Female Acupuncture Model Female Acupuncture Model whole body front Female Acupuncture Model whole body Female Acupuncture Points Front Body Original article and pictures take www.acupuncture-treatment.com site
Hi everyone! Today’s post is a juicy one. A peek into the finances of a total stranger, yay! God bless the internet for making these things possible.
(But wait, before we get to the good stuff, I need to share something with you, internet friends. I started the process of house hunting! It’s exactly like you see on HGTV, except 800% less glamorous. Shag carpet and wood paneling, anyone? Pink bathtubs? Furnaces from 1957? I’m so excited! And mildly terrified. Is this #adulting? I’ll keep you updated on my progress!)
Anyway… back to my finances. If you’re not familiar with Modern Acupuncture Marketing already, I work at my acupuncture alma mater, Finger Lakes School of Acupuncture & Oriental Medicine at New York Chiropractic College (I know, longest name ever). And occasionally I lecture in the Integrative Practice Management class for third year students, which is something I LOVE (obviously, right?).
In Integrative Practice Management, it’s standard to have each student create a projected outline of their practice startup costs, based on the kind of practice they plan to have, their location, cost of rent/living in that area, etc.
(If your acupuncture school doesn’t make you do this as a student, that’s crazy sauce. You MUST. It is essential to have a plan, or you’ll risk wasting money and floundering in the dark. Use my Acupuncture Startup Cost Worksheet [click below] at the very least, and then ask one of your acupuncture professors to give you feedback on it. Do not graduate without doing this.)
After asking the students to complete their project startup costs budget, they were curious about what a real person actually spent to start a practice. As an over-sharer, I was happy to volunteer that information for them.
You guys know I’m always encouraging students and practitioners alike to learn from the experience of those who have gone before them.
I’m like a broken record, but I’ll say it again: as a group, acupuncturists have a wealth of knowledge and experience about practice building that we can share with others to help everyone succeed. The more we share, the better off our profession is as a whole, and that’s win-win.
So I thought it would be beneficial to share my startup costs here on Modern Acupuncture Marketing, for any students out there who are about to get started. I also think it’s interesting for established practitioners to see how others began their businesses, if for nothing else than curiosity’s sake. The internet thrives on sneaking a peek into the lives of total strangers, right? I’m all for that ??
Before I give you my budget, let me outline my personal philosophy on acupuncture practice startup costs. I think this is important.
In a word: Minimalism.
I always encourage the acupuncture students at FLSAOM to start small. I don’t understand why sometimes people think they need thousands of dollars or a huge business loan to fit out a whole office or multi-room space. I suppose it depends on your future plans and ambitions. But if you have no patients at first, why do you need to rent several rooms or an entire building?
(And yes, I have heard of real students who graduated, rented entire buildings with multiple treatment rooms, and then wondered aloud why they struggled to pay rent. It’s because you’re paying for more space than you need, or can possibly fill at that point.)
I’ve heard it suggested by other practice management professionals (not naming names) that you should set up your “ideal office” right after graduation, with the number of treatment rooms you ultimately imagine using once you’re “successful.” I suppose this is what the students that I mentioned above did, who wondered eventually why they couldn’t pay rent.
I personally think this is terrible advice. Then you have to pay to fill a reception area and multiple rooms with furniture, treatment equipment, acupuncture supplies, plus pay rent and utilities on a larger space. Yet you have no patients to fill those treatment rooms. This feels backwards to me, and I disagree with it. (If you disagree with me, let me know in the comments. I’m interested to hear your opinions.)
My personal philosophy is to start small and expand into a larger space as you grow.
So obviously I made a huge effort to keep my personal budget very low when I first started. I’m a minimalist in many areas of my life (hello, only eight outfits in my closet!), so starting my practice was no different. I knew how much money I had to spend and had no intention of going into more debt to get my practice rolling.
Now, I know minimalism isn’t for everyone. Perhaps if you have different goals or ambitions, or a family, or more or less student loan debt, or a hefty savings account, or whatever your case may be, you’ll be inclined to set up your practice differently. All I’m suggesting is that you consider minimalism as a viable possibility, because it certainly worked for my practice.
You can upgrade to fun, cool stuff later on, when you have an actual income. In the first year of practice, your income can be very variable while you’re building. This variability can be stressful. The lower your startup costs are, the more cash you could theoretically have on hand for unexpected expenses in your practice (or in your life).
Why make your life more stressful than it has to be by overspending and taxing your budget from the very beginning?
So I’m just sayin’… this is my advice. Fit it into your life as you see fit.
Finally, the details…
For reference, when I started it was January 2011 and I was renting a single room in a wellness center in a suburb of Rochester, New York. The reception area was taken care of by the wellness center; I did not have to contribute anything (money, furniture, etc.) for that. I already had a laptop, and they had a printer in the reception area that I was allowed to use, included in my rent.
Exactly What I Spent to Open My Acupuncture Practice:
$35 – Doing Business As (DBA) name
$150 – Needles, biohazard boxes, moxa, etc. from Lhasaoms.com
$0 – Borrowed a TV tray table from my parents to take patients’ pulses
Total: $1738
A few considerations:
You’ll notice I didn’t use software for my patient notes. Patient management software was just becoming a “thing” in 2010 when I started, and I didn’t feel like I needed it. I also have an affinity for writing on paper (I’m sorry, trees ?). If that’s something you feel like you must have (and the laws about keeping medical records may dictate it eventually), then budget for it. The cost of electronic medical records software can range widely, from about $45 to $100 per month.
I also didn’t start out with an online schedule (like Schedulicity or Genbooks) because that wasn’t really a thing yet either. Online scheduling also ranges in price, depending on the features, but I think $20 or $30 per month is fairly average. And sometimes the patient management software above actually has an online schedule feature built-in. Even though an online schedule may make your life easier and be “the thing to do,” it is technically optional when you’re first starting out.
I would also challenge you to really consider whether you need an Earthlite table. It’s “the brand” to have but since graduating I’ve discovered other, less expensive, perfectly good brands for $200-ish. We have Earthlites here at FLSAOM, so I think our students automatically decide to get an Earthlite without checking other prices. But there are many options out there, at many price points.
And I chose a DBA over an LLC because I had no possessions (home, etc.) to protect or family to worry about in case of litigation. (Check out this awesome free course from AcuProsper about the differences between a DBA, LLC, and PLLC.) An LLC or PLLC is more expensive than a DBA, and costs can vary state by state. Check your state’s “Department of State, Division of Corporations, State Records” (at least that’s what it’s called in New York) for more info.
Later on, when I felt financially comfortable, I eventually purchased a TDP heat lamp for about $120, a table warmer for around $45, and much later, a nicer Earthlite table (i.e, not the folding travel model) for about $450. (Which felt pretty baller, I must admit.) And later still, I opened a second office space in another town and spent the money to fit out that treatment room as well.
All of these costs and considerations (and many others) are included in the free worksheets below. I laid it all out there: all the various things you could potentially purchase to get your practice started. The idea is to choose what you feel you need.
I also added a section on projecting your monthly expenses, because this is as important as preparing for your initial startup costs. If you notice that I forgot anything, leave a message in the comments below so I can add it!
Download the free Acupuncture Practice Startup Costs Workbook:
Please let me know what you think of the workbook. For established practitioners, if you have advice or anything to add to the worksheets, please leave comments below. It’s so important that we make an effort to share what we’ve learned through experience so everyone can be successful and our profession can grow as a whole.
Share your practice startup costs in the comments below. I would love to see them. The more examples students can read about the different ways people started their businesses, the better informed they can be in their early practice decisions. Our transparency is essential in helping others build their own success. I hope you’ll volunteer your startup costs in the comments.
Or if, you’d like to be interviewed anonymously in order to share your startup expenses, please shoot me an email at ModernAcu@gmail.com – I want to hear from you!
People take dietary supplements for lots of different reasons. Some are simply looking for nutritional insurance, a feeling of security that lapses in the everyday diet will not lead to inadequate amounts of this or that nutrient, such as inadequate B-12 as we get older, inadequate lutein to protect the eyes from sun damage, and so forth and so on. Others have more specific concerns, such as protecting against cardiovascular damage or speeding exercise benefits and recovery in the case of athletes. Whatever the reason for taking nutritional supplements, research normally is considered to be on the plus side of the equation both to confirm likely benefits and to show that there should be no harm. Both of these goals, unfortunately, can prove to be problematic in unexpected ways.
Lately, there has been no shortage of headlines asserting that dietary supplements lack utility in helping to maintain health. Indeed, in a recent issue of Total Health (Total Health Online Thursday, 01 May 2014) I debunked a claim that supplementing with omega-3 oils, primarily from fish oils, can increase prostate cancer. I argued that the conclusion is not supported by the evidence, most of which indicates that the opposite is true. In another article in a separate journal (Clouatre and Bell, J Nutr Food Sci 2013, 3:3), a coauthor and I rubbished claims that L-carnitine increases cardiovascular disease (the opposite is true). In these and similar instances, the supposed debunking of nutritional supplements had been presented as being based on scientific research. However, when examined closely, the research was found to be faulty, the conclusions did not follow from the research, the statistical model(s) used was/were misleading, the wrong questions were asked, or some combination of such issues came into play. The headlines might be attentiong-rabbing, but the research itself often was questionable on a number of grounds. Sadly, it is only the headlines that people tend to remember.
Earlier this year, yet another flashy headline appeared in a major journal asserting that multivitamin/mineral supplements are not useful for maintaining health. The responses from many of the most prestigious researchers in the field were not kind. One such response came from Balz Frei PhD, chairman of the Linus Pauling Institute at Oregon State University, Bruce Ames, PhD, of the Children’s Hospital Oakland Research Institute, Jeffrey Blumberg PhD, of Tufts University and Walter Willett MD, of the Harvard School of Public Health. These particular authors objected to the manner in which trials were selected for inclusion to prove that multivitamin-mineral supplements to not prevent chronic diseases and may actually cause harm. As noted by Balz Frei in an interview, these conclusions were arrived at by ignoring many beneficial effects that appeared in specific studies.
Frei pointed out that, among other benefits, multivitamins can help make sure that individuals meet the RDI of essential vitamins and minerals, e.g., “92 % of Americans do not consume the recommended amount of either vitamin D or E; 61 % don’t consume enough magnesium and 50% don’t take in enough calcium or vitamin A.” In addition, one large National Institutes of Health trial (Physician’s Health Study II) found that use of a multivitamin was associated with an 8 percent reduction in cancer incidence and reductions in total and nuclear cataracts by 9 and 13 percent, respectively. A casual observer might note that these results were found with physicians, a population of individuals that one might expect already to be taking better care of themselves than most of us, hence less likely to show benefits merely from supplementing with a multivitamin.
As Balz Frei argues in addition to the foregoing, multivitamin and mineral supplements not only offer inexpensive nutritional insurance, but also are remarkably safe. Dangerous dosage amounts are above clearly established tolerable upper levels of intake. Hence, merely following label instructions is a good guide to safe usage.
Is an Eight Percent Reduction in Cancer Meaningful?
One often-expressed line of criticism of dietary supplements made mostly by champions of drugs is that the benefits are not at a meaningful level. In many ways, this is a highly distorted line of criticism. Pharmaceuticals, of course, are expected to have very large effects in sick populations. Dietary supplements, in contrast, typically are tested in relatively healthy subject populations. Not surprisingly, the magnitude of the benefits found in the latter are likely to be much smaller than those that are found with drugs. After all, individuals who are reasonably healthy are just that, reasonably healthy. Moreover, drugs always come with numerous risks, whereas dietary supplements generally are extremely safe for most individuals.
A quick example indicates the differing scales of the two approaches: Weight loss in a morbidly obese patient (think of a person standing 5 feet 8 inches, yet weighing 300 pounds) happens very differently than in the average individual who only needs to lose few pounds, for example, 10 pounds. The morbidly obese patient on an effective compound can lose many pounds per week, whereas more normal-weight individuals not on a starvation diet simply will not lose more than 1 to 2 pounds (at the outside) per week for any extended period of time. Indeed, losing weight more rapidly than this can lead to problems, such as gallstones.
More about Vitamins, Herbs and Safety
In the November 2014 issue of “Whole Foods Magazine
The supposed reason for the trial described in the medical journal was to “characterize hepatotoxicity and its outcomes from HDS [herbals and dietary supplements] versus medications.” This no doubt is a laudable goal for a study, but if this was the only goal, why did the study exclude the single largest source of liver complaints in the U.S., acetaminophen-induced liver injuries? Moreover, as Cory Hilmas points out, the “Hepatology” article was not even designed properly to prove that supplements were causing an increase in serious liver disease. For instance, it was not designed to weed out major confounders, such as alcohol use, prescription drug use, family history, etc.
It should be understood that the likelihood of liver injury from pharmaceuticals and supplements can be difficult, if not almost impossible to discover in advance even with massive clinical trials. Having reviewed adverse event reports myself in the case of kava kava, I can attest that the vast majority of such reports are incomplete and even in the drug trials liver injuries often do not show up until the drug has been on the market for months or years.
Does the Food and Drug Administration have a good program in place to uncover liver damage from dietary supplements? Yes, it does. Hilmas writes that FDA’s Center for Food Safety and Applied Nutrition (CFSAN) has the CFSAN Adverse Event Reporting System (CAERS) to determine whether liver issues are actually related to dietary supplements.
To return to our starting point, it is important to have scientific validation of the benefits of herbals and dietary supplements whenever such studies are available. For historic reasons, such studies are not available on a number of traditional herbal products and formulas. Nevertheless, good science is always to be welcomed, “good science” being the operative phrase. Science is an ongoing enterprise and it is subject to the limitations of all human projects. It easily can be skewed by the inappropriate inclusion and/or exclusion of data and trials, by the drawing of conclusions not properly backed by either the study design or the evidence collected, by unrecognized weaknesses in the evidence, and so forth and so on. All these factors need to be kept in mind the next time one is drawn in by an attention-grabbing headline, whether the headline purports to provide news either good or bad regarding herbals and dietary supplements.
Original article and pictures take www.corespirit.com site
