01.30.07

Podcasts for Small Business Owners

Posted in online resources, startup at 4:10 pm by amit

The SBA has a bunch of podcasts available on their site. I haven't had a chance to listen yet, but the titles sound enticing. Lots geared toward startups, including:

Check List for Starting a Business
Financing a Small Business
Creating a Business Plan

There are also transcripts for the non-casters.

Small Business Administration Podcasts

01.29.07

Acupuncture Book Review

Posted in strategy and philosophy, industry stats, acupuncture, books at 11:05 am by amit

I just finished Lisa Rohleder’s book, The Remedy: Integrating Acupuncture into American Health Care. I’d discovered her book and Working Class Acupuncture, via the Integrator Blog a while back, and she was kind enough to shoot me a copy of the book to review.

If you’re NOT an acupuncturist, let me grab you before you go: this book is a good read for anyone in the CAM profession. If you’ve wondered from a business perspective about the viability of chasing solely mid-to-upper class dollars, or about how to transition to a volume practice, this book is a must read. If you’ve ever felt the ethical twinges of focusing all your efforts on the small demographic segment that can afford your services, Lisa makes a rational, sensible case for more broadly affordable health care.

Still here? Good. Rohleder’s position is that acupuncture as a profession is screwed (my words). Despite 4-5,000 new practitioners entering the market each year, the number in practice continues to hold steady in North America at about 15,000. Of those, many have second jobs and supportive spouses, or suffer from stress and burnout. Acupuncture is a profession in jeopardy.

The solution in The Remedy is to return, from a business perspective, to the Taoist roots of acupuncture. Before your eyes glaze over, let me tell you this is far simpler and more comprehensible than it sounds to the non-TCM practitioner. Essentially, it involves acupuncturists lowering their prices (to a sliding scale of $15-35 per visit), seeing more patients, and building a community-based practice.

In business terms, it means making your money on volume, not on high prices. In health terms, it means more accessible health care that works better.

If you’re a struggling (or not) CAM practitioner, I’m sure your first question is the same as mine: can you make a living lowering your prices?

As Lisa says in the book:


"Incidentally, I make a lot more money now than I ever did when I charged $65 per treatment.”
I believe it – volume business can be good business. Think of Wal-Mart.

It got me thinking, though, about the practical transition from higher-priced boutique clinic to volume practice. What if you’re on the financial edge right now? How do you cut your prices by 75% or so, and hang in there until the volume kicks in?

So I asked Lisa.
“Even people who were very nervous about losing money during the transition said that they initially made the same amount, and over time gradually began to make more. Those folks also reported that their job satisfaction went way up, and both their stress and total hours worked went way down, immediately after they made the transition, so they were happy.

One way around that problem might also be to have a hybrid practice for a while -- keep seeing the patients who want one-on-one, and just add "community hours" two afternoons a week. One initially nervous practitioner started out that way, and a year later her practice is 95% community acupuncture.

But I guess I would say that if a practitioner is truly freaked out about losing money, they probably shouldn't be doing this anyway. Passion is an important ingredient, and if you have more fear than passion, this is not for you.”

So let’s see. More money, more satisfaction, less hours worked. Sounds like the American (Acunpuncture) Dream.

A volume practice might not be for you, though, and that’s fine. My belief is that there’s a niche for everyone doing something that they love. Personally, I like the idea of volume and higher prices together, but that’s a challenging position to reach and hold in the market for any length of time, and it doesn't make services more accessible.

If you’re struggling or just plain curious, The Remedy is a good read. I know from our discussions that Rohleder’s got some strongly held anti-classism values, but they’re well presented – she can write, and well. This is a thought-provoking book, well grounded in solid business experience, with some cool Tao Te Ching verses along the way, which makes the book an interesting yin-yang package in itself.

If you’re interested in a copy of Lisa’s book, you can get it here:
http://stores.lulu.com/store.php?fAcctID=660094

01.25.07

How To Handle Free Advice-Seekers

Posted in startup, strategy and philosophy, patient quality, pro bono at 10:34 am by amit

Reader E. writes:

“I was wondering how you handle when people start to ask for free advice. I am starting out my practice and want to come out of the gates honoring my abilities and not giving things away for free. I don’t mind a general question here and there, but when someone keeps asking very detailed, specific questions where my education and experience really comes into play – I want to set that boundary.”
This is a common practice challenge, particularly for startups. Early in your practice, you may not yet have the confidence, experience and poise to deal with the patients who constantly ask for free advice. I’ve written before on pro-bono work, but this is a bit different. How do you deal with those clients who seem to have a knack for getting you to cough up free advice?

First, Change Your Mindset
What’s really at the root of giving out too much free advice? Often it’s a failure to truly value the service you’re providing. This leads to a subconscious reluctance to bill for your time.

Sometimes you need to remind yourself that you’re really worth it. Try adding up how much you’ve spent on education and starting your practice. Then look at how much it costs per month to operate. It’s likely no small number. Your expertise is worth money, period. You need to “own your fees” – be comfortable with your rates, and feel no reluctance in billing for any amount of time. That’s not to say you shouldn’t ever do anything for free, just that you should feel comfortable billing when it’s appropriate.

Know What Free Advice Isn’t
Not every question that arrives without a check attached constitutes free advice. A patient calling for clarification is not asking for free advice – they’re trying to correctly follow the advice you’ve already given. An inquiry as to whether you can help someone with a specific condition isn’t free advice, it’s simply a sensible inquiry into how you can help. You may even want to dole out “freebies” to good patients – the kind who come often, pay promptly, and refer frequently.a

The easiest way to tell if you should be billing is this: if you feel like someone is taking advantage of your time, then they likely are. They may not be doing it on purpose, but nonetheless, it’s time to start handing over the invoice.

Adjust Your Paperwork
It’s important to let patients know the deal. State outright on your intake and consent forms that you bill for phone and email consultations. Decide your rate, and clearly state it. This will brush off a few advice-seekers, and give you (and your staff) a clear process for billing the rest.

Use Your Staff to Turn Advice-Seekers Into Bookings
It’s easy to bill people when they’re in your office. The office is where money changes hands – patients expect to spend money in your place of business. Try to respond to requests for free advice by getting people in for official visits.

Use your staff to help with this. Have them screen your calls, and book appointments instead of transferring advice-seeking calls through to you. If someone emails you asking for advice, simply reply with something simple and pleasant – “It sounds like we should get you in next week for an appointment. I’ll have Susan call you.” Just CC your receptionist, and he/she can call the patient and book the appointment.

If you don’t have staff, use the same line. “It sounds like we should see you in person.” Be diligent in this.

Explain Why
It’s potentially unsafe, unethical, ineffective and dumb to diagnose remotely – by phone or email, for example. One of the strengths of most CAM modalities is the ability to see a broader picture of an individual’s health, and you can use this as a tool to deal with free advice-seekers. Simply tell them that you need to see them in the office to get more details.

Be persistent. When a patient asks, “Can you just tell me if such-and-such herb will help my diabetes?” tell them no. Every patient is unique, and you need to see them in the office. In the end, they’ll get better treatment, love your service, and refer more patients to you instead of getting advice based on poor information, then complaining that your services are lousy.

Bill Them
If you absolutely can’t dodge someone (on the phone is typically the toughest to deal with), just bill them. Period. Once you’ve decided your phone consultation rate, just send a bill. Don’t be afraid – you’re a professional and your expertise is worth money. It’s critically important that you learn to respect your time. Until you respect it, other people won’t.

The truth is, if you have patients who are trying to get free advice from you on a regular basis, they’re really not the patients you want. If they corner you on the phone, just bill them. You’ll either convert them to solid, paying patients, or you’ll lose them. Either way, you’ll be further ahead.

Related Posts
Pro Bono Work and Discounts: What's a CAM Practitioner to Do?
What Makes a Great CAM Patient?

01.21.07

Bush to Urge New Tax Plan for Health Care Coverage

Posted in Uncategorized at 2:27 am by amit

President Bush intends to use Tuesday’s State of the Union address to tackle the rising cost of health care with a one-two punch.

01.20.07

Pennsylvania Governor Pushes Health Plan

Posted in Uncategorized at 4:28 am by amit

Gov. Edward G. Rendell’s plan would not only extend health insurance coverage to the state’s 760,000 uninsured adults, but also cut billions of dollars in heath care costs.

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