Here’s my question for you: can you describe that “mental ju-jitsu” in more detail? The reason I’m asking — this is another issue that came up repeatedly in the class I taught at OCOM ( one of the two acupuncture colleges in Portland). Lots of students said in the course of the class that what they hoped to do when they graduated was to have two different practices to serve two different markets: a community clinic where they could see their friends and neighbors, and a conventional clinic where they could use all the techniques they were taught in school, to help the only people who could afford those kinds of services — upper middle class and upper class people. I found myself saying to them over and over that this wasn’t realistic.

My experience of practicing acupuncture is that it is infinitely more demanding than I expected it to be when I was in school — demanding in a good way, not in a bad way, but demanding all the same. It requires all of my internal resources; it has changed many other seemingly unrelated aspects of my life. To be consistently effective, happy, and energized in my work with patients, I find that I need a very high level of integrity in my life. I need to meditate regularly, I need to get enough sleep, I can’t have any drama in my personal life, I can’t be distracted or divided or ambivalent. I can’t be different people at different times. I’m very grateful that my work forces me to have a stable, peaceful, focused existence; it’s a great benefit. However. Every acupuncturist I know who is in practice long term says basically the same thing — that doing acupuncture, no matter how good your boundaries are, takes more out of you than you think it will. People who maintain two practice locations or two different business models rarely keep that up long term, because it’s just too tiring. Eventually they have to choose, one or the other, not both.

It’s been my experience that the success of my practice has largely depended on my personal integrity. First, people like integrity; it’s magnetic, and it attracts patients like crazy. Second, integrity is EASY. It’s comfortable. It’s simple, it’s uncomplicated, and it saves a lot of energy — energy which is freed up for my practice. I’m all for challenging my comfort zone, and I would say nothing in my life has ever expanded that comfort zone the way running a business has, and I’m unendingly grateful for that. But I think there is a blurry place where stretching your comfort zone, moving outside of what you know, is potentially the place where you lose your connection to who you really are. If you lose that, you have nothing real to give to anyone else.

So this is why I am interested in your “mental ju-jitsu”. I’m pretty sure I could be successful as an acupuncturist in any viable market. The problem is, though, that I can’t imagine having the energy to do it long term anywhere except within my natural community. Being successful as an acupuncturist represents an enormous commitment and a huge outlay of energy, no matter where you do it. I’m trying to imagine that commitment and that outlay added to the energy it would take to break away — and stay away — from your natural community. And I can’t see it. There’s enormous comfort and nourishment for me in serving the community I live in, the people I know, and I can’t imagine going to work day in, day out, for years, without that nourishment.

So can you explain how you could do that mental ju-jitsu without compromising your integrity and cutting yourself off from what sustains you?

You’re absolutely right about the challenges of pricing yourself out of your natural community. It IS hard. But I think there are two kinds of hard in there. The first is the difficulty you face when you price yourself for a market that doesn’t exist, is too small, or is saturated. That’s BUSINESS hard.

The second is when you set your fees outside of your personal comfort zone (which is likely determined by your natural community). That’s MENTAL hard.

I like to believe that practitioners who want to run businesses in markets outside of their natural community (love that term, BTW) can learn to deal with that second kind of hard - it just takes some mental ju-jitsu to get there. In other words, you may have a natural predisposition for a certain market, but you really can succeed in any viable market.

It may be hard to move outside of what you know, but I have to believe it’s possible for those who want to.

Thanks Lisa!