In my first article of this series (January, 2012), I stressed that making private practice work requires an understanding of the interconnectedness of clinical and business concerns. In this article, I want to start from scratch and consider just what running a private practice delivering acupuncture services is all about.
Some of what I have to say will seem to be stating the obvious, but I have learned from talking with students and practitioners that not everyone in this field actually grasps some of the basic concepts of managing a private practice and others who think they get it have some serious gaps in their understanding of the fundamentals. I mentioned in my first article that I will be offering some "outside the box" ideas, but the overall poor success rates of acupuncture practices necessitates some new ways of thinking.
First of all, one needs to be clear that opening a private practice means that one is opening a business. Technically, you will be managing a "service business" and delivering a service for a fee. The sub-category of your service business is "health care" services. The new way of thinking I encourage you to contemplate is that you are offering a very different type of health care service and recognizing this can be critical to your success. What is different about the health care services delivered in an acupuncture practice is that we deliver "natural healing" health care services – we stimulate the body's ability to heal itself. The fact that acupuncturists specialize in delivering natural healing services needs to be fully appreciated because it holds the key to addressing many of the stumbling blocks to successful private practice.
One of the biggest stumbling blocks is that you will not be successful with every patient. No one cures everyone and while there is a general recognition in our society that there are no guarantees in medicine, managing the uncertainty over treatment outcomes is an important skill you need to develop. Your patients are coming to you for the service of getting help for their problems, not just to have needles stuck in them. The fact that you cannot guarantee just how much you can help your patients' problems – or even if you can help them at all — makes charging for your services a stressful thing. When you add to this the fact that the public has little understanding of how acupuncture works and little appreciation for the training licensed acupuncturists go through, this stress is compounded that much more.
So, how do you deal with the stress of being a service provider whose training is not well respected, offering a service whose mode of action is not understood and whose outcome is uncertain? The best way I have found to manage this stress is to explain to my patients the strengths and weaknesses of a service that seeks to stimulate the body's own healing resources. By keeping the focus on the fact that acupuncture stimulates the body's internal resources, you can answer every question your patient has about your services — including those involving the uncertainty over the outcome—while also establishing a constructive working relationship with them moving forward.
Turning Brown Grass to Green
I emphasize with my patients that our bodies are constantly trying to heal every health problem that develops, but just because a problem does not spontaneously heal on its own does not mean it is beyond our body's resources. We rarely get 100 percent of our body's full potential for self-repair. When the body's efforts to heal a problem fall short, it is kind of like a lawn turning brown because it is not getting enough water. If you could add some minutes to the automatic sprinkler system, this can give the grass the resources it needs to turn from brown back to green. The same thing goes for stimulating the body's self-healing resources. A good course of acupuncture treatments should always be able to boost the body's resources at least a bit – like adding more minutes to the sprinklers. What remains to be seen is how much good this boost will do. That is what we will seek to find out by doing an initial series of treatments – around 5-6 for the majority of chronic cases and up to 8-10 for the most serious, long standing ones.
I also tell my patients that when a lawn turns brown and you add more minutes to the sprinklers the grass will not usually turn green overnight. This is my way of warning them not to get disappointed if they do not have a dramatic improvement with the first one or two treatments, although that can sometimes happen. With chronic health disorders, it is much more common to see a subtle and gradual improvement as the body repairs itself just like a lawn gradually turning green.
Finally, I remind my patients that sometimes when a lawn turns brown, certain areas may have gone past the point of no return and now, no matter how much water you put on those areas, they will not spring back. This is what can happen in those health issues when a problem is of the type or gets to the point that the body's resources cannot heal it. It can be difficult to tell just how much — if any — improvement will occur by boosting the body's resources. This, again, is where the initial series of treatments is employed to help us gauge how the patient's problem is responding. In some stubborn cases, we may reduce the symptoms by 70-80 percent, but the last bit of the problem remains because it has gotten to the point of being beyond the body's self-healing resources.
The limit of acupuncture is the limit of the body's resources. Acupuncture can't make the body heal something it never had the ability to heal in the first place. Patients will respect you if you are upfront about acupuncture's limits. No one expects you to be a miracle worker that can heal everything. The "turning brown grass to green" analogy allows you to explain the limits of acupuncture in a logical way that people will respect. Doing so reduces the stress of the uncertainty over the treatment outcome. It also allows you to explain why acupuncture can be effective in a remarkably wide range of problems including many problems for which conventional medicine is ineffective. Once your patients begin to understand that acupuncture boosts their body's resources, they can grasp why it can be effective in so many different health issues. This type of explanation not only helps your patients understand what to expect from the treatment process they are seeking your help for, it also opens their eyes to the fact that you have the potential to address a remarkably wide range of health issues. I will cover that aspect of this explanation in my next article.
I hope you find this article helpful and I encourage you to give this way of framing acupuncture services some serious thought. After treating thousands of patients over the last two and a half decades, I have found this to be simplest and most comprehensive way to explain the services I offer while helping me to build and sustain a steady practice.
Click here for previous articles by Matthew Bauer, LAc.