What to do about the disappearing patient?

We all have the experience of a patient who comines in once or twice and then never makes another appointment or does not show up for one that was already scheduled. It may be that you "cured" them in a couple sessions, but it is more likely that something in your new-patient procedure needs improvement or your bedside manner did not meet their needs on that day. When this happens to me, I try to reach that patient and learn from them what could have been done better or what did not work for them. This may be difficult in that they may be embarrassed to tell you what was wrong with their expeirence or they may not really be able to articulate it. They may not return you rmessages or emails or, if they do, they may just say "they could not afford any more appointments." However, if you can get them on the phone, I suggest the following approach that may disarm them enough to actually try and tell you about their experience of your clinic and your care. This can be painful if they are critical, but how can you improve what may need to be improved if you are unwilling to hear it?
Hopefully, you've already done a standard bonding call with the patient. If you have, you hopefully have some idea of how they responded to the first visit to your office. If you did not do a bonding call, this could be the first thing you need to add to your procedures. This is discussed at length in my book (link below) and in my upcoming, revised course on practice success (available early 2013).
In any case, first ask them how they are doing, how are their symptoms in comparison to when they came to see you. Tell them you were sorry that they did not return again and you wanted to know if their experience was not everything they expected it to be or hoped it would be. Tell them you'd be happy to assist them in finding anothe rpractitioner or another type of service to solve their health problem if your services don't seem to be a good fit. Such caring should disarm, to some extent at least, their embarrassment or discomfort at speaking with you.
Then explain to them that, as a health care practitioner, it is your responsibility to close their file with some "release from care" and you need to know that they are better or have determined another way to manage their problem.
Depending upon how they respond to this, ask if they have any advice about what you or your clinic staff could have done better or differently that would have allowed them to make the decision to return for further treatment. Then them for tring Chinese medicine or acupuncture care and assure them that, should they have further problems or questions about their health, you would be most happy to hear from them again and help them if you can.
This is a class act, and anyone that you'd really want to have as a patient will recognize it. Some may even reschedule on the spot. But even if they don't, tell them you will put them in your inactive files and consider their record closed for the present time but that any other practitioner of any discipline is welcome to request a copy of their file if it would be helpful in their future care.
If you are lucky enough to get advice or a complaint, do your best not to be defensive. Listen carefully, take notes, and decide if their statment is valid in all or in part and if there is anything you can do to improve in whatever area(s) they bring up.  Thank them for their honest feedback. Then discuss what they tell you with your staff or partners (if you have any) and try to find a way to respond that is workable for you.
If the patient really wanted to continue but money became an issue for them (this has happened to many people in some parts of the country), are their ways you can work with them? Do you have time-payment plans, community-style-clinic days, time-of-service or other discounts, package payment deals, or any other way to help them so that you don't just walk that business out your door? If you don't have any financial flexibility, maybe it's time to consider a few creative financial options for your patients.
If you follow this procedure with every dropped patient and listen carefully to any advice you receive, my experience is that the numbers of "disappearers" will decrease with time. Because of your forthright honesty and caring for them, some of the people you contact are likely become patients again when some other health condition presents itself.
I'd like to hear any feedback anyone has on this issue, as I know it is a real bugaboo for many acupuncturists and I believe there are creative ways to work with disappearing patients. Meanwhile, good luck, best wishes, and thank you to all my readers.
This article is excerpted and adapted from Points for Profit: The Essential Guide to Practice Success for Acupuncturists
Watch for Honora's revised and updated online course on Practice Success, coming in early 2013.

Moxibustion for Longevity and Health Preservation

by Honora Lee Wolfe, Dipl.Ac.

The Chinese have been researching various anti-aging and life-extension strategies for several millennia. One of the most enduring methods that is still agreed upon today throughout various Asian cultures is moxibustion at several points on the body, used at specific times of year and in varying amounts depending upon one’s chronological age. These practices were first promulgated in writing by a famous doctor from the Three Kingdoms period [220-265 AD] named Ge Hong. Other doctors throughout the history of Chinese, Korean, and Japanese medicine have written about various longevity moxa protocols. I will share several of these protocols in this article.

Moxa on Zu San Li [St 36]

Zu San Li [St 36] is arguably the most important and therapeutically reliable acupoint on the human body. Depending upon one’s source material, this point has potentially scores of uses. In the Song dynasty, a doctor named Zhang Gao taught that “to be sound [of body], San Li should always be wet.” The implication here is that one should raise a moxa blister on this point on a regular basis by burning a large cone of moxa directly on the point, all the way to the skin. In Zhang’s protocol one used direct, suppurating moxa at both equinoxes and solstices, as well as the “beginning” of each season, which in Chinese culture takes place approximately 5-6 weeks prior to each solstice and equinox, which occur at the exact middle of the season in question. One can find out the beginning of the seasons by knowing when Chinese New Year occurs. Then count the number of days from Chinese New Year, which is the beginning of spring in Chinese culture, to the Spring Equinox. Take the same number of days forward from the Summer Solstice and you have the beginning of Summer. The beginning of each season can be calculated in the manner. Books such as these include many anecdotes of healthy centenarians who maintain acute hearing and sight and are still working, free of disease and debility.

Another source encourages moxa on San Li with direct cones the sized of a grain of wheat from day one to day eight of each month. This text does not say how many cones to use, but Korean texts would suggest between 7-10 small cones on each side.

Moxa on Qi Hai, Guan Yuan, or the Dan Tian

In his Qian Jin Fang (Prescriptions [Worth] a Thousand [Pieces of] Gold, Sun Si-miao of the Tang Dynasty, suggested the use of Qi Hai [CV 6] for supplementing the original qi to nourish life and promote health. In another source from the Song dynasty, Dou Cai suggested one should moxa Guan Yuan [CV 4] with 1000 threads each year between summer and autumn. While it is not clear exactly how to perform this protocol, there are so many variations from different doctors, there is nothing wrong with simply making up a protocol that works for you or your patients. For example, one could start in mid-August using 20 small wheat-sized cones each day, continuing through the end of September. That would total somewhere between 900 and 1000 cones. These may also be done directly on the skin, or on top of slices of fresh ginger root.

A modern Chinese moxa expert, Liu Jie-sheng, suggests alternating these two points, using Qi Hai at the Beginning of Spring and Guan Yuan at the Beginning of Autumn. He performs moxa on slices of uncooked ginger punctured with several holes, about 30 cones each time for 10 days in a row.

The Dan Tian is believed to be a three dimensional space in the lower abdomen, located approximately between these two acupoints, Qi Hai and Guan Yuan. The Dan Tian is thought to be “the root of the human body in which the essence-spirit is stored.” Thus using moxa on the Dan Tian can warm and nourish the original qi, invigorate essence-spirit, and protect the root of life. Since the location of this area varies from source to source, one may achieve the same result by using either or both of the two acupoints in this area of the abdomen.

Moxa on the Umbilicus or Shen Que [CV 8]

This point, while forbidden to needling, is considered an important point for moxibustion. In this case, one usually uses a slice of fresh ginger root with small pinpricks in it upon which to place moxa cones. Alternately, one can use a mugwort roll and moxa indirectly.

It is also possible to fill the navel with salt and place cones of moxa on top of that. However, because salt conducts heat very well, one must be careful not to cause a burn in this case. Another source suggests making a paste of warm medicinals ground into a powder, such as rou gui and fu zi, and placing moxa on top of the paste. This last method may be used to enhance immunity in the elderly. A schedule for doing moxa on this point was not mentioned, but one could use a schedule similar to those listed above, such as 300 cones over a period of 15-30 days.

Moxa on Gao Huang Shu [Bl 43]

In early Chinese medical literature, it is often stated that needling on this point is not effective and that only moxibustion could “reach” this point. That suggests something that I have yet to mention in this article, which is that moxibustion is a more powerful treatment than acupuncture using a regular filiform needle.

While regular cones of moxa may be applied directly to this point or over ginger slices for a variety of diseases such a chronic lung infections, generalized aching and pain all over the body, it is also sometimes treated with a paste of Bai Jie Zi (Semen Sinapis Albae), which is slightly irritating to the skin similar to a mustard plaster. When this technique is practiced at the height of the summer heat (July), it is thought to prevent lung disease from occurring during the following winter by boosting immune functions.

If you are not using moxibustion techniques in your practice or for your own health, I highly recommend them. Moxibustion is one of the most powerful tools in Chinese medicine, and is not used as often as it could be for our patients’ benefit.

Much of this information was taken from two sources, A Study of Daoist Acupunctureand Moxibustion by Liu Zheng-Cai, and Classical Moxibustion Techniques in Contemporary Practice, by Sung Baek [Out of Print], as well as the author’s personal clinical experience. To develop a much deeper knowledge of moxa and a wide variety of moxa techniques, check out Lorraine Wilcox's course, A Hands-On Moxa Workshop...which has lots of video and photos along with all her info. Great class!

Money is a Form of Qi!

Money is A Form of Qi!!

by Honora Wolfe

Family Money Traditions

Every person receives a whole variety of messages about money as children. This “information” can cloud our vision where our finances are concerned and keep us from having a healthy relationship with the green stuff that we need to be successful business people.

Here are a few of the most common messages about money:

“money doesn’t grow on trees”

“money is the root of all evil”

“money makes the world go around”

“do you think I am made of money?”

“you have to work hard to have money”

“you need to marry a rich spouse to survive”

Sound familiar?

Because money is such a survival issue, these messages get imprinted deeply within us and can control us unconsciously all our lives, often to our detriment.

Each of your parents probably had a different money “style.” Each of these has good and bad points in how they handle money…and what you internalized as a child. How has this affected your professional life and relationship with $$?

Were your parents:

Worriers (always obsessed with all the bad things that could happen)           

Monks (money is bad, embarrassing, causes anxiety, and to be avoided)

Gamblers (always risking the family assets one way or another)

Amassers (love to have more…but not for any particular reason)

Overspenders (shopaholics)

Avoiders (“I won’t think about this now, I’ll think about it tomorrow.                                                                     

This person never balances their checkbook!)

Hoarders (Like to count their money, but don’t like to spend it.)

My Relationship to Money

Take some time to think about the questions listed below. Write down your answers. Written messages to yourself have great power.

1. What messages about $$ did you receive as a child?

2. Did your family have traditions about $$, work, spending, saving, and/or investing that you are adhering to or departing from in your life and how well is that working for you?

3. How have those messages affected your relationship with $$ as a professional for better or worse?

4. What one thing would you like to change about your relationship with $$?

5. How would that one thing improve your professional life?

What is Money?

Basically, money is a form of energy exchange. We have decided what is of value in our culture and we exchange our time and our energy in lesser or higher amounts to get what we want.

If we think about money as a form of qi, this may help us to revise our thinking and our relationship to this vital part of our life.

What do we know about diseases of the qi?  There are two basic things that can go wrong in the body (or in the universe) with qi.

            1. Not enough

            2. Not flowing freely

So it is with money, too. If we remove all our value judgments about it, we need it in adequate amounts and we need to keep it flowing freely, as long as it is the basic form of human energy exchange that is currently in use.

However, if you have unnecessary internal “judgments” about money in your bodymind, it may be difficult to maintain #1 and 2 above. For example, if your money style is hoarding, it will be difficult to maintain the free flow of it in your life.  If your money style is an avoider or a monk, it may be difficult to ever have enough money because the money makes the avoider nervous and it makes the monk feel guilty.

Assignments:

1. Worriers: Give yourself the assignment that for one day per week you will not think about money and not worry about it. Then do your best to follow through.

2. Monks: One day per week buy a small thing that you don’t need and see what comes up.

Examine feelings that arise and see if they have any reality or not. Where do they come from?

3. Gamblers: Take a look at all the ways that you gamble in your life. Are there ways you can get

the same thrill that don’t involve the use of money? (People with serious gambling problems

need to join Gamblers Anonymous!)

4. Amassers/hoarders: Consider your reasons for enjoying the collection of money for its sake

alone. Could you replace that satisfaction by collecting friends, good works, or climbing ‘14ers?

5. Overspenders: Create a budget (or should we call it a spending plan?) for one month. Put in a

line item for clothing or other discretionary spending and stick to it.

6. Avoiders: Spend one afternoon each week or every other week balancing your checkbook,

creating a budget, or organizing your finances in some way and see how that feels.

These are just suggestions. You might think of other personal “assignments” that feel more to the

point. For me, even the acknowledgement of my money “style” helps me keep it from hurting me

(and those who work with me!) as a business-person because it no longer resides only in my

unconscious. I highly recommend this exploration.

For more help getting to the bottom of your own money issues, there are many books on this

subject. One good one is The Money Mirror by Annette Leiberman.

http://www.amazon.com/Money-Mirror-Reflects-Womens-Desires/dp/1880559412/ref=sr_1_5?s=books&ie=UTF8&qid=1319490591&sr=1-5

Improve Your Response Rates in Email Marketing

Yesterday I listened to a one-hour webinar on effective email marketing from an email/online advertising company, Pinpointe.com. The webinar had two themes:

1. Avoiding spam filters and improving your odds of making into your potential customers’ inboxes (the more technical part of the presentation) and
2. How to get people to actually read and respond positively to your emails (the more writing skill part of the presentation).

Below is a précis of their presentation…at least the parts that I think are relevant to our market.

Stay out of the spam filters!
In order to do this, stay away from specific words in your Subject Line and in the email in general:

1. “Dear Friend”
2. “Dear (name of client)”
3. “Amazing Results”
4. “Call Now”
5. “Buy One Today”
6. “Guaranteed Results”
7. “Make her happy tonight”

You get the idea here. Keep your subject line short and relevant. If your emails start getting trapped by spam filters, pretty soon the ISO companies tend to put ALL your emails into the spam box, or, worse yet, delete them and not send them on at all.
You can test your email before sending it to see its “spam quotient” (which ideally is lower than 2.0) by testing your email before you mail it at: http://spamassassin.apache.org/tests_3_3_x.html

Clean up your email list
If you are getting bounce-backs for dead email addresses, remove them from your list promptly or get your email provider to remove them if you are not doing this yourself. Over 1-2% hard bounces are a red flag for ISO companies. A positive number for bounce backs is less than 1 per 2000 emails.

Once you get into their inbox, how to you get people to read them?
First, remember their reasons for subscribing to your newsletter, blog, or email service in the first place and keep your content relevant to your customers’ interests. The main reason that people subscribe to any email service are:

1. Discounts
2. Special promotions
3. Regular customer of the company
4. You offer some exclusive content
5. You are a non-profit that they support regularly

Second remember why people do or don’t open an email. They open it it:

1. They recognize who it’s from
2. What is in the subject interests them

They don’t open the email if:

1. You send too frequently
2. They get too many emails in general
3. They don’t remember that they signed up with you
4. They are no longer interested for whatever reason

So that means you have to…..

Write good emails!
The most important part of your email is the subject line. As many as 80% of people will read the subject line, but only 20% will read the whole email. Also, 60% of spam complaints to an ISO are based on what’s in the subject line! That means you should spend as much as 50% of your time crafting your subject line and 50% writing the rest of the email!
Then in the body of the email, write a short intro/salutation. As early as the first or second sentence, put in your first “call to action.” In other words, tell them as immediately as possible what you want them to do (buy your services, come to your event, download your free ebook, etc.). This means there is an obvious button or words for them click on right there at the beginning.
Last is your signature with your physical address (makes your email legal) AND a PS with another call to action live link. For example, something like: “Thanks for reading my email, Check this product out today” or “Download your copy now.” Research suggests this second call to action link is the second most clicked-on item on your page.

Who is this from?
In the “sent from” field, it’s best if it is your name…not just the name of your clinic, for example. This means you are more likely to create relevant content because your name will be on it! And it makes it far more likely that you escape the spam filter and that your reader opens the email. People are wary and want to see emails sent from a valid address that they know. Even if this is a “POP” address and the response goes to your front desk staff or wherever…a real person they know is better than info@.....com or donotreply@...com

Use of space
Put everything necessary for a response above the fold. Make the opening sentence stand on its own and tell enough of the story for them to be interested. Tell them the 3-second version of the story, plus a “Click here to___” button.
Make sure you have an “Unsubscribe” or “Safe Removal” button at least at the bottom…but at the top of the email as well is courteous and reduces spam complaints down to almost nothing.

Images
They may look cool in the design, but large images increase your spam score! Avoid them or use sparingly. They suggested using text-to-tag images (words inside the picture box telling the viewer what the picture is), because 70% of your recipients will have images blocked as a preference. If you have a coder helping you design your emails, tell them to code your images as if it were 1999. For example, Outlook ’07 does not support background images, forms, flash, java script, and heaven knows what else. Keep that stuff to a minimum.

Final suggestions

1. Keep your subject line short. Research says the best length in 30-45 characters (which includes spaces between words)
2. Keep the width of your emails between 600-800 pixels
3. Keep your emails short and to the point
4. Run them through a spam checker if you can
5. Don’t put the recipient’s name in the subject line
6. Put your call to action in the first paragraph and again at the end
7. Don't send more often than once per week. Too many emails is the #1 reason for “Unsubscribe” responses.
8. Don’t send because you think you should. Wait until you have something useful to say to your subscribers!
9. Don’t sell, rent, or give away your emal list; remove bounce-backs and unsubscribes promptly.

Best of luck and I hope these tips help you with improved results in your email marketing. To get professional help, take a look at all the blogs, ideas, and services at www.pinpointe.com.
Click here to get Honora’s marketing ebook!

Your Phone is STILL a Marketing Tool!

by Honora Lee Wolfe

Today I had a discussion with my son about the relative merits of voice mail vs. text messages. He’s right, I need to give it up and learn to use texting if I want to stay in touch with him. That said, although I am trying to march bravely into the 21^st century where technology is concerned, I still believe that we need telephones and we need to use them wisely to be successful. Here are notes from a recent lecture I gave about the importance of your telephone. While it seems like a no-brainer to me that our phones should function like any professional medical office, my experience is that at least 80% of acupuncturists rarely answer their phones! When I call an acupuncturist's office during working hours and all I get is an answering machine, my response to this is always "really?"..."I mean, come on folks!"  "Can't we do better???" "

My belief is that we could do better and that the practitioners who are making the best living made a decision early in their careers to hire someone else to answer the phone for them, promptly, intelligently, and courteously between 9 and 5! If we want to have "medical parity" in terms of respect and public expectation, this would be one good way to move in that direction. So...here are my suggestions.

Staffing your phone
If you cannot always answer the phone, create a way to get your messages as instantaneously as possible:

• Answering service, buzzer on your belt, pager, check messages once per hour, MyReceptionist.com
• Make a short-term goal to have someone answering your phone within a year. I guarantee you will make more money and there's plenty of other stuff this person can do to help you grow and manage your practice! For a laundry list of ideas about that, see page 205 of the current edition of Points for Profit: The Essential Guide to Practice Success for Acupuncturists

Inbound calls: Make the number easy to find.

• Your phone number should be on every piece of written material that goes out your door
• You need to write down what you or your receptionist will say when people call. How do you want your phone answered? Don't let someone else determine this for you!
• What are the most common questions prospective patients ask and how will you answer them? (This could also be used as an FAQ on your website and a handout in your presentation folder).

Inbound calls: Answering the phone

• Speak clearly, slowly, and smile when you answer the phone (People can hear it.)
• Return calls promptly
• Better yet, answer your phone every time!
• “White Crane Clinic, this is Joseph, how may I help you?” Or…“Thank you for calling White Crane Clinic. How may I help you?”

Inbound calls: Answering questions
People ask pretty predictable questions, so write down how you want to answer the most common ones. You’ll sound more intelligent and your receptionist will thank you!
• Do you do acupuncture? (Of course you do, but what other services?)
• How much does it cost for a treatment?
• How many treatments will I need?
• Can acupuncture treat my________?
• Do you have experience treating ____?
• How often will I have to come in?
• Are there any discounts?
• Can you bill my insurance?


Inbound calls:  When patients have problems
How will you answer these types of question? My thought is not to be defensive, listen carefully, don’t panic, be honest, and have a plan in advance. (Such as having them come back in, offering a liniment to help with any bruising, reviewing their chart to see if you missed something…but generally going TOWARD the problem and not stonewalling or running away from it.)
• “Hi, this is ___ and I was in yesterday. You gave me some herbs…well, I took them last night and I couldn’t sleep. So I stopped taking the herbs. What do you think I should do?”
• “Hi, this is ___ and I was in this morning. Well, I have developed a bruise where you needled me. It’s kind of painful and I need to know when this will go away.”

Outbound calls…
• Bonding call: “Hi, this is Joe from White Crane Clinic. We like to call our new patients within 24 hrs of your first visit to our clinic to see how you are doing, if you have any further questions, and what your response to the treatment was.”
• Reminder calls: A call/text message/email the day before every single appointment cuts down on patients forgetting or blowing off their appointments by 50% or more!

Outbound calls: To research the reason for a disappearing patient
• Hello, this is Joe from White Crane Clinic. We noticed that you had cancelled your last treatment and haven’t rescheduled. We were wondering…..
- if there was any problem
- if you are all well
- if there is something we could have done better
- if you’d like to try a different type of therapy that we offer

Outbound calls:  To request referrals
”Hello, this is Joe from White Crane Clinic. I recently sent you a letter about my specialty acupuncture practice in sports acupuncture. I wonder if you’ve had time to read it. At present, I have a patient who needs something other than what I offer and I may wish to refer them to you. Do you have time to chat for a few minutes, or could I visit you at your clinic later on this week?”

The Telephone is not dead!!!
•  People like to speak with a real person
•  People like to feel heard and understood
•  Really using the phone effectively is a way to set yourself apart in our profession!
•  Use the phone effectively and not jst 2 txt ppl or chk eml or whtevr.
•  Remember that many patients are boomers and they, at least, still like to talk on the phone! For most of the above uses, a real voice is better than a text message.
To check out my video on the above topic, click here: http://www.youtube.com/watch?v=b_dXVu2bZhY&list=UUlUh7FwkY04rwqWzOnJQX3Q&index=12&feature=plpp_video
For more marketing articles see this blog archive or check out my book, Points for Profit: The Essential Guide to Practice Success for Acupuncturists.

So you think you want to start a blog???

Here's a link to a good article on being a blogger and whether it's a good way for you to promote your practice...cause once you start you have to do it regularly. Even someone as prolific as I am struggles with the requirement for regularity and consistency. This article is worth reading if you are sticking a toe in that water.
Enjoy

http://netprofitstoday.com/blog/is-blogging-right-for-you/

Hand Strength and Walking Speed Correlates to Fewer Strokes (and a stronger spleen?)

Surfing the internet health news is actually a pretty interesting way to spend a morning. Everything from how our culture sabotages children's health to a controversy over people taking anti-depressant drugs for grief to this gem of a research study that I found quite interesting from a Chinese medical point of view.

In this study, more than 2,400 men and women with an average age of 62 underwent tests for walking speed, hand grip strength and cognitive function. Brain imaging studies were also performed. During the follow-up period of up to 11 years, 34 people developed dementia and 70 people had a stroke. The study found people with a slower walking speed in middle age were one-and-a-half times more likely to develop dementia compared to people with faster walking speed.

Also, strength appears predictive among older individuals as stronger hand grip strength was associated with a 42 percent lower risk of stroke or transient ischemic attack (TIA) in people over age 65.

So how can we interpret these results from a Chinese medical point of view? I was immediately reminded of some statements of fact from Bob's book by that title, "...in the elderly, blame the spleen," and "when the qi is strong, it is able to control the blood and prevent its spillage externally from the blood vessels." If we remember the various functions of the spleen qi, these include the strength of the muscles and the ability to feel energetic, strong, and lively, manifesting as the benefits of healthy post-natal engenderment of qi and blood.

Here is a wonderful quote that describes exactly what this research showed from Aging and Blood Stasis: A New TCM Approach to Geriatics, a book by Dr. Yan De-xin, one of the most famous and effective geriatric medicine specialists in China.

The four limbs receive their qi from the stomach. Sometimes, the spleen qi does not reach the channels due to a disorder of the spleen. As a result,it cannot move the fluids and humors of the stomach. The four limbs thus do not obtain qi from water and grain. Hence, the qi is gradually weakened. The circulation of the [blood] vessels is not smooth, and the sinews, bones, and muscles all lack the qi to exist; so they cannot function well.

As a clinician, what this suggests to me is the importance of doing anything I can to help my patients maintain the strength and health of their spleens, whether this be through acupuncture, herbal supplementation, tuina, dietary therapy, and/or exercise suggestions. And now we have a Western medical research study that supports the importance of these efforts!

This research also corroborates the power of Miriam Lee's Great Ten Needles approach to treatment and her belief in Li Dong-yuan's idea that truly accurate five-phase theory would be visualized as a cross, with the spleen and stomach right in the middle of both health and disease in our many of our patients.

Have a great , everyone.

Chopping Wood and Carrying Water Amidst Mayans & Dragons

Many of us have seen and heard warnings and portents for this year…even a disaster movie called “2012” came out recently. But who of us can really know if the Mayans have their timing right? At the turn of the last millennium and many other times in history there were predictions about the end of the world as well, and yet here we are, still.

But if these were really end times, would you change what you are doing today or your plans are for the coming few months? Would you give everything away and go into a meditation retreat or get a non-stop party started? Would you take that trip with your spouse to Fiji that you’ve always dreamed of, embark on a quest, apologize to your worst enemy, start a non-profit foundation, or…would you simply keep treating patients, taking care of your family, doing your best to live well each day?

Since none of us know the day our own personal Armageddon will arrive, it’s probably not a bad idea to think about these things, Mayan predictions notwithstanding, and live accordingly as much as we are able.

Not to wax too philosophical or lose my sense of humor, here are some of my personal goals in 2012…and hopefully beyond.

• I will make a new friend and reach out to at least one person I’ve not heard from in years. Why not?
• I will deal with real problems that crop up as best I can, but not carry around worries and fears about imagined ones. It's usually hard enough to deal with what actually does happen much less what could happen!
• I will take time for some exercise each day. It makes a difference no matter what else is going on.
• I will start each day with the most important things that need to be done.
• I will try harder to be courteous to everyone…it costs nothing and makes people happy.
• I will take on at least one technological learning curve in 2012 (since many of them don't last more than a year anyway). Yikes!
• I will tithe regularly. What goes around does come around.
• I will be up early enough to greet the sunrise more days than not. I read somewhere that if you get up 1/2 hour earlier each day, you get an extra 7.5 days per year. I could use an extra week here and there, couldn't you?
• I will reduce my personal possessions/projects/clutter by 10% or more by the end of the year. Whoa!
• I will remember to be here now. If I’m not here now, sure as shootin’ I won’t be there then!

I’ll let you know how I did a year from now if we’re all still here!

Whenever the world ends for you, what do you want to know that you did-learned- shared-gave-loved-created-released to the best of your ability? Don’t wait! Don’t die wondering! I wish everyone a happy, productive, meaningful, fun and funny, lively, bubbly, zingy, roaring, powerful, and best-year-ever Year of the Dragon! Visit me on Facebook, too!

Solving the 5 Most Common Marketing Problems

1. “We’re a small new clinic and don’t have the budget to compete with the established practices…but we know that we’re good at what we do.”

Much of your best marketing can be done on a very low budget. Giving talks, writing articles and blogs, Tweeting and Facebooking, or simply volunteering with groups of people in your community cost you nothing but time, which at the beginning of your practice you probably have more of than you’d prefer! Brochures can be purchased cheaply or created and printed out on your color printer in small batches for a few cents apiece. Do spend the $50+ it costs for 1000 nice business cards and don’t go anywhere without them. Remember that the ability and willingness to talk to anyone and everyone about what you do and to hand them a card with a smile is some of the cheapest and most effective marketing you can do.

2. We’ve never done much marketing before…and now we need to implement some kind of marketing plan.

Regular marketing activities must be built into your schedule. In other words, make appointments with yourself, write them in pen (or digitally) in your calendar, and keep them no matter what. What will you do during those appointments? Start with creating a description of your perfect patient (musicians, climbers, golfers, lawyers, mothers with babies, people who want facelifts, etc.). Where do these people hang out? What publications do they read, what clubs to they join, what websites do they frequent, where do they volunteer? Whatever the answers to those questions are should suggest the first steps in your marketing plan. If you can speak or if you can write or if you like to play golf or play music or climb mountains, do those things for and with the people who are your “perfect patients.” Each appointment with yourself represents time to write those articles, participate in those clubs and volunteer activities, make phone calls to organizations needing speakers, create a blog and the subsequent required Twitter and Facebook and LinkedIn posts, find and sign up for a Health Fair booth (and create the plan for that event), or write a brochure about your specialty. Keep track of which activities actually produce patients and do more of them as much as possible.

3. We have more & more competitors popping up and grabbing our patients…and making it hard to distinguish our clinic from the competition.

Write down a list of all the ways in which your clinic, services, and skills are different from everyone in a 10-mile radius. Have you been in practice for many years? Do you have an easy-access parking situation? Are you on a bus line? Do you offer a specialty in your practice? Do you have a brilliant bedside manner? Do you have a children’s play area, great research files for your patients, offer classes, dietary counseling, reflexology before treatments? What else? If you cannot think of anything, write a list of how you’d like to distinguish yourself and what it would take to make that happen? Then, when you do public talks or write marketing copy for ads and brochures, emphasize these differences. If you want your current patients to know every way in which your clinic is different from others, make a small “Did You Know?” poster or flyer and post it in the bathroom.

4. We’re getting killed on price by new, young practitioners who are offering lower priced services.

Remember that many people don’t make decisions about their health care based on price! Studies done on almost any type of product show that people do not usually go for whatever is the cheapest; they go for what feels like the least risk. How do you lower people’s risk? First, by doing the best professional work that you can do, day in and day out. Second, by participating in your community because people like to buy products and services from those they know and trust. Third, by running your office like a well-oiled but human and humane operation. Fourth, make sure your patients know you want and appreciate their referrals. You can even put a short statement on the back of your card that says something like “The greatest compliment you can give me is the referral of your friends and colleagues. Thank you for your business.” Then charge what you need to charge to live your life both with integrity and with fairness to yourself.

5. We’ve spent a ton of money on advertising and marketing, but don’t seem to be getting much bang for the buck.

Remember that few of us choose our healthcare providers based upon ads in the paper. It is a far more effective strategy to give talks, teach classes, write articles, join organizations, be a volunteer, or even start a blog. Such activities make you a de facto “expert” and are far more likely to bring you patients than buying ads. If you want to spend money on marketing, web-based marketing on every health-provider listing service you can find and having a simple, easy to find website (with good Search Engine Optimization) is a better expenditure of your money.

For many more ideas on marketing your practice, see Points for Profit: The Essential Guide to Practice Success for Acupuncturists by Honora Lee Wolfe, Eric Strand, and Marilyn Allen, from Blue Poppy Press as well as lots of FREE articles on my blog at www.bluepoppy.com.