De-lurking my business partner

Lately I have been a total slacker blogger by asking others to write stuff for me to post. And so I am at it again. This month I asked my fabulous business partner Pam Chang to write about her experiences of opening a new CA clinic as a newly licensed practitioner. Some of you know Pam’s great article in Yes! magazine, but she is a pretty quiet person and doesn’t usually post on CAN. I thought it was time folks got to know her better.

Just a few little numbers before I let Pam take the stage: we have been open for almost 8 weeks. We have given a total of 221 treatments. We made a profit in our first full month (April) and were able to pay ourselves a little bit. We are having a great time! – tatyana

ok, here’s Pam’s post:

On Opening Sarana Community Acupuncture
by Pamela O’Malley Chang, April 2008

In Practice Management Class, I was the student who was certain that I
never wanted to open my own acupuncture practice. I wanted to work for
someone else, see maybe five clients per week, and I expected to
support my acupuncture hobby by continuing to do freelance
architecture/civil engineering. This is my view of my journey to
becoming co-owner of Sarana Community Acupuncture as seen from six
weeks post-opening.
This journey begins with an overheard conversation in the school clinic
where I was interning. Clinical Supervisor Tatyana Ryevzina had just
returned from the first Working Class Acupuncture Workshop (WCA, Oct.
2006) and was enthusiastically describing the concept of low-cost group
acupuncture. Her description made utter and immediate sense to me as a
way to: 1) make acupuncture affordable to people like me who have
chosen frugality over full-time wage-slavery, 2) enable people to find
their own solutions to everyday health issues, and 3) shorten those
horrendously long intake sessions that wore me out at our school
clinic. Shortly thereafter, I’d read The Remedy, enrolled in WCA’s February 2007 workshop, and tried to persuade my best study-buddies
to open Community Acupuncture(CA) clinics where I could be an employee.
As it turned out, I couldn’t find a local CA clinic to hire me, but by
this time, I’d found my calling. I wanted to practice community-style
acupuncture even if I had to create my own clinic to do so. After
taking my licensing exams in August, I got back in touch with Tatyana
who, by now, had been practicing community acupuncture in a subleased
space on Friday evenings for the past nine months. She was ready to
find a permanent home for an expanded CA practice and was already
talking to one prospective business partner.
Three of us started meeting in September ’07. We wrote up and exchanged
purpose/value/vision statements, traded resumes, and talked … and
talked. Tatyana drafted a business plan that we edited and re-edited.
By December when we thought we might be close to finalizing the
business plan, we started looking at rental spaces. Rental spaces gave
us real numbers but facing reality brought us up short. We started
haggling over compensation and whether each partner’s payout should be
based on the number of treatments given. Tatyana wanted us to
acknowledge the value of her established clientele and proposed that
the business buy her practice over a 12-month time period. I balked at
incurring this debt and felt that she was reducing her risk by
increasing ours. Our third partner kept insisting that we have more
pieces in place – a firmer budget and articles of incorporation –
before we proceeded further. Yet time was getting on. Tatyana’s
sublease was expiring; I needed employment. And everything was
circularly dependent: we needed a place to have a business; we needed a
business to have a place; and most of all we needed to trust each
other. We needed to know that we could rely on our partners for good
judgment, ability to follow-through, and long-term commitment.
By the end of January, Tatyana and I had split with our third partner. Her
caution frustrated us but it forced us to think more thoroughly about
how we wanted to run our business and gave us the opportunity to
observe each other under adversity, thus, annealing our business
relationship. By February, things suddenly came together. Tatyana and I
formed a partnership with my capital contribution set equivalent to her
contribution of capital plus prior practice. We chose to share risks
and earnings equally although eventually, we would like to pay
practitioners salaries of $18-22/hour, pegged to scheduling rates of 3,
4, or 5 clients per hour. We signed a lease on the smallest and least
expensive of the spaces we had looked at, agreed –after months of
indecision – on a business name, wrote website text, developed health
history and other forms, obtained various permits, a bank account, and
business insurance, and agreed on business hours and sharing of
responsibilities. Tatyana took the lead on computer-related tasks,
designing our business cards and scouring Craigslist for used
furnishings. I planned space layout and installed things. Tatyana’s
life partner donated his time to developing our website and setting up
our computer system. My friends donated plumbing help, pick-up truck
use, and performed a Shamanic blessing ceremony. Lots of people donated
furnishings. We opened our doors on March 19, 2008 with some 100+
appointments pre-booked on-line, mostly Tatyana’s clients who scheduled
weekly through April and even May.
How has it been to go from six to sixty treatments per month in a single
month? The hardest part of being a new acupuncturist is wondering if
I’ve chosen the right acupoints. CA speeds up the decision-making and
would seem like an ill fit for my methodically-plodding mind. Yet
instead, the increased speed feels rather liberating, forcing me to
insert the needles and move on. My faith in my ability to do
acupuncture is perhaps upheld by my experience as an architect where
I’ve learned that there isn’t a single right answer. Many solutions
work, some better than others. Research and study help, but trial and
careful observation of results are the only means to knowing what
works. I am lucky also in having had some training beyond the standard
TCM pulse/tongue diagnosis for picking points quickly: jingei pulse diagnosis, Dr. Tan basics, the “N+1” treatments described by Joseph Helms in Acupuncture Energetics,
Travell and Simons’ Trigger Point Therapy, Miriam Lee’s 10 points, and,
most recently, Tatyana’s been showing me Master Tung points for various

I’ve started out scheduling clients at 20-minute intervals, 40 minutes for
new clients – half speed by WCA standards, but, initially, just barely
comfortable for me. On my first shift, I had three clients, five the
next, and now typically 7-9. I seem to be keeping up except for the
inevitable logjam when late and early clients all arrive together, or
on days with multiple new clients. I hope to be seeing 4 clients per
hour by mid-May yet I also want to heed the advice of my very slow
dentist who advises me that treating people well wins loyalty far
better than speediness.

My client base is growing steadily. Many of them are spillovers from
Tatyana’s full schedule. This was pre-planned strategy as, so far, we
each only treat for 2 shifts per week. We will add more shifts as the
demand picks up. Other clients include people whom I treated at my
school clinic, yoga students whose instructor announced our opening,
acquaintances who received my e-mail announcement, and a retired couple
on social security who saw our flyers at the library. What is most
gratifying is achieving success: Sandy raising her arm and saying that
this is more mobility than she’s had in months, or Sally’s comment that
the pain in one leg has been gone since her first treatment. People
return because they find the treatments to be profoundly relaxing or
beneficial. One client has brought in 3 other family members. Our
retired couple comes in twice weekly and they have distributed our
cards at the local senior center.

All in all, I feel good in this space and business we’ve created. I am
deeply grateful to all the people who have given their time and
goodwill to this enterprise but, especially, I am grateful to my
business partner, Tatyana Ryevzina. Not the least, it is her
established practice that gives me freedom from worries about paying
the rent while I learn to be a Community Acupuncturist. Beyond that, I
have come to trust Tatyana’s business acumen, reliability, and
commitment. So far at least, I’m happy to say that co-founding Sarana
Community Acupuncture has been a fine if unexpected adventure.
Author: tatyana

<p> I grew up in the Soviet Union and immigrated to the United States as a teen, living in New York and Chicago before moving to the Bay Area in 1998. I began as a Yoga instructor and as a practitioner of Ohashiatsu bodywork and have been practicing Acupuncture/Chinese Medicine since 2003. Before switching to community acupuncture practice model I had a sporadic and struggling private practice, worked as an herbal pharmacist, as an instructor and clinical supervisor at an acupuncture school, plus did a two-year stint doing acupuncture at a public health clinic, working with mostly HIV/HCV+ populations in San Francisco. </p> <p> My discovery of Community Acupuncture practice model (via Lisa Rohleder's Acupuncture Today columns) profoundly transformed my life -- not just my work life but many other aspects of it. I gained a vocation, a community of friends and the most stable and rewarding job I have ever had. I see community acupuncture practice model as the most sustainable and most fitting to my values. It makes sense to me from the point of view of healthcare access, social justice, spirituality, and as an antidote to isolation. In 2008, together with another stellar acupunk Pam Chang I...

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  1. Great to hear more from you,

    Great to hear more from you, Pam!  Sorry I was such a phlegm-head at the BA CA meetup and didn’t get to talk to you more (or see you at all, Tatyana, but Pam passed on your greetings).  Look forward to stopping by Sarana sometime when I’m up that way again…


  2. Congradulations

    A nice story, reporting how you and Tatyana managed to put together a community-based health service based on alternative medicine. Maybe one day you’ll come East where we really need these kind of services.

    Claudia Chang

  3. Pam and Tatyana, 
     Way to

    Pam and Tatyana, 

     Way to overcome doubt and inertia and dive in to your dreams. CA isn’t all of what I expected (fortunately) and at the same time, it’s more than I’d ever dreamed…

     your compadres in Seattle


    Cynicism is a smokescreen for laziness and fear. Clear light mind awaken! Pierce through all layers of doubt and delusion! Inspire me onwards in ceaseless waves of selfless activity.

  4. Love those start-up details!

    Tatyana and Pam, thanks so much for posting this. I am always hearing from those contemplating CA that they want to hear about all the nitty- gritty of the start-up process. Hearing what you did and how you did it makes other people believe that they can do it too. Hurray for you!