To CAN or not to CAN as it were...
Posted December 9th, 2007 by mountainlaurel
That is to say, I have a pretty standard private practice here in western Maine, that is doing quite well in fact. I started it up about three years ago. The minute I finished building my office out into two little treatment rooms and a tiny waiting room, I found and read Lisa Rohleder's book. I thought, dang it, I could have just left those walls out and could have had something really unique. But I started up my regular practice and found that people are really hungry for alternatives in health care, no matter what. So I went three years at a breakneck pace. This December is my first real slow down.
Last June I organized a conference in Maine for Lisa to teach, and was interested in the comments from the crowd as well as noticing that not many community clinics have started up in Maine yet. I am sort of disappointed, but since I have not really changed my practice over to a CAN type clinic, who am I to talk?
I have wrestled with the whole idea: to CAN or not to CAN? After all, one of my sides is saying: if its not broke why fix it? My practice is great, I am making money and paying off my student loan which is still hefty even after all these years. But... but... then there is the part of me, quite insistent part, that agrees with most of what is written about community acupuncture and how it is practiced. I am interested in the challenge of treating more people at once, intrigued by talking less to people, fascinated by what acupuncture can REALLY do, which I have seen some of in my practice. What I notice is that when people show up in my office I can really help them. Sometimes they have the drive, the resources (either their own or some other) and the willingness to stick with me and we really get a lot done. Its great! Others are daunted. By what, I am not always sure. Some of them clearly find the financial part of it daunting, and for others it is the commitment of time or to themselves (a particular sort of yin deficiency shows up as a lack of really being able to place value on self care). And oh I could go on about my thinking process. But I won't bore you.
Then I saw an ad about this thing called Charity and taking less:
http://www.odemagazine.com/doc/49/No-more-charity-please
And this describes perfectly how I feel. So I'll leave it here. Enjoy the article. And send me some good vibes for moving closer to the CAN clinic of my dreams.
Sandy in Maine
Re: To CAN or not to CAN as it were...
As a new grad who happened to put up walls for two treatment rooms and THEN read The Remedy - I feel your pain!
I operate a small-town (5000+ people) practice and was running a high-pay-end system. Honestly, right now I don't have the capital to change over to the CAN model, but I have taken a lesson or two from the book.
I created a sliding scale with no income verification required. I took out the huge Initial Consultation fee and all that "wait-a-week-before-we-get-a-plan" approach. I don't have my clients sign off on a course of treatment anymore and just recommend a course of 10 once per week to start. I say 10, they come 10!
I am the first Chinese Medicine clinic to open here on the Eastern Shore of Nova Scotia, so they don't know what to expect. I make the mold out here, as do a lot of acupuncturists when they open a practice.
After being a lot more financially accessible and not so "hard-sales," I have had my clientelle double to 20 clients per week. This is after fumbling around for 8 months trying to find myself in this practice-thing.
Lastly, it still does eat at me sometimes about the way I do business. I still don't think it's entirely accessible the way I'm doing it. After an initial course of 10 treatments, I do the *usual* once-every-two-weeks bit. For some clients, this doesn't work and they relapse bad. It makes me mad.
For now, I have to wrestle with this and figure out how to change it to make it work for everyone. Maybe CAN is the answer - maybe my own model will do. For the meantime, I'm working with what I have!
Thanks for reading...hope this helps.
Best,
Kenton Sefcik
Re: To CAN or not to CAN as it were...
There is a large dose of spiritual nourishment in:
Helping LOTS of people
Helping people who can't afford 12 different options
Helping people develop an ongoing relationship with acupuncture through which it has a far reaching ability to positively impact their lives, and the lives of their friends and families
Charging what you yourself could afford, even when you were a student, or an artist, or an activist, or....
Building something extraordinarily accessible
This style of practice makes me happier, hands down, than my years of "conventional" practice. Even if the salary were the same, I'd take this job in a heartbeat.
Re: To CAN or not to CAN as it were...
CAP is a business model. It works and makes sense.
Some of the aspects of the community practice can be made into a gimmick of sorts. But rarely is giving away free stuff ideal in building business loyalty or does it foster sustainabilty.
much like acupuncture can be a gimmick for other professionals or clinics
Yet it is truly effective when it is done in a focused and committed fashion by the flesh on both sides of the needle point
The boutique practice is another business model. The model somewhat supported defacto by the teaching acupunks /acuschools. There seems to be a lack of real analysis and support (which could be perceived as intentional ignorance). Rather you can take a CEU class or upgrade your degree if you want
CAN offers a workable flexible and growing analysis and technical/psychological support important to the new and veteran acupractice business have-er.
Opening a business is scary...or at least thinking about it.
Challenging the status quo in acceptable business models or acceptable classes of folks is hard work and scary.
much the same as acupuncture
selling people on the idea of jabbing them with stainless
however sterile it may be
is scary
thats why many will try other things first or parts of things
In business, you got go with your gut and back it up with the accounting and love
I have been practicing for 7 years
I am 1+month in to a community practice
It took me a year since I found CAN to get here
I was scared but
Its better than I imagined
its what I am meant to do
May you find joy in whichever model you create,
jimmyjabs
Re: To CAN or not to CAN as it were...
Hi Andy,
Thanks for the great message! I completely agree. And I am sorry if I came off as sounding like I think CAN is a charity. I didn't mean that! What I am obliquely, alright, poor writing, what I am referring to is what seems to be going on in the acupunk world at the moment which is thinking up ways to give away free treatments to people, which is charity, and then going ahead and charging high prices anyway in one's regular practice. Some acupunks are using the community style treatment as a free thing, and as a way to draw people into the acupuncture world. Others are doing the free community style treatments as free "clinics" (meaning one day stand alone things) and then just running the practice the normal way.
So I don't really mean to be picky here and pick apart what others are doing as wrong. Its just that I wanted to get the charity article out there because I thought it was interesting. And I think it really fits in with CAN.
I guess the upshot of what I am trying to say is that we are, as a profession, trying to think of ways to get acupunture out there into the mainstream, into America's health care system because we know it works. As far as looking at the ways that are coming to the lime light, I think that CAN is the best.
As far as my own work, I am just muddling along waiting for Christmas to be over with so I can take another step forward. Feeling grinchlike this year, I have to admit.
Sandy
Re: To CAN or not to CAN as it were...
love that yin defficiency part...
Re: To CAN or not to CAN as it were...
Sandy,
Some thoughts...
- I am also managing to pay off my student loans and other personal bills while maintaining a payroll of two employees, and sneaking away some dough in anticipation of bigger things to come for community acupuncture in the NH area in the near future. I am doing this while running a CAP.
- Consider the number of people who you are currently able to help via acupuncture. Now consider how many people you'd be able to help when your prices allow many more people to come and see you. Would this not only make you more satisfied, but also the new folks whom you'd be inviting into your clinic?
- I do NOT describe or consider the CAP in Manchester or CA in general 'charity'- not even remotely. It is simply leveling the playing field , to borrow a cliched sports analogy.
- I admire your willingness to write about the thought processes you are wrestling with.