I am the queen of cheap. My dad was a college teacher, so I grew up poor. I actually did have to wear duct-taped glasses to school in fourth grade (thanks, Dad). Given the current economy, I am now considered hip and fashionable, rather than a cheapskate. The pendulum always swings back.
Frankly, I was appalled when our business teacher at acupuncture school opened up with "Take out a loan and get expensive business cards." WHAT? Is she nuts? We're not brain surgeons or bankers. Of course we should all be marinating in money; we do important work. But alas, this is the planet where lawyers and singing heroin addicts get rich rather than the rest of us. Only a handful of acupuncturists make it relatively big.
Beware of the gurus of "Make a Million Doing Acupuncture from Home." Many of them are not slugging it out every day in a clinic. I personally know a guy who wrote one of those books. Right out of the gate, he got a loan for his clinic building and fancy new equipment, opened up a full apothecary and hired a full-time receptionist. He was a big marketer and wrote a book about how great all that was. Now he does construction. When the going got tough, the tough switched careers.
I, on the other hand, have discovered the secret to happiness in life and in business: Need less. Well, OK, Buddhists and Taoists have been trying to make that point for a few centuries. I just stumbled across it.
Many of my budget office tricks are borrowed from my habits at home. Sure, you need office furniture, but does it have to be brand-new and full-priced? You probably need office help, too, but does it have to be full-time? Do you know someone who wants to trade? When I needed art for my office walls, I offered the wall space to an artist patient of mine for her personal art gallery.
I started out with a garage-sale metal desk and file cabinets. I have since graduated to a huge four-drawer, locking lateral cabinet that I bought for $75 from a professional cage fighter who was moving out of town. It's in good shape and goes for about $800 new. Besides, how many cage fighters have you met shopping at Office Depot?
I have whittled my office laundry down to almost nothing. I tried the linen service for a while. That was OK. But then I figured out that I really didn't need all those linens. I know an uncovered table can be cold in the winter, so this year when I was shopping for another table, I bought a heated one for just a few more dollars. Most everyone loves that table, especially when it's 10 F outside, and it saves me time and money on linens.
Here, I should explain that two days a week I run a sliding-fee community clinic. I see 17 people a day, three at time on those days. I designed a system where patients schedule themselves and pay unassisted, so I'm not paying office help to perform work they can do, which will keep my costs down (and theirs, too). The bottom of the fee scale is really quite low, so I figured, if they want towels, they can bring them. This is a no-frills clinic. I hand out orientation packets that include suggestions like that, and everyone is fine with it. People understand that they have to pay for all the extras, and these days, most people would rather keep their money than pay for monogrammed toilet paper or executive assistants.
Speaking of assistants, you can use technology for a lot of the functions a receptionist would perform. I hunted around until I found this really great single-line phone with about 10 mailboxes on it. People can press "3" to listen to the message that describes how my clinic operates and how you make an appointment, or "1" to leave me a message. I can also leave directions for people to hear custom messages like, "Andy, your herbs are in." You can also use smart phones as substitute office managers.
I use discount and auction sites for buying almost all my books and supplies online whenever possible. Last year, I bought 100 boxes of high-grade German needles off E-bay for less than half price. You never know where your next great find will be. Some sites have a notification service that will e-mail you when an item you want goes on sale. Buy in bulk. When my needle suppliers have a sale or free shipping, I load up.
Disposable goods are part of the medical field, and I use disposables wherever they are cost-effective, which isn't all that often. I think table paper is useless, so I don't use it. My patients know to bring or wear loose clothes that we can yank around to get to the points. It's cheaper and easier to just wipe the table off between appointments. I do, however, use oversized dental bibs for pillow covers, which I buy in bulk from an online supplier. They are relatively cheap and waterproof, so they protect the pillow from slobber, tears, and other undesirables.
There is nothing wrong with renting space, especially in an economy like this. How much energy do you really want to spend on stressing out over the mortgage payment for your office, especially if you are just starting out? Keep in mind that most acupuncture school graduates either never practice full-time or throw in the towel shortly after starting. Live with your office practice for a while before you marry it. You might not like each other after all, and may need to just get out of there and go back to fixing transmissions.
Your patients want you to succeed. One of my patients, a Japanese lady, was going back to Japan for a month, so I asked her to pick me up $100 worth of moxa. She was thrilled to be my "connection" and brought me back a large bag of some of the cleanest, purest moxa I've seen. If you need something, ask around or post it in your office. I publish a newsletter every other month, and I can make announcements in there.
I not only love to save money, I really love to save time. While I'm not exactly digging ditches, I find my clothes sometimes get dirty at work. T-shirts are way cheaper to replace than couture, so I wear a "uniform" of khakis and a fitted T-shirt. In the morning I might be thinking about the day ahead and find it annoying to have to interrupt that process to make fashion decisions. Some days, I'd get to work before I figured out that I looked like a refugee from "Pee-Wee's Playhouse." Now I can get dressed and out the door in five minutes and always look professional without even paying attention.
In real life, our time is not measured at $200 an hour. Sometimes, you have more time than money, and sometimes you have more money than time. Be aware of where you fall on that scale right now. Newbies with lots of unbooked time can afford to clean their own offices. If your office needs cleaning but your practice is really filling up, hire or trade for the cleaning service.
Seize the moment. My practice is in an office building. Last year, my carpets were due to be cleaned, and I was putting it off because who wants to spend their day off doing that? One Saturday, my husband was going in there for something or other and found the carpet-cleaning guy working on the hallway. He gave the guy $25 to steam-clean the traffic areas in my office, too. Done. Easy. Cheap.
If you want to market to the rich and famous, knock yourself out. I'm looking to the future, and I see dwindling herds of rich and famous. I'd rather stay in business than pretend that I'm going to be Oprah's acupuncturist. Besides, I've treated some rich and famous, and they have never shed tears of gratitude for my work. The poor and anonymous, who are, after all, my people, have.
Julie Crist is a 1996 graduate of Northwest Institute of Acupuncture and Oriental Medicine in Seattle. Her first small-town practice was in Brookings, Ore., and she currently practices in Colville, Wash. She can be contacted at