Wednesday, October 9, 2013

Honora's Farewell Blog

“…won't you celebrate with me
what i have shaped into a kind of life?”
   –Lucille Clifton

Dear Friends and Colleagues,

It’s a little difficult for me to believe, but today I come to the end of my tenure here at Blue Poppy. The company is, I believe, in good hands to continue the work Bob and I began over 30 years ago to help our profession succeed. Though there may be things left undone, I surrender the weight of them to those who follow me!

I haven’t much more to share with you (after all, I’ve blogged and lectured and written continuously for that last decade and more), but I do want to thank everyone who has taken the time to read my books or my blogs or attend my classes, workshops, and webinars. I’ve been blessed to have a good career, most of the time doing things I enjoyed with people I liked. If you got a tip or two along the way that helped you be a more effective clinician or a more successful businessperson, I’m satisfied that it was not all just hot air.

Before I ride into the next sunset, I want to thank anyone and everyone who helped me in my career. So many kindnesses from colleagues who set up a class for me, bought a book, attended an event, or believed that what I had to share was valuable! Especially I want to thank my co-workers at Blue Poppy, without whom the work I did would have been impossible, not to mention lonely. I wish them all success and happiness; I’ll miss the collaboration and camaraderie.

Last, I’d like to thank my business and life partner, Bob Flaws, from whom I learned the medicine and whose tireless work for our profession is still the foundation upon which the edifice of Blue Poppy stands. His contribution cannot be overstated in my estimation.

Final thoughts. I believe that at the end of the day (or the end of our lives) we won’t remember much about what we owned, what cars we drove, or how much we spent on our wardrobe. (We’ll be lucky if we can remember anything at all if we live long enough!) The only things that will matter are who we helped, what we gave back, and how much we loved and shared in our short visit to this small and beautiful planet.

So please don’t be lazy, pay attention, share when and what you can, and smile, laugh, love as much as possible.

Happy trails,

Honora Lee Wolfe

Tuesday, October 8, 2013

Why Do Patients Leave Our Care Before They Got Better? Part #3

When patients have money issues, we may think there is no way to keep them in our practice. But perhaps we need to think more creatively about this. There may be several ways you can give these patients more affordable options so that they will keep coming. Here are a few ideas.

  1. Time of service discounts
Some practitioners only take cash for services rendered, which means that you have one price for all everyone. If, however, you are billing insurance or any type of 3rd-party payers, it is legal to offer a time-of-service discount or 10-15%. Why? If people pay you at the time of receiving services, you don’t have to do any further paperwork or send out any billing, which requires time and expense for your office. In that case, most states allow you to give patients who pay you up front a discount for making your life easier.
  1. Sliding scale payments
If you wish to go to the trouble, you can create a sliding scale similar to what is used by organizations such as Planned Parenthood, which charges fees based on your income-per-household. You may choose to require some type of proof for the discount, or take people at their word.
  1. Package deals
In Colorado, we are allowed to give package pricing, as long as there is a signed statement that the patient understands they can get any remaining fees returned to them if they discontinue services prior to using up the total amount. This is a good deal for patients and has the advantage of giving you a larger of income amount up front. Then it’s up to you to do such a good job that the patient wouldn’t think of leaving before all the services are rendered!
  1. Clinic “membership” discounts
One clinic I have worked with locally, offers a 15% discount for all services if you become a member of their clinic. What this implies is that the patient will get at least one treatment per month for being a member.
  1. Monthly payment schedule with a credit card
If the person says they can only afford $XX per month, but you know they need more treatment, they can give you a credit card to bill over however many months are necessary at an agreed upon rate per month. Get this in writing and signed by both you and the patient!
  1. Bill something to insurance
Does the patient have insurance and you have not explored whether they have acupuncture benefits? Insurance patients typically are willing to take more treatments more often than those who are paying on their own.
  1. Partial trades
Does the patient have a skill or service that would be useful to you? Explore what you could do outside the world of cash. You will be surprised at how often a patient could trade you something that you want or need outside the cash economy.
  1. Space treatments further apart
As a last option, you can suggest spacing treatment further apart, unless you think that will cause the whole treatment plan to be ineffective for the patient. You might also consider switching to herbs-only treatment if that is less expensive.

There are eight options for working with patients who complain about your prices or their inability to pay. You don’t always have to lose a patient because of financial limitations if you can be creative!

Final advice: There are lots of things you can do to improve your patient communication and education, clinic and business operations, and creative financial options, in order to keep more patients who walks in the front door from getting a couple treatments and then walking out the back!

Last but not least, maintain your interest and passion about the medicine and about helping patients heal! Keep learning and keep improving your clinical skills. Do your best with each patient, every time. Patients can feel that and instinctively know this! Make them believe they’d be crazy to be seeing anyone else!

Good luck and best success in your practice.
Thanks for reading.

Monday, October 7, 2013

Why Do Patients Leave Our Care Before they Got Better, Part #2

In the first installment of this blog, I wrote about patient communication and education. It’s my personal belief that everything about how we run our business is also a very powerful aspect of our communication with patients. As such it is more subtle, often non-verbal, communication which makes it more difficult to “teach” but possibly even more powerful than the things we write or say out loud.

What do I mean by office-operations-as-unspoken-communication? Pretty much everything! This includes things as diverse as how (and whether!!!) the phone is answered, how easy or difficult it is to get an appointment, the quality and ease-of-use-and-understanding of your patient paperwork, ease of finding your office, ease of use of your website, whether you run your clinic on time, your bedside manner, the lighting and décor or your rooms, efficiency of check in and check out process, to the cleanliness of the bathrooms. The better you do at all of these, the more satisfied your patients will be with your services. It might even make your treatments work better because all these things are part of placebo effect. Let’s talk about a few of these in more detail.

Phone communications

People in our profession who’ve heard me speak about business know that I have a pet peeve about how poorly we do, in general, with this service to our patients. Without whining too much let me say two things:
1. The lion’s share of the people who are making any serious money in this profession are not answering their own phones.
2. People expect that professional, “real” medical services will be open for business during regular hours. Nothing says dilettante or “playing doctor” more loud and clear than a message about how you’ll get back to them soon and their message is important to you.
3. If you were to become one of the clinics that has it’s phone answered every time someone calls, you’d be in the minority and you’d be more likely to be successful simply because you are open for business and people can get hold of you.

Efficiency of your check-in/check-out

People want to be greeted by a friendly face, sign whatever they need to sign, not wait too long to actually see the clinician, be able to get water or tea, pay their bill quickly and be on their way. Inefficient management of your reception services: no one there when they come in the office, paperwork that cannot be found or is not ready to fill in (best if they can download from your website), paper not loaded into the credit card machine, lights that don’t work, scattered and disorganized operations, running out of toilet paper or facial tissues, all these things indicate to people that the business is not well run. If the business is poorly run, how do they know they can trust any other aspect of your work (like your treatments, for example)?


In our world, people expect any type of medical office to be spotless. That includes bathrooms, carpets, walls, windows, equipment, everything. Period. This is really not optional.

Ease of getting an appointment

This goes back to phone service, but may also involve your website and email communications. If I want an appointment, but I want to ask you a question first, or I want an appointment today, I need someone to answer the phone or get back in touch with me within minutes of my leaving a message, or answer my email within an hour of when I sent it. If this is not happening in your clinic, you’re going to lose patients. People should not have to work at getting in touch or getting in to see you. In fact, landing on your treatment table should be in every way possible, as easy as sliding down a greased pole and landing on it before they knew what happened!


There is an entire chapter on this subject in Points for Profit, but just to reiterate, the basic idea for décor in your clinic is one of a few options:
• either knock the socks off your chosen niche of patients, or at least make them feel that the entire place is “all about them” in some way.
• go for a classy, simple, appealing to everyone haven where anyone could relax and be comfortable
• make your space very community oriented, with bulletin boards, announcements about your volunteer activities, offer your space for community meetings, food co-op pickup and drop-off, and generally make it homey in a community oriented way.
No matter what else, keep it clean, clean, clean.

All the above things go into making sure your business approach is patient centered and totally easy and comfortable to interact with. Make sure these are NOT reasons why patients stop care before you decide, together that it’s time.

Next time…Part 3 of this blog: What Payment Options can you offer your patients so they don’t quit for financial reasons?

Friday, October 4, 2013

Why Do Patients Leave Our Care Before They Got Well…and What Can We Do About It? (Part 1)

We’ve all had it happen. A patient comes in once or maybe even a half dozen times. Then they break their next appointment or don’t make one at all and never come in to our clinic again. They don’t return our calls or emails.

What happened here? Of course there could be many possibilities and it may have nothing to do with you at all. But chances are it comes down to a few things we could all do differently to lower the number of disappearing patients. Here are my ideas on this subject and I hope they resonate with you or offer you some food for thought.

I believe most patient disappearance comes down to three things: poor office-patient communication and education, poor business and office management, or inflexible pricing and payment options. Here are some ideas on how can you improve?

Improving office-patient communication and education

To keep a patient for the long haul, we need to do our utmost to make sure that patients see, hear, and understand all our communication with them. Firstly, this is important when educating patients about the necessity of getting a full course of treatment, however many you believe are required to get the patient well using acupuncture. With herbal therapy this may translate into how many weeks or months of herbs you believe they will need to take.

Secondly, signage in your clinic can go a long way toward explaining things about our medicine as well as what you specifically offer to patients and to your community. You can and probably should have “did you know” type signs about various conditions that you like to treat. For example if you like to treat insomnia, a simple sign that says “Did you know that sleep disorders are the most common diseases in the US today? Acupuncture and Chinese medicine can provide quick and effective help for many patients who suffer with sleep disorders. Ask for information for a friend or family member today.” can be effective at educating your patients about the broad scope of conditions that you can treat and about which they did not know. Also, signs that offer your services as a speaker for your patients’ groups and affiliations, signs that let patients know about your volunteer activities, and signs that offer free or reduced price treatments in exchange for participation in a fundraising or volunteer activity all let your patients know that you are a community participant and care about something before your front door. All this kind of information all should be on your website or company Facebook page.

Third, your written educational materials should be easy-to-read and understand. Be wary of using the word “qi” when speaking to patients or writing educational flyers or website copy. We are not even able to translate this word accurately into English. I suggest discussing ideas that Westerners can understand, like balancing your nervous/endocrine/ system, improving your immune response, engaging the body’s innate ability to heal itself, improving organ function, helping the body overall back to proper homeostasis, as better approaches to helping patients understand something about what we do. Always write copy for brochures and your website for the first time reader who knows nothing about acupuncture and Asian medicine.

One friend of mine always schedules an extra 30-45 minutes into her first appointment with a patient. This time is spent allowing her and her patient to get to know each other a little, doing extensive and planned patient education, as well as making sure the patient understands and agrees to a specific financial arrangement with the clinic. In her case, that may mean having her assistant check on insurance benefits while she is working with the patient, it may be creating a payment plan or agreeing on a treatment schedule that will work clinically but also be workable for the patient’s budget. She loses very few patients before their care with her is complete. She says her goal is to keep every patient for life.

Finally, I suggest bonding calls and reminder calls (or texts or emails), as well as semi-regular email and snail mail communications. A bonding call is done within 24 hrs of a first appointment and treatment. It allows you to answer any questions that may have come up in the patient’s mind, reassure them that you are there for them and really concerned about their care, and allows you to nip most problems of perception or misunderstandings in the bud very quickly. Reminder calls or texts are self-explanatory, but they will cut down your no-shows and most people appreciate these. (Who among us has never forgotten an appointment just because of the busy-ness of life?) You can use an opt-in email newsletter to stay in touch with patients, but mostly make this type of communication about cool things you are doing in the community (especially if they can participate), classes you are offering, the discount of the month, a book review, a video of you teaching a seasonal qi-gong exercise or preparing your favorite seasonal recipe. Think fun, light-hearted, community-centered. 

As for snail mail, I think the best use of it is to send a birthday or “thinking of you” card now and again, but one that has a specific, hand-written message in it instead of just signing your name. For example, “Dear ____, Here’s hoping this card finds you well and thriving. I saw that your birthday is coming up and it occurred to me that I recently attended a seminar where I learned a new type of treatment for your condition. If you ever have a recurrence of symptoms and would like to discuss it, please don’t hesitate to give me a call. Meanwhile, stay well and enjoy your birthday.  PS. Did your son get into one of the colleges he had applied to?”  You get the idea here. Keep it friendly, short, and specific to their life in some way.

There are many more suggestions about effectively managing patient communication in Section 2: Chapter 13 of the new and updated edition of Points for Profit (10/2013)

Next time…Part 2 of this blog: What Does Your Office Management Communicate to Patients?