We have a great opportunity to help this patient population. We know acupuncture is amazing at treating painful conditions. We can also help patients get off strong pain medications and hopefully avoid the plague of opiate addiction that is sweeping our country.
AT: What are some of the Traditional Chinese Medicine principles you personally follow to achieve success?
KJ: It has to be a fundamental principle of our medicine, yin yang theory. When I first learned during Tai Chi classes that this beautifully simplistic yet deeply profound concept was at the heart of acupuncture, I took a turn on my professional studies path in nutrition and on a whim decided I had to study Chinese medicine. I think about these principles daily as I educate my patients on how acupuncture works, recommend dietary changes and instruct in qi gong during treatments. Yin yang theory follows me into the back office too as I see my business partner, Josh, and I operating in harmony explained by yin and yang. He'll be busy with important detailed tasks like balancing books as I send emails to senators announcing our open house. Yin and yang continue into my personal life as I return home to my husband and two small children, ages four and two. Our family realized quickly after the birth of our first son that two parents working with irregular schedules was incredibly difficult. We took a chance then, when my practice was still small, for my husband to quit his job and be a full time, stay at home dad and I would work full time and build the practice. Daily, I see my very outwardly yang husband doing yin tasks and vice versa. This has worked well for us, and we check in daily with the balance of work life and family life.
AT: What do you think is the most important business lesson most acupuncturists need to learn to succeed in today's world?
KJ: I guess each person's definition of success would have to be considered. My definition of success in business is financial security, personal freedom, and daily joy. To achieve this I've benefited from flexibility and adaptation. There are plenty of acupuncturists who have built wonderfully successful practices without taking insurance or bending to the Western world. If an acupuncturist is not one of those providers and is looking for an alternative, I would suggest considering if their practice can fit into the referral based system that is already built. The network that exists based on primary care referring to specialists has been around a long time. There is a place for us within this system. If they are in an area where patients have insurance coverage, I would suggest learning to take insurance. Providers do not want to refer to out of pocket expense services. It has been helpful for our practice to move to electronic medical records as well. This eases the referral relationship. Follow up with every referral with a note, and speak in Western terminology. Providers are insecure to refer to acupuncture if they can't explain how it works to the patient. Give potential referring providers educational materials for their office (don't forget the plastic stands for the brochures) and offer to do lunch time meetings to teach them how does acupuncture works in their terminology (offer to bring everyone lunch).
AT: What has been the greatest business lesson you have learned?
KJ: I was lucky to grow up in a small business family. My mom and step-father invented a wonderful wooden toy in the 80s and managed to get it into Toys R Us. The company eventually failed, I guess it was too early for eco-friendly, made in the U.S.A., toys for the market. The lessons I learned during that time period greatly impact my business now. The most important lesson came from watching my mom's relationships with people. She's an outgoing, cheerful soul, it's easy for people to connect to her, to like her. I've realized people want to do business with people they like. So never speak ill about another provider, always take the first step to introduce yourself to providers in your community, follow up with thank you notes, and send referrals back when necessary. It never hurts to smile too, and it moves qi in Stomach channel as well, so it's a win-win.
AT: What tips would you give seasoned acupuncturists still trying to find their niche?
KJ: I would say above all, do what you love. To continue to pour the effort required into private practice, you have to be authentically inspired by what you do. If you're looking to specialize, I'd recommend evaluating your community and see where a need lies. In my area for example, getting an appointment with a dermatologist may take four months. I would imagine a number of patients would try acupuncture whom may not otherwise, if there was a specialist in dermatology just because they are in need of care and can not be serviced by western medicine in a timely fashion. Asking primary care providers where a need lies would be a great way to get your services to a population in need of them. I would also not hesitate to recommend to any outgoing and flexible acupuncturist to consider spending some time doing a contract on board a cruise ship. Consider it an internship in business, it may provide some new ways to operate and if nothing else you'll learn how to treat sea sickness very well!
Kerry Boyle Jenni M.S., L.Ac. and Joshua Singer L.Ac., own Integrative Acupuncture and Oriental Medicine. To connect with Kerry find her at www.integrativeaom.com or at www.facebook.com/integrativeaom.
Do you have a practice success story you would like to share with our readers? Email bduran@mpamedia.com.