The Long-Term Futility of a Solo Practitioner

I am an acupuncturist.

I am not a receptionist. Nor am I a bookkeeper. Or a human resources director. Or a publicist. Or an administrator. Not me at all. Clinic manager? Ha. Good one. No.

Are we clear yet? I am like most of you. I needle people for a living. I went to school because I wanted to learn to be an acupuncturist and ever since I graduated that's what I wanted to do.

But it's funny. Like the great majority of acupuncture school graduates I too set up a solo practice. Just me. I did the normal solo practitioner stuff: I needled people, collected money, paid my bills, tried to get people to see me, etc. It was stressful, trying to make ends meet, not doing such a good job at it. In part it was because it was a typical boutique acupuncture start-up but also it was because I was doing everything and I don't like doing all that other stuff. And I wasn't making any money. No doubt if I had stayed on that path I would have been like most acupuncturists and been out of the profession within a couple of years.

Within a year I packed it in and started doing public health acupuncture. It basically paid my expenses but I (and Lisa and our three kids) weren't actually raking in the big bucks. But at least I could concentrate on just poking people, and in a way that was a relief. I wasn't collecting money or scheduling people or telling people they owe money because they missed their appointment or stuff like that, all of which truly distracts an acupuncturist from doing his job. But I didn't particularly like the bureaucracy either: all those rules that someone made up who wasn't even an acupuncturist. In fact I was fired from one public health job, but the next one I ended up in, where I was for six years, was okay enough.

But as the story goes that some of you know, Lisa and I became frustrated with the company we worked for and we decided to start our own clinic together. At the time we didn't really know what we wanted to do, though we did know that we wanted to take certain aspects of public health work (mostly the accessibility) into a different way to do a private for profit clinic.

I am not going into the details of how WCA started and grew here. I'll just say that we've grown to include (beside Lisa and me):

- A non-acupuncturist partner
- One full-time acupuncturist
- Two part time acupuncturists
- A clinic manager
- A part time bookkeeper
- I think five part-time receptionists
- We are about to hire two more acupuncturists both of whom will be full-time eventually and we will probably hire a couple more before this time next year.

No doubt I've forgotten some people.

So we now have what is called by the feds a small business. Whee. Remember earlier in this article that I wanted to be an acupuncturist? Well I'm not anymore. I have all these... people to work with and I am very ambivalent about it. On the one hand I like all my coworkers very much and they are doing jobs that I definitely don't want to do, nor should I do. On the other hand all the structure that is now needed to run the place bothers the chaotic part of me. That part of me liked working by my own rules.

I went into acupuncture in part because I was tired of working in companies with their rules. Let me put it another way: I wanted to be a health care provider but part of the special appeal of acupuncture for me as opposed to most other heath jobs (i.e. doctor) is that I get to set my own rules. My own hours. I want to make decisions for myself. Understand? I thought so.

So now I am in this small business and I look around at my fellow CAN-mates and I see them all starting up and having various struggles as they try to do everything all themselves and I can relate. I can particularly relate to [url=http://www.communityacupuncturenetwork.org/forum/read.php?22,3909]Diana's post, Growing Pains[/url] as I see her where I was a few years ago: lots of big decisions about how to cope with success. I think Diana is doing really well. I can see that she has some really hard decisions to make, like hiring another acupuncturist. I also see decisions that she will have to make that she didn't even write about. Every one of these decisions will take her away from the simple solo practice that she used to have not so long ago. But the thing is, if she is to succeed long-term, then she needs to grow and add people to her clinic. As do all acupuncturists in their solo practices.

That long-term thing: making a living so that I have a lifestyle I like, so that my kids can go to college, so that I can retire sometime etc.: I'm afraid it can't really be done with just a solo practice, CA or BA. I need to work with a bunch of other people for it to happen. That bunch of other people will either come into my practice if I make room for them or they will come through me working other jobs (teaching at an acu school, working for other acupuncturists, working some completely different type of job, etc). I've already done the work-several-jobs thing, which is ultimately just treading water not getting anywhere marginal sort of existence and I am much happier being in one place all the time.

Those of you who are CAN members might have seen a thread I started, "Make No Small Plans!" on the forums. It was greeted by a good amount of skepticism by CAN members. But the thing remains that one can only go so far in a solo practice and that regardless of if you are doing a CA or BA clinic working by yourself will burn you out eventually. You need support from others and you need to be responsible to others in order to succeed- and by others I mean coworkers, not patients.

We acupuncturists are an ornery bunch. We don't like being told what to do. Getting one of us to go in a certain direction is about as easy as herding a cat. That's also true with getting us to work with other non-acupuncturist people. In that sense starting off in a solo practice makes sense. Eventually though you must expand somehow because working by yourself is not fulfilling enough in any sense of the word. You must learn to trust others even if they screw up. This lesson is not only hard for me but I am still learning it. But if you want to be a successful acupuncturist you must learn it.