Another Take on the Fees Issue
Posted June 22nd, 2008 by Lisa Rohleder
Dan Clements of the Alternative Health Practice Blog sent me an email saying that he had put up a post titled "7 Ways to Make Peace with Your Fees" in response to the dialogue that Burton Kent and I had. I like Dan and his writing, so I went and checked it out, and then it got me thinking. And I'm wondering what you all would think. Note: this is an acrimony-free conversation so far, and I'm pretty sure it will stay that way -- so all of you who are tired of fee- related acrimony need not fear.
http://alternativehealthpractice.com/2008/06/7-ways-to-make-peace-with-y...
Great blog and comments.
Should be part of CAN 101.
Thanks!
Oh Good For You!
I had an experience with a denstist once. It was my first visit with him and he was scraping and poking around and he asked me what I did for a living (why oh why do they ask you questions while their hands are stuffed in your mouth?) and I answered that I was in my first year of school studying acupuncture. He hesitated for a moment and replied with more enthusiasm than was necessary, "Oh good for you!" I wanted to take that pointy, hooky, insturment and do some scraping of my own.
Perhaps I am being harsh, but I mentally titled the article, "7 Ways to Make Peace About Charging High Fees" and community acupuncture got a nice pat on the head and a sickly sweet "Oh good for you!" I don't think it was intended to come across that way, but from my perspective, it did. I really got stuck with number 2, "differentiate between what you're worth, and what your services are worth." I guess it's nice to say "don't have low self esteem because you use a sliding scale, and you high fee acupunks, try and be more humble", but these are deep waters with issues that are more complicated than can be wished away with "I am good enough, I am smart enough, and doggone it, I am worth it!"
The idea that made shivers run down my spine, integrity. That is powerful. It made so many ideas that I have had running through my mind (more on that later) snap into place.
That's my two cents, though that does not reflect the value I put on my self....
-Chad
I think you're exactly
My Town
Dan,
Let me tell you about Phoenix, Arizona.
As of 2007, Phoenix's population is 1,512,986 people. Since 2000, it has had a population growth of 14.53 percent.
The average home cost in Phoenix is $230,000. A fairly drastic change from 2007 where average price was $260,00. We were hit hard when the housing bubble popped and foreclosure rates are at record highs.
Mean Annual Wage is $38,360. With that income, no down payment (5% on a $230,000 house?) and some debt, according to a morgage calculator, a house should be no more than $60,000. To afford the average house in Phoenix with the same perameters, a yearly wage of $80,000 is needed.
Compared to the rest of the country, Phoenix's cost of living is 4.23% Higher than the U.S. average.
Average gas price is $4.08 per gallon. Phoenix is a commuter city. It is spread over a wide area and we tend to do a lot of driving since public transportation is very limited. We are getting a light rail (yeah!) at the end of the year.
The wealthiest part of the Phoenix area is Scottsdale with a population of just over 200,000 with an average income of $58,000. From the information I could find, there are 62 acupunks in Scottsdale, this does not count Chiropractors, NDs, DOs, or MDs who can all do acupuncture in AZ.
My point is, I don't see the problem with high fees as purely internal within the practitioner. I think I could self-affirmitize myself until doomsday and yet the real numbers would still be there when I opened my eyes.
A good portion of my school mates got into acupuncuture as a career change from someplace they were not happy with. It is very sad to me to see these people accrue the debt and spend the time and energy necessary to practice acupuncture, and only find themselves just as unhappy as before.
-Chad
Good Point
I think this is great.
I think this is great. When I went to school the only thing taught was the high fee model, and not just market rates, we were told to charge more than everyone else because people would think we were better if we cost more. I was business naive and exhausted from school, so I assumed this must be right no matter how bad it made me feel.
I was in private practice about 5-6 months before I found a work comp job. There was a little bit of joy in those five months, and a lot of misery. I knew I couldn't approach people from my own background, they couldn't or wouldn't pay my fees. In my background the idea that high cost makes something more valuable is absurd. We simply don't look at things that way. I ended up joining professional groups and trying to meet people I wouldn't naturally be interested in meeting. I met some great people and it's great to get to know people out of my normal circle, the problem was I felt I had to pretend I was someone else.
After my work comp job ended I quit practice for 2 years, I wasn't sure why it made me miserable, it took a long time to figure it out, and finding CAN was a huge part in getting me back in practice and elated to be there. I have never thought my value was based on how much I charge, or that acupuncture's value was based on the fee. To me they have always been completely separate, that is part of CAN so I instantly felt at home.
The founder and I come from similar backgrounds so that makes sense. Lisa has brought some of the working class values I grew up with into the "upper middle class hippie dippy "alternative" world" AND it's a great business model. Who'd a thunk it?
I am now happily at peace with my fees, and loving acupuncture again.
Oh yeah, and I'm making money
.
I like it
and I didn't have a negative reaction to #2 about separating your worth from what you charge. I think many of us have made that point over and over. I thought the piece was balanced and brought up good things to think about.
And it will be in the revised CA 101, Lumiel! I've been watching and collecting things to add and will be doing a revision when I get the survey done.