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The Community Acupuncture Network (CAN) model is a VERY interesting business model for acupuncture clinics. It is based on a group treatment room. Usually there are a bunch of reclining chairs in a single room. The payment is sliding scale, so patients pay as much as they’re able – usually $15 to $40, but sometimes more. To make up for the lower fees, CAN practitioners treat more people per hour. This is the basics – there’s more to it than that. CAN started with Working Class Acupuncture in Portland, Oregon.
CAN seems to get good word-of-mouth marketing naturally - exactly what I like best.
CAN practitioners call “regular” acupuncture given individually “boutique acupuncture”, “private room acupuncture” and other names. (We’ll just call it “private room acupuncture.”)
One thing a lot of practitioners have said (both in public and privately to me) is that CAN style pricing will cut into the market for acupuncture and force people out of business. One practitioner told me privately, “The model of Walmart seems very similar to Community acupuncture. High volume, low prices, and eventually you will force out the mom and pop shop that has to charge higher rates to survive.”
That’s just not true. In Lisa Rohleder’s free ebook on marketing (which seems to have disappeared from the site), she mentions that there are two private-room acupuncturists in the same building as Working Class Acupuncture, and they’re doing just fine.
I can see the concern – there is a very limited pool of people educated about acupuncture. For you to get a new patient, some other practitioner can’t have that same patient. Does that mean the market is saturated? Not even close! That’s why I recommend so strongly to EDUCATE your patients and the public – you’ll expand the market for acupuncture that way.
If anything, CAN will expand the market by making acupuncture more accessible to more people. The more people hear about and see other people getting acupuncture - the more normal it seems. And that makes it far more likely they’ll do it themselves!
Also, comparing CAN to Walmart is inaccurate. Even CAN practitioners do this, but I disagree. They’re much more like Southwest Airlines. Southwest examined the business practices of the airline industry, and realized that speed was key to making more money. Turning around planes faster means they can make more flights. So what they did was examine Indy racecar pit crews. A pit crew at a racetrack can fuel, change the tires, and sometimes fix a car in mere seconds. Southwest learned to turn their planes around much faster - without compromising quality.
It looks like CAN uses Jingei Pulse Diagnosis to quickly diagnose patients. This is one of their secrets to speed without compromising quality. They also have other secrets they teach in their CAN trainings.
Two things strike me about CAN in particular, that I think most people probably would never notice. First, what I’ve noticed while reading articles about them, effective CAN clinics seem to have a “culture” of sorts.
Some people know I actually have two business degrees – a MBA and a MOB. An MBA is basically a business degree focused on money and numbers. An MOB is a business degree focused on people – it’s the one that really means something to me. Learning about people, what motivates them, makes them happy, helps people work together vs. money and numbers? No contest. So culture is very interesting to me.
I wouldn’t be surprised if culture can make or break a CAN clinic. In my private discussions with Lisa, and her public comments, she makes it very clear that a CAN practitioner’s attitude is VERY important to the health of the clinic. Running the clinic as a charity, being classist (having prejudices against people with less money), or being overly “professional” can ruin a CAN practice. (Like any business model – not all CAN practices succeed. Lisa seems concerned that CAN style clinics attract idealists. Since idealists are often not the most business minded people, if they fail, it reflects poorly on CAN.)
But if you read articles like this one by a practitioner who visited Working Class Acupuncture, you’ll find that people like and appreciate the group atmosphere.
The other thing that strikes me about the CAN model is their sliding scale. CAN practices set scales where a patient determines their ability to pay within a range, usually around $15-40. It’s a really elegant way to charge patients – as the Working Class Acupuncture site states “The purpose of our sliding scale is to separate the issues of money and treatment.”
I don’t consider the sliding scale a true “discount.” It doesn’t devalue acupuncture, because it’s pretty clear that the top end of the scale shows what it’s valued at. If a scale is set at $15-40, and patients pay less – they’re still getting a $40 treatment. And even though that treatment is less than the usual “private room acupuncture” fee, there’s a reason for it. The CAN business model is obviously different than private room – people are getting what they pay for.
I’ve been considering using a sliding scale myself with my coaching.
One thing that has always bothered me with marketing and business coaching is that the people who need it most are usually least able to afford it. At the same time, I know that my rates are more than worth it. I expect coaching clients to make back whatever they pay me many times over.
Any kind of marketing MUST be an investment, or it’s a waste of money. Period.
In “The Faucet” I show VERY conservatively how each new patient is worth at least $150 (probably closer to $400 or more). When I coach someone to get more than 2 new patients, the coaching is more than paid for that month – and their marketing will be even better next month. It really starts to add up over time. That’s the problem though - the payoff occurs over time.
The one thing that has been stopping me from offering a sliding scale is that I don’t want people to be less motivated if they pay less. Coaching means I help focus your efforts so you can REALLY make things happen. That means you have to actually DO something. If you hire me for coaching at $300 a month and do nothing, you’re out the $300. No one wants to lose money like that. But at the same time, if you are paying only $125, that’s not quite as motivating to take action. (I hope I’m wrong about this!)
Still, I’m going to try a sliding scale for a limited time. Visit the coaching page for details.
3 responses so far ↓
1 Lisa Rohleder // May 30, 2008 at 10:57 am
Dear Burton,
thank you, very very much, for the thoughtful and thorough clarification.
The point about the culture of the community clinics is very important and it leads to some issues that are relevant to your site, your work, and your interest in using a sliding scale. (Cool!)
At WCA, we never ask patients for referrals, not because we don’t want to, but because we don’t need to. The other way we’re like Southwest Airlines is that we’ve been successful in attracting not just customers but “raving fans”, to use Southwest’s term — patients who are so excited about what we have to offer that they do our marketing for us. I think community clinics, because our financial margin is so slim, really depend on attracting, supporting, and retaining this kind of patient.
How this relates to your sliding scale coaching idea: very often people are not willing to pay for a service that they don’t know anything about, that they have never used before and that no one they know has ever used before. Once they find out that the service is helpful to them, not only will they continue to invest in it (even if their funds are limited) they will try to get everyone they know who needs it to try it too. The kind of person I’m describing does not respond well to “special time limited offer” or “discount” or anything that seems like a sales pitch. Also, I would imagine that, sometimes, coaching like acupuncture takes time to show really good results. That means the only way to get people to get the kind of results that causes them to refer others is to lower the barriers to trying the service in the first place, and trying it in a meaningful way, not just a “free sample”. This is how to convert skeptics into enthusiasts.
WCA has one particular patient who watched our clinic for two years before he made an appointment — who came in, who came out, what they said. When he finally made an appointment he told his acupuncturist that he was giving it ten visits, and if it didn’t work, he was never coming back. On his ninth visit the back pain he had had for 25 years went away entirely. Since then, he has paid for first visits for at least 40 people. When people miss appointments, he calls them and tells them to reschedule. He explains to new patients how acupuncture treatment plans work. Community clinics need this kind of patient.
Which gets me to the last thing I wanted to say — because we depend so much on the goodwill of our patients, because they have entrusted us over and over with what matters most to them — the health and wellbeing of their families and friends, because they are responsible for our success, we are grateful to them, and protective of them. Which is why I react so strongly to the implication that “people who pay less are worse patients”.
There is a video link of our patients talking about their experience with acupuncture;
http://video.google.com/videosearch?q=working+class+acupuncture&sitesearch=video.google.com#
I promise, Burton, if you get the right people, what they pay you is not going to determine their motivation. You might even meet your favorite people by making it easier for them to work with you. Best of luck.
2 Lynn // May 30, 2008 at 10:58 am
Burton-
Thanks for writing about the community acupuncture model. I think it’s a great concept and will help further our profession by bringing acupuncture to more people.
I am a “single room” practitioner specializing in helping people with mental health conditions. The nature of my practice, the need for privacy, and a certain amount of candid discussion with my patients doesn’t lend itself well to a community style set-up. Many of my patients are aware of community style acupuncture, and I have referred some people to the community clinics in my area. I have the utmost respect for the community model.
I have a problem, however, with my clinic being called “boutique style” or “spa style” acupuncture, simply because I treat one patient at a time. Those terms demeaning and infer that what I do is somewhat “frilly” and unimportant.
What we all do is important and necessary, but is delivered in different ways. This different style of delivery is common in most health care professions. We need to act like the professionals that we are, and support each other, because the survival of the acupuncture profession depends on all of us–not just one style of acupuncture or one kind of business model.
3 Sidney Barthell // Jun 2, 2008 at 11:55 am
I think all this is wonderful! At our local recreation center, the locker rooms have open areas, and private areas for showering and changing clothing. Some people are fine with walking around butt naked, and some people prefer privacy, for any number of reasons. We don’t argue about it. We just make space available, eh?? It really is about facilitating people’s inherent worth. –And the workman is worth his wage, and that makes him no better or worse than anyone else.
Massage too has many applications, although public dorm style table massage doesn’t seem to catch on here for obvious reasons. There is orthopedic massage, there is sports massage, there is medical massage, and there is relaxation massage, and each catagory can be implemented in many different ways. It’s about making the client feel better.
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