Birth of a Clinic: on Finances, Bookkeeping, and Internalized Sexism

Like most acupuncturists, I got zero business training in acupuncture school. Even though I was lucky enough to get a job at an established community acupuncture clinic, and was spared a lot of the responsibility for bookkeeping etc, I still made some very obvious mistakes — including not setting aside anywhere near enough money for taxes and having a nasty surprise in my first year. (I’d never made enough money to owe taxes before; didn’t see that coming!)

When I first began to consider making the leap from employee-punk to clinic owner, the scariest thing for me was managing a clinic’s finances. Scarier than leaving my whole life to move 4000+ kilometres away, mind you. I can’t pin this all on the gaps of my acu-education; I have recently come to understand that this also has very much to do with female socialization. Anyone remember Teen Talk Barbie?

Despite never having played with Barbie, I definitely got the message that my strengths as a girl lie in my appearance, and my capacity as a caretaker and people-pleaser. Not in my brain, or ability to do math, or run a business, or make sense of an Excel spreadsheet.

I’ve been involved with the international Re-evaluation Counseling (RC) community since 2001. Basic RC theory assumes that everyone is born with tremendous intellectual potential, open heartedness and natural zest, but that these qualities have become blocked and obscured in us as the result of being hurt. RC aims to build networks of counselors who take turns counseling and being counseled. When adequate emotional discharge takes place, we can be freed from the rigid patterns of behaviour and clouded thinking.

This distress around finances and bookkeeping has generated a lot of anxiety for me in the last year. I’m talking about the kind of nagging worry and steady unease that can shit all over your quality of life. It was peaking right before POCAFest.

Thank god for Korben Perry, fellow acupunk, good friend, and RC ally. We had us quite a few Skype sessions involving him bearing calm loving witness to my epic laughcrying freak outs about not being smart enough or DIY enough to have mastered the QuickBooks accounting program to reconcile the books for the last few months. (Reconciliation, in this context, referring to the process used to ensure that the money going out matches the money spent.)

“Korben, I have to do it before POCAFest!! The whole Finance Circle will be there! What if MaryMargaret Dobson asks me how I’m doing with the bookkeeping? What if Carmen Doerge can see the big red QB of shame on my forehead?!”

Ridiculous? Yes. But also, very real. These feelings can really fuck up a person’s ability to think clearly. Oppression likes a vicious circle. When you’re told that your brain doesn’t work as well as a man’s, when you grow up hearing dumb blonde jokes, when your body is repeatedly used by those who have no interest in your intellect, all that hurt can cloud your thinking. It does interfere with the brain’s functioning.

Well, I didn’t reconcile the books before POCAFest. But I did go to Carmen’s very well-attended basic accounting workshop, and my first quiet revelation that day was that “I am not the only one who struggles with this.” I pondered this at great length later on in the afternoon during an hour long solo swim in the lake (don’t tell the Methodists) and came to my second quiet revelation: that it would probably be ok to just pay a bookkeeper to help me with this stuff.

I can’t tell you what a relief this was. That alone was worth the round trip ticket to Providence.

But wait, there’s more. I paid for some of the bookkeeper’s time upon returning from POCAFest, and this time, my brain was able to grasp the basics of the accounting software in a way that it just hadn’t before. I reconciled the books for April, on my own*, and not only was it not that hard, it was actually

kind of satisfying and fun.

“Oh look, all the numbers align!”

By the time I’d reconciled June, I felt truly badass. Take that, nagging sense of inadequacy and shame. Take that, Teen Talk Barbie. BOOYAH.

*Please note that I am not suggesting that you’re a bad feminist if you hire a bookkeeper to do this for you.

Lisa B.
Author: Lisa B.

Lisa prefers fireflies to fireworks, reverts to bluntness in stressful moments, would happily wear legwarmers year-round, and probably wants to be your friend.

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  1. lisa b., i too had similar anxiety when first starting out. i had met with an accountant who helped us set up our QB, and gave me the overview of what i had to do every month (basically, get in there at least twice a month, and catch everything up, and reconcile monthly). i would obsess and worry daily about my abilities to do this, for months on end. it’s worth noting that i had actually been an accountant, of all things, before going to acupuncture school, reconciling accounts and watching millions of dollars for other people. still, the fact that nobody was watching me or double-checking my work, that i was ultimately the one responsible, led to intense insecurity. i certainly can link this to female socialization, which is relieving and vindicating in a way (that i’m not crazy), and completely maddening and angering (that our society is).
    then, i got good at running our books, over time– and found extreme satisfaction in reconciling that fucker to the penny every month. i did our own payroll. i understood all our taxes. now, in the clinic where i work, i’ve just recently learned their bookkeeping systems and i’m keeping things caught up during the owner’s family leave. all my old insecurities came reeling back at me– that i’m not quick enough, that i’m bound to make mistakes, that i didn’t want to look inept. but guess what–after a couple weeks of breathing deep and opening QB and an online banking tab, it’s fine. i can do it easily, and i’m not stressed out. shows me that action is really the antidote for all worries, fears, and anxieties. just DO IT already, know when to ask for help, and remind yourself (then revel in) how wildly capable you are.

    p.s. every single person i’ve mentored (all female) have struggled with and obsessed about clinic accounting too.

  2. and i feel confident to speak for the whole Finance Circle, in that if we’d known you were so worried about us grilling you about your accounting, we would have scooped you up in a giant group hug and laughcried it out with you. especially that MM–she’s quite a hugger.

  3. I think there needs to be a course in POCA Tech that says:

    Bookkeeping is Easy (101): Hire a bookkeeper (Read this course title for .25 credit)

    We can’t (and shouldn’t) be good at everything. Bookkeeping gives me the fits, and now that I have a bookkeeper who seems to have everything well in hand, I can sleep at night.

  4. Great post, Lisa!

    As a tangent I’ve come to realize that our business training in acu-school is as poor as it is because the intent of the schools is not to help you make a successful practice but to have you buy into the fantasy (my words) of becoming like the ancient scholar physicians in Chinese history: literate, wise, admired, member of the .001% where talking about money is just…gauche. Thus having a business class is beyond the pale. We didn’t actually go to a professional school; we went to Orientalist Boot Camp. Bah.

    PS RC is great! I used to do it a ton in the 90’s and I only stopped because I moved to different things (not better, just different). RC is sooo sooo helpful and I am always grateful for what it continues to help me understand even now.

  5. Lisa,

    I cannot tell you how timely your post is. SO helpful on a few fronts. Every night I cozy up to “Quickbooks for Dummies” and feel like a dummy because it is totally a foreign language. I have an accountant lined up to walk me through and set up QB but this conversation is a good reminder that the process of knowing how to do it well on my own is just going to take time. I’m sure I will think it is easy when someone is holding my hand, and then shit bricks when I am left alone with the first round of numbers to insert.

    Thanks for sparking this conversation!


  6. Interesting post.
    I came at acupuncture from an engineering and architecture background. Architecture can be as flakey and un-businesslike as Acupuncture, but part of my engineering coursework and licensing exam required accounting — not much, but enough to give me the basics. And of course, engineers are all about number-crunching, so the fear of numbers -factor wasn’t an issue.
    But, it seems to me that POCATech should include an intro to accounting section — does it?

  7. I freak out about bookkeeping and accounting all the time! It’s really great to be able to opening talk about it.

    The other thing I feel like is being a woman and looking young when I deal with male professionals like lawyers and accountants and bankers sometimes they act like I am an idiot. And that’s really annoying.

  8. Thanks for sharing Lisa,
    I also felt like I was the only one that was freaking out about bookkeeping but in all honesty I felt crappy about myself after sitting in on Carmen’s accounting class.
    In my head I was thinking ‘what the hell, you’re just gonna tell us to get an accountant. that’s it?! I NEED to learn this crap!’ I didn’t feel like she gave us any details on how to do it ourselves and every time a question was asked she directed our attention to the printout. I was like ‘what is the point of teaching this class if everything is on the form? Perhaps we should just sit here in silence and read the handout?’
    Before this looks too much like a Carmen bashing, let me clue you into my own internal freak-out that was causing me to have such a huge chip on my shoulder about this class.

    In a nutshell, I am a huge disappointment to my father!

    I already have an accountant. My dad is a partner in a major accounting firm servicing multi-million and multi-billion international companies…. and I don’t know S#!% about accounting.
    At first when I was in BA for 3 years, I was doing my own numbers on Quickbooks and it was kinda fun in a monotonous way to enter the data each month. I thought I was doing great. Then the end of the year came and whamo! My Dad tells me I had $7,000 in my savings account according to QB! (I did not) It’s the end of the year and he is stressed to get my taxes done, along with all those gazillion earning companies I mentioned, and he starts talking about credits and debits and a bunch of other words I don’t recognize nor can I give definitions for. He gets frustrated and starts cursing as he tries to figure out QB, eventually he gives up and has to calculate my books without QB. Then once tax season is over, he is too tired to give me the 101 on what the hell I’m supposed to do to keep track of my numbers.
    This happens every year without fail for the last 4 years!
    I am currently freaking out because I failed using QB so bad that even though I have all my receipts, I haven’t entered any data into the system because my father was going to create a spreadsheet for me to use instead of QB… still waiting for that spreadsheet.
    I never learned anything about taxes because every year they were magically done for me, now I’m clueless. I’m kicking myself for not asking him to clue me in on the process and feeling like a total selfish princess. (not the nice kind of princess)
    What I realized in Carmen’s class is, I didn’t even know the basics, I couldn’t understand most of what was said about filing taxes because I was hoping to hear more of how to make a spreadsheet to give to my accountant.
    In the future, I would love to see a class about what debits, credits, what deductions are good, and what your spreadsheet should look like. I didn’t speak up in Carmen’s class because I thought my questions would look stupid and elementary:( Now I see I may not be the only one who doesn’t understand.

  9. Meridity, that sounds incredibly stressful! I have a few thoughts I’d like to send you via private message but I can’t find you on this site. If you want, email me at info(a) and I’ll tell you my thoughts.

  10. Lisa Thank you very much. I’m sorry I didn’t contact you but I have an update and it’s good news!
    Over the holiday (miracle of miracles) my Dad got some time off and he sat me down and created an excel spreadsheet for me and then he taught me how to use it! I’m so friggin happy I could burst. I’ve spent many happy hours plugging in the various receipts and logging my revenue into the spreadsheet and low and behold another miracle! My numbers actually matched my bank account.
    Looks like my very public and very strange pity party via the POCA forums got the attention of the accountant gods and I managed to pull this thing together.
    Thanks for the support, I may contact you in the future if I run into an issue if that’s ok.
    and here is my email incase you ever need anything
    thanks again