55-85%

This morning I revisited something I wrote about in the forums a year and a half ago. Back then I said that it felt like the capacity of WCA topped out at about 80%, meaning that once we filled about 80% of our slots it became increasingly hard to fill the remainder because it got increasingly harder for patients to find open slots that met their time constraints. (This is a variation of the difficulties one faces when moving at speeds close to the speed of light. Surprised .)

When I first wrote this some folks had slightly different percentages for their clinics. Makes sense- results will vary.

As some folks here know last fall WCA hired three new Punks to expand our capacity. (We have this huge warehouse space.) Now we didn't hire them on for full-time right away; we've been gradually increasing their hours. One of them is now full-time, which we define as 20 hours/week and the other two are at 16 hours/week, soon to be 20. Last week WCA saw 411 patient visits. 411 visits translates into 68% of the total slots being filled. Every day was filled to between 61% to 83%, with Sunday actually completely 100% filling up. So I reckon we have some growing capacity still. Good.

We strongly feel that patients need to be seen often AND at the same time a community setting benefits greatly by being at least partially full. So there's that balance of what I figure to be between 55%-85% of capacity, preferably closer to the higher end, that is ideal. In figuring out how many hours a clinic should be open I think its important to be open only enough hours so that your available slots fill up at between 55%-85% of capacity. If you are at your clinic more than that it will feel to the patients as too quiet, too vacant and that's not good. Patients actually do like having other patients around, even if at first they may not know that. On the other hand if you are pushing 80% capacity its time to either expand your hours or hire someone. That's a whole other kettle of fish.

Skip Van Meter
Author: Skip Van Meter

Skip is Lead Acupuncturist and Co-Founder of <a href="https://www.workingclassacupuncture.org/" target="_blank">Working Class Acupuncture</a> in Portland, Oregon. With the earlier part of his life spent acquiring knowledge about geology, urban planning and teaching high school, he has now been an acupuncturist for 19 years, using about a 1,750,000 needles poking his patients. He likes all things soccer, has three fabulous sons, the best wife in the world, and a great dog and two cool cats.

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  1. A few comments. First – your

    A few comments. First – your picture….Skip you are the totally enthusiastic coach, rooting us all on to keep working at this game. It’s quite encouraging, and humorous also (knowing the person behind the picture a little bit).

    Second. Yes, I agree that clients do like to be in there with others cooking and not in a big vacant empty space which they have to fill with their Chi all by themselves. Though, I would be careful about insisting on applying the 55% to 85% formula to everyone.

    Every clinic is unique and there are probably many different phases of development. Last Saturday, Serena was 75% full. She saw 18 people in 4 hours. Many shifts are at 10 or 20% though. On the other hand, our overall patient volume has been rising every month….around 280 patient visits for the month of February.

    Our monthly numbers have dramatically risen each time we’ve increased our hours. Currently we are both at 20 hours a month and are unlikely to increase them again until we get to 350 or 400/month.

    So the “empty treatment room” effect needs to be balanced against the need to be open a certain minimum number of hours in order to accommodate the diverse scheduling needs of modern humanoids. We are open 2 full days, and 4 half days (40 hours total), which seems to be a good compromise. Sometimes the treatment room is a little quiet (now there are 2 people cooking), but often there are 4 to 6. (Max capacity is 8 though once we had 11 going simultaneously with people being treated in our comfy waiting room).

    Having a bigger clinic – you obviously need to pay a lot more attention to these details because you have people on salary. With just two people though, the quiet times seem less of a critical issue.

    People understand we are still building our community though, and they often seem to take an interest in asking us how they can help us grow.

  2. Sorry, still getting used to

    Sorry, still getting used to the new format and I thought it would automatically identify me, but the post says “Guest” so I’ll remove my cloak – this is Jordan.

  3. Hi Jordan!

    I figured it was you. I agree- I don’t want to be insisting on at least 55% for everyone. Think of it as “Guidelines”. Its a way to look at the efficiency of one’s clinic and no doubt there are other ways. One thing I worry about with new CA clinics is that the practitioners might get burned out by having too many hours. Having sane hours (for you) is vital in this business. Notice that I define a full-time practice as around 20 hours a week. That doesn’t include non patient contact hours (bookkeeping, and the like) but IMO Punks start to lose effectiveness when working much past a 20 hour week.

  4. Oh- the picture!

    As you know I have three boys. The youngest is a cross country runner and I would help out on the team, taking splits, cooking for the team on their summer running camp above Sisters OR (the team still calls me Cookie, and in general cheerleading. I also do Acupuncture on the team. That photo is me cheering a JV runner in his 1st ever race right at the end.

    I put my whole self into what I do.

  5. I also agree with the 20

    I also agree with the 20 hour treatment guideline. More than that on a continual basis would seem conducive to burn out. And burnout creates a negative feedback cycle-energy which turns away patients. Of course, this is mitigated somewhat to whether your clinic is at 85% or 25% capacity, though there are a lot of other variables.

    Partnerships are sure great compared to sole proprietorships, especially when the partners have a good relationship supporting each other when the other needs to rest and relax.