Road to Gotham

Starting this business has been one of the best experiences of my life. And whenever I’m in danger of losing sight of this, I pull out one of my business cards, put it on the table and have another look at it. And there it is, Sarah Hayes, LAc, Acupuncture Northwest, The Gotham Building, Suite 171, Portland, Oregon. Yes!

While I was on that long road from graduate school to practicing acupuncturist, I initially had only vague notions of how I was going to reach my professional goals. I had no idea how many business questions I would be asking, or how many people I would be relying on to help me know what questions I should ask. Three and a half years of medical training had me ready to treat patients, but the two business classes (two!) left me feeling like a babe in the woods.

Looking back, we were all so wrapped up with our studies that the business ahead of us was the last thing on our minds. We were focused on learning the medicine. If I thought about it at all, I thought I might join another practitioner, or maybe a group of alternative care practitioners, or maybe purchase an established practice. Like I say, it wasn’t exactly clear during my student days. In the end I decided the way I would ultimately be the happiest was on my own. I wanted to go it alone. Looking back, it was the right choice for me.

First questions

How much rent could I afford to pay? How much should I charge my patients? How many patients will I need in order to break even? What part of Portland would be best to locate in? Is off-street parking important? What should my business cards look like? How much do they cost? How else to advertise? Should I create a web site? What insurance companies should I contact for liability insurance? How do I become eligible to charge patients’ insurance companies? What kinds of treatments are covered by insurance companies? Who are the best medical suppliers? Should I build my own inventory of herbs? What software would be best for bookkeeping? On that glorious day when I have my own treatment room and a treatment table, should I use sheets or a paper roller to save on laundry?

Finding a business manager

So what I really needed was someone to put these questions in their proper order, tell me which ones to answer first. I remember thinking “Shoot, what I need is a business manager.” Followed by “Oh my gosh, that would be me.” I was about to become a business- managing/landlord-contacting/insurance-calling/bookkeeping/ laundering acupuncturist. Last thought that night before going to sleep: “Oh my god.”

A comparative study looking at CAM practitioners

How many times has this realization occurred to someone like me? Many, many times, as it turns out. The Sept-Oct, 2002, issue of the Journal of the American Board of Family Practice has this article in it: Characteristics of Licensed Acupuncturists, Chiropractors, Massage Therapists, and Naturopathic Physicians. The authors (Cherkin et al.) wanted to compare practitioners of the four main branches of complementary and alternative medicine (CAM) with conventional physicians. The result that caught my eye was that more than 60% of the acupuncturists in their survey practiced solo. This compares with about 25% for conventional physicians.

Also mentioned in this article is the fact that although there is increasing interest in and use of CAM, there is still a good deal of separation between differing healthcare services in general. CAM practitioners, when they do work in clinics, tend to associate with other CAM professionals, and likewise for conventional physicians. Acquiring integrated care, at least by this measure, is still largely the individual patient’s responsibility.

Feeling lucky

Why I feel lucky to be practicing Chinese medicine

Starting my business — Acupuncture Northwest — has been one of the best experiences of my life. I really think that I am in the right place at the right time, doing the right thing. Attitudes toward complementary medicine (CAM) have been changing dramatically over the past few years, and in addition to success stories such as Portland’s two colleges of Oriental medicine (Oregon College of Oriental Medicine and National College of Natural Medicine), Western doctors are increasingly recognizing the need for complementary therapies.

An interesting CAM study

Medical publications have quantified this trend in various ways. As an example, here is an abstract on the topic from the journal Pediatrician and Adolescent Medicine. Interestingly, studies such as this one often find that a large proportion of Western doctors are interested in learning more, and even being trained in, CAM.

An MD talks about CAM

James Rotchford has written a compelling article that is aimed at his MD colleagues searching for expanded treatment options for their patients. An excerpt (from Medical Acupuncture):

“. . . we uncommonly have the opportunity to see our patients feeling better when they leave our offices than when they arrived. However, patients who have received acupuncture often feel better and have objective signs of improvement even before leaving the office. In part it could be due to the endorphins that are released through acupuncture. Nonetheless, the sense of well being and the immediacy of effect are noteworthy and satisfying to see in patients who have received acupuncture.”

And continuing in his advice to Western doctors he relates:

“For me the medical history comes alive in new and exciting ways as a result of my studying oriental medicine and acupuncture. With oriental medicine not only what the patient tells you but the context in which they tell you is very important. If you enjoy literature or listening to a good story, I’m confident that you will experience a new satisfaction in taking a thorough medical history . . .”

All I can say to that is Amen, Brother. The more all health practitioners can know about context, the more we can really know the person we are treating, the better we are able to offer healing.

Maybe we’re all in the right place at the right time. Wouldn’t that be nice?

First blog

Hello. I’m Sarah Hayes, a licensed acupuncturist with a clinic in Portland, Oregon. And as of today, I’m also a blogger. My hope is to use these pages to join the community of healthcare givers who share their insights and experiences with anyone and everyone who is interested. If that doesn’t mean blogging, I don’t know what does.

My contribution to those interested readers out there? Well, I’ll be writing mostly about my patients, what it means to be a practitioner, and the interactions that have taken place between us. Because I practice Chinese medicine (I’m also a certified Chinese herbalist), there is this important aspect of interaction. Some, for example Ted Kaptchuk in The Web That Has No Weaver, refer to this interaction as a healing alliance. I like the term. (Ted Kaptchuk discusses more about Western and Eastern medicine in an interesting interview conducted by Scientific American Frontiers.)

So my focus will be on Chinese medicine, probably some expanding on the comparisons with Western medicine, what it’s like to be an acupuncturist, and what rewards and surprises I’ve found by following this path. Speaking of surprises, I’ll be including some of my experiences on the business side of things, too. What it was like to graduate and, gulp, step into the world of spreadsheets and laundry sheets. And medical suppliers and taxes. And just how does one go about getting patients to walk through the door, anyway? Why didn’t graduate school have a class in acubusiness? These were the things on my mind back when I first opened my clinic’s door in December ’05, and for the most part they’re still on my mind today. How much longer will I go on doing my own laundry?

I’ve done some looking around, but not nearly enough I fear, locating informative blogs on alternative medicine to share here. What I’ve got so far you can see in the sidebar. Since I’m new at this, and the volume of voices out there is daunting, any suggestions you have for locating relevant sites to check out would be much appreciated.

OK, I’m off and running. I’ll be posting here regularly for the foreseeable future. Wish me luck.