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Acupuncture Today
September, 2010, Vol. 11, Issue 09
 
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Plotting Your Course

By Denise Cicuto, LAc

It's not enough to want to make a living to do what you do. Nor is it enough to be extraordinarily talented - the world is full of passionate, talented failures. If you want to earn money with your passion, you'll be running a business, and the sooner you accept that, the sooner you'll be able to plot your course.

This is a quote from an artist I know named Marrus, in an interview she did recently. I think it's apropos to anyone who follows their dream and runs their own business, including acupuncturists. It's not enough to have your acupuncture license; you'll also need to know some things about running your own business.

What part of being an acupuncturist and small-business owner do you find challenging? Is it the bookkeeping? Or maybe it's public speaking? What about insurance billing? You don't have to navigate these things alone. There are other professionals who are experts at what they do who can help you out, or you can take courses on the subjects. For some of them, you may even be able to get continuing education credits. If it's a more general business concern, you can look at your local SBA for a list of classes.

Let's start with the basics. What are you going to need to start your acupuncture practice? There are some things you can do while you're waiting for your acupuncture license to arrive in the mail and some that you can do right after you receive your license. This is based on a list compiled by Sabrina Kirkland, LAc and it's incredibly useful if you're just starting out.

Your acupuncture license and malpractice insurance: These are absolutely essential to have in place before you start practicing acupuncture. Hopefully your acupuncture school guided you through how to apply for both of these and the requirements for the state where you live or how to apply for a national NCCAOM license.

DBA (Doing Business As) name and business license: The process for obtaining a DBA name includes deciding on a name and running an announcement with your DBA name in three newspapers as a new business. The newspapers will send you copies and you can use these to apply for your business license and bank accounts. The process for applying for a business license varies depending on where you live. Check with your local city government to find out more information.

Bank accounts and loans: Set up a separate bank account for your business and you might also want to apply for a business line of credit. You can check with your local Small Business Administration about small business loans that are available.

A place to practice: Are you going to rent space by yourself or share space with others? Do you want to be in a clinic just with acupuncturists or with other kinds of practitioners? Would you prefer a more medical clinic environment, a spa or somewhere in between? These are options you'll have to consider. You can look for treatment space through word of mouth, help from your acupuncture school, or online or print classified ads.

Needles and treatment room supplies: These items were probably supplied by your school's clinic when you were interning so you probably didn't even have to think about them. Now you'll have to order needles, exam paper or massage table sheets, gowns or drapes for patients, alcohol dispensers, cotton balls and container, clean fields or a tray for your clean needles, sharps/biohazard disposal container and herbs.

Figuring out what kind of needles to use is a matter of personal choice. Once you apply for your acupuncture license you'll be on suppliers' mailing lists and will get samples to try. You'll need to set up accounts with herb and needle supply companies and they will require you to provide a copy of your acupuncture license. You'll have to make arrangements with a company to dispose of your used needles as well. There are several available.

Office forms: You'll need new-patient forms and SOAP notes. You might have a template for this already. If not, you'll need to find them or make your own. The CD that comes with Points for Profit has samples of forms. Also, there are forms available for you and your patients from different companies online.

Curriculum vitae/resume: It may have been a long time since you updated yours and now's the time to do it. Insurance companies, networking organizations and other people who will interview you will want to see one.

Merchant account for credit cards: A lot of patients pay with credit cards, flexible-spending account cards or debit cards. In order to accept them, you'll have to set up an account with a merchant account services company and get a machine to process them. If you work in an office with other practitioners, you may be able to all share a machine and have separate accounts on it. There are also smart phone applications for processing credit cards, or you can set up a Pay Pal account for patients to pay you.

Health Insurance: Figuring out the complexities of insurance billing can be very time consuming. You may want to consider using a medical billing company to handle insurance claims for you. For a percentage (somewhere around 7 or 8 percent) of what you'll receive back from insurance companies, a medical billing company will take this off your list of things to do. Some practice-management software programs have modules for filling out and submitting insurance forms as well.

If you decide not to take insurance directly at the beginning of your practice, you'll at least need a three-part form called a superbill that you can give to your patients with your contact information, ICD-9 codes and CPT codes. If you are lost about what those codes are, you can take a continuing-education class on insurance billing. There are books and even applications for your smart phone with the most commonly used insurance codes for acupuncture.

A computer and a few programs for your practice: At the very least, you're going to need a bookkeeping program to input patient invoices and keep track of your money. In my experience as a former bookkeeping assistant, most accountants and bookkeepers prefer Quickbooks. They can also help you set up the program from the start so it'll be easier when it comes time to have them help you with your taxes. Believe me, this is something you want to think about sooner rather than later. There are also different practice-management programs that are specifically designed for acupuncturists. Some programs, such as MacPractice, have special modules for chiropractors that acupuncturists can also apply to their practice.

Those are some of the physical things you'll need for your practice, but we're not done yet. There are also some fears that come up when starting your acupuncture practice. Having only a handful of patients at the beginning is one of them. Public speaking may be another. How are you going to pay the bills might be a very basic one. There are some concrete things you can do to help you overcome your fears when starting out your practice. Some of them take a little bit of thinking outside the box.

Reach out. Where else in your community, aside from your office, can you do acupuncture? This may include physical rehabilitation centers and community centers. Since ear acupuncture is so portable, you might want to do ear acupuncture sessions in an office environment for small groups of people. Would you also consider doing house calls for some patients who otherwise wouldn't be able to come to your office?

Don't have blinders on. I know some of us would like to specialize in different areas. There may be a particular area of medicine or a particular population that inspires you. That's fine but when you're starting out, don't let it limit what patients you're going to see. (But don't treat someone if you are unsure how. That's what consulting with other acupuncturists and referring to other practitioners is about.)

Find your niche. Think of what you do socially. Are you in any clubs or on any sports teams? Consider them as potential markets for acupuncture and perhaps do a speech or a workshop about acupuncture aimed at them. I've given a basic introduction to Chinese Medicine class to people for the "medieval fighters" in the historical reenactment group I'm in and included samples of topical pain ointments for the participants to try.

"If ninety-eight percent of our medical students were no longer practicing medicine five years after graduation, there would be a Senate investigation." This quote is from Art & Fear by David Bayles and Ted Orland. But how can this possibly relate to being an acupuncturist? While the book focuses on art, it challenges the reader that the most difficult thing that separates artists from success is themselves. The book is only 118 pages long and well worth reading.

Remember when you're starting out that you don't need to be an expert in everything about running your acupuncture practice. It's OK to ask someone who specializes in a particular area for help, be it a bookkeeper, a web developer or a medical billing company. Focus on what you do know - the acupuncture and herbs. You're now an acupuncturist and a business owner. In fact, you'll have to be both to be successful.


Denise Cicuto is a licensed acupuncturist and Chinese herbalist, specializing in women's health and immunity. Denise has a private practice with offices in San Francisco and in Alameda, Calif. She can be reached at www.cicutoacupuncture.com.

 

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