Tips Of All Sorts

The SBA has a bunch of podcasts available on their site. I haven't had a chance to listen yet, but the titles sound enticing. Lots geared toward startups, including:

Check List for Starting a Business
Financing a Small Business
Creating a Business Plan

There are also transcripts for the non-casters.

Small Business Administration Podcasts

I just finished Lisa Rohleder’s book, The Remedy: Integrating Acupuncture into American Health Care. I’d discovered her book and Working Class Acupuncture, via the Integrator Blog a while back, and she was kind enough to shoot me a copy of the book to review.

If you’re NOT an acupuncturist, let me grab you before you go: this book is a good read for anyone in the CAM profession. If you’ve wondered from a business perspective about the viability of chasing solely mid-to-upper class dollars, or about how to transition to a volume practice, this book is a must read. If you’ve ever felt the ethical twinges of focusing all your efforts on the small demographic segment that can afford your services, Lisa makes a rational, sensible case for more broadly affordable health care.

Still here? Good. Rohleder’s position is that acupuncture as a profession is screwed (my words). Despite 4-5,000 new practitioners entering the market each year, the number in practice continues to hold steady in North America at about 15,000. Of those, many have second jobs and supportive spouses, or suffer from stress and burnout. Acupuncture is a profession in jeopardy.

The solution in The Remedy is to return, from a business perspective, to the Taoist roots of acupuncture. Before your eyes glaze over, let me tell you this is far simpler and more comprehensible than it sounds to the non-TCM practitioner. Essentially, it involves acupuncturists lowering their prices (to a sliding scale of $15-35 per visit), seeing more patients, and building a community-based practice.

In business terms, it means making your money on volume, not on high prices. In health terms, it means more accessible health care that works better.

If you’re a struggling (or not) CAM practitioner, I’m sure your first question is the same as mine: can you make a living lowering your prices?

As Lisa says in the book:

"Incidentally, I make a lot more money now than I ever did when I charged $65 per treatment.”

I believe it – volume business can be good business. Think of Wal-Mart.

It got me thinking, though, about the practical transition from higher-priced boutique clinic to volume practice. What if you’re on the financial edge right now? How do you cut your prices by 75% or so, and hang in there until the volume kicks in?

So I asked Lisa.

“Even people who were very nervous about losing money during the transition said that they initially made the same amount, and over time gradually began to make more. Those folks also reported that their job satisfaction went way up, and both their stress and total hours worked went way down, immediately after they made the transition, so they were happy.

One way around that problem might also be to have a hybrid practice for a while -- keep seeing the patients who want one-on-one, and just add "community hours" two afternoons a week. One initially nervous practitioner started out that way, and a year later her practice is 95% community acupuncture.

But I guess I would say that if a practitioner is truly freaked out about losing money, they probably shouldn't be doing this anyway. Passion is an important ingredient, and if you have more fear than passion, this is not for you.”

So let’s see. More money, more satisfaction, less hours worked. Sounds like the American (Acunpuncture) Dream.

A volume practice might not be for you, though, and that’s fine. My belief is that there’s a niche for everyone doing something that they love. Personally, I like the idea of volume and higher prices together, but that’s a challenging position to reach and hold in the market for any length of time, and it doesn't make services more accessible.

If you’re struggling or just plain curious, The Remedy is a good read. I know from our discussions that Rohleder’s got some strongly held anti-classism values, but they’re well presented – she can write, and well. This is a thought-provoking book, well grounded in solid business experience, with some cool Tao Te Ching verses along the way, which makes the book an interesting yin-yang package in itself.

If you’re interested in a copy of Lisa’s book, you can get it here:
http://stores.lulu.com/store.php?fAcctID=660094

Reader E. writes:

“I was wondering how you handle when people start to ask for free advice. I am starting out my practice and want to come out of the gates honoring my abilities and not giving things away for free. I don’t mind a general question here and there, but when someone keeps asking very detailed, specific questions where my education and experience really comes into play – I want to set that boundary.”

This is a common practice challenge, particularly for startups. Early in your practice, you may not yet have the confidence, experience and poise to deal with the patients who constantly ask for free advice. I’ve written before on pro-bono work, but this is a bit different. How do you deal with those clients who seem to have a knack for getting you to cough up free advice?

First, Change Your Mindset
What’s really at the root of giving out too much free advice? Often it’s a failure to truly value the service you’re providing. This leads to a subconscious reluctance to bill for your time.

Sometimes you need to remind yourself that you’re really worth it. Try adding up how much you’ve spent on education and starting your practice. Then look at how much it costs per month to operate. It’s likely no small number. Your expertise is worth money, period. You need to “own your fees” – be comfortable with your rates, and feel no reluctance in billing for any amount of time. That’s not to say you shouldn’t ever do anything for free, just that you should feel comfortable billing when it’s appropriate.

Know What Free Advice Isn’t
Not every question that arrives without a check attached constitutes free advice. A patient calling for clarification is not asking for free advice – they’re trying to correctly follow the advice you’ve already given. An inquiry as to whether you can help someone with a specific condition isn’t free advice, it’s simply a sensible inquiry into how you can help. You may even want to dole out “freebies” to good patients – the kind who come often, pay promptly, and refer frequently.a

The easiest way to tell if you should be billing is this: if you feel like someone is taking advantage of your time, then they likely are. They may not be doing it on purpose, but nonetheless, it’s time to start handing over the invoice.

Adjust Your Paperwork
It’s important to let patients know the deal. State outright on your intake and consent forms that you bill for phone and email consultations. Decide your rate, and clearly state it. This will brush off a few advice-seekers, and give you (and your staff) a clear process for billing the rest.

Use Your Staff to Turn Advice-Seekers Into Bookings
It’s easy to bill people when they’re in your office. The office is where money changes hands – patients expect to spend money in your place of business. Try to respond to requests for free advice by getting people in for official visits.

Use your staff to help with this. Have them screen your calls, and book appointments instead of transferring advice-seeking calls through to you. If someone emails you asking for advice, simply reply with something simple and pleasant – “It sounds like we should get you in next week for an appointment. I’ll have Susan call you.” Just CC your receptionist, and he/she can call the patient and book the appointment.

If you don’t have staff, use the same line. “It sounds like we should see you in person.” Be diligent in this.

Explain Why
It’s potentially unsafe, unethical, ineffective and dumb to diagnose remotely – by phone or email, for example. One of the strengths of most CAM modalities is the ability to see a broader picture of an individual’s health, and you can use this as a tool to deal with free advice-seekers. Simply tell them that you need to see them in the office to get more details.

Be persistent. When a patient asks, “Can you just tell me if such-and-such herb will help my diabetes?” tell them no. Every patient is unique, and you need to see them in the office. In the end, they’ll get better treatment, love your service, and refer more patients to you instead of getting advice based on poor information, then complaining that your services are lousy.

Bill Them
If you absolutely can’t dodge someone (on the phone is typically the toughest to deal with), just bill them. Period. Once you’ve decided your phone consultation rate, just send a bill. Don’t be afraid – you’re a professional and your expertise is worth money. It’s critically important that you learn to respect your time. Until you respect it, other people won’t.

The truth is, if you have patients who are trying to get free advice from you on a regular basis, they’re really not the patients you want. If they corner you on the phone, just bill them. You’ll either convert them to solid, paying patients, or you’ll lose them. Either way, you’ll be further ahead.

Related Posts
Pro Bono Work and Discounts: What's a CAM Practitioner to Do?
What Makes a Great CAM Patient?

As a registered nurse, I have learned a lot over the years about acne scars, acne scar treatments, and acne scar removal.

Acne is one of most common skin conditions in the world, affecting more than 40 million Americans. Nearly 80 percent of people from ages 11 to 30 years old have acne, most often on the face, chest and back.

But acne isn’t restricted to any one age group. Adults who are in their 20s, 30s and even into their 40s can get acne.

Most cases of acne do respond to treatment and clear up without leaving any scars. Healed acne leaves scars in some people however, and it isn’t easy to predict who will end up with scars after an acne outbreak and who won’t.

Severe, inflamed, cystic acne always leaves scars after healing. And in some people even superficially inflamed acne can result in scarring.

Whether acne scarring is deep or superficial, extensive or scattered, the end result can be less than desirable and even disturbing.

Acne scars can give the skin an aging look. Scars may also contribute to a person looking older than their age as the skin loses its elasticity over the years.

A number of treatments are currently available to remove or improve acne scars. The type and depth of the scars influences the choice of treatment.

Here are some basic facts about acne scars:

Facts about the types of acne scars: Acne scars result from increased tissue formation, response to the inflammation of acne and loss of tissue.

Facts about increased tissue formation: Scars caused by increased tissue formation are caused by a build-up of collagen in the skin. These are called hypertrophic and keloid scars.

Keloids usually are found among several family members. There is a genetic predisposition to form keloids after tissue injury. For example, African-Americans often are prone to keloid formation. Some families also tend to more so, form hypertrophic or thickened scars.

Facts about scars resulting from loss of tissue: Acne scars resulting from loss of tissue are more common than scars resulting from increased tissue formation.

There are several types. They are ice-pick scars, depressed fibrotic scars, superficial and deep soft scars, and atrophic macules.

Ice-pick scars get their name from the way they look. They may be superficial or deep, are usually small and have steep sides like an ice-pick wound. They may be hard or soft.

The soft scars are usually more superficial and the hard scars are usually deeper. The bottom of the hard scar under the skin may be wider than the scar at the surface of the skin.

Depressed fibrotic scars are usually large scars that have sharp edges and steep sides. They look very much like deep chicken pox scars.

Superficial and deep soft scars vary in size. They have sloping edges that merge with normal skin.

Atrophic macules are soft, flat scars that often have a bluish or violet color on white skin due to the underlying blood vessels. These macules tend to fade away over time and become less obvious.

Acne scars are an ongoing reminder of a common skin condition that can cause embarrassment and social isolation. Acne scars can also contribute to the appearance of premature aging.

The good news is that today, there are several types of treatments to choose from for acne scar removal,. See your dermatologist or dermatologic surgeon for the best acne scar treatment for you.

About The Author

For more information on acne and acne scars and acne scar treatment, go to http://www.Best-Skin-Solutions.com a website specializing in acne, pimples and skin disorders with tips, advice and resources including information on natural treatment for acne

Herbal Remedies have been the treatment of choice for arthritis for centuries. Below are listed some of the most effective herbs and supplements for arthritis.

Alfalfa

Alfalfa can be sprouted and eaten with a salad, or used either powdered or drunk as a tea. It’s easily prepared by placing one ounce of alfalfa in a pot, adding one quart of water and boiling for thirty minutes and should be strained and drunk over a day. The treatment needs to be continued for at least three weeks and then a break for seven to ten days is taken before resuming treatment again for best results.

Black Cohosh

Black Cohosh is an American Indian treatment for arthritis. There are five species being used globally. The constituents are anti-inflammatory, antispasmodics and aspirin like substances which makes it an excellent herbal remedy for arthritis.

This can be prepared by simmering one teaspoon of black cohosh root in one cup of boiling water for duration of twenty minutes. The tea is then strained and taken in two divided doses during the day. The regime is continued for duration of three weeks before taking a break of ten days in between.

Boswellia

Boswellia has been known for centuries as a natural anti-inflammatory. It has been proven that boswellic acids contained within the herb can block the formation of leukotrienes, the immune cells responsible for inflammation, while also promoting the formation of free radicals. With regular use, blood supply to the joints is also maintained, keeping soft tissue nourished and viable.

Celery

Celery as a natural remedy for arthritis has proved very effective The different parts of the celery plant contain well over twenty-five anti-inflammatory constituents. A cup of celery contains well over three hundred and forty milligrams of potassium, which makes it particularly effective considering that Potassium deficiency leads to aggravation of symptoms of arthritis.

The preparation is easy with one teaspoon of celery seeds being placed in a cup and filled with boiling water. Allow to stand for fifteen minutes. Then strain and drink three times a day during an acute arthritic attack for best results. Alternatively it can be eaten fresh.

Devils Claw (Harpagophytum Procumbens) is found only in Africa, Devil’s Claw has powerful anti-inflammatory properties. It is used globally for osteo-arthritis, fibrositis, rheumatism, small joint disease and lower backache. Because of its strong anti-inflammatory properties, Devil’s Claw is not recommended for people with stomach ulcers or heart conditions, unless medically supervised.

Dong Quai (Dang Gui)

Also called Angelica, this herb has been used in Europe for centuries as a herbal remedy for arthritis. The western variety is known to have twelve anti inflammatory constituents (which decrease the symptoms of pain and swelling of the joints), ten antispasmodics (muscle relaxants) and five anodyne constituents (pain relievers)

This is best taken by placing one tablespoon of the roots of any of the species in a pot and adding of one pint of water which is then brought to the boil and then covered and boiled for two minutes. The pot is removed from the flame and left to stand till it reaches room temperature and then strained and drunk.

Do this two or three times a day for a duration of three weeks. This is followed by a break of ten days before the treatment can be resumed again.

As with all herbal remedies for arthritis, not all these remedies will be instant. They may take a few weeks to build up in the body. But persistence will bring relief.

About The Author

By Wendy Owen Visit http://www.natural-arthritis-medication.com/herbal_remedy.shtml your resource for information on natural remedies for arthritis. The author Wendy Owen is a natural health writer and researcher. Join our list and receive a free 6 part arthritis mini course