January 2018

January 2018

The Office: MPD – How To Treat Extremely Thin Pulses (Yin Def./ Yang Def.)

Notes

  • Depending on how pounding the high thin pulse(s) are, determines how cold the herbs should be.
  • Use vasodilators to widen out the pulses:
    • Dang Gui 15
    • Chuan Xiong 15
    • or Sheng Ma 15
    • and/or San Qi 15
  • Use Yin tonics:
    • Qi Ju Di Huang Wan, if irritable (too high left Guan) 20
    • Zhi Bai Di Huang Tan, if left left Chi too high 20
  • Use Blood-movers:
    • Vitality or Xue Fu Zhu Yu Tang 20-30
  • So you are doing all 3: moving blood thru the vessel, widen out the vessel and moisten the body.
  • Yin deficiency is the most severe degree of damage to a person’s physiology.
  • If the pulses are paper-thin and not too high or maybe even too low, then that’s Yang deficiency (depending on its severity)
    • Rx:
      • Yang Tonics: Si Ni Tang, Ba Wei Di Huang Tang
      • Use vasodilators: Dang Gui, Chuan Xiong
      • Blood-movers: Vitality or Xue Fu Zhu Yu Tang
      • A sweet formula (also widens the vasculature): Shao Yao Gan Cao Tang or Gan Mai Da Zao Tang

The Office: DPM – Doane’s Patient Management System: How to Double Your Practice, Part 1

Notes

  • Sign-Up patients at events for 30min IVs (Initial Visits) that cost $150, but if paid in advance it is discounted to $60.
  • At the IV, there is extensive paper work.
  • At the IV, MPD is performed before the paper work is viewed, impresses the patient, because you can usually the majority of their main complaints from the pulse.
  • I tell the px (patient) that we use acupuncture to treat the pain problems and Chinese herbs for the internal problems.

  • I tell them that our therapies generally work very well and that our failure rate for different diseases is different (e.g. most problems 10% or auto-immune system 25%)
  • I gauge the px now that I go thru the paper work. If the px is really motivated, I present a plan to them right away. If they are not, I set up 3 acupuncture visits with them. – Day 1 – Day 3.
  • Day 1: is full medical intake (45min) and an acupuncture visit (45min).
  • With the acupuncture we target a musculoskeletal problems, bc if their shoulder pain will respond to the acupuncture, then it is very likely they will respond to the herbal treatment as well.
  • The px gets homework, which means he or she needs to write down how long it takes for the pain to return. Px also needs to check off which main complaints he or she wants to be treated.
  • At the next visit (Day 2) we review how long the pain stayed away, which will give us an idea of how many visits it will take (this information plus age, pulse and general health). Also, depending on how many problems they want to have treated, we create a plan for them, while they are lying down for acupuncture.
  • We usually present 5 month plans. For herbs, it’s 1x per week for one month and then 2x per month for 4 months, totaling 12 visits. Each visit is $65, totaling $780. Herbs in our pharmacy cost $0.85/gram, the total five month plans will cost around $2000 total.
  • These plans are credit-plans, not time-based plans.
  • We add up all the costs and give them 3 payment options.
  • Option 1: Pay as you go, with no discount.
  • Option 2: Pay 100% upfront and get 20% discount ($600-1000).
  • Option 3: Pay over 12 months with 8% interest.
  • Then we wait and let the patient make the decision.
  • Conversation rate for patients wanting to join plans:
    • 2017: 84%
    • 2016: 76%
    • 2015: 83%
  • In part 2, I will talk about the mistakes you may be making, if your conversion rate is not there, and how to avoid them…

The Office: DPM – Doane’s Patient Management System: How to Double Your Practice, Part 2

Notes

  • If the patient is not convinced that you can help them, you will not commit patients to treatment(plans).
  • You have to sell!
    • Life is selling.
    • Chinese medicine is not indigenous to our culture, so you have to present it to the patients well.
  • You have to do 3 things:
    • 1. Demonstrate expertise/authortiy: You have to impress upon the patient that you are an expert in the field.
    • 2. Demonstrate enthusiasm: You have to have a lot of energy. You have to be energetic.
    • 3. Demonstrate generell intelligence: You have to be sharp as a tack. You have to be clear. You have to be fast.
  • I present a plan on Day2, if they got a good result, if not, then we wait until Day 3.
  • If there is no result from the acupuncture on Day 3, you usually lost the patient, because your treatment did not provide any immediate value.
    • You probably used too many needles.
    • Hurt the patient.
    • The patient was uncomfortable.
  • If you see that they are enthusiastic, then present the plan the first time you see them, even before treatment.
  • I find the conversation rate best on the very first interaction, because the patients are at their highest level of motivation.
  • You NEED TO SELL CHINESE MEDICINE, because it is not part of our culture. MDs can be pricks and people keep going, because we are socailly trained to believe in them.

The Office: How to Double Your Practice Part 3: The Genius Of Prevention Plans

Notes

  • When the treatment plan(s) are over, we present a prevention plan for them to keep healthy. They are credit plans not time plans, but the rough timeline is 6 months.
  • Herbal plan only: 2780 USD, but only charge 1600 USD. 12 visits (65USD each) and $400 discount on herbs = 1100USD discount.
  • Statistics:
    • 2017:
      • ca. 29.000 pxs visits
      • 798 pxs on treatment plans
      • 388 pxs on prevetion plans
      • Gross revenue: +3 Mio USD
      • Show rate: 83%
      • Refund rate: 8%
    • 2016:
      • 32.000 pxs visits
      • 656 pxs on treatment plans
      • 341 pxs on prevetion plans
    • 2015:
      • numbers less
  • 2 offers for prevention plans:
    • acupuncture and herbs
    • herbs only
  • acupuncture and herbs:
    • 6 acupuncture visits
    • anything beyond that is free
    • a2-4 times/month acupuncture visits are recommended
  • herbal plans:
    • 2000 USD worth of herbs
    • 700 USD worth of visits (12 visits over 12 months),
    • Discount it down to 1600 USD by waiving the herbal consultation fee and taking off 400 USD off the herbs
  • Pxs pay upfront for the full discount. If they pay by the month over 6 months or 12 months, they do not get the discount. (if they pay over 12 months, we add 8% interest)