Running a Multi-bed practice

Often in workshops we run, the question that pops up is ‘How do I run a multi-bed practice?’. If you are only running one room or perhaps 2 and want to run more the prospect of changing how you operate can be daunting. Here we will discuss the pros and cons and the how to’s.

Why should I consider running a multi-bed practice?

For me the primary reason for a multi-bed practice is being able to treat more people in less time or even the same amount of people in less time. Why? In a nutshell it’s to prevent burnout. And trust me, I know. I have burnt myself out twice in my career and it is not a fun experience. Previously I ran one room and was treating upto 55 clients a week over 6 days. Crazy I know but at the time I was the only income earner and we had significant costs to live. If at the time I had decided to run two rooms instead of working 50+ hours a week not including admin I could have dropped my hours down to 30 hours a week. If I had decided to run 3 rooms, what I do now, that figure would drop to 22 hours per week. This can be done easily in 3 days.

The average working week is 40 hours and I feel like we have fallen into the trap of considering this as the standard number of hours we should all work each week. However this does not take into account the intensity of the work we do. We treat people day in day out who are extremely distressed, and doing this for long periods in my experience and the experience of many practitioners I have spoken with over the years will take it’s toll. At this stage in my career, I am not convinced that practicing 40 hours a week is sustainable for the average practitioner over the long term. So that being said, the idea of a multi bed practice makes sense.

The other thing to consider is if you are working 40 hours a week in practice not including admin then you are limiting your earning potential. I know, I know it’s not all about money, but if you are struggling to cover your bills every week this fact will also take it’s toll. High stress does not make us the best practitioner we can be.

What are our resistances around running a multi-bed practice?

The most common resistance to a multi-bed practice is we all want to spend the time with our clients, give them space to talk about what they are struggling with and to be able to talk with them.  And look, I used to be 100% of this mindset. However, we can easily fall into the trap of becoming quasi counsellors. Whilst some of us might have some skills in this area I think we need to be very careful playing this role. It is not our scope of practice and there are other professionals who are better placed to provide this service. I’m not suggesting we become clinical autobots, however we also should be mindful of counselling too much.

Another argument is that practitioners want to make sure they are providing value for money. Many practitioners provide massage, cupping, acupuncture, moxa etc etc within their consultation. Is this for better therapeutic outcome or is this because we fear our clients won’t value our service? These days I largely use one or two needles with significant therapeutic effect and use no other modalities within my treatments apart from herbs. The reason is my clients are paying for results, not more modalities within the treatment. I have proven this multiple times by changing my approach significantly using less input but with greater therapeutic effect with my clients. No one, and I mean no one had an issue.

How do I run a multi-bed practice without reception?

The simple answer is systems. The more systems I have in place that give me more time the easier it is for me to scale my room numbers.

In my clinic I have 3 separate rooms to ensure privacy for my clients but some practitioners like to use dividers or even community acupuncture setups. So many different options. When I first scaled to 3 rooms I went to seeing 75 clients per week in 27 hours. I initially needed to bring on reception to help me navigate the change. However, after a few years I decide to remove reception support and now see 58 clients per week in 22 hours which includes treating, rebooking clients, taking payments and making up herbal formulas for between 10 and 15 clients per week. It’s important to note that running multiple rooms does not mean decreasing the quality of treatment or service. I get solid results and have very happy clients.

  • Online bookings – I use this as my main pathway for client bookings except for rebooking clients after their session. I rarely answer the phone as in my message I tell people how they can book online. If someone wishes to speak with me, they can leave a message and I can call them back.
  • Fast diagnostics – I use a very quick pulse diagnosis approach that saves my client having to tell me a massive story. We can still talk about it, but it speeds up the process. My palpation diagnosis is also a key component to rapidly assess a client.
  • Acupuncture – these days as mentioned I rarely use more than two needles with strong therapeutic effect that I can ensure my client observes and can see the change. So my treatment is fast.
  • Timing – I am very strict with my timing, however as my sessions are 50 minutes in duration, I have some wiggle room if I absolutely need it. Most of the time I don’t.
  • Late clients – If a client is running late, I do not extend their time. It’s not fair that the next client is waiting because the current client turned up late. I also tell my clients if they are running any more than 10 minutes late, I will not be able to treat them.
  • Client intake – In our confirmation email we send an intake form. If someone hasn’t filled it our I resend it a couple of days prior to their appointment to prompt them. In our confirmation and reminder emails we tell our clients to arrive 10 minutes prior to their appointment if they haven’t filled out the online intake form.
  • Admin – As I am not working every day in clinic I have loads of time to do my clinic admin, marketing etc.
  • Preparation – I make sure all equipment, toilet rolls, eftpos rolls etc are well stocked every day before I start. I also give myself time to run through all my client notes before starting.
  • Treatment notes – I prefill as much as I can in my treatment notes before the client arrives. My treatment note template already has a bunch of things ready as a tick box method to streamline my note taking and my ability to scan my notes quickly for previous appointments.

How do I transition to a multi-bed practice?

The most important thing is scale gradually. When I did it, I added one room and gradually worked out my timing and approach. You might make some mistakes, but we all do, I did. You must keep your eye constantly on the clock, so you don’t get side-tracked. Once you feel comfortable with 2 rooms you can scale to 3.

How are you feeling? A little daunted? If you weren’t I’d be worried. Any big change in our clinic makes all of us nervous. But this doesn’t mean we should be directed by our fear. It also doesn’t mean you have to go to multiple rooms. Your practice is your own and everyone has the right to choose how they want to operate. If you are not happy with the amount of hours you work and/ or your remuneration at the end of the week then this is definitely an approach worth considering.

Oh and by the way I think about it these days is the more people we can treat the more of our community begins to realise the power of our medicine. The more Chinese medicine can be seen as the top tier modality it is the more people will seek it out, the more people will want to become practitioners and then we are on the path to world domination mwah ha ha.

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Jeff Shearer is a registered Chinese medicine practitioner in Newcastle, Australia. He has been teaching practitioners since 2009 helping them to become the best they can be to serve their communities better.