A warm welcome to Michael Fox, current President of the California Acupuncture Association! Michael’s been in practice ten years and owns Silverlake Acupuncture in Silver Lake, California (which is in Los Angeles). Today I’m excited to interview Michael about his successful private practice and learn his tips and advice for marketing and practice management.
Today we’re covering:
- How Michael got a head start on success by starting his planning early.
- Which marketing tactics have worked for him.
- Why being an active member of your community is essential for success.
- His tips for current acupuncture students to prepare for practice.
- The current goals of the California Acupuncture Association.
And I’m offering a bonus Marketing Checklist:
The Marketing Checklist condenses all of Michael’s marketing and practice management advice and helps make it actionable for the rest of us. If you like it, please tell your friends and let me know in the comments so I can keep producing similar downloads for you!
Let’s get down to business and start learning more about Michael!
Where did you go to school for acupuncture and how long have you been in practice?
My Masters degree in Oriental Medicine is from Samra University of Oriental Medicine in Los Angeles. My PhD in Oriental Medicine is from American Liberty University in Newport Beach. Before that, I got a BS in Chemical Engineering from University of Oklahoma.
I opened my practice at Silverlake Acupuncture in 2006 in the Silver Lake neighborhood of Los Angeles, California, and was at my first location for nine years. In 2015 I moved into a larger space that I helped design. So: ten years doing acupuncture professionally.
What was your first exposure to acupuncture and/or herbs?
I started working with western and Ayurvedic herbs back in 1990 when I first moved to Los Angeles and was scrapping for work as an art director in the movie biz. One of the odd jobs I had was to write book reviews, and my first assignment was the first edition of The Male Herbal: The Definitive Health Care Book for Men and Boys by James Green. That book had a profound effect on me both in my interest in treating with herbs, and in my interest in specializing in men’s health.
My first exposure to acupuncture was the interview process I devised to choose my acupuncture school. I went to all the student clinics and got treatment. I talked to the supervisors, interns, and herbalists. Then, later, I went for the official campus tour.
How did you initially start your business after acupuncture school? Were you ever an associate, or did you go right into private practice?
I grew up in an entrepreneurial family, so it never really occurred to me to work for anybody else as a private practitioner. Six months before I graduated, I began developing a business relationship with a chiropractor near my home, and the day I got my notice from the State Board that I had passed, I walked ten blocks to my new office and signed the lease.
I wanted to be a neighborhood acupuncturist, and discovered that my neighborhood didn’t have an acupuncture clinic named after it. I reserved “Silverlake Acupuncture, Inc.” with the California Secretary of State 30 days before I took my Board exam. The State allows you to reserve a name for 60 days. Once I had my license number I was able to file the incorporation papers I’d already prepared, and I was ready to start legally practicing the day my paper license arrived—30 days after I passed the exam and 60 days after I reserved the name. I also discovered that http://www.SilverlakeAcupuncture.com was an available domain name and I bought it right away.
That 30-day wait between taking the test and getting the results was spent recovering from the stress-induced fatigue, taking the NCCAOM national certification exam, and developing my practice forms for intake, chart notes, privacy notice, and those types of things. The day I got my results, I phoned my attorney and had the incorporation papers filed; OKAY, the day after. I spent the first day celebrating.
I made a conscious decision to assume I’d pass and gave myself 30 days to be ready to open my doors. My mother owned a local newspaper when I was growing up, so meeting project deadlines is part of my psyche.
That is so bold, moving forward before you had your exam results! I love it; assume you’re going to succeed!
You have some really unique specialties, including men’s health and dermatology, and that you treat a lot of people in the entertainment business. What made you choose these specialties, and how do you have so many patients in entertainment?
As I mentioned before, my interest in men’s health was initially sparked by informal herbal studies and James Green’s book. It developed further when I found that a large number of practitioners were opting to specialize in women’s health, women’s fertility, women’s menstrual issues. My idea at first was to strictly work with men, but as my success in treating them became more widely know I found it difficult to turn down the women in their lives and now my practice is more gender-balanced than early on.
My interest in dermatology grew from a desire to help treat a family member suffering from psoriasis. That can be a stubborn, recalcitrant condition and the simplistic herbals and topicals we’d tried hadn’t been successful. I decided to study herbal treatment of skin disorders with Mazin Al-Khafaji in London and that effected an enormous change in the way I’d prescribed Chinese herbs before his tutelage. Mazin’s diplomate course is a rigorous program spread out over a year’s time.
After I moved to Los Angeles, I worked as an art director in the film business, doing mostly episodic television and movies-of-the-week. These were short-term jobs lasting one to four months, then it was on to the next one. That’s where I met so many people working in the film business. When I first opened my practice, I went back to the offices of “Crossing Jordan” and worked on the crew one day a week while I built up my patient load.
How long did it take before you felt like you’d “made it” with your business?
For the first three years, I did everything myself: scheduling, billing, phones, herbs. I was also teaching three classes at Samra and being a Clinical Supervisor in their clinic. Everywhere I went, I had my phone, my spiral-bound appointment calendar (old-school, I know), and a stack of business cards. I talked about acupuncture all the time, all day, every day. I felt like I’d “made it” when I could finally leave the calendar at the office, take weekends off, hire a front desk person and hire a biller. That started happening at around three years and by four years things were in full swing for me. Finally, I could have conversations about “normal” things.
What marketing tactics have worked best for you in building your practice?
I put a lot of effort into designing an eye-catching business card, logo, name, address, phone, email and website. My website at http://www.SilverlakeAcupuncture.com had matching branding and I viewed that as an electronic business card. Its purpose was to get people to phone me and make an appointment.
I made a particularly strong effort to avoid a site that attempted to teach the patient everything there was to know about acupuncture, or to just have a laundry list of conditions treated. 2006 was before mobile-enabled web sites were the norm, and my idea was to get the patient to phone me and actually talk to me.
That model worked well at first, then later it became invasive to my time away from work. I signed up with a lot of free directories, and Yelp was especially helpful in getting people to my business, once I was blessed with a few 5-star reviews.
I also had business cards with me at all times, and handed them out everywhere. There’s a bulletin board at the corner hardware store that always had one of my cards pinned on it. Every time I went there, I’d put up a new one. I treated the bartender at the corner restaurant and he started handing out my cards. My hair stylist started telling people about me.
I really spent time and effort being a part of my neighborhood and my neighbors told my other neighbors about my work. I went to Toastmasters every week for a year, and every time it was my turn to prepare a speech it had something to do with Oriental Medicine. I had to think long and hard about how to turn the assigned themes of “Independence Day” and “Wizard of Oz” into speeches about Oriental Medicine, but I did it.
I also spent a lot of hours actually in my office even when I didn’t have a patient scheduled. When I answered my phone, I was at my office and it sounded like I was in my office, not driving around or running errands. I had access to my patient files, in-stock inventory, and calendar, so I could answer any question right away. I know that being in the office when you don’t have an appointment is not a favorite work ethic among millennials and thirty-somethings, but as a patient, the millennials and thirty-somethings expect quick responses and they respond positively to this commitment.
Now things are a lot different. Still I work a little more old-school than I should. I use an online calendar and inventory program which auto-emails appointment reminders. I finally got it set up to do on line booking, but just recently. My billing is done via emails to my billing company, EOBs are sent electronically and all my payments are auto-deposited. My office manager deals with all that. People still want to phone and ask questions. I am not a texter and generally give text messages less urgency and importance than a phone call.
I am more in tune with social media now, but nowhere near an expert. I post on Facebook two to three times per week for my business and four to five times per week on behalf of the California Acupuncture Association. I try to do something on Linked In once a month or so. The Big Fail for me is Instagram; I haven’t started yet.
My best free discovery regarding social media is Canva.com, where I design my own graphics for photo posts, and they are perfectly formatted for Facebook.
Which marketing tactics haven’t worked well for you? Anything that you felt were a waste of time or money?
I paid for some printed ads for a couple of years, mostly through a local health co-op. That advertising was actually inexpensive for printed ads, but the only patient inquiries this brought me were from patients wanting Medicare to cover their acupuncture, which it didn’t. It was completely the wrong demographic even though it was a neighborhood newspaper. I avoided printed ads like the Yellow Pages altogether; they were prohibitively expensively and completely untargeted.
I tried some of the networking groups briefly, but I quickly decided they were “notworking” groups. They became a social speedy-commercial and my energy was drained after all that intense, non-clinical interaction. For some people and some businesses they will work great, just not for me. I did join the Silver Lake Chamber of Commerce, one that was specific for my neighborhood, and found that to be enjoyable, enlightening, and productive.
There are a lot of healthcare directories that want to charge money for their listings. I tried that for a couple of years, and never got a single patient as far as I could tell. Sign up for all the free ones, but only AFTER you have a business phone number that’s different from your personal phone number.
If you could give current students advice about starting/running their future practices, what would it be? What advice can they put into action right now, in preparation for running a business?
My number one recommendation would be to plan and run your business like a professional medical office, rather than a hobby. By medical office I don’t necessarily mean a white, sterile hospital. My offices were decorated by an Emmy-nominated production designer, I wear sharp clothes often with a Mandarin collar and embroidered dragons, and I comport myself as a doctor.
My patients are not seeing me for a spa treatment, but I make an enormous effort to be prepared for the patients’ needs. Sit in your own waiting room and decide how long you want your patients to wait on you. Be on time. Wear the gown you expect your patient to wear, lay on your own table for an hour. If it’s unpleasant in any way, fix that.
Anticipate their questions, address their concerns, and in general be there for them. And then set boundaries and stick to them. When I decided to stop being available seven days a week and actually close two days in a row, my spirits improved and my patients got better results. Taking time off is professional behavior, too.
Get a business phone number that’s different from your personal phone number, right from the start. Not only does this reinforce your Business Mindset, but when you need to get away from work you can. Publishing your personal cell phone on the internet is a bell that can’t be unrung. I used my personal cell phone to start for about a year, then changed it. Even nine years later, I’m still finding newly-populated directory sites that publish my old number, and they often charge money to make corrections. So even now, my personal cell phone voicemail message includes, “If you’re calling to set up an acupuncture appointment, please phone my office number 323-662-6560 so my office manager can find the best time for you.”
Get a Federal Taxpayer Identification number (TIN) that is different from your social security number. You don’t want your SSN floating around all those insurance companies, who will require a federal number before they will pay you.
Get a professionally designed web site, right from the start. Even if it’s a static, multi-page electronic business card, like mine is, people will not take you seriously if you don’t have an internet presence that isn’t tied to your personal Facebook page.
Take an insurance billing class and start billing yourself, right away. Get over your fear of doing it, and do it. Take the class again if you need to. Personally, I love Acuclaims.com. There are lots of experienced acupuncturists that will help you with you billing, but don’t take up their time unnecessarily! Take the class first, and then you’ll be able to ask informed questions when you don’t know what to do. Send in a W-9 form with the first claim you file with a new insurance company, before they ask for it.
Make a commitment to improving your TCM diagnosis skills, and keep improving. One of my pet peeves is getting onto an online Acupuncture forum and reading this: “I haven’t seen this patient yet, but she’s got [insert Western Diagnosis here]. Any suggestions?” This is worse to me than a writer bringing a first draft to a professional writer’s group for assessment.
An MD would never do this, why would an LAc? Have enough respect for your colleagues’ time and use your education and skills and to do your own basic research on [insert Western Diagnosis here], make an informed evaluation and treat accordingly.
If you don’t get excellent results, then go to someone more experienced and present your case as a professional would: “These were the signs and symptoms, this was my diagnosis and subsequent treatment, and the results were disappointing. How would you treat differently to improve these results?”
I advise doing this because your skills and your confidence will soar if you do this instead of posting on social media: “I don’t know what to do, somebody else do the work for me and give me the answer.” That attitude of minimum effort becomes obvious to your patient very quickly.  In my opinion, if you really don’t know how to diagnose and treat a patient, it’s unethical to fail to refer that patient to someone else.
Favorite part of running a business?
Treating patients. Getting fantastic results and being surprised that “it worked.” Researching, digging for answers, sorting out a difficult diagnosis, and bringing a successful treatment to the treatment room.
Least favorite part?
Arguing with lawyers about payment reductions in Personal Injury cases. I had to delegate that task right away, it wrecked my peace in the treatment room. My biller does these negotiations for me now, and she does an excellent job! And my next least favorite thing is subpoena compliance, because it can be very time-consuming.
What’s the next step for you in your practice or business?
I’d say I’m in the “Go Big or Go Home” phase. I’m planning on substantially expanding the practice even further with associates and additional services. If that doesn’t work out, I’ll retire early and travel.
Do you have a support network of acupuncturists?
Yes, I try to get acupuncture every week and I notice when I miss it. Actually, I’m more dependent on my support network of non-acupuncturists: business manager/therapist, biller/therapist, office manager/therapist, spouse/therapist, Dalmatian/therapist. And don’t forget Mom/therapist.
Haha, I totally get that. I have a cat/therapist that I rely on as well. What’s the best piece of advice someone has given you regarding being a healthcare professional?
“Find some good-looking comfortable shoes you love, and buy two pair.” –Marilyn Allen
“Your morning ritual should start with RPM: Rise. Pee. Meditate.” –Wendy Ellin
“The herbs won’t work if they sit on the shelf.” –Curtis Baumgartner
Any practice building advice that we can all put into action right now to boost our businesses?
- If you’re not billing insurance right now, start. Even if you’re out-of-network for everyone.
- Get online scheduling.
- Schedule your day(s) off and stick to it. If it’s a scheduled work-day, be at work even if there are no appointments scheduled. My only exception to my day-off rule is on those few occasions when I do a post-IVF acupuncture treatment.
- Be early for your first appointment. Be on time for every appointment after that. Make a commitment to do that all the time, it shows that you value your patient’s time and they will, in turn, respect yours. On the rare occasion when that doesn’t happen…everybody will know it’s a rare occasion.
You’re the President of the California Acupuncture Association. Can you tell us more about what you and the CAA are doing?
We’re online at http://www.CaliforniaAcupunctureAssociation.com. Our goal is to be a representative voice for California acupuncturists in legislation and issues regarding scope of practice, workers compensation regulations, best practices and insurance reimbursement discussions.
For example, we are working hard to bolster support for the federal bill HR 3849 Acupuncture for Heroes and Seniors Act with a big push for patients and practitioners to fax letters to their Representative.
In California, we’d love to push through AB 41 to guarantee parity in payments to acupuncturists in accordance with section of 2706 of the Affordable Care Act, but that one’s been held in committee, unlikely to make it out. When Dry Needling becomes a legislative issue in California, we’ll be there too.
And lastly, do you have a mentor, or someone in particular who inspires you?
I really admire Trevor Erickson in Vancouver BC for his work in TCM dermatology and Eric Vander Wal currently in Tokyo for his work in TCM andrology. Someone I’d love to meet is Geovanni Espinossa, a Cuban-American in the Bronx specializing in men’s health via alternative medicine.
I’d love to have a mentor, but I haven’t made that connection yet in the acupuncture world. I’m avidly creating abundance for that to happen soon.
Thank you, Michael! You’ve given us a lot of really great, in-depth advice to consider. I know that even though I “know” that I should do certain things to promote my practice, sometimes I get lazy (should I not admit this?) and reading about how important they are from someone else’s perspective is incredibly helpful. It inspires me to get a move-on and make the effort again. Can never have too much of that!
Don’t forget to grab your free, instantly downloadable checklist:
Thanks for introducing those great and financially responsible bloggers.