Nov
11
The early stages of business planning : difficulties and strategies
Filed Under Getting Started, Our Story, Vision and Mission | 1 Comment
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Amanda and I have been working on our business plan for our center for natural medicine for a while. We started planning long before I had any business classes in my program at NCNM. In fact, we’ve been planning since I started school! However, we still have a lot of work to do. Why?
I believe that the early stages of the business planning process are the most difficult. We have had multiple meetings of 3-4 hours where we did nothing but flesh out the basic idea behind our business model. We’ve revisited notes from these meetings several times, only to come back at some later meeting to rehash similar ideas. This process is slow and sometimes frustrating. Every once in a while I despair that we are making no headway at all!
Still, I think this is all a very important part of building a sound business. While we haven’t done all that much that could be put in an official business plan and submitted to a bank for a loan review process, our work has been extremely valuable. There are three major reasons I believe it’s important to take plenty of time to ruminate over the most basic elements of a business plan.
- Good ideas take time : Just like cramming for an important test doesn’t leave you the time to comprehend the material, trying to cram for a business plan will find you in a business to which you do not feel passionately connected. When you first start conceiving of your new clinic, your ideas will be rough and disconnected. As time goes on, you start to see the relationships among your various ideas and new ideas are born from that fertile ground. Further, as you accumulate experience simply by going through your normal days you will be better able to refine your current ideas and come up with new ones. All this time spent will pay off with handsome dividends in the end
- It’s more complicated than you think : While your clinic idea may seem simple, with enough time you begin to see the complexities involved. If you don’t leave yourself enough time to fully explore the plan, you may end up rudely awakened by some unexpected difficulty. Failing that, you may simply miss out on a great opportunity that you would have been able to take advantage of if you had fully comprehended the intricacies of your situation earlier.
- It’s more fun / less stressful if you take your time : It’s simply more fun to have big ideas and work out their implementation when you have time. Trying to cram a business plan into the last 6 weeks of your schooling is only going to stress you out. That’s pretty contrary to the spirit of natural medicine, isn’t it? Give yourself a break!
Anyway - our business plan is really coming together and with every meeting I get more and more excited about our basic concept. I’d like to explore that concept in future posts both here and at Deepesthealth.com. Until then, thanks for reading.
Eric
Oct
6
Why Chinese Medicine is a great healthcare choice during an economic downturn
Filed Under Education, Marketing, The economy | Leave a Comment
I’ve just begun a discussion about Chinese medicine and the economy over at my other blog, Deepest Health. It’s an issue on many of our minds lately, so worthy of a robust conversation. Here on Natural Medicine Business Success, I want to look at a slightly different angle. It seems that many people still see “alternative medicine” therapy as an expense that fits into the “disposable income” category of their budget. In my money management software, it fits most neatly under “Spa” activities, which are in the same place as haircuts and bikini waxes. I’ve recently gone to great lengths to alter this so I can place it in the same place as “Dentist visits” and “Pharmacy.” That’s where it belongs.
Now, there are many issues involved in this discussion. It’s important not to obscure the conversation by leaving them all mixed up together. One important distinction involves insurance. Many people still do not have insurance to cover acupuncture and Chinese herbal medicine. In an economically depressed time, people will most likely stop using any healthcare that does not get at least mostly reimbursed by their insurance. Likewise, uninsured people are quite likely to stop getting healthcare services altogether when their finances get tight. The whole question of insurance is a separate, but embedded, concern in this conversation.
All things being equal, I still feel that many people would preferentially choose Western medical treatment over any “complementary or alternative” healthcare treatment during tight economic times. I feel that this is the fault of “complementary and alternative” healthcare practitioners, for the most part. We are absolutely responsible for being an educational force in the world. When we have fewer patients, we should be doing double education duty out in the community. Giving talks, getting articles in the paper, writing to our blogs, working on our books and journal articles, teaching cheap and free classes in our clinics - all of these things can help continue to educate the general public about the great benefits of what we do.
If people are more educated about the benefits of Chinese medicine (or whatever modality you practice) they are less likely to see it as “disposable” and thus more likely to continue visiting you during difficult economic times.
Personally, I believe that this sort of socio-economic climate makes Chinese medicine therapy more important for people than ever. This is also true of most alternative medical modalities. Why? I can think of three major reasons, all of which would make worthy talk/article topics for your renewed public education efforts:
- Stress relief : Nearly all alternative medical therapies are well-suited to help patients manage stress. When economic pressures are high, people get tense, and the damaging health and relationship effects of stress are well-documented. While it’s hard to keep a long-range view when short-range difficulties are so present, being aware of stress’ effects will pay off. Even from a more short-term perspective, the improvement in daily functioning, work performance and sense of resilience should more than justify the relatively small costs associated with acupuncture (or other) treatment.
- Avoiding major illness : When your belt is tightened, the last thing you need is to miss work because of a terrible cold - much worse to have a flare up of your lupus symptoms, need to increase your pain medication, or end up in the emergency room because of some serious health concern. Keeping one’s body in balance with Chinese medicine or other complementary medical therapy just makes good economic sense from the perspective of avoiding a paycheck draining visit to the MD or ER. I have seen many patients stay strong through cold season (thus no visit to the MD, plus no loss of work time) when normally they would have had to take sick days. I’ve also seen patients have the opportunity to decrease pain and other medication (thus reducing costs) because of acupuncture and Chinese herbal treatment. Think about it!
- For some conditions - natural medicine therapy is just cheaper! Let’s face it - Western medicine doesn’t have great solutions for a variety of medical conditions. Consider Chronic Fatigue Syndrome - Western medical intervention is both expensive and largely ineffective for the majority of CFS sufferers. Why pay exorbitant office visit fees (even if you only have to pay a co-pay) and fill your body full of expensive pharmaceuticals (that rarely get to the root of the problem)? While I’m legally obligated to avoid saying that Chinese medicine can “cure” CFS, I can say that I’ve seen CFS sufferers have energy and optimism for the first time in many years after a fairly cheap course of Chinese medicine therapy. Even a fairly expensive practitioner should be able to make good progress with a CFS suffer for under $1000. This is a seriously debilitating condition for people who experience it - $1000 is a small price to pay for the ability to go to work, have satisfying relationships and get on with one’s life.
I’m interested to hear others’ perceptions about how economic downturns impact natural health practices. Please leave your thoughts in the comments!
Eric
Aug
25
Open For Business…I Think
Filed Under Business Planning, Getting Started | Leave a Comment
This is the second of three articles written by Bonnie Koenig about the first steps in starting a business. You can read the first in the series by clicking on I’m an acupuncturist, not a business person! You can find Bonnie’s bio here.
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Starting a business after having been a student for years can come as a shock. Instead of being told what to do and what to study, now you are in charge and have to start figuring out what to do and what to study. It seems like there is so much to do starting out that it can feel overwhelming, particularly because there is always the fear of forgetting an important piece of legal work.
The first step in creating a business is creating a plan. Creating a plan can be as formal as writing up a formal business plan or as simple as creating some goals. In either case, it’s important to have a vision of what you are doing in the business and how the business looks. For instance, are you working with other practitioners? Are you the one running things? Are you just a partner who does your own work and someone else takes care of most things? Are you renting your own room from someone else? Is there someone making your appointments or are you doing it yourself?
The clearer your picture of your ideal practice, the easier it will be to create that ideal practice. For instance, if you see yourself in charge of others or intend to start out with an employee, such as a receptionist, you will need to find out minimum wage laws and OSHA laws, whereas if you are going to begin by doing everything yourself or working in someone else’s office, you don’t have to worry about those things.
If you have a hard time envisioning your ideal practice, it might be a good idea to find help. Business coaches abound and many specialize in helping small business owners understand their vision. If you know what you want to do when you start up your practice but don’t know how to get that done, there are places that can help you with that too and not all of them are expensive.
The government offices you work with can also be very helpful when they understand you are just starting out. I’ve had to do this for a small company I worked for. This was a huge advantage because I was far less nervous when I did the same thing for my own business a few years later. Yes, the government does want their cut, but the people working in these offices understand it’s far easier to train someone right than try and correct mistakes and misperceptions later on.
After you have set up your business and know what it is you want to do, you may need help with running your business. What sorts of help depends upon your own skills and what you like. If you aren’t sure but are feeling overwhelmed with running the practice, you may again want to seek out a business coach to help you define what roles you really want to play (in addition to healing) and what roles can be given to others.
Office help can range from someone who just answers the phone and appointment scheduling to hiring someone to take over all the administrative tasks. Obviously you need to pay someone who is doing your bookkeeping, phone answering, insurance billing and overseeing other employees more than you would someone who just answers your phone.
If you aren’t ready for an employee you can still find help. You can hire out your accounting to a bookkeeping firm. You can hire insurance billers to do your insurance billing. There are companies that will come in and pick up your laundry. Cleaning people are typically hired as contractors rather than as direct employees.
Every time you hire someone, there will be a cost. Very often we only look at the dollar amount. However, you also need to factor in your time. Money is wonderful and in the beginning we are often struggling and have to maximize our financial income. However, at some point, we need to create a life not just a living wage. At that point we can think about hiring or contracting help with the tasks that are the most burdensome to us.
Some people really enjoy the day to day challenge of running a business. Ultimately being in charge means that if you have extra space you can rent out that space or take on associates, thereby increasing your income further. The more amenities you have in an office, (such as a receptionist), the more you’ll be able to charge for others to use your space.
Some people think the idea of setting up and running a business seems overwhelming. The money isn’t really that important and all they really want to do is practice their healing modality. That’s a valid practice vision as well. There are practitioners who have run their business for awhile and who want assistance in their practice, taking the overflow and allowing more patients to come through the doors. There are many models, some of which include just renting space and assisting in paying any employees. There are also more formal models of working as an associate, which is basically becoming an independent contractor to a practitioner who pays you per patient.
The challenge in all of this is finding the people who can help you with the areas you are less comfortable with. In the next post in this series, I will point out some good places that you can look up in your local area and online.
Bonnie
Aug
23
I’m an Acupuncturist, Not a Business Person
Filed Under Blogging, Business Planning, Getting Started | 2 Comments
This is the first in a series of three by Natural Medicine Business Success contributor, Bonnie Koenig, writer at the Acupuncture Marketing Blog, among other sites. You can view her short biography by clicking here.
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The business of being an acupuncturist is very different from practicing acupuncture. This is often the reason that those students who are the stars of acupuncture classes achieve only mediocre success in their personal practices.
Successful business people have one set of skills and this particular skill set is not necessarily the same skill set required to be an exceptional acupuncturist or other healthcare provider. Additionally, it’s human nature to absorb more from studying those things we love as opposed to those things we are told we have to learn. This means that people who love the business end of running their practice often learn more far quickly than those who run a their practice business rather under protest.
I checked out the school of business at my undergraduate alma mater. They have a total student body of approximately 2500 students. Their business school has 480 students. There is a requirement that in addition to the regular core undergraduate classes that 49 semester hours (students normally average 16 to 18 credit hours per semester, with 20 credit hours being a doable but heavy load) of business classes. This means that if you only studied the business courses, you would need an additional 3 semesters, or a year and a half minimum to learn what this college feels is appropriate to someone who wants to manage a business. This is for an undergraduate degree. The masters level coursework is an additional two years (assuming mostly full time enrollment).
Acupuncture students are lucky to get two business courses during their entire education.
Certainly you don’t need a business degree to run a business, nor am I suggesting this. I point out the fact that business majors get this much subject matter because as new practitioners we often expect ourselves to just know this information. Many business people say that most business information is just common sense. Most of our life lessons apply to business. The problem is that many people who are new to running a business don’t realize what they already know and even if they do, they don’t really know how to apply it.
Initially, I had thought to make this point and offer suggestions in one post, but it’s gotten ponderously long. I’d like to tackle a couple of points in future posts.
In the first post, I’ll discuss the need for finding good help. Good help may start with finding people who can offer some basic business advice to those just starting out. Additionally very few practitioners are strong in all aspects of running a business so at some point we’ll need to find help. Part of this post will focus on the types of help we may need, from deciding if we need a book keeper or legal assistance or maybe we just need someone to do our laundry.
In the second post, I’ll discuss some of the places practitioners can go to find assistance in starting their businesses. Some of these resources are online and some are offline. I’ll offer some potential pros and cons for the different types of services and try to help practitioners set appropriate expectations for the type of help they receive.
Starting up a business requires a lot of effort and energy. Very often, as healthcare providers who have just come out of school we tend to minimize the amount of work starting a business requires. We also like to just push through this part of creating our business because suddenly our student loans are going to come due. However, creating our ideal healthcare business takes time and effort. Thinking carefully about exactly what we want can lessen headaches in later years.
Bonnie
