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.