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On Tuesday I wrote about the Sanborn Maxim. It states that:
“Those who are willing to pay the least will demand the most.”
Some of the many comments about it made me think a lot of people read this as:
“Those who pay the least will demand the most.”
Do you see the difference? Just because someone can’t afford your rates doesn’t mean they don’t or won’t appreciate you. They could be perfectly willing to pay, but simply unable.
Also, Lisa Rohleder wrote on the Community Acupuncture Network blog about something similar - her concerns with my apparent attitude towards payment. The way I read her concerns, assuming money = appreciation is an insult to people without money (these are not Lisa’s exact words - just my interpretation).
I totally agree with Lisa that money=appreciation is a faulty equation. Most of the people who responded to Tuesday’s article seem to think it’s about money in one way or another. (Others just didn’t like high maintenance patients and got rid of them. Good for them!)
I may be alone, but I really think money is only a surface issue. It’s really about appreciation. The way I read the Sanborn Maxim is more like:
“Those who appreciate the least will demand the most.”
Here’s why. When you exchange money for services (or goods), your focus is almost always on one side of the exchange or the other. Either you’re more focused on the money, or more focused on what you’re getting for your money. Are you more concerned about what you have to pay? Or are you more interested in the benefit of what you paid for?
If people are more focused on what they have to give, they just won’t appreciate what they’ll get in return. If they’re more focused on what they’ll get, then what they have to give isn’t as big of a deal.
(This is just one reason why marketing to your existing patients is so important. The more patients appreciate and understand what they’re getting, the happier they’ll be.)
So discounting your services isn’t bad in itself. It’s HOW you do it that matters. Do it wrong, and you’ll cause people to focus on the money. Do it right, and you’ll cause people to focus on what they’re getting. It’s the FOCUS that’s important - the money is secondary.
The sliding scale used by Lisa, Working Class Acupuncture and the Community Acupuncture Network is absolutely ingenious in how it directs people’s focus. As far as I’m concerned, it’s not even a “discount.” I’m going to explain exactly why on Tuesday.
Until then, I’m curious. Most people I’ve talked to who use a sliding scale love it. So I’m wondering:
(please leave a comment below.)
1 response so far ↓
1 Jared McCollum // May 24, 2008 at 8:19 pm
I read the book that inspired the community acupuncture movement and was very inspired to give it a try. I converted a large space of my office into that model and contacted community groups, joined a local currency exchange and meeting group and did several talks to community minded organizations . After several months of using the sliding scale and spreading the community model gospel. I was making half the money I was previously and was in danger of losing my practice.
My practice is in a middle class neighborhood and the city itself could be described as upper middle class. The people that would have benefited from this service did not likely live close by but I did practice a 5 minute walk from the light rail transit line. When I did talks and discussed the service with communities the comments I got were to far away not convenient. I assumed that a $40-$50 discount in services would be enough to draw patient from all over the city which has a population of over 1 million.
What I learned is that community acupuncture does not work for the upper middle class, and that the majority of my patients preferred private treatments considerably.
when I went back to full price ($85 per visit), it took only months to get up to my patient load of 40-50 patients per week.
I do like the idea of community acupuncture but I hope that an acupuncturist first do there homework to see if this style fits their community and is in demand. In my case my zealous desire to help others almost put me in the position where I could help no one.
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