Yesterday I had lunch with a couple of colleagues—acupuncturists who have been practicing for decades. After catching up on what was going on in each of our lives, the conversation turned to the recent story of Southwestern College of Acupuncture in New Mexico that has received failing marks from the US Department of Education. Based on a ratio of student debt to earnings after graduation, Southwestern College was cited for failing to prepare its acupuncture students well enough to find jobs that earn enough for them to pay off their student debt. Perhaps the most disturbing part of the report was that the median income for acupuncture graduates was only $17,260 per year.
While one of my lunch partners was a graduate of Southwestern College, the report hit close to home for all of us. We are all in private practice, so we are all well-aware of how hard it is to make a living practicing acupuncture.
We spent some time talking about how acupuncture schools could better prepare their students to market themselves, the role of continuing education, and areas of the country where the market was becoming saturated. (If you don’t think so, try opening a practice in Boulder or Santa Fe.)
These concerns really are secondary to some underlying problems—paradoxes, even—that can determine success or failure in building an acupuncture practice. Here are a few:
-Acupuncturists are healers. We’re drawn to this profession because we want to help people and we’re drawn to this particular medicine. It’s natural, time-tested, gentle, and slow. That’s a good thing. The dilemma is that many practitioners tend not to be particularly business savvy. And I have found from teaching practice management that some students aren’t particularly interested—or they’re overwhelmed. Talking about a business plan, profit and loss, and marketing can be like speaking a different language.
-In Chinese medicine, we are working with an entirely different paradigm, and it can be a challenge articulating exactly what we do. On my first day of acupuncture school, an instructor told our class not to try to explain Chinese medical theory in terms of Western biomedicine. That’s fine, but when it comes to marketing, too many acupuncturists talk about achieving balance, energy flowing in pathways, and depleted Qi. That’s a problem when your prospective patients just want to know if you can relieve their back pain or treat their gout.
-Chinese medicine is time-tested. We are working with theories, points, and herbal formulas that likely were developed more than a thousand years ago. That’s great, but our patients are also seeing doctors who are using gene therapy, robotic surgery, and artificial joints. We need to point out the benefit of the history of our medicine—not just that you’re using a technique that’s thousands of years old. While we may be impressed, our patients may not quite get it.
-Whether or not you participate in managed care by accepting insurance for your services can also create a dilemma. I recognize that many practitioners feel that they owe it to their patients to take insurance. These practitioners may also feel that it is the only way they can make a living as an acupuncturist. I get it. However, there are probably just as many, or more, acupuncturists who feel like they can’t or won’t accept insurance—and the reasons are many. As a single clinician, dealing with insurance takes hours of your time outside of treating patients. Insurance generally pays you quite a bit less for your time. In order to make it in an insurance-based practice, many acupuncturists find that they have to work two, three, and even four rooms at a time. And finally, many acupuncturists choose not to participate as a provider in a health care system that’s not really about health care. The bottom line is that you may be able to treat more patients as an insurance provider, which is a good thing, but it will definitely change how you work.
So I acknowledge that it’s tough to make it as an acupuncturist, but many practitioners do, and some make a good living. There’s no one single path to making it happen, but like the health of your patients, many small adjustments can make a big difference. Embrace the business side of your practice. Figure out what marketing strategies you’re comfortable with and which work to bring in patients. Track how each and every new patient heard about you. Send thank you notes to those people who refer patients to you. Talk to patients and prospective patients in a way that resonates for them (back pain vs stagnant Qi!). Stay current on new technologies that enhance your practice. Figure out what works, what you’re good at, and what you enjoy in your practice, and do more of that.