Not long ago, an alert reader pointed out a conventional acupuncture marketing blog (www.acupunctureclinicmarketing.com) that had a link to CAN and to The Remedy. Wow, that’s interesting, I thought, and decided to check it out. In general I find marketing to be an intriguing topic, maybe because it reveals so much collective unconscious material with so little effort of examination: new car = sex = power, antibiotic spray = maternal love, allergy medication = a joyful life, etc. The revealed material might be appalling but it’s almost never boring. When it comes to reading about acupuncture marketing, I usually learn something about how the acupuncture world sees itself and how it sees patients, which is almost always useful to me when I teach workshops.
This is why I downloaded the first two free chapters of Burton Kent’s new book, Never Market Again: the guaranteed formula for attracting patients naturally.
And then I sent him this letter:
first, thanks for putting a link to my website and my book on your site. I
appreciate the help in getting the word out.
Second, we don’t know each other at all, but would you be interested in
having a heart-to-heart talk? In public? Meaning, on the Community
Acupuncture Network blog, and yours as well, if you want.
Here’s why I’m asking. There’s lots on your site that I agree with
completely: about not spending money on advertising, about generating
word-of-mouth promotion through strong patient relationships, about how sad
it is that so many acupuncturists are so terrified of business that they go
out of business almost immediately. Most of all, I agree with you that
acupuncture saves lives. I’ve experienced this first hand, and it’s
basically why I’m writing to you. Because I think that it’s incredibly
important that acupuncturists can make a living doing acupuncture, so that
more people who really need it can get acupuncture.
And also because it’s my job to educate acupuncturists about classism,
particularly the intersection of classism and business. I teach an elective
at an acupuncture school where we talk about these things a lot; a big part
of what the Community Acupuncture Network does is to help acupuncturists
see through classist thinking, so that it doesn’t get in the way of
growing their practices. Consequently I am always looking for opportunities
to address obvious examples of classism in acupuncture.
In Chapter 2 of your book, “What Will Hold You Back”, you list
“feeling guilty about charging a fair rate”. You don’t define what a
“fair rate” is, and I’m curious what you think it is. Then you
“There’s another side to charging a fair rate. Doing so actually helps
people get more value from your treatments. Think about it this way. If you paid $1,000 for a course
manual, and you paid $15 for a book, which would you take more seriously? Which would you be sure to
learn from and follow? The course manual, right? But what if the $1,000 manual and the $15 book contained the exact same information? I think you get my point. The value and importance we place on something
is heavily influenced by price. By underpricing your services, you make your patients undervalue
your services. They’ll comply less, complain more, and actually be worse patients because of the price
Don’t cheapen yourself, your skills or your profession. They’re worth
far more than you realize. “
Even though you didn’t define “a fair rate” as “market rate”, you
are saying here that patients benefit more (“get more value”) from
acupuncture if they pay more for it, and that when they pay less for it,
THEY ARE WORSE PATIENTS. This is a brutally classist thing to say.
If you cited my book in your links, I have to think that you know that I
charge my patients $15 to $35 per treatment — they decide what to pay on
that scale. My patients, 60% of whom pay at the low end of the scale, are
not “worse patients”. They don’t complain. They comply with treatment
plans better than any other patients I’ve ever met ( in part because the
treatments are priced so that they can afford to comply). Some of these
patients are being treated for life-threatening conditions: liver failure,
asbestosis, late-stage emphysema. These are real people who are just as
committed to acupuncture, if not more so, than people who pay more for it.
They just don’t happen to have a lot of money. If you make minimum wage,
$15 IS a lot of money.
You have an MBA so you must understand numbers. Have you looked at the the
income figures on any recent census? Only a tiny sliver of the American
population either 1) can afford to pay for acupuncture at market rates out
of pocket, or 2) has insurance that covers enough acupuncture to be
effective for any chronic condition. If acupuncturists charge market
rates, $75 to $100+ per treatment, they are targeting at best maybe 20% of
How do you reconcile your belief that acupuncture saves lives with
encouraging acupuncturists to charge prices that ensure that the vast
majority of people can’t afford it? I have news for you: when people are
sick enough to need acupuncture to save their lives, they are quite sick and
you are talking about a LOT of acupuncture. If someone has a
life-threatening condition, they need acupuncture twice a week at least for
an unlimited amount of time. No insurance company in the world will pay for
that. So are you saying that only rich people deserve to have their lives
The gentle, homeostatic nature of acupuncture means that it usually
doesn’t work fast. A lot of acupuncturists fail not only because they
don’t know how to market but because they don’t get good enough
clinical results to generate word-of-mouth referrals. They don’t get good
clinical results not because they aren’t good acupuncturists, but because
their patients are not getting enough acupuncture to DO any good. They
can’t afford to; they can’t come up with $75 to $150 out of pocket for
ten weeks in a row. I know a lot about how results generate referrals; six
years ago, I was treating twelve patients a week; last week, my clinic
treated 442 patients. I don’t even have a Yellow Pages ad. My clinic
employs six acupuncturists, four of them full time.
There is only so much room at the top of the economic pyramid. If you are
serious about doubling the number of acupuncture clinics in the US, you
need to come to terms with how acupuncture works (only frequent, regular
treatments consistently produce results) combined with the economic reality
of most people in America (almost no one can afford frequent, regular
treatments at market rates). The value of any form of health care is NOT
enhanced when people pay more for it. Your $1000 manual/$15 book analogy is
sadly applicable to the current healthcare system in the US. Any number of
studies have shown that healthcare in America is more expensive than health
care in other countries, and yet the actual quality is no better. The cost
of health insurance premiums has risen 75% between 2000 and 2008; do you
think all of the people who can barely afford health insurance now value it
more, or get more value from it? Your more expensive = better theory does
not work, not for healthcare, not for acupuncture, not for 80% or more of
potential patients, and not for acupuncturists who are trying to make a
living — unless those acupuncturists are willing to explicitly write off
80% of the population as not worth treating.
I’m hoping that you might be willing to have this conversation in public
because this is something that the acupuncture profession as a whole really
needs to come to grips with. I don’t have a problem with acupuncturists
who openly acknowledge that acupuncture at market rates is essentially
boutique medicine for an elite population of patients; they have a right to
run their businesses and select their patients however they want to. I do
have a problem, however, with the suggestion that pricing acupuncture out
of reach for most people is somehow the right thing to do, because more
expensive equals better for everyone. Lower price does not equal lower
value, not in everyone’s minds; suggesting it does is not only a great
example of classism, it’s part of how America wound up in our current
health care crisis.
And then we had this correspondence:
Interesting how you bring this up at the exact same time I just finished writing a post about the Sanborn Maxim. Sanborn Maxim states /“The customers who are willing to pay you the least will always demand the most.”
/(I just scheduled it to be posted May 16th)
About right now you’re probably thinking I’m even *more* classist than you thought. I can see how you would think that, and started writing a response. But I’ve removed it, because it would be better to save it for our discussion.
How about you post a reply after May 16th on the CAN blog? I hope you’ll include what you wrote below. We can have a back and forth discussion between blogs – referring to each other’s posts. Or would you rather do it another way?
By the way, Lisa, I grew to admire you while reading your book. I can totally understand why you’d be miffed (or at least concerned) with what I wrote – I actually thought about you while writing that part of chapter 2. I’ll look forward to discussing it with you.
first, sure, I will start the thread on the CAN blog on May 16th and link it to your post. Referring to each other’s posts sounds fine.
Second, wow, I now feel even worse than I did before. You a) read my book, b) grew to admire me (? ) and c) thought about me (?!) while writing that passage. And you don’t get that what you wrote is insulting, especially to my patients? You don’t realize that the exact argument you’re making in that passage is the kind of thing that kept me from even thinking about creating the community model for seven years or so — and is the argument that’s used against acupuncturists who practice community acupuncture in general? You don’t get that you are making my life harder? I was sort of hoping you had linked to my book and WCA by accident or something; knowing that you actually read what I wrote is really depressing.
I guess this will be an interesting discussion.
Also, one other thing – that part of the book was NOT directed at you or the CAN business model. I just realized the way I worded my reply might have come across that way.
I think it’s a great business model, and I hope it becomes much more common.
So here we go: www.acupunctureclinicmarketing.com
And for those of you who may be thinking, geez, Lisa, why do you bother with this stuff at all? I must say that I had the same thought — but since teaching a class at OCOM, I’m aware that the idea that” patients won’t value your services unless they are expensive”, is in fact alive and well, at least at OCOM, and that it really does stop some students from thinking critically about the realities of making a living doing acupuncture. So I thought it was worth a try.
Your comments, please!