That IS sad… I folks get to read your reaction and let it sink in- I’m not just blowing wind, but people really do have these reactions to sliding scales…

Sounds like a great plan there. One thing that you wrote, however, raised a red flag for me:

“For instance, treating 30 patients per day, M-F., at $60 per 1 hr. visit equals 5 hrs. per day and with acupuncture, herbs, and neutraceuticals, that comes out to near $90,000/yr. You’re running solo with no employee responsibilties or headaches. Use the other 4 to 6 hrs. remaining in a normal workday to venture into an online business endeavor such as marketing, consulting, selling information or whatever you wish to do with your computer. ”

And it jibes with what you wrote later:

“Some people are just mentally and physically geared to treat volumes of patients per week, but for others, examine your own heart first. Do I possess the extra drive, focus, and intention it will take to do the extra processing and treatments required in higher volume practice…and can you do that happily? Will the added stress impair one’s focus and intention and rob patients of the treatments they deserve.”

In my experience holding that many patients takes some energy and transition time. Five hours of client time is rarely the whole picture.

In addition, you actually have to -run- the business. The extra 4 to 6 hours (whoa! 9 to 11 hours/day! that’s some hard work…) is actually going to be tied up in helping the business maintain.

I never suggest anyone start two businesses at the same time. Get one business stable, get the help you need, outsource help to people who are competent at it, and then, if you have the drive, start a new business.

However, I totally take your point about being productive with your time. I think that’s a great thing to be clear about.

IMHO,

Mike Eidson

Thanks for bring that approach to my attention. It seems very similar to my Your Right Price exercise- thus proving again that what works is already available all around us, and that we need often look no further than our own hearts for the true answers. I’m glad you’re doing what you’re doing!

I do have one caution about the ‘value’ conversation. I think it can be such a painful place for people to land, that I try to steer folks away from thinking about ‘value’ completely- because in my experience, it’s never about value.

Did you see Why valuing yourself more can shut down your business?

I’m just careful about placing blame for what’s not working. I have seen a lot of people struggle starting their practices, but it’s not always the economic system or the way acupuncture is presented that’s 100% at fault. If acunpuncturists, and other practitioners, put in 20% of the effort into learning how to be business that they put into their education, many of them would not be struggling nearly as badly, or at all.

And that would free them up to be generous and be able to volunteer, donate, or otherwise make their services available to those with less disposable income.

Thanks again for bringing all of this up.

I’m enjoying receiving your ezine, and read this recent one with interest, in part because, while I don’t currently use a ’sliding scale’ in my coaching business, I did in the early days of establishing myself. I was quite satisfied as were my clients, and have suggested this as one way for new coaches starting out to consider, especially if they have questions like: “How do I set my fees? How much should I charge for my services?”

I have found that the answers to those questions are different for each coach and often go to the heart of some important ‘self-esteem’ questions, like “What am I worth?, “Will people really pay me to do something I love?,” etc.

A sliding scale, as outlined below, can often resolve these questions. Perhaps it’s more accurate to call this approach a ‘modified sliding scaled.’ It goes like this:

1. Determine your standard coaching plan as a starting point. Then, ask yourself, “What is the lowest monthly fee I am willing to accept for a standard amount of coaching that I will continue to feel good about, and that won’t leave me feeling like I’m undervaluing my services?” This gives you the bottom level of your sliding scale.

2. Next, ask yourself, “What do I feel like I’m really worth and that I’d be thrilled to receive on a regular basis for my standard plan?” In asking this question and the one under #1, you can try out different amounts. For instance, you might start by saying, “I’d love to receive $500 per month for my standard plan.” Yet, as you say this you also hear yourself say something like, “Yeah, in your dreams. No one will ever pay you that much.” This is a signal that your belief isn’t at that level of income yet. So, you try $400. That probably feels a bit better but may still be a little higher than you can believe. Continue to work with it until it feels right. For this example, let’s say the figure you come to is $350 per month. That now becomes the high end of your scale.

Thought you and your readers might find this other perspective of value. If you’d like to hear how I shared this plan with my clients at the time they are hiring me, I’d be happy to oblige.

Simply and purposefully,
BRAD
Dr. W. Bradford Swift,
Founder & Chief Visionary Officer, Life On Purpose Institute
Author, Life On Purpose: 6 Passages to an Inspired Life

OUR VISION: A World On Purpose — People living lives of:
* Purposeful, passionate and playful service
* Mindful abundance balanced with simplicity, and
* Spiritual serenity.
http://www.lifeonpurpose.com

I am I total agreement with you that the one business class that was offered to me in my last semester of acupuncture college was totally inadequate. I started to think about starting my practice a year before I graduated…for this reason I started reading your book the Heart of Business to help me prepare!!!

I commented on your article initially because of the words you used: “horror of the sliding scale”. I didn’t think most people would go the extra mile to see the possibility —- with clear intention about money – there could be another model.

The reason that I said the current model, at least with acupuncture, was not working is that as it stands now the majority of people who can afford to receive acupuncture have insurance and/or disposable income. This group is a smaller percentage of the population as compared to the people who don’t have disposable income or insurance. The idea of a new model, at least for acupuncture, is to open up the market to a whole new population of people who would not have even considered the remote possibility of trying it. It’s a big leap for many to try acupuncture beyond potential costs. It creates a win-win scenario for both the practitioner as well as the patients.

I think there is something wrong with the system when I have seen many acupuncturists burn out after a couple of years of practice or still trying to cobble an income together after several years of practice. That is a poor return on a big investment! I know a very successful acupuncturist who has made it by all accounts in the current model, but is not happy. As a savvy businessperson this acupuncturist is keenly aware (or maybe worried) of the possibilities of this new model. There is a medical doctor here in Portland who has started a sliding scale clinic, which starts at $60 for the first visit. This doctor works outside of the medical system – no insurance.

The reason that I want to try to bring this home here, to a spiritually minded community, who I believe are the true leaders, is that it is easier to ride the wave early on then to wait for it to crash and figure out how to do it later. At least with the health care system, this is my perception of our current state of affairs.
Thinking in different categories can save the day.

For anyone interested
A video of Lisa Rohleder, L.Ac. from the Working Class Acupuncture Clinic presenting another model to OCOM acupuncture students this past spring on the state of the profession. http://video.google.com/videoplay?docid=-8437007730452187420&hl=en

Mark, Thank you again for allowing me the space here to share my point of view.
All the best to you.

Peace,
Joseph