Image of Mandy Gratzer with the text, Episode #51 of the Acupuncture Marketing School Podcast: The Business of Practice with Mandy Gratzer

This week I’m chatting with acupuncturist and practice growth strategist Mandy Grazter, who is based in sunny Australia.

This is our THIRD attempt at recording this episode, and I’m thrilled it worked out. Our first two interviews were disrupted by an impossibly bad internet connection and a serious house flood, so it’s a relief and a pleasure to finally bring you Mandy!

Mandy helps new acupuncturists in particular get set up to run and market their practices with confidence.

We both teach marketing with a very similar approach: the focus is on authenticity and bringing your enthusiasm and passion for this medicine to the forefront.

In this episode, we talk about:

  • Letting your personality and passion for this medicine shine in your social media
  • Setting your prices – Take the emotion out of that decision
  • Feeling comfortable raising your rates
  • Building a retirement as a small business owner
  • The cost of acupuncture school in Australia and their unique loan repayment approach
  • And more

Join us!

🎙️Episode #51: The Business of Practice with Mandy Gratzer

Show Notes:

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Transcript:

[MICHELLE GRASEK] (00:04)

Welcome to the Acupuncture Marketing School Podcast. I’m your host, Michelle Grasek, and I’m here to help you get visible in your community, take marketing action with confidence and get more patients in your practice and more money in your pocket every week. We both know you’re a talented, passionate acupuncturist and that acupuncture has the power to change lives. So let’s dive right into this episode and talk about how you can reach more patients.

(00:35)

Hi there, welcome back. This week I’m talking with acupuncturist and practice growth strategist Mandy Gratzer, who is based in Sunny, Australia. This is our third attempt at recording this episode, and I am thrilled that it finally worked out. Our first two interviews were disrupted by one, an impossibly bad internet connection, and then two, a serious house flood, so it is a relief and a pleasure to finally introduce you to Mandy. Mandy helps new acupuncturists, in particular, get set up to run and market their practices with confidence. In this episode we talk about letting your personality and passion for this medicine really shine in your social media, setting your prices and taking the emotion out of that decision, feeling comfortable raising your rates, building a retirement as a small business owner, the cost of acupuncture school in Australia and their unique loan repayment approach and much more. I hope you enjoy this episode.

[MICHELLE] (01:37)

Without further ado, I bring you Mandy Gratzer. Hello. Hello. How are you?

[MANDY GRATZER] (01:43)

Good evening/morning. Hello, how are you?

[MICHELLE] (01:48)

I am great. So nice to talk to you again. This is our third attempt.

[MANDY] (01:54)

We are not letting it get us. Technology will not beat this conversation from happening for the world.

[MICHELLE] (02:03)

So I am in upstate New York, and it is 6:30 AM And you are where?

[MANDY] (02:09)

I’m currently on the other side of the country. Normally, I live in Perth, Western Australia, but I am just finalizing my road show for new grads. So I’m currently in an Airbnb in Sydney where it is 10:30 at night.

[MICHELLE] (02:23)

Wild on the other side of the world. I was trying to like calculate the time difference this morning. I gave up

[MANDY] (02:30)

Yeah, I gave up too.

[MICHELLE] (02:31)

Not enough coffee had happened.

[MANDY] (02:33)

Correct. Keyed into the converter man.

[MICHELLE] (02:37)

Well, I’m so glad you’re here. I love your website. I love your Instagram and everything that you are teaching acupuncturists. I think we have a very similar approach where we’re both really trying to remind people just to be authentic in their marketing and how much that will help them and how much it will resonate with their audience. I am so curious, what got you started in teaching practice management and marketing?

[MANDY] (03:05)

I think it came organically after I had a new grad observing me. They were doing their clinic obs and what I realized was happening each time she was coming in, is that fair enough she was watching how Interact with my patient and what choice of points I would do. We’d talk about the herbs or what advice I would give her and what advice she would have given them. It was lovely banter. But what was actually happening was that it was all the conversations in between that we were having, there was so much more happening in our sessions together and I thought far out I wish I’d had this when I started out. Like I had none of this. It wasn’t an option. I was also quite remote, so I was removed from considering mentorship or clinic obs or post grad. But just realizing that that conversation isn’t happening at all unless you have a good mentor when you finish up. So that really prompted me to go, hang on, there’s a real need here to nurture the new grads, and I wanted to be part of the difference.

[MICHELLE] (04:13)

That is wonderful. I know that you have your online class, but tell me about this road show, is that what you called it?

[MANDY] (04:21)

Yeah, I’m calling it the road show, even though I’m flying everywhere because Australia’s far too big to drive. Well, it’s not. I have circumnavigated most of Australia in a car at some point in my lifetime. However, on this …

[MICHELLE] (04:32)

So it’s an air show.

[MANDY] (04:32)

It’s an air show, totally, but I’m not the one flying the planes. But yeah, so I don’t know if you’ve known, but the world went mad a couple of years ago so no one could hang out. And so everyone’s, I think there’s a real lust for the return to face-to-face learning and human connection and interaction and the natural conversation that happens when you are with someone versus when it’s your turn to talk if you’re on Zoom together. So rather than in the past couple of years, I’d run it as an online course, a four-week webinar, come and sit down with me for a couple of hours each week and we’ll run through these modules together, this time I thought, no, no, no, we need to get together. It’s time to do this stuff in person. So I’ve managed to compress it all into one day, which is a lot of talking, but it’s beautiful and I’m having the most wonderful time doing it, no regrets. Absolutely love it. We’ll do, we’ll repeat again.

[MICHELLE] (05:31)

That is wonderful. I have actually been thinking about asking some other marketing teachers in the industry if they wanted to put together something similar, like a weekend in-person, because I have not taught in person in many years. I used to teach an acupuncture practice management class at the local acupuncture school and then it closed in 2020. So I also miss the opportunity to interact with students and man, they have such good questions

[MANDY] (06:03)

Oh, they do.

[MICHELLE] (06:04)

So that’s wonderful.

[MANDY] (06:05)

Indeed. And it’s so quick to reassure them or to steer them in the right direction. And had they not asked that question, it would still have been unanswered them, and they may or may not actually have been able to find the answer and may have made, for want of a better description, a poor decision whereas we were able to just answer it straight away and give them all clarity. The beautiful thing about group learning like that is that one person may not want to ask the question, or it may not occur to one person, but when someone else sends it, they all pipe up. I’m like, oh. So then this contribution of shared ideas happens, which is really, really cool.

[MICHELLE] (06:43)

Yes, and I feel like if one person is wondering something, that means like six other people in the room are also wanting to ask the same question, but wondering like, is it the appropriate moment? So once they ask it, everyone’s like, oh yeah that, I need the answer to that.

[MANDY] (06:58)

Absolutely. I would also say to that that we both use that quite consistently in our marketing as well, because if one patient asks it in the clinic, it’s a darn good question to use on your socials, like remember those conversations. But I digress.

[MICHELLE] (07:13)

Well, okay, let’s talk about social media. I really enjoy your Instagram account because you are just so honest about like what it is to be a practitioner and a business owner and to wear all those hats. I’m wondering when you’re teaching your students social media marketing, what are the most important things that you recommend for them?

[MANDY] (07:42)

Okay, well, I think that, I thank you so much. I’m really glad that that’s the vibe you get from me because it’s what I’m trying to achieve. I want to normalize what it’s like to be a practitioner, and I want others to feel heard or validated if they’re having a crap day or provide some sort of direction if they’re thinking of something or just validate that practitioner life looks like this and make that a real approachable conversation, not taboo or judge judgment-free zone. You can still be, you have a healer’s ego but you can still get tired of seeing the same thing or have a rough day. But when it comes to, I would say the word convincing comes to mind, convincing other practitioners in Australia, specifically to jump on socials is really, really tricky and so it’s usually about empowerment, about what you can say, rather than be limited by the things that you can’t say and therefore feel like you can’t say anything at all.

(08:40)

Because as you know Australia is governed by a whole bunch of regulations for registered health professionals, which means you can’t claim to treat anything without citing a large body of research, which we don’t have a lot of in acupuncture. So my biggest task usually is empowering them with what they can say and getting them to share their message and their passion and their values because essentially your patient, this is your patient’s opportunity to interview you before they meet you, to build a portional amount of rapport, to demonstrate a level of trust in your rooms, in your treatment space. Especially if you do any videos or photographs of your clinic space people can visualize themselves there so if they have any anxiety around trying this therapy for the first time, they can see that your space is already legitimate and that the way that your voice, is the way you talk. By sharing that you are demonstrating, you are allowing the opportunity for them to get to know you a bit. We just, we’ve never had this opportunity to connect with practitioners before we meet them. Normally, the very first time is when we walk into their clinic. So this is a huge opportunity for connection. That’s my first tip is really just empowering them with the why, why is it important because of this?

[MICHELLE] (10:01)

Sometimes I think about the way that we would choose a healthcare provider in the past, and it would basically be you look up your insurance and then there’s a list of doctors locally who take your insurance and it’s just a crapshoot. You’re like, I like this person’s, I don’t know their last name sounds cool. Like, I picked this person. Or this person’s only three miles from my house. Whatever it is, it can be totally random. Then what happens I think with MDs is you pick a doctor and you go see them and for most people, if you don’t resonate with them, they’re like, oh, I’m going to get a second opinion or find someone else. But with acupuncturists, at least where I’m located, I find that if people pick an acupuncturist and then don’t resonate, they think that acupuncture’s not for them. Not that that provider’s not for them, but all of acupuncture, which really breaks my heart. I totally agree with you that social media can be such an amazing way for a person to connect with you before they meet you and already know that you are a great fit and that acupuncture’s probably going to help and be a great fit as well. I think it’s amazing and it’s free.

[MANDY] (11:15)

It’s the free marketing tool in the pocket, of your hand. Don’t pay for advertising until you have to.

[MICHELLE] (11:24)

And I’m always trying to convince people that video is their best option because I think about it in terms of touchpoints. Marketing is made up of all these touch points, and you build trust with each touchpoint, but some build trust much faster. So talking to someone in person is probably the warmest touchpoint. It helps people identify really quickly when they’re standing in front of you, do I trust this person enough to put needles in me and share my personal health information? And then like, the next best thing would be live video and then recorded video. But it’s so hard to convince acupuncturists to get visible on video and to be comfortable with it enough to do it regularly. So I understand that that, becoming comfortable with video is the process, but is that something that you talk to your students about?

[MANDY] (12:17)

Yes, it actually came up when I was in Brisbane. One of them just went, “Nope, not at all. Not happening. It won’t be me. It’ll be my 15-year-old daughter who’s managing my social media.” I said, “Cool. Make sure she takes some photos of your face then.” Because I said, the next best thing, you have to build up to this. It’s not just a I’m going to start talking to my video and not feel like a tool, which is an Australian word for feeling a little bit sill, but that’s a real thing. People feel like, I remember the very first time I did a video, I recorded it like a dozen times and kept saying, and then I’d stop and then I’d do it. It was for like a minute. It was a minute worth of talking Michelle, and I was so critical of myself that I just kept, not that actually my grid just looked like all of these times where I’ve gone no, not happy with it because I was so judgmental about whether I looked authentic or whether I was making a fool of myself. So I get that it takes time to, but I just said to all of them, you need to lean into connection.

(13:18)

So remember that when you take a photo and put your face on there, because if you can have a beautifully curated feed, but that doesn’t tell anybody anything about you other than that you are an organized person and possibly OCD. It actually, it doesn’t show them you and that’s what they want to know. So at some point, if video just feels so far away, then the bare minimum is just use a photo man. And write the way you want to write. Use the words that are authentically the way you would talk to someone. Like, I’m quite conversational in my posts on purpose because that’s what people, especially in my text as well, on purpose so that that’s, I’m sharing the message that you’re, this is what you’re going to get. That’s important.

[MICHELLE] (14:10)

Yes, I do think that the caption on any social media is important because some people prefer to watch videos, some people still prefer to read text and it really conveys your approach to the medicine. It conveys your personality. I think we sort of forget that just the way we talk and approach a topic and its resolution helps people decide even unconsciously if we are a good fit for each other. But I mean, that’s another beautiful angle of social media.

[MANDY] (14:44)

Yes, and I think it really helps to demonstrate that you know what you’re talking about and the more of that you can reiterate, the more confidence they have, oh, maybe this person actually understands my health condition because it’s really complex and no one else has been able to answer it so far or I haven’t had good success in other avenues so far, especially if they’re thinking about taking a punch or having a go at something different like Chinese medicine. If you are writing in such a way that explains that you know Chinese medicine well, but you also know these particular conditions you’ve got, whether you specialize or not just talking about health. You don’t necessarily have to say acupuncture is good for, these Chinese herbs are good for, but you can demonstrate your knowledge of any health condition and you’re already showing them that you understand them.

[MICHELLE] (15:33)

I love to treat digestion in my practice and I have celiacs and for a long time I didn’t, it never occurred to me to mention that I have celiac and that I have been managing my celiac with acupuncture since my diagnosis like seven years ago. So now I try to think about it because I’m a pretty private person and I know that a lot of my marketing students and lots of acupuncturists in general, like we’re a little introverted or we tend towards that way and we prefer our privacy and like, we don’t want to be the people who just like lay it all out there on social media.

[MANDY] (16:13)

No one wants to be the oversharer.

[MICHELLE] (16:15)

Yes, I totally understand that. But once I started sharing just that I have celiacs and I don’t even really share what my symptoms are, I don’t want to gross my audience out too much, like, that might be too much for them, I usually will tell them I’m managing bloating, like abdominal bloating and digestive discomfort with acupuncture and sometimes herbs. That really help people, potential patients to recognize that I can relate directly to their experience even if they don’t have celiac because lots of people have other things like ulcerative colitis or whatever it might be. But they’re experiencing those same symptoms and they’re like, oh wow, this person has been doing this for a long time and knows what it feels like in her body when there is a change.

[MANDY] (17:06)

Yes, I think there’s some real validation around that. I’m not much of an oversharer when it comes to my own private health, but I have a couple of slipped discs in my lower back. Again, managed by physio, rehab, Pilates and acupuncture and Cairo. I use lots of systems together to keep it well, not to mention physical activity. So when someone comes in and they’ve just, that it’s just happened to them, I usually tell them at some point privately, listen, I know where you’ve been and this is how it can change, but this is what you’re going to be looking at. It just helps them feel like, and you don’t have to have shared that at all to say those things, but I do think that it helps, I don’t know, a sense of compassion and understanding for the patient as well. So yeah, it’s sometimes a little bit of share, a little bit of give, goes a long way.

[MICHELLE] (17:58)

And I think It’s always a balance in the treatment room. I am always, I don’t know why I’m the practitioner where I have to remind myself not to overshare, like don’t make this about me. It’s because I like to have conversations. And you can just, like the conversation just winds its way into wanting to relate to the person. So yeah, I have to remind myself of that. But it’s funny on social media, It’s almost like I have to remind myself to share that just a little bit, just a little vignette of that idea. Is there anything else you wanted to share about social media?

[MANDY] (18:35)

Something else that I would say is that for anyone who’s struggling, it’s usually about making it manageable. So the key isn’t such and such has got an amazing social media presence. I could never do that. It’s not about that. It’s not about comparisonitis at all. It’s about choosing a frequency of posting and the type of stuff you want to talk about that lights you up. As soon as it’s about passion and as soon as it’s something that’s sustainable or manageable, it’s much easier to be successful at it. Obviously, there’s lots of different recommendations around how frequently you should post depending on your agenda. I’ve just been in launch mode, so I posted every day for the last month, but that was important because I was basically repeating myself until, I was sick of it. And there were still people who only heard it once. But I had an agenda.

(19:29)

If you are talking about promoting your clinic, then it’s more about a sustained frequency that you can manage. Because that’s the only way it’ll be successful. Because if you blow out three posts in a week and that exhausted you and then you hated it, you’re probably not going to pick it up and do it next week. Then those, all of those people who saw you three times in one week are then conditioned to expect three posts a week from you. So choosing what feels manageable and digestible, even if it’s two posts a week on your best day, do that, use the insights, get a sense of, really use stats to give you the best chance of making those posts most visible and most successful. Then you’ll start to get lit up by your engagement and it’s almost like the, what do you need, the feedback return, I put this out and then people came back to me. So that always reinforces us to keep doing it if you get good engagement. So I think it’s about managing something that’s actually sustainable for you and not the shoulda, woulder, coulda assist or sitting in comparison city because neither of those states will help you to run your business and run your marketing. But just know that it’s important for, there’s a thing about talking about how your website works for you, but it only works for you because people are already looking.

[MICHELLE] (20:50)

Yes.

[MANDY] (20:50)

Whereas on social media, you are telling them that you exist when they may not ordinarily have been looking for you. So it’s a presence for those who aren’t already looking. Then the conversation gets off the platform and goes to your website and into your schedule and dah, dah, dah, dah. So it’s talking about the validity of this being free marketing advertising for growing your practice and that’s why it’s important. Your website’s great, but that’s only going to get the people who are already looking.

[MICHELLE] (21:18)

Social media is so much about discovery with algorithm. It loves to like show you new people. So I usually tell my marketing students, or recommend, that if they have a hard time being consistent on social media to think about batch creating their social media, whether it’s taking lots of photos around their office and taking some selfies that don’t look like selfies and we talk about how to do that or doing video, but setting aside a day or an afternoon to create enough content for the month, for example. But then I think what happens is people do that, they’re so motivated. They’re like, yes, I have all this content and they want to share it as quickly as possible. They’re like, wow I just created eight pieces of content. I could release that every other day for two weeks.

(22:15)

What I usually encourage them to do is to space it out, like, let’s say you could do twice a week and then you have two months of content. You can set it up for whatever frequency seems reasonable, as you were saying, like, what can you maintain, but I sometimes see my students will just release all their content in a really short time and then they realize, oh my God, now I have to start over and I need another afternoon where I’m batch creating all this content. And we know that content can be quite a lot of work, especially in the beginning when you don’t have a streamlined process because It will get better and you’ll get much more efficient at it, especially things like creating reels or TikTok that takes practice to be able to do it quickly. But yeah, just encouraging people to think about like, what is a reasonable frequency for my life? Like you have a real life and this is going to take time in your day and what makes sense for your practice, how much time do you want to spend on it, and then release the content, like drip it out over whatever your set timeframe is, weeks or a month so that you can have that consistent presence without having to actually show up all of those times.

[MANDY] (23:37)

Yeah, that expectation to create on the spot is just no good. It’ll never happen.

[MICHELLE] (23:42)

Yes, unless, I suppose I talked to an acupuncturist recently who said that she tries to get to clinic early, like 15 minutes early, not super early, two or three days a week and just creates a quick 7-second reel in the morning and then doesn’t think about it. But she’s built that into her schedule and it’s a very regular, she’s been doing that for months and months, so it’s very regular part of her practice life. And I don’t think you have to come in early because when someone’s like, you just go into your clinic early, I’m like, I can just about get there on time. That’s probably not going to happen.

(24:18)

I live, guys, this is so embarrassing, I live a 55-second car drive away from my office. It’s a nine-minute walk. I don’t walk. I’m like, oh my God, I can’t carry my lunch. My lunch is so heavy. So I drive and like, my goal is always to get to the office a half an hour before the first patient. I’m generally there 20 minutes early, but it’s like every day I feel like I’m running late because the goal is a half hour and that is not achieved. So anyway, my point is that if coming in early, does it make sense? We can almost always carve out 15 minutes a day if we choose to. We don’t have to scroll on TikTok during our break. We could do something productive. So there are lots of options based on like your personality and what makes sense for your day in clinic or your life to make space for content creation, but I think whatever you choose, making a regular part of your schedule is so helpful. The less you have to think about it and convince yourself the better

[MANDY] (25:31)

To do it. You’re right. This is my homework, oh, I haven’t done my homework. But if you have already batch-created, and even if you do it through Canva graphics then it’s stuff that you’ve just done on your computer 10 minutes, create a few quotes tiles. East Asian medicine is full to the brimm of amazing quotes. I use them all the time. Is it meditation tips? Is it latsu, Thích Nhất Hạnh, Buddha, Confucius, all of these amazing quotes. So you literally haven’t even had to record yourself. So again, I very much value batch recording as well. I’m like, if I’m going to set the tripod up and walk around my clinic, I’m going to do like three or four reels and all I’m doing is recording the bit. I’m going to build it later. But the recording part is done then. Because you can always build it and edit it on your phone later, but it’s about working smarter, not harder so that you’re not spending individual time to create one thing because that’s not productive as you say.

[MICHELLE] (26:31)

I also love the idea that there are lots of videos you can record that don’t necessarily have to be your face. I mean, I definitely agree with you. I think it is nice for people to see your face, to know who would be putting needles in you. I know that there are some people, I’ve received emails in the past, “For religious reasons I cannot share my face. What do you recommend?” But I do think there are lots of options. Even if you are showing a clip of your video and then doing a voiceover, people will connect with your voice, and as we were saying, they’re going to connect with your words because of the way that you explain your approach to the medicine. It’s either going to resonate with them or it’s not and that will help them identify as your people.

[MANDY] (27:15)

Yes, yes, I love that. And I think spoken word is far less daunting than video can be because you’re just saying it. No one’s watching you say it. So whether it’s that you are giving a tip or a hint, whether it’s that you’re showing a little how-to or a demo or maybe you’re reading something really inspiring and it’s a video of the light coming through your window. You just happen to catch the morning glow or you just happen to catch the incense trail as it burns up in one long stream. So you just video the incense and it’s you talking. Or anything that allows your patient to visualize themselves in your room.

[MICHELLE] (27:54)

I think that’s also a good starting point for people who know how important video is, but they’re not ready to do their face. Take it in stages. Record things around your office and use your voice at first and get used to that. Sometimes it feels really cringey to hear your own voice.

[MANDY] (28:14)

You’ve just got to move faster.

[MICHELLE] (28:16)

Everyone feels that way, your voice is never right. You’re like, “Oh my God, is that me?” The first time I recorded Acupuncture Marketing School, I hated editing those videos because I had to listen to myself talk. Then you’re doing that like pause, reverse, pause, reverse, like going back over things to fit everything together and I was like, I just can’t wait for this to be done. So in the beginning it’s just going to be cringey, but it gets so much better

[MANDY] (28:46)

Because also nobody else knows what your sound, your voice doesn’t sound like. It’s just your own self-critique, they just want to know what you sound like. It’s just how we feel about it.

[MICHELLE] (28:55)

So something else that you teach your students is how to set their pricing. I know you have a really nice approach to that. So do you mind sharing with us?

[MANDY] (29:04)

Yes, so I think that it’s really important to, as soon as you possibly can, and I know this takes a lot for people, but take the emotion out of it. This is not about what you feel comfortable to charge and it’s not about your self-worth and value to charge a certain rate. It’s about your bottom line. Do you know your fixed costs of running your clinic, whether you see a single patient or not? Have you done a balance sheet that actually shows you what it costs you to be a registered practitioner and run a clinic? Because if you start with your numbers game and work back from there, you have far more likelihood of understanding that your rate is determined by those figures. So it’s really important to know your bottom line. I say this all the time, but you can’t steer the ship if you don’t know what your bottom line is. So it’s really important to start there.

(30:07)

Then on top of that, your consumables and everything else that comes up once you are busy. Then look at how many, maybe you add that up and you divide it by 12 and you work out how many patients you need to see a month. Maybe you start with that. How’s that bottom line look? Is it actually getting you there? Or how many patients at your current rate is it? And then you’ll see is there any food on the table with that or is that just covering clinic? Because if there’s no food on the table, you’re working for free guys. We love it and we’d all love to be martyrs who work for the love of it, but this is our vocation and this is our profession and we practice what we love. We do what you do and practice what you love. So it has to work for you.

(30:54)

So commanding your rate has to come from that solar plexus chakra. If you need to cover that in all the yellow stones you have, whatever you need to do to enrich that sense of self and then discard it completely because It’s got nothing to do with it. It’s absolutely a numbers game. Try and take the emotion out of it is my ad advice. It does make a massive difference to recognizing what you actually need. I used an example with this year’s course. I do a price increase at each, at the beginning of each year. I put a email out to my existing patients and I update all of the fees on my online booking form so that anyone who then books already is aware of what the rate is. There’s no notice on my website that the rate is changing because anyone who’s booking for the first time is seeing that these are the rates. So it’s more a courtesy to notify existing patients.

(31:52)

Then I put it on my social media as well. I usually give people a lead time of about a month, which was done this time as well. I said something between $2 and $5 per thing, whether it was cost or service. I said, everything’s going up between $2 and $5, just expect that at your next consultation. I did the Maths on my current weekly numbers of patients, so I said if I just increase my follow-up rate only, not considering any other services, any other product inflation rates, nothing else, if I just increase my follow-up rate by $2 times the standard amount of patients, regular patients I would see in a week, not expand, not factoring in growth, just an average, it’s an extra three and a half grand in my pocket at the end of each year.

[MICHELLE] (32:41)

Amazing.

[MANDY] (32:41)

It’s like taking the olive out of qantas’s salad and they save $3 million a year. They take out one olive out of the Greek salad. So really consider, you don’t have to make a big change to really improve your bottom line. This isn’t about being unaffordable for your patients because I know that’s something people really struggle with, is wanting their medicine to be affordable and approachable, but it also has to sustain you, so consider that.

[MICHELLE] (33:09)

Yes, and I think that a lot of people don’t change their rates for years. So inflation is always happening. I think we forget that our patients are perfectly aware of inflation and changes in the economy and they understand when things are more expensive, like products. They know that you have overhead rent, other things that you pay for to support your practice to even be able to be open and it’s really, for the most part, it’s okay with them. Do you know what I mean

[MANDY] (33:48)

Absolutely. They’re so aware. You’re absolutely right. They really do.

[MICHELLE] (33:52)

It makes sense to them.

[MANDY] (33:53)

Yes, because they’re hearing it everywhere. So they’re like, oh, well of course, insurance, products especially, they all go up every single year because they have to. As you say, it’s inflation. So it has to be absorbed somewhere and I think if people feel guilty about upping it, then they need to do the work and do their little research and have a look at those numbers to get confident to command that rate. And you don’t have to be afraid of offending your patients. They won’t be offended. They genuinely won’t.

[MICHELLE] (34:22)

I mean, I find that my patients, everybody is always like, I have the best patients, but no, I have the best patients over here. They care about you. Like the people that you’ve had for a while, they care that you run a small business in the community and they want to see you succeed. I think it’s really nice to remember that when you can

[MANDY] (34:45)

I, actually, even this year, I always get replies, but this year I got really heartfelt replies from my patients saying good. One of them was just good, full stop. Another was said, she’s in her 70s, she goes, “Very well said, Mandy, very well approached. I like what you wrote. We are fine with the increase. We’re delighted. We can’t wait to see you next time.” She was, it was a full endorsement, almost like we didn’t need, but it’s so nice to have. So really people are not bothered. They accept it and expect it as well.

[MICHELLE] (35:17)

Maybe you could, you can’t do this because of HIPAA, but if you want to send me her email so I can put her on my list so I could use that email response and I’m going to read it in an Australian accent, the rest of my inbox, and just feel like so supported and held, would be wonderful.

[MANDY] (35:33)

Oh, that’s what it’s about. That’s what it’s about. We love our cheerleader patients. Everyone’s got super fans and they’re just the most wonderful people to have in your circle.

[MICHELLE] (35:41)

Yes. I always recommend to my new grads that they, and I’m curious if you do this as well, that they start on a shoestring budget, if possible, instead of, I mean, you can always take out loans and build out your dream clinic and then it’s possible to fill it, and to do the marketing and to get out there and be visible in your community and to fill that up. But I think that is a little, I don’t want to say risky. I think it depends on the person and their personality, et cetera, but for me, what I have seen most often is it makes the most sense to start small and then build out your space and your overhead as you grow and as you can afford it. Like, don’t set up a clinic built for three patients an hour when you have no patients because the overhead is likely going to be very high.

[MANDY] (36:41)

Yes, I agree.

[MICHELLE] (36:42)

What do you usually recommend?

[MANDY] (36:43)

The first thing I say is don’t quit your job and start a business, because it’s about making, because the focus is that your clinic and your income from your clinic needs to cover the clinic costs first before you can even consider generating an income from it. If you make a huge startup fee for yourself, then there is already a level of angst or worry or extra pressure that you’re putting on yourself to meet KPIs, to get those numbers, to pay that debt or return what you’ve borrowed or spent on starting up with big numbers. So I usually say keep the part-time job, the one that you’ve had during your days whatever that looks like. Make it manageable so that you are not working 10 till 3 overnight in a bar and then trying to do clinic the next day. Like, you have to be smart about your clinic hours.

[MICHELLE] (37:37)

I know people who’ve done that.

[MANDY] (37:38)

Yes, and you’re cooked, you can’t do either of them well. You’re completely cooked. But the point is that there’s that little baseline reliable income coming in from the part-time job that allows you to cover your living expenses while you are building the awareness of your clinic and building the numbers so that they can cover the clinic expenses. Then very quickly what you will find is that the part-time job is getting in the way of your clinic hours and then you know she’s time to let go and you and absolutely the patients will come because the space is there. But yes, I also agree and I advise when they’re starting out, I show them what the breakdown of all of the expenses are for becoming a legally registered practitioner, everything down to their insurance, registering, the cost of registering their business name.

(38:27)

So I’m showing them those startup costs before they’ve bought a single thing for their clinic room. That in itself can be costs that need to be broken down over a few months at least. And that’s without their part-time job sustaining their living expenses. So I’m like, listen, this is transparency. This is what you’re in for. These are your startup costs before you’ve bought a single thing for your treatment room. So you need to be able to cover that and support yourself at the same time. Don’t make the responsibility of how many patients you see be the difference between whether or not you’re eating two-minute noodles.

[MICHELLE] (39:05)

I’m curious, I don’t really know very much about acupuncture school in Australia, but here in the US it is very expensive and the student loan debt is, I would say on average upwards of a hundred thousand dollars for a three- or four-year program. So when I’m telling people to think about the costs for their clinic and starting up, or how many patients do you need to cover your expenses, I try to ask them to remember and calculate in their student loan payment. And of course, we haven’t, in the US we haven’t been obligated to student loan payments in several years, but having an awareness of that, if you want to be paying them down or when they return, I think that so many acupuncturists here at least are afraid to know how much they owe, what repayment plan they’re on, how long is it going to take, and how much will it cost them each month and how many patients is that. Because it’s sometimes a staggering number, but you can’t ignore it. I mean, as I said, we have been ignoring it for a little while and that’s been a pure delight, but I think you can’t stick your head in the sand about that. That is an important part of —

[MANDY] (40:22)

Of business.

[MICHELLE] (40:24)

Yes.

[MANDY] (40:24)

Yeah, absolutely. I say the same about superannuation, which is our retirement funds as well. Once you’re self-employed this is a factor you need to consider whether you have bucket in bucket accounts and things like that so that this little slice is going away and being put where it needs to. Otherwise, you get to your 30s, 40s, 50s, and you haven’t been contributing. Oh, maybe I should start contributing now, and by that stage, you’ve lost a quite a long time of being aware of what you need to contribute. Now, the beauty of student loans in Australia is that you don’t start to pay them back, and you pay them back in increments from, the government will issue you a bill when you do your tax return and your income has hit a certain threshold so you only are expected to pay them back once your income, your taxable income has reached a certain threshold where it’s deemed that you are financially capable of returning it.

(41:23)

So once you are, when you are starting out, if you are low-income earner for a few years, there is no expectation of you having to pay that back. That’s a real leg up, but once it happens, it’s like, okay, now this is where my tax return’s gone, or this is a bill I now have periodically each end of financial year that I need to pay. It’s at least a little bit more manageable. And you can pay it off faster if you are really, but, and that depends on the person. They’d be like, yeah, I need to get this out from over my head. If they’ve had a great year, they might increase it by whatever factor is relevant to them, but at least that’s an option. But yes, you do need to be factoring this stuff in. You need to be bucketing little slices of your income each week or month or fortnight, whatever works for you so that you are not stung with a massive bill at the end where then you’re like, where am I going to find this money from?

[MICHELLE] (42:14)

I have two thoughts. I just don’t want to forget to mention the first one, and then I have a question for you. So I would say that for anyone who doesn’t have a retirement plan out there, just know that the more money you put in early, like in your 20s, in your 30s and your 40s, the compounded interest of that and the return on your investment is so much higher, so much greater than the money that you put in later on. Because I mean, that’s what a retirement plan is, like the longer it’s in there, the more money it makes on top of itself over and over again, year over year. I think that, man, we are not taught enough about retirement plans in any stage, like in high school, in undergrad, in grad school, as adults. So we as small business owners have to make the effort to start putting even small amounts of money away as early as possible. I mean, if you feel like it is just absolutely not feasible right now, if your practice just isn’t at that level where you have that extra income, I totally get that. But the moment you can put away like $30, $50, $100 a month, you want to start doing that. I’m serious, even 50 bucks will make you so much money over the long-term.

[MANDY] (43:36)

Yeah, so true.

[MICHELLE] (43:37)

I think, not that we have, we barely even have time in acupuncture school for thorough marketing classes, but a class on investing and like setting up those accounts, even just like one day where we talk about it, really helpful

[MANDY] (43:52)

Any financial advice, any financial advice would be welcomed.

[MICHELLE] (43:58)

Yes, because I mean, I’ve had so many different kinds of jobs, I worked for two different universities and they typically have outstanding retirement accounts. That’s really what helped me understand that as a small business owner, like that just went away. There was nobody who was saying, who was like managing my accounts. There was no like automatic withdrawal. So I realized I’m not even doing this. But it is essential. So that’s just a little public service announcements for financial health.

[MANDY] (44:30)

This is all part of it. We’re talking about business, man, that’s what it’s about.

[MICHELLE] (44:34)

And then, so my second question is how, I’m just curious, how much is acupuncture school in Australia? I know you’re in Australian dollars, but we can sort of calculate the difference in our heads.

[MANDY] (44:45)

I actually don’t quite know the total cost because some are three-year degrees and some are four-year degrees, depending on the training organization and whether they’re purely acupuncture or they’re herbs and acupuncture together and if they’re run by a college versus run by a university. So slightly different rates depending, but I now know that the units, so each subject is $1,200.

[MICHELLE] (45:12)

Interesting. So when you say unit, that’s like a class

[MANDY] (45:14)

The subjects, that’s one subject.

[MICHELLE] (45:16)

Like PCM theory?

[MANDY] (45:16)

Yeah, exactly. Acupuncture point, location, so per class, per semester, so depending if they’re doing four to seven subjects a semester.

[MICHELLE] (45:24)

I wonder if that is similar to here.

[MANDY] (45:26)

I think we’re getting, I think we’re close. I believe it’s 80 plus, is what I believe, which is insane in terms of the number. So it is good that you don’t have the obligation for returning that until you are earning a certain wage. They’re not trying to cripple you when you’re starting out, which is great, but I think there’s also a sense of, okay, when I’m actually ready at least I can start to get that off my plate and start focusing my money where I want it to go.

[MICHELLE] (45:56)

I have one more question for you, and I’m asking everyone this question, what is your definition of success?

[MANDY] (46:03)

Ooh, I would say that success is defined differently for everyone, but it’s the striking, and this might sound a bit like a rainbow unicorn too, but striking the work-life balance that works for you. It’s not about the numbers through the door, it’s not about the nature of what you’re treating or the satisfaction of your practice. Those are all lovely, but the success is the longevity and how it’s sustainable and living that work-life balance that works for you because remember that you are running this business, so whilst you might be providing a service to others, it’s your business. So it has to work for you first before you can work for everyone else. That’s my measure of success is finding that sweet spot for people and for myself.

[MICHELLE] (46:53)

I think in a previous conversation you had mentioned that if your business isn’t working for you, it’s not your business.

[MANDY] (47:01)

Oh, I just, I can’t reiterate that enough. Because I just think that otherwise what are you doing it for? Because you think this is how it should look? It doesn’t have to be like that. Give yourself permission for it to look how you want it to look so that it serves you, because then you will, it will light you up and it will be easy and you don’t have to convince yourself. There’s no resentment. And you won’t burn out because the whole point is we don’t want our amazing industry to have a failure rate. We don’t want people burning out. We have a huge failure rate of small business in Australia. It’s like 50% in the first 12 months, and it’s 80% after five years. So we don’t want 80% of self-employed practitioners who have no business knowledge bailing out after five years when they’ve spent just as much time learning this medicine. So the success is in making sure it works for you as well.

[MICHELLE] (47:58)

I love the idea of longevity in your practice and your career.

[MANDY] (48:03)

Yeah. Whenever we get the poll, we get a, we get an industry poll every year when we register, when we re-register with the Chinese Medicine Board of Australia. It says, how many hours have you worked where you worked in a part-time or full-time position? It asks you a bit of industry workplace questions. And one of it says, how many more years do you intend to be in practice? I’m like, forever

[MICHELLE] (48:26)

Yes. That’s awesome

[MANDY] (48:27)

In some capacity or another. And I’ve answered the same, given the same answer for a decade, like I can’t see myself never not being in practice in some way. I’m sure there’ll become a time where I want to hang up the pins, but it ain’t right now and it’s about making sure that that lust for what you do and the passion for what you see it’s keeping that fire alive, I think.

[MICHELLE] (48:53)

I love that. You’re like try and stop me. You don’t even have a box on this form for me to check.

[MANDY] (49:00)

Correct.

[MICHELLE] (49:02)

Amazing. Well, thank you so much for joining me. I’m so glad that our conversation finally worked out. This is an amazing start to my day, so thank you so much for showing up late in the evening your time. I really appreciate it

[MANDY] (49:15)

Thank you for having me.

[MICHELLE] (49:17)

Where can everyone find you online and follow you and take a look at your classes?

[MANDY] (49:22)

Please, please come and follow me. If you want to get in spell about how I talk to my patients, you can follow my clinic page, which is Mandy the ACU Perth. If you want to have more of this conversation, the business of practice, come join me at the Acupuncturist Biz Hub. The links in my bio have all the online classes, content stuff, social media classes, whatever you need, it’s there. And a podcast link should be just about ready for you by the time this goes to air. So, yeah, exciting stuff.

[MICHELLE] (49:48)

Well, thank you so much.

[MANDY] (49:50)

Thanks for having me.