Life After School And Other Ridiculous Notions

New Life

Life begins (again) after grad school.

When I was in acupuncture school I was so consumed with school itself I didn’t really have a picture of what life would look like once I graduated. I had some vague notions about being self-employed and going to Barton Springs whenever I wanted to, but other than that I had no clue how the actual ‘making a living’ part would work out.

Now here I am almost 2 years later and I’ve gotta tell you that the reality here is very different than I thought it would be. What you will find here, in no particular order, are the myths I told myself and the real scoop. Let me assure you that none of this is bad! I’m not going to tell you scary tales of bleakness and woe. But I do want to let you know what’s going on out here.

Myth #1: I will make my living doing acupuncture.

True and yet extremely incomplete. If you look at my schedule (which you can’t because that would be a HIPAA violation) you will see that in the last 30 calendar days I have treated 55 clients. I don’t work on weekends, so that’s 22 practice days worth of seeing clients. That’s 2.5 clients per day at 1.25 hours per treatment, which means in any given day I’m spending maybe 3-4 hours doing acupuncture. Now, really it’s more likely that a day or two out of the week is quite “empty” and that several days have 3-6 clients. So what am I doing with all of that “free” time?

Most of the time, as a matter of fact much more time than I spend doing acupuncture, I’m doing one of these things:

    1. Teaching Stuff
      Preparing or delivering Reiki and/or Practice Management classes, tutoring acupuncture techniques/treatment/diagnostics, herbs, and all kinds of other subjects.
    2. Business Stuff
      Marketing, accounting, networking, researching herb and nutraceutical companies and products, answering e-mail, identifying and pursuing alternative income streams.
    3. Office Stuff
      This includes all the stuff I will someday delegate to an office staff and may that day come soon! This is stuff like typing charts, filing, chart maintenance, ordering office supplies, ordering herbs, filling out forms, sending out thank you notes and other kinds of correspondence. 

This leaves precious little time to learn new cool things or to write stuff like blogs, which honestly I could do 24 hours a day if I had the time. I seriously should have been born a trust fund baby. And that brings me to the last item I tucked into #2 above….identifying and pursuing alternative income streams.

If you plan to make your living only by giving acupuncture treatments and selling a few herbs, especially the first few years you are out of school, you’d better be living a very charmed life and maybe have you own leprechaun….one who squeezes gold out of rocks or something. Am I saying it’s impossible to make a living doing acupuncture? I am not. This is just a facet of owning a small business. Small business owners are always looking for multiple income streams. Look at Insights for Acupuncturists. The woman who runs this site has been in business for a long time now and yet she still advocates multiple income streams. Not only does this supplement your income when you are working, but it can continue to feed your income when you can’t work. “Can’t work” could be an illness (either yours or your family’s), vacations, funerals, or repairs to your office or to the road which goes to your office. If one or more of your multiple income streams is independent of your physical business location, even better. If it’s a passive income stream, hallelujah!!

The reality is this: most of us will be small business owners as soon as we are licensed. Running a small business is hard work no matter what it is you are doing. And most small business owners are always looking for income streams.

I hope you won’t be depressed by this, because it isn’t depressing. Really! I love what I’m doing. Love. It. But if you want to be successful you have to stop thinking of what you are going to be as just an acupuncturist/herbalist. You will be a small business owner. Don’t think in terms of running a practice, but in terms of running a business. This business will support your life, but in order to do this for years to come you must make it healthy by all of the moral, ethical, and legal means that are at your disposal.

Myth #2: I will never sell nutritional supplements!

I’m not talking about Chinese herbs – they work and I believe in them (and yes, I know the FDA considers them nutritional supplements). Besides, we were trained to love Chinese herbs, right? I’m talking about nutritional supplements like vitamins and probiotics. I declared loudly and with fervor that I would never sell these things. I thought that supplement sellers were just hacks who couldn’t cut it at their craft. Listen to me carefully when I say this, because I hate admitting it: I. Was. Wrong. Dead wrong. Selling product in general is a fabulous income stream. Find product lines you like, ones that work, lines that are reputable and you feel enhance your reputation.

In a perfect world we would prescribe food therapy, people would do as we recommend, they’d get fabulously healthy and love us for this forever. But the reality is health care practitioners, including acupuncturists/herbalists, spend an awful lot of time band-aid fixing things that are generated by diet and lifestyle choices which many patients are unwilling to abandon even if it greatly improves their health. Many (perhaps even most) people don’t  get what they need from the food they consume. That’s where nutritional supplementation comes in.

Almost everyone I’ve ever asked says they are taking some kind of vitamin supplement. If you google “vitamin pill passing through colon” you will see tale after tale of people seeing whole pills that have passed in their stools. This is more common in cheap pills like over the counter vitamins. My logic is I’d rather they get their vitamin supplements from me. At least I’m selling them something that will absorb, that is ethical and healthy, and that has good quality control. That’s better than the Centrum (or whatever) bullets that rocket through the digestive tract and pass unchanged into the stool.

The upshot of this tale is that I am selling nutritional supplements. It’s a lovely thing to do for my clients, I see improvements in health when they are compliant with them, and it’s a great additional income stream.

Sidebar: 
All of this said, beware of MLMs. MLMs are Multi-Level Marketing schemes. These include Amway, Shaklee, Tupperware, Advocare, Mary Kay and anything else that makes you a “distributor” where your profit goes largely to the people above you and in which you are promised riches untold once you get people under you too. Look for claims such as this (name “blah blah blah’d” out to avoid a potential lawsuit): “In our first six months in Blah Blah Blah, we earned over $30,000 in Rookie Bonuses alone!” If it looks too good to be true, it probably is. And these kinds of claims are mighty tempting when you are first starting out and might be short on cash.

Myth #3: The people who need to see me will be drawn to me

Ok, that one is actually true. There are people waiting for you to get out of school so they can come see you. That doesn’t mean you don’t have to market yourself because you do. Get in the habit of thinking of everything you do as marketing yourself. I’m not talking about the cheesy face-on-a-billboard kind of marketing. I’m talking about building relationships with people and being willing to talk about Chinese medicine in any given setting. Think of yourself as an ambassador for how great Oriental medicine is and what it can do for those with whom you come into contact.

I have magnets on my truck – both sides and the tailgate. A couple of people have come to see me just because of those magnets. Not many, but a few. So are they a waste of marketing money? Not really. I’m getting visibility in the world, but more importantly, they remind me that my behavior in public is always on display. I never want to hear of someone refusing to come see me because I was a jerk to them on the road…or in the parking lot. Whether you hang a sign on your body or your property advertising yourself as a health care professional or not, you are always on display.

People probably aren’t going to come to see you as the result of a flyer, a truck magnet, a t-shirt, or an advertisement in a local magazine. They are going to see you because 1) they have met you and like who they met, 2) they heard you speak somewhere, or 3) someone they know and trust says you are ok. All of these are either direct or indirect personal contact. Sticking needles in someone is a very intimate and personal activity. Do you really trust someone you saw on a billboard to do this for you without some personal knowledge of them? Well, neither will your potential clients.

Let me emphasize: In my opinion, the most effective marketing you can do is personal contact marketing. Here are a few suggestions for doing this.

    1. Get comfortable with public speaking
      Does this terrify you? Join Toastmasters. This is the best way to learn to give talks. People at Toastmasters are there to help you get good at this in a supportive environment. If you do this for yourself you will thank me and them about a thousand times. Giving talks at workshops, public events, in offices at brown-bag lunches and such, at churches, etc. can directly increase your number of clients. This is also a fast way to interact with a number of people at once. Still too terrifying? Read on.
       
    2. Get your acupuncture speech down to a fine scienceYou need a couple of these speeches. People in our culture commonly make small-talk by asking what you do for a living. When you say “acupuncturist” they are almost always interested on some level. You can get them interested with your 5-second speech, also called an elevator speech because you that’s about how long you have between floors if someone speaks to you on an elevator. If you don’t catch someone’s attention in the 3 seconds, they probably won’t hang around for the next however many minutes you can wax poetically and raptly about acupuncture. If, at the end of your 5-second speech, they ask questions and want to know more, move to your 30-second speech. If they’re still asking questions by now, you have them and can converse freely.

A couple of general points about talking to people about acupuncture. First, you have to be able to speak in plain common terms in whatever language you are speaking in rather than in “Acu-speak.” If you start talking Qi, meridians, and ‘you have a weak Kidney’ you will lose your audience before they ever have a chance to know how awesome you are. What we do is rather out of the norm for most people. Your job is to make acupuncture make sense to an ‘acupuncture virgin.’ Second, don’t make your speeches “Al Gore-like.” The dude is brilliant, but he’s wooden. His speeches feel like static recordings – he rattles them off flawlessly, but I always have the impression his mind is off fishing on some lovely pond while his mouth is talking about global warming. Let your passion for our medicine come out even in your 5-second speeches. Which brings me to the third point: don’t be a freaky zealot. Those make people uncomfortable. Not the best way to win patients.

Myth #4: I will never get wealthy doing acupuncture.

True, it doesn’t happen very often, but why is that? It’s not society’s fault, it’s not western medicine’s fault. It’s our fault. Not so long ago chiropractors were in the same boat in which we now find ourselves. When I was a kid my mom started going to a chiropractor and everyone we knew thought she was throwing her money away. No more. Ask almost anyone you meet (assuming you don’t live in some tiny town far from a chiropractor) if they have a chiropractor and I’ll bet you they do. Their profession is only a little over 100 years old in this country and they have far greater student debt than we incur yet they make so much more than we do pretty quickly after they get started “chiropracting.”  What are they doing that we aren’t? They have figured out how to market themselves and they teach it to their students. We don’t know how to do that yet. Chiropractors who graduate from school know that they are probably going to be solo practitioners and they plan accordingly.

If you plan to have a practice you will have just that – a job you go to day after day and stick needles in strategic places on patients. Don’t build a practice. Build a business. There’s a big difference. A business is something you can sell. A practice is something you do. The next jump after business is an enterprise. An enterprise is something that keeps working even when you don’t.

I live in Austin, Texas. There are a lot of midwives here. I know some people who are just that – midwives. They see clients, deliver babies, and may or may not struggle to pay their bills. They run practices. There are a few who have businesses – they deliver babies, see clients, they have built communities of women who join together to do yoga, take walks, and who come back to the midwife for their next baby.

And then there is Jean Stokes. Jean has built the Austin Area Birthing Centers (AABC). Jean has a small army of people (midwives, birthing assistants, clerical staff, HR personnel etc.) working for her and two really beautiful birthing centers where whole families come for their birthing experience. AABC also offers classes free of charge to mommas who have given birth there – yoga classes for parents with newborns, toddlers and parents by themselves, breastfeeding classes and a kind of a ‘giving birth 101′ class. Jean has built an enterprise. This enterprise sustains her and a large number of people whom she treats really well. She lives in a beautiful house, she drives a nice car, she takes awesome trips. She has broken the mold of a poor but happy midwife who brings babies into the world. Jean has created wealth where most people said it could not be done.

Have you noticed there aren’t very many acupuncture stories like this? That’s ridiculous! We have the potential to do this. We just haven’t figured out how to do this as a collective group yet. I believe this is why we have to create petitions to submit to the White House begging to be included in the conversation about national health care.

Do we need to westernize Chinese medicine to be accepted? No. We need to market ourselves properly and build enterprises. This is what will get us automatically included in the national conversation about health care. Once everyone in America “has an acupuncturist” the way they “have” a chiropractor or a doctor then we will be integral to that conversation.

The moral to this story: the end of your acupuncture education is only the beginning of your business education. Educate yourself. Try reading The E-Myth Physician. It’s a real eye-opener and I think you will find it incredibly motivating. Also, it’s cheap to buy: $8 if you get the Kindle edition, $11.50 if you want a physical copy. You aren’t born as an entrepreneur, but you can become one.

That’s enough blah blah blah out of me. I’ve got some income streams to check out!

Waiting here to welcome you to the other side of school,

Cat

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6 Comments

Filed under Patient Communication, Practice Building

6 responses to “Life After School And Other Ridiculous Notions

  1. I love how you’re keeping us informed as to what is going on NOW with Cat? Love it!

  2. Cat you are fabulous! Thank you. I am in my second year and preparing for the day the school unleashes me into the wild world of business. Your blog brings a wealth of info. I too blog about school and see it as content building. I share your website with all my class mates. I hope to follow I your steps.

  3. Andi Kohn

    Cat you are awesome. Great article, thanks for sharing :)

  4. ahhhh…. a woman of my own heart! =)

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