Know your patient market

This letter is another response to the Acupuncture Today article written by Ms. Dunas, one of the leaders in our acupuncture field. The original article can be viewed here: http://www.acupuncturetoday.com/mpacms/at/article.php?id=31577.

Dear Ms. Dunas,

Your article in Acupuncture Today, “Money Is Qi Is Money”, has provided much for me to consider as a fellow acupuncturist. I appreciate your idea that it is both possible to make a good living as an acupuncturist, and that being successful in acupuncture can be good for everyone involved in the process (the practitioner, their patients, and other businesses via consulting). I found that beyond this general message I have a different point of view on many of the ideas you shared.

In any industry there are many potential target markets on which to focus your services and products. The current application of acupuncture and oriental medicine (AOM) in America appears to be focused on two main target markets, each serving a relatively small percentage of the overall population of the United States. The markets I am thinking of are at opposite ends of the economic spectrum. One target market is the substance abuse population. Businesses that serve this market are primarily government funded low income service programs using some form of ear protocol acupuncture and other therapies, for example counseling. These services are typically free upon meeting certain age and economic requirements. On the other end of the economic spectrum, private pay patients are served by mostly sole proprietorships. Practices created around this market typically charge somewhere between $50.00 and $200.00 or more for each treatment. The majority of American acupuncture schools only teach students about these two patient markets, so many acupuncturists tend to believe that these are the only two markets available.

It seems to me that you are suggesting that focusing on the wealthiest patient market will bring prosperity to any acupuncturist who charges higher fees. That may be, until the wealthy patient market becomes saturated. With acupuncture schools encouraging their students to focus on this specific market, saturation of this market seems inevitable. Most Americans fall somewhere in the middle of the economic spectrum between very poor and very wealthy, so it is surprising that there are few if any AOM practices that structure their practice around the needs of working class people. As an industry, AOM is losing out on the majority of its potential patients by charging fees that do not reflect the economic reality of most Americans. Further, it seems to me that providing realistic access to therapy is essential to staying in business as an acupuncturist.

If your end goal in practicing AOM is to become very wealthy, then it makes sense to charge the highest price possible. However, some acupuncturists simply want to exchange value for value and make enough money to live comfortably. Charging top dollar for AOM services may be considered good business to some acupuncturists; however, what I am not hearing in your discussion is how to reach more patients with acupuncture. Your practice model reaches only the very wealthy patient market, what about the majority of Americans who can’t afford these prices? After all, according to data from the 2005 census bureau, the vast majority of potential acupuncture patients in America are not able to realistically afford a course of 5-10 treatments per month that range from $50.00 to $200.00 or more.

It may be that some of us in the AOM field have a “poverty consciousness”, meaning that we are more focused on giving than receiving in our health care business. However, while it is true that charging fair market rates is a necessary step for all business people, fair market rates depend on the target market you choose to serve.

I think that if you surveyed the acupuncturists in this country you would likely find that many acupuncturists do not prefer to only serve the wealthiest patient market, wear designer clothes, or drive Porsches. Some of us would simply like to make a good living practicing a medicine that embodies ideals that we support. In any business, doing what is close to your heart, what really feels like an authentic reflection of your personal values will tend to be the easiest to maintain. If serving a wealthy target market and providing AOM consulting to large corporations truly feels like a good fit, I say go for it. All the same, if you come from a working class family and relate to working class people because you are one, you will likely find more success providing AOM services to people you naturally associate with. If you are practicing acupuncture in a way that is in line with your values, it just feels good.

It seems to me that access to acupuncture is the most important factor in developing public awareness of AOM services, and thus it is important to encourage more people to give acupuncture a try. As an acupuncturist, if I can find an abundance of patients to treat and charge them a fee that is affordable to them (based on impartial census data) then I will have a chance at making a living wage while staying in business. I will be charging less than most practitioners, but if I creatively structure my practice around the needs of my market, I can find a way to be both effective and profitable.

One option for those of us who want to serve the majority of Americans and make a good living while doing so, is community acupuncture. This is a practice model that resembles how AOM was practiced in ancient China. By way of explanation, here is a quote from the Community acupuncture network website: “Acupuncture has been a community based medicine for most of its long history. In Asia, acupuncture has traditionally been practiced in group rather than individual settings. For acupuncture to be most effective, patients need to receive it frequently and regularly---far more frequently and regularly than most insurance plans will pay for. As acupuncture has moved toward the mainstream, it has been forced into a paradigm of one-on-one treatments and high prices, which has decreased not only patient access but treatment efficacy. Community acupuncture clinics represent a return to tradition. Community acupuncturists focus on using “distal” points (below the knee and elbow, and on the head and neck) so that patients can remain fully clothed during treatment. Community acupuncture clinics often use recliners rather than treatment tables.” (communityacupuncturenetwork.org)

I work as a community acupuncturist at the Working Class Acupuncture clinic in Portland, Oregon. In my experience community acupuncture is a viable format for marketing AOM services to working class people. I hope that as a leader in our profession you will consider promoting community acupuncture as a third acupuncture practice option. Looking into the future it seems vitally important that we acupuncturists create viable businesses for ourselves that reach every socioeconomic stratum in this country---not just the super rich.

Moses Cooper, LAc