Michelle Grasek:

Welcome back. Today, I’m joined by Amy Abelar, founder of Acupuncture Practice Systems and the owner of a thriving multidisciplinary clinic with 24 employees.

Amy has built an incredible practice over the past 18 years. And in this conversation, she shares her journey from starting as a massage therapist to growing a large acupuncture business with systems, team members, and strong leadership. In this first part of our conversation, we talk about what it really looked like to grow her practice, including while she was still in acupuncture school, how creating systems became the key to scaling her practice, when she knew it was time to hire additional providers, what marketing worked well for her in growing her practice, and an overlooked marketing strategy that can dramatically increase patient retention and referrals. If you’ve ever wondered how larger practices are built, I think you’re really going to enjoy this conversation.

And this is part one of a two-part interview with Amy. So be sure to come back in a couple of weeks for the second half. All right, let’s jump in.

Today’s episode is sponsored by Jane, a practice management EHR for health and wellness professionals. Maybe you’ve heard about AI Scribe and it’s been on your radar. Maybe you are already using it every day.

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Hello, Amy. How are you?

Amy Abelar:

I’m good. How are you?

Michelle Grasek:

I am good. Thank you so much for being here today. Before we get started, will you introduce yourself for the audience?

Amy Abelar:

Sure. My name is Dr. Amy Abelar, and I’ve been in practice, self-employed for the past 18 years, been growing my business. And I’m also the founder of Acupuncture Practice Systems, because I love to help other acupuncturists be successful and navigate the business side of running a practice.

Michelle Grasek:

I would love to start out with your background and how you built the incredible clinic that you have. I was on your website and I was looking at how many massage therapists do you have? Eight?

Amy Abelar:

I think right now we have 15 or 16 right now.

Michelle Grasek:

Fifteen. Okay, I didn’t get to the bottom of the page.

Amy Abelar:

Yeah, it’s all good. Yeah, 24 employees.

Michelle Grasek:

Okay, so then you and you have another doctor of acupuncture who are practicing acupuncture. Yes. So how did all of this come about for you to build this really very large business?

24 is a lot. A lot of employees.

Amy Abelar:

Yes. I’m very lucky to have an office manager who is amazing. She handles so much stuff for me that there’s no way that I would be able to practice acupuncture and own the business.

And if I didn’t have amazing front desk staff, an amazing office manager, I’ve built the systems. They run the systems and it’s, yeah, that’s hugely, hugely helpful.

Michelle Grasek:

And so you were originally a massage therapist, correct?

Amy Abelar:

Yeah, I started massage a long time ago back. I was 18 and I worked somewhere else for a couple of years. And then after working somewhere else as a 1099, I decided to open up my own thing and start my own massage practice and been self-employed ever since last 18 years.

Michelle Grasek:

I love it. So what made you decide to go to acupuncture school?

Amy Abelar:

So to be totally honest, I loved massage. I really did. If I could have done it forever and ever, I might have.

I love the one-on-one working with patients or clients. I loved being able to help people. I loved that personal connection that you get when you’ve seen people for a long period of time.

And so I really enjoyed that piece of it, but massage is just too physically demanding to be a lifelong career. So when I first started out doing massage, I was like, I’m never going to college. I just want to be a massage therapist.

And then about six months in, I was like, oh, this is really a lot of hard work. I’m not going to be able to do this for my entire life. And so I thought we’ll all go to college and I’ll get a bachelor’s in business and eventually I’ll hire other massage therapists.

I’ll do the business side of things when my body can’t do massage anymore. I’ll just own the business. And I went through a time period where I think it was a car accident that I was in.

I had to take a break from massage for a few weeks. And in that time I had other massage therapists who were working for me, but I really just, I noticed that I wasn’t, I didn’t enjoy just the business piece of it. I really missed the working.

Yeah. I missed the working with clients. And so I thought, okay, even if I could financially afford to pay all of my bills by just owning the business, I really needed, I felt like I needed something where I would still be able to work with people one-on-one and be able to help people.

I felt like I would really just, I would miss that so much that just owning the business wouldn’t be fulfilling. And so I started looking at what else I could get into. And at the time, my now husband and I were first dating and I was having this horrible neck and shoulder pain that was a reoccurring issue from being a massage therapist.

And I thought I had tried everything and he said, well, have you tried acupuncture? And I was like, no, I haven’t tried acupuncture. So I went to an acupuncturist and I think it was my second or third treatment.

I was laying on the table, just so impressed at how much acupuncture was helping me physically. And then this light bulb went off and I thought, oh my gosh, this is it. This is what I could do.

I could transition from being a massage therapist to an acupuncturist. And it checked all my boxes. It was less physically demanding than massage.

I could still help people. I could work with people one-on-one. I could continue to be self-employed.

It was something I could easily add into my business. And so that was really kind of where that took off from. So I actually came home from that appointment and immediately got online and started researching acupuncture schools.

Michelle Grasek:

I love it.

Amy Abelar:

And yeah, and he’s like, so how was your treatment today? I said, it was great. I think I’m going to go to acupuncture school.

Michelle Grasek:

And he was like, oh, that escalated very quickly.

Amy Abelar:

Totally. But he agreed. He’s like, that actually makes a lot of sense because, one of my big things is I can’t use my body for work forever.

I’m going to have to transition into using my brain more than my body. And yeah, it checked all my boxes. And it’s been really incredible to have an acupuncture career and see so many people get relief from things that they never thought they could ever get relief from.

Like it’s like, acupuncture is just magical in that way.

Michelle Grasek:

It really is. I heard a statistic once related to massage therapists that the average massage therapist’s career is about eight years. Have you ever heard that?

Just because it is so physically demanding. And in particular, it’s hard on the joints of the wrists, but even people who have outstanding ergonomics, it just is challenging.

Amy Abelar:

Yeah, I haven’t heard that statistic, but I would say that is probably pretty true. Most people who end up being in massage long term end up transitioning to doing more Swedish, more lymphatic drainage, craniosacral. They’ll usually, if they don’t have a different career they transition to, they’ll usually transition into something that is less physically demanding because, yeah, you just can’t, especially if you gave a lot of deep tissue.

That was one of my big things was I did do a lot of deep tissue work. And so I just, yeah, it’s very physically demanding for sure.

Michelle Grasek:

Yes. Well, we had been talking before we hit record about how when you decided to go back to acupuncture school, you had already hired other people and you were in decision mode of what am I going to do? Is that the right order?

Amy Abelar:

Just trying to figure out how I was going to handle the fact that I had a lot of clients and I was now going to have more clients than what I could accommodate because of having to pull back on my schedule to start grad school.

Michelle Grasek:

So you didn’t have employees at that point, but that’s when you started hiring. So you had people working for you while you were taking classes.

Amy Abelar:

Yes.

Michelle Grasek:

That’s the dream.

Amy Abelar:

You know, it’s so funny. So on the one hand, it is totally the dream. And on the other hand, it was a huge challenge that actually ended up being a blessing in disguise because having someone else there to do the massages on the days that I was not there, totally huge blessing.

The challenge was I also hired an admin because I was not going to be able to answer the phones when I’m giving massages, nor am I able to answer the phones when I am in grad school in class. And so I had hired an admin, but I really had to go through a lot of that initial practice management problem that a lot of people have where your admin is telling you all the time, what do I do for this situation? What do I do for that situation?

Somebody came in and they want to buy a gift certificate and I haven’t sold one in a while and I don’t remember how to do it. And I’m in the middle of class, stressed out, trying to figure out how to like multitask, paying attention in class and getting these answers. And so it was really that like squeeze of having that situation where I realized, okay, I have to write some SOPs.

I have to make protocols. I have to do step-by-step instructions. I have to delegate with more instruction that of course, this person doesn’t just automatically know the answers to everything when they just got into this role.

I have to set them up for success in that way. And so it was challenging, but it kind of forced that initial process of making sure that they had what they needed so that I didn’t get bothered by the same thing all the time.

Michelle Grasek:

Trial by fire, right?

Amy Abelar:

Oh, a hundred percent. Yeah. If you ask anyone who was in my master’s cohort with me, they were like on those 10 minute breaks, Amy was out in the hall on the phone trying to figure out trying to troubleshoot things.

Yeah, it was a little bit rough, but glad I did it looking back at it, but it was a lot for sure. It’s a lot to try to grow a business and be in grad school at the same time.

Michelle Grasek:

Seriously. And so you, you graduated acupuncture school and then, so then you’re back in practice in your practice finally, and you are growing with more and more massage therapists. What did that look like?

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All right, let’s get back to this episode with Amy.

Amy Abelar:

And my husband was like, you’re crazy. Why are you expanding while you’re still in grad school? This is nuts.

I was like, I have the demand. What am I going to do? Not take the opportunity?

Of course I’m going to do it. So I did, we moved to a four-room office and I hired more massage therapists and we had the receptionist. So yeah, we just kind of continue to grow as the demand for massage increased.

I hired more massage therapists and we had, by the end of grad school, by the end of my finishing my master’s in acupuncture, we had grown through that four rooms during that time. And we ended up moving to an eight-room space right after I graduated. And so, yeah, it just kept growing, which was great.

Michelle Grasek:

Wow. So how did you know when it was time to hire another acupuncturist?

Amy Abelar:

Yeah, so the answer is I was going to have my second baby. So really, for the first, for the start of my first maternity leave, I chose not to have, not to hire another acupuncturist. So I had passed my boards.

I was working as an acupuncturist, but I did not hire another acupuncturist for my first maternity leave. And that was because I didn’t have enough clients yet to feel like I could really justify bringing on another provider. And it was also new to me.

I’m entering this new like motherhood era and that was new enough. That was enough new things for me at the time. Even though I had hired plenty of massage therapists, I was nervous to hire my first acupuncturist when I was also going to be entering this other new like unknown era of life.

And so I chose to just refer my patients out during that time. But for my second maternity leave, I had grown enough acupuncture clients that I wanted them to have someone to go to during my maternity leave. But I also knew that I wanted to keep somebody on after that.

That like my clientele of new acupuncture patients was continuing to increase. Marketing efforts were taking off with that. And so because there was enough new clients that were constantly coming in, I also wanted them to have somewhere to go.

And so that was kind of how I ended up making that decision.

Michelle Grasek:

Makes sense. So do you feel like when you were growing the acupuncture side of things, there were marketing strategies that worked really well or things that did not work that well?

Amy Abelar:

I will say that there’s two different ways to market from my perspective, particularly with acupuncture. One is by getting new people in the door and then the other one is to market like really, I hate to say it this way because it sounds kind of, it sounds bad, really leverage the patient who is already in your office. And so what I mean by that, I guess I’ll touch on that first.

So what I mean by that is you already have this patient in your office. There’s somebody who is already open to acupuncture because they’re there. And so using some of your treatment time to explain to patients all of the things, you don’t have to run down like a list of 150 things that acupuncture helps with, but I do it in two different ways.

One is I will talk to a patient about what it is that they came in for. I’ll talk to them about their main concern and maybe a secondary concern. So an example is I had a patient who came in for shoulder pain.

That was his number one thing. He also checked off that he has anxiety and he deals with a lot of stress because he is self-employed and owns a business. I shouldn’t say just self-employed.

He owns a business. He has lots of other employees. And so I talked to him about it and I said, we can definitely take care of the shoulder.

That’s your number one complaint. We’ll have our focus be there. But if you’re okay with it, I can add points in to help with the anxiety as well.

And he said, Oh yeah, okay. That’s great. He had no clue that we could help with that.

Michelle Grasek:

Always.

Amy Abelar:

100%.

Michelle Grasek:

Always. Yes.

Amy Abelar:

Yes. Totally. So I, so I treat his shoulder and he’s noticing he feels so anxious.

He feels more calm throughout the week. He comes in for his third treatment and I asked him, it was his third or fourth. I asked him how his shoulder was doing and each week it was getting better.

So on, I think it was his fourth treatment. I asked him how our shoulders doing and he goes, Oh, I kind of even forgot I was coming in for that. I think I’ve just been mostly, I feel like he goes, I feel like I’ve mostly been coming in for anxiety at this point.

And so that is the best. Yes. So there’s two reasons why I love that.

Number one is now instead of this patient coming in three times, his shoulder being better and him being out in the world and not still in my treatment office, right? He’s now coming in more consistently. So that’s a good thing for me as a provider who’s trying to fill my schedule, but it’s also not in a selfish way.

It’s a good thing for him because he doesn’t just have improved shoulder and an improved shoulder and now he’s back out in the world. He’s now coming in and getting help with his anxiety, which is going to be an ongoing thing because he ongoingly owns this business. So I’m able to help with so many other things and patients like if you don’t tell your patients that they’ll never know.

So it could be that he goes out into the world and now someone else is talking about how they’re, managing their business is so stressful. A lot of business owners know each other, right? And he now has an opportunity to say, you know what, I’ve been getting acupuncture and it’s made a huge difference, but that person may not have shoulder pain.

That person may just have anxiety. And if I wouldn’t have told him, he wouldn’t have had the opportunity to share. So I think really educating your patients on what else you can help with makes a big difference for them in their life and also for them to refer.

And then sometimes it’s just the other way I’ll talk about it would just be if you have people who are, they’ll say, Oh, like, what got you into acupuncture? You know, I’ve new patients ask me that all the time. And I use this opportunity to answer their question and also talk about how one of the reasons why I love acupuncture and why I’m so passionate about it is because it can help people with so many things that they would have never thought that acupuncture could help them with like migraines, like insomnia, like fertility issues, like menstrual cycle issues.

And I’ll just list a few of the main ones. And without a doubt, 90% of the time patients are like, Oh, I didn’t know you could help with migraines. My wife gets migraines and now his wife comes in to see me or their coworker has been talking about how they struggle with insomnia or their friend has been struggling to get pregnant.

And so talking about it in a way that’s not like, Hey, do you know someone who has these ailments that you could refer because like, that doesn’t feel good to us either. It feels really salesy. But if you’re just saying I’m passionate about Chinese medicine, because it can help with so many things.

That’s true. I don’t know any acupuncturist who’s not passionate about that, right? And then it gives an opportunity for that person if they know someone to, refer them and who doesn’t want to refer their friend or their coworker or their partner to someone who can help and who’s passionate about helping.

Once people are in the office, I think patient education can be so powerful.

Michelle Grasek:

Yes. Oh, I am so glad you brought this up. Because I think that we can also take this approach to make sure that our patients are aware that we have different services.

So not just to point out all the different symptoms it can treat, but also making sure they know that we have microneedling or cosmetic acupuncture or offer customized Chinese herbal medicine and why they might want that. I had a story related to this. So one of my associates was saying that she had this cosmetic acupuncture patient.

And what we’re doing right now is we are just sort of testing the waters to see if any of our cosmetic acupuncture regulars would like to do microneedling because it’s something that might be within their interest. So just sort of having conversations with people and asking like, Oh, do you have an interest in this different method of collagen building? And there was this one patient and I had asked, Oh, is someone so interested in microneedling?

What do you think? And my associate was like, I’m, I’m not really sure. She seems pretty happy with cosmetic acupuncture.

And I’m like, okay, microneedling is not for everyone. But then my associate said, we didn’t, we sort of like beat around the bush with the conversation. She’s like, I’ll try again.

I’ll try to get a more clear answer from her. And I do send emails about microneedling. I have in the past when we launched it, and it’s been on sale a couple of times.

I was also on local live television recently, like a local morning show, talking about microneedling. And before I went on live, I sent an email to the patient list saying I’m going to be on TV talking about this topic. And then afterwards, I sent a follow up saying, if you missed it, here’s where to watch the segment where I talk about microneedling.

So my associate comes back and says, Hey, I had a conversation like a very direct conversation about microneedling with this patient. And it turns out that she did not know that we offer microneedling. She had no idea.

And it is just the case that she is not a huge email person. She was not paying a ton of attention to her email that week. I don’t think she gets the channel that I was on for the live television.

So it really just emphasized for me, actually, let me go back a step. So they had this conversation. She didn’t realize we had microneedling, but she was very interested and she signed up for it right away.

So for this particular patient, the most effective touch point was having a conversation in person with her provider. And I think that all of the marketing that we can do is wonderful because people do respond to the emails that I send. And we do get feedback from when I’m on the live TV, thank goodness, because it’s not my favorite thing to do.

But I do it. But just not everybody is absorbing content from the same places. And sometimes that one-on-one real person conversation is the most powerful thing that you can do to, as you were saying, help someone continue treatment, or maybe even transition them to multiple different kinds of treatment at your office so that they become a long term patient.

Amy Abelar:

A hundred percent. Yeah, people are more inclined to listen when they’re already there. And then they are to open an email.

People love to be able to just see things or know things without having to really, I hate to say like without having to work hard for it, because we think like opening an email is not that hard. But for some people, it’s like, I don’t have time for this, when they’re looking at their email, they’re in that mode of I just need to do what’s my absolute half to and the rest of it delete goes junk, especially opening an email clicking and then watching four minutes, like even that four minutes can be too much for some people, depending on the mindset that they’re in, right?

Michelle Grasek:

If they’re just cleaning their inbox, that’s not the place they’re in.

Amy Abelar:

Yeah, absolutely.

Michelle Grasek:

Yeah, I don’t share that to make it sound like why bother sending emails and do it making all these efforts totally. But it’s more like you have to have repeated touch points.

Amy Abelar:

100%.

Michelle Grasek:

I always tell people take every opportunity to repeat yourself. You’re not bothering people because their attention is so scattered. They’re not going to think to themselves like Michelle has talked about this nine times before.

Finally, a bell is going to ring and they’re going to say, Oh, that’s what this is about.

Amy Abelar:

100%. Well, and to your point of making sure that you are connecting, and it’s not to say not to email, let’s say she saw that email come through, she didn’t even open it. She didn’t pay attention to the fact that it was about microneedling, but she had to cancel her last cosmetic appointment and hadn’t gotten rebooked yet.

And she sees your email pop through. And she’s like, Oh, shoot, I forgot to book. And then she calls into book cosmetic.

So it’s not even necessarily about exactly what the content is. But it is just another ping another, Hey, we’re still here. This is what we got going on.

There’s that too, that it is, like you said, the touch point of being in front of people often enough that they think of you.

Michelle Grasek:

Yeah, I love thinking about email as like you said, literally a reminder. Still here. Remember, remember how you meant to reschedule your appointment.

We’re still here.

Amy Abelar:

Totally.

Michelle Grasek:

That’s all for today’s conversation with Amy. Be sure to tune into the next episode to hear the second half of her interview, including topics like what marketing did not work as well as she thought it would, why it’s essential to have an ads professional who knows what they’re doing, why tracking or marketing is essential for success, how to get MD referrals, and how she became a primary referral source for a nearby fertility center. Can’t wait to talk to you next time.

As always, thanks so much for listening. If your marketing is feeling stuck, I’d love to help you figure out exactly what to focus on next. The marketing business profile and other parts of your online presence with clear, practical recommendations tailored to your practice.

No generic advice, just the changes I would prioritize if this were my own clinic. You can learn more and reserve your spot at michellegrassic.com forward slash audit. Thanks so much for being here.

I’ll talk to you next time.