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Acupuncture Malpractice Insurance – An Associateship vs. Starting a Private Practice


And so we’re gonna go over the idea of employment versus private practice. And so I don’t mean just employment as employment in a hospital.

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hello, and welcome to another episode of To The Point. I am Dr. Nell with American Acupuncture Council. Let’s go to the slides.

So today we’re gonna go over a topic that, again, every time I bring these to you guys, there seems to be a theme where many people are coming to me with these same questions. And so we’re gonna go over the idea of employment versus private practice. And so I don’t mean just employment as employment in a hospital.

We could talk about . Contract work synonymously. Really the idea we wanna dive into is the idea of growing your own business versus being a part of someone else’s business. And what are some of the pros and cons there? What are some of the considerations and things we need to go over? Why this is such an important topic to me is I have done all of these different variations of this.

I’ve done the cash practice, the insurance practice, I’ve done contract work worked in a medical facility, been part of a group practice, . There’s many different ways that you can build your career in this profession, in the clinical space, if maybe this’ll be a future one that we do. Talking about all the other different revenue streams you could potentially have, and ways that you could make impact or be employed in this industry beyond the clinical space.

But today we’re really going to hone into the clinical aspect of this. So with that, what are we thinking about today? What’s the considerations that we wanna have? We wanna talk about the risk reward ratio. . There’s nuances with that. If you’re on your own versus working for somebody else, same thing with costs.

The costs are gonna be drastically different. And even within those two different options, they’re gonna be different cost considerations, and then the benefits comparison, because of course, whatever decision we make, we always wanna be coming from. A really informed place and making decisions out of having substantial information rather than making a decision based on, oh, insurance feels complicated.

I don’t wanna deal with that. Or, I don’t know anything about owning my business, so I’m just not gonna do that. So we wanna look at what’s the benefit for us but also what are those risks, those costs, really the overall considerations that we need to have when making this informed decision. So let’s look at the risks and the rewards of both of these options.

Like I said, in that employment independent contractor piece . First and foremost, you wanna have malpractice insurance. Whether you’re working for yourself or you’re working for somebody else. You are gonna have the flexibility of how you manage risk when it comes to your own private practice.

You’re gonna have a lot of autonomy when it comes to deciding what is your environment going to look like? How am I going to control all these different variables around me? You’re not worried about, . Potentially other providers causing issues or sharing patients. If it’s you get to make the rules, right?

You also get to make decisions around what type of malpractice coverage you’re going to have. The limits. If you are working for somebody else, they are going to make a lot of these decisions. So that environment, if it’s a shared environment, you are not an autonomous entity there. I’ll give you an example.

When I first started my practice in Beverly Hills, I was sharing a medical space. So it was amazing for a new practitioner because I was in an environment with a neurologist, a chiropractor, massage therapy, Ayurvedic care nurse practitioners. Really loved that multidisciplinary approach. However, . We shared a waiting room.

We shared office staff, and even though we were all running our own businesses . When Covid happened, there were certain risks and, rules that were in place. And I got really concerned that, okay, what if these other providers aren’t following the rules? Could I get fined? Could I get in trouble?

And so there is an additional risk at having this multidisciplinary kind of space and not having that autonomy over your own space. Also, if you’re working for someone else let’s say you work at Modern Acupuncture. . They are going to determine what your limits of liability need to be. The the type of policy that you need to have.

They are going to have the setup of their physical space, right? So you are not going to have a lot of decision making power when you are working for somebody else. There are things you can do. Of course, you’re gonna be practicing clean needle technique. . You’re gonna make sure that you keep your risk as low as possible.

But at the same time, there’s only certain things that you can control when it is not your space. The rewards of that though, we’re gonna get into, and some of that has to do with the cost. So let’s look at that. It’s very interesting to me that, over 90% of acupuncturists are sole proprietors.

So running our own businesses going out on our own functioning as entrepreneurs. And yet, like 2% of our education is focused on business training and most small businesses fail within their first few years. . There is something really interesting about how that is set up and certain realities that we need to be aware of with that.

And cost is really one of those. So when you’re looking at the cost of starting your own business now, yes, we are in an industry that has pretty low overhead. We don’t need a lot of expensive equipment to get really dramatic results for patients. We need our needles, we need our basic tools. For CNT, we need a treatment table.

If you’re doing community acupuncture, you might not even need a table. You might need chairs. So there are ways to offset a lot of this cost. You can share space when you’re first practicing. You can rent a room, so you are operating as an autonomous entity, but you’re minimizing the cost of your initial investment in your practice and how that looks.

Obviously if you’re working for someone else, a lot of that might even be taken care of, that already low overhead could get even lower. So I had done an employment agreement with another acupuncturist when I was first starting, and I worked with him two days a week, but. He paid for all of the supplies.

He was, doing all of the insurance billing. He had a scheduling software that he was paying for. He had office staff, so all I was doing was showing up and treating. And so when we think about cost, we also wanna think about what does that mean? For what it’s potentially costing us as well, right?

So if you are operating in your own business, you get to determine what that fee schedule is. You get to determine what your take home from your business is going to be. Whereas if you’re working for someone else, you’ll see a lot of these jobs advertised online and sometimes it is nowhere near what you could make in private practice.

And that’s because. This entity that is employing you or contracting you is taking on not only a lot of that risk, but the cost as well. And so they have to offset that in some way. But I do really wanna talk about the benefits because this is going to look a little bit different depending on not only like what your risk tolerance is, what your interests are, what you genuinely want to spend your time doing.

So like I mentioned with private practice. You get to determine what your fee schedule is. Nobody is making that decision for you. You can do your own market research. You can say, I’m going to have a relationship based practice and I’m going to go out and make friends with other healthcare providers and make sure that I have a ton of referrals coming in and I keep my patients really happy.

You could have a FI high volume insurance practice where you are in network with a lot of companies that are essentially . Pre-qualifying people for you who are on those websites looking and saying, oh, hey, I’m interested in acupuncture. Where is there an acupuncturist in my area? So that flexibility and the autonomy that you will have in private practice is really your major benefit.

You get to make. All of the decisions that for some cannot feel like a benefit at all. Some people, and I would venture to say a lot of people in our industry did not get into this medicine to run a business. They are not interested in being entrepreneurs. That is not, top of mind. It’s that they wanna be incredibly cli, clinically competent, which most acupuncturists are who are licensed and they want to deliver incredible patient results.

And that’s what we like to do, right? The benefit of working for someone else, when you give up some of that autonomy, you get back a lot of that focus on being a clinician. So I loved at that point in my career, when I was first starting out for two days a week to be able to show up in an office and just treat and have a full schedule and never worry about recruiting patients or what the overhead was, or was my, business license renewed.

Did I pay my taxes, did I get my articles of incorporation in ? All of those things were taken off my plate as an employee as a contractor as well. Like I’m not worried about those things. I get to show up and do what I wanna do best. So when we are looking at . The benefit analysis here that is going to be highly individualized depending on who is looking at this.

I personally see so much benefit in running your own business and getting to determine what your marketing strategy’s gonna be. Who are those partners you’re going to bring in? . But a lot of people might not feel that way. I have a provider who works for me in my practice, and she is incredible.

She’s been licensed for 12 years and she, the entire time has only been interested in employment opportunities or contract work because she is very clear that she wants to spend every hour possible in her day. Focusing on patient care and treating patients, and she has absolutely no interest in running a business.

So looking at benefits that is highly individualized. There are certain things that you’re gonna say, oh hey that sounds really good to me. That will not sound good to somebody else. So just like our medicine is so highly personalized, this decision is as well. But I think the important things with this to remember are you have tons of flexibility.

. You get to decide if you want to only run your own business, if you want to work for someone else, if you wanna work with someone part-time. If you wanna have multiple locations, that is a really beautiful thing about not only the personalized aspect of care that we have, but the personalized aspect we can have with our clinical setup and the way we deliver that care.

It’s very important though to know your state laws. So for example in California it is very difficult to contract people. A lot of those laws were built around trying to protect independent contractors like Uber drivers that type of thing. And. The side effects of that have permeated into the healthcare delivery system.

And so you need to be knowledgeable about, okay, am I even allowed to have independent contractors? Am I allowed to be an independent contractor? If I’m an employee, who do I need to be employed by? Another California example you need to be employed by a professional corporation. So if you don’t, your employer doesn’t fall into that category.

They’re not supposed to be employing you as an acupuncturist in that state. So there is nuance there and workarounds for all that too. That’s where the flexibility comes in. That’s where talking to an attorney comes in. That’s where talking to me, letting me guide you and send you to the right people to help with this setup.

And the last thing I wanna end with is that. As a, not only a medical provider, but a provider of acupuncture and traditional medicine who is working in such a highly specialized area of healthcare. yoU are your business. So whether you are, presenting yourself and saying, Hey, like I have my private practice, but I also work here and I work here and I work here many times, we become the brand for our own entity.

People are drawn to you a lot of times, even more so than the medicine. People get very attached to their providers, and so while that provides a lot of . Flexibility. There’s also a ton of responsibility that goes along with that, and I think that’s, I wanna link that back to the risk management piece at the beginning that we really need to be mindful of.

Because even if we’re out there, we’re, posting on our own personal social media, we’re still representing ourselves and our business, whether we are employed or whether we are practicing independently. I love talking about these different options. I’ve been able to help a lot of providers navigate that landscape that’s my happy place.

So please feel free to reach out. We definitely have the risk management piece covered, and don’t forget to tune in next week for another episode of To The Point. Thanks for tuning in. .


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