My journey to providing accessible healthcare begun shortly after attending Canadian College of Naturopathic Medicine. During my first year there, I learned about the affordable healthcare model that has been successfully practiced at The Herbal Clinic and Dispensary.
This resonated with me strongly based on my family’s history and background (you can read more about my family’s story here); I couldn’t stop thinking about this business model and was excited to implement it into my own practice. In fact, it felt wrong and inauthentic not to practice this way.
Throughout the program, I thought a lot about providing affordable naturopathic medicine. It wasn’t until after graduation that I took the necessary steps to truly learn how to start and implement this model. I sent dozens of emails connecting with like-minded practitioners and set up meetings to discuss about their practice, what worked for them, what didn’t work for them, and suggestions on how to make accessible healthcare possible.
I focused heavily on making naturopathic medicine financially accessible. However, through several meaningful conversations, I learned that there are so many other ways we can make high quality healthcare accessible (read about what this means to me by clicking here).
The purpose of this post is to share what I have learned through multiple conversations about the considerations of starting a naturopathic practice, and how we (as a profession) can help remove barriers to wellness.
1) Know your product
With any business, it is important to know your product. What this means is that you should know who you are, what you are doing, what you are trying to achieve, and who it is for. You should always ask yourself if you are here to solve a problem (in this case, the problem is that there is still a majority of people who are unable to access high quality healthcare). Understand what you are offering and how you are solving said problem.
Whatever your branding is, consider providing barrier free ways for people to sample your product. For example, offering complimentary 15-minute consults allow people to test “your product/service” for free with no commitment. Because let’s be honest, naturopathic fees are not pocket change to many. It is also a great opportunity for them to get a sense of your energy and how you can help them solve their problem.
In addition to this, it is important to consider all other potential barriers for everything you do. It can range from the set up of your website, your booking system, to picking your clinic space; anything that can be viewed as an “obstacle” should be addressed. See considerations for clinic space for more.
Tip: Ask yourself what excuses are there for someone to NOT see you based on your current set-up?
2) How to market
WORD OF MOUTH
All of the naturopathic doctors I spoke with said their main avenue of marketing has been word of mouth and referrals. This is true for any and all businesses. If you have customers or patients who really like you, they will rave about you.
I had the opportunity to chat with a motivational speaker, and he brought up the concept of having “1000 true fans”. The goal is not to obtain a million fans, but to obtain 1000 true fans. True fans are the ones that will buy all your albums, attend every single concert, and buy all your merchandise. If you have these fans, they will naturally do the marketing for you. I thought this was an interesting concept and it made a lot of sense.
With naturopathic medicine, we are able to spend a significant amount of time with our patients to build that relationship. If they do well and see results, they will become your true fan. When you encourage referrals, they will be happy to do so. Of course, as naturopathic doctors we probably don’t need 1000 of them, but having a secure client base (whatever your number is) is a good start.
THROUGH CONVERSATIONS
If you are a chatty individual, this one is for you. Tell whoever you interact with about what you do (in a natural way). Whether you are at a cafe, chatting with a local business owner around the corner, or having a random conversation with someone you just met, you can always sprinkle in what it is that you do in an organic way. Pique their interest, tell them why you love doing what you do, and offer some business cards.
Tip: Get to know your community. Go around and introduce yourself. Carry around extra business cards with you. You never know when a good networking opportunity will come up!
SOCIAL MEDIA & ADS
Many found social media to yield very little patients if at all. It can be argued that the bombardment of ads may actually deter individuals as it can become annoying (but they still work). Regardless of the relationship you choose to have with social media, it can still be beneficial to build an online presence so the public knows you exist in the first place.
Even if the conversion rate is low, there is a potential for indirectly conversion. This means that those who saw your ad may not come to see you, but may tell someone else about you and that person books an appointment. Either way, you are still taking up space online.
Of course, this has changed since the pandemic; as we try to navigate around transitioning to/incorporating online services, we rely much heavily on our online presence.
Are you interested in providing accessible healthcare?
POSTERING
A lot of times, your clients/patients are ones that either live in the neighbourhood, or passes by the neighbourhood regularly. To increase your exposure, postering around the area can help (although it is not the most sustainable way to do so). Offer flyers to local businesses or hang some on telephone poles and bus stops. Having your name and face around will help build your presence in the community.
VOLUNTEER
TALKS
One of the most commonly discussed way of marketing in the naturopathic profession is providing talks and/or workshops. This makes sense because we are providing free information on a selected topic, and we are able to give the public a sense of who we are and how we can help them.
However, there is a strategy behind it. One-off talks do not convert as much. General talks about what naturopathic medicine do not convert. If you do decide to lead these events, it is better to do focused topics and consider doing a series of them. This provides valuable take-away information, and allows more opportunities for people to attend if they are unable to make it for one of the days you’re hosting it.
This ties in nicely with volunteering. Many community centres look for healthcare professionals to do educational workshops or talks. They want to provide valuable information to the public that otherwise would not be given. Again, this aligns well with the accessible healthcare model.
Of course, with the pandemic, more people are offering talks, masterclasses, and webinars online instead – but the concept is similar.
3) Choose the right wording
As subtle as this is, your choice of wording is crucial. This applies for your website and all your marketing strategies. For example, distinguishing between affordable and accessible for clarity, and alternatives to using “pay-what-you-can” to avoid stigma around “discounted” services (which can be misinterpreted to lower quality service)
This is also important in the LGBTQ2S+ community. If you are providing accessible healthcare to this community, make sure your forms and the questions phrased in visits are appropriate. Cyndi Gilbert offers great resources on how to ensure your practice is LGBTQ2S+ friendly. It’s the little details that make a significant difference!
4) The pricing set-up
Depending on how you define accessible healthcare in your practice, the set-ups may be different. Here are a few options to consider:
- Selected times: With this, you offer certain time slots for affordable care. This often happens during your otherwise down times and allows you to fill those slots up. You can set up a wait list if you get booked up, and boundaries should be established. Though this gives the opportunity for someone to see you at an affordable rate, it is not as accessible since there is a huge time/date restraint. This may not be possible for those who need to work as they live paycheque-to-paycheque.
- Home visits: This is great for patients who cannot leave the house or have extreme mobility issues. The advantage with this is that you get to keep 100% of what you make. However, travel time and ability to transport equipment becomes a huge obstacle. Unless you have a car, it is not very doable. Even with a car, it can be time consuming and may not be worthwhile if you are seeing enough patients at your clinic. You can also charge extra for travel but this reduces the affordability of it.
- Telemedicine: This is a great way to have a consult in the comfort of their own home. Similar to the above, it is suitable for those who cannot leave the house, have extreme mobility issues, live far away, or just have a busy schedule. It is convenient for the patient which means that they are more likely to attend the appointment. Of course, this is only for consults or counselling that do not require any physical treatments (i.e., acupuncture) or testing. Regardless of the type of practice you do, this is a great asset to have. The importance of telemedicine has risen since the pandemic. If you don’t have this incorporated into your practice, make sure you do so!
- Sliding scale: You can come up with a range for patients to choose from. Often, the lower end of the scale is determined by your overhead. It is the value that is enough to sustain your practice (or pay for your overhead) if every patient paid this amount.
- Tiered system: You can have your regular full rate, 75% of your rate, or half rate; whatever you make the system to be. This makes things a bit easier on the billing side and less ambiguity for the patient to choose from. Again, providing accessible healthcare means so much more than just financial accessibility. It is okay to charge regular rates!
- Pay-it-forward system: Here, you are charging your regular rates but give the option for your existing patients to contribute on top of that towards a bursary fund. Once the fund reaches a balance that is equivalent to a session, you can offer an appointment for free to the next person on the bursary wait list. With this set-up, free sessions are more unpredictable which can impact the accessibility you offer to your community.
Other things to consider:
- Often clinics do not require proof of income as this can become awkward for the patient. Asking for proof can be seen as a potential barrier to receiving your service.
- Think about how you want to communicate your billing. Some practitioners would mention it at every single visit, others will assume a regular rate unless the patient states so otherwise. Do you want full transparency on your website or do you want patients to inquire directly with you? Do you want to communicate and determine the amount at the beginning of the visit or at the end?
- There is no hard and fast rule on how to do accessible healthcare properly. Do what works for you and your patients.
- Just to reiterate, it is important that you are sustaining yourself and your practice when you are providing affordable healthcare!
5) Picking a clinic space
This has been one of the most difficult part for me. The process of finding the right space has been a long one. I’ve been very patient with the process, and try to not settle for a space just for the sake of starting practice sooner. Here are some steps and considerations to help you find the right clinic space:
- Google existing clinics in different neighbourhoods. Go through their website to get a sense of their vibe, understand their values, and who is practicing there.
- Drop by clinics. See how busy they are, do they naturally get foot traffic (i.e., stores, gyms, integrative clinics, yoga studio), what energy do they give off, does it resonate with you?
- Don’t write off clinics that do not practice accessible healthcare. If they are supportive of the model, it is possible to provide such a model out of this space.
- Chat with the receptionist, get a sense of their attitude and how they work. They are the frontline workers of the clinic. No matter how good you are, if you have a bad receptionist, it affects the entire experience.
- What are the clinic owner’s values. Does it align with yours?
- Get to know the practitioners there (if there are any), what is their dynamic like? What are their experiences?
Other things to consider:
- How many locations do you want to work out of? Most clinics offer part time rentals. Depending on how many days you want to work, you may be at 2-3 different clinics (unless you want to run your own clinic of course!)
- Some prefer being at 1 clinic, others like multiple locations.
- This depends on how you work and the type of person you are. If you don’t want to spread your energy across different areas, want to avoid lugging around equipment or materials, and want more of a consistent routine/schedule, 1 clinic may be for you.
- If you want to work in different environments and people, avoid office politics, and provide your services to varying patient populations, multiple locations may be better for you.
- There is no right or wrong way, it just depends on what works for you.
- Do you want to pay rent or do a split? For rent, consider the average rates in the neighbourhood. For split, most agree a 65/35 split should be the absolute minimum. Ask the renter what it does and doesn’t include:
- For example: use of front desk/reception, booking and POS system, service included (laundry, cleaning, garbage), supplies (cotton, swabs, paper towels, tissue, alcohol, hand sanitizer, garbage, linens, needles, biohazard), wifi, EMR, building access, online/website profile, marketing, commission if there is a dispensary/store on site
- You can also inquire about their demographics if you have a specific niche
- Do you want to pay rent or do a split? For rent, consider the average rates in the neighbourhood. For split, most agree a 65/35 split should be the absolute minimum. Ask the renter what it does and doesn’t include:
- Does the space pose any barriers to patients? For instance, individuals seeking affordable care may feel uncomfortable walking into an upscale clinic or neighbourhood even if you do provide affordable rates. If your space has several flights of stairs, elders, those with chronic pain, and individuals who need support with exercise may dread going to their appointments as the act of physically going into the clinic is an obstacle itself.
- Would you want to practice here 5-10 years down the road? Relocating is stressful and you will likely lose a lot of your patients. Try to stay in a particular area. But also know that it is okay to move if the space just isn’t working out for you.
- If you find that you are not growing or progressing after a full year (despite all your efforts), it may be time to relocate (assuming you want more growth).
5) Challenges
There are obvious challenges with starting your own business. However, there are specific challenges that come with accessible healthcare, especially in regards to affordability.
As passionate practitioners, it is easy to work out of “social obligation” or “labour of love”. We want to give back to the community, and we want to help everyone.
However, this leads to burn out and is just not sustainable. It is important to ensure our model is sustainable for us because if it isn’t, then we wouldn’t be able to practice the way we want to anyways. Be aware and recognize when these feelings come up. Ask yourself how you can make ‘x’ more sustainable for you.
Another huge challenge revolves around the scarcity mindset. This is the belief that there is not enough to go around. We may get criticisms on our practice model. Others may believe that you are “taking from them”, or devaluing our services.
However, this is not accurate; we are not doing this to compete. The patients we attract are unlikely to be the same ones they attract. We are not devaluing our services because our intent is accessibility, and not because we don’t believe in our services. Of course, these criticisms are out of our control. We can only control how much we let this affect us.
Lastly, with an affordable healthcare model, it is easy to tie our self worth into the amount our patients pay us. There may be a patient who comes in wearing a $700 jacket, but pays you the minimum for your service.
Naturally, this can be bothersome. However, in order to not let this affect the way we practice and the quality we provide, it is important to learn how to decouple the association.
Most of the time, it has nothing to do with you or your worth, but more about what works for the other person. Yes, there is a risk that patients “take advantage” of the system, but there is no way for us to know their story or situation and why they made particular decisions.
By having an abundance mentality (the belief that there is more to everything), we can shift our thinking and allow us the space to practice the way that is true to us.
Conclusion
My journey towards accessible healthcare has been an exciting and challenging one.
I am grateful that I was able to join the clinic that started it all (The Herbal Clinic & Dispensary), along with another amazing clinic closer to home (Urban Wellness).
Wherever you are on your journey, I believe that when the time and space is right, it will happen.
Be patient, do your due diligence, and the right things will come along.
Hope this entry has been helpful for new practitioners, and for those wanting to offer accessible healthcare – we need more of it!
Special thanks to the wonderful people who took the time to chat with me:
Chris Pickrell, Cyndi Gilbert, Caroline Meyer, Crystal Chanderbhan, Richard Kwan, Laura Burns, Yan Yen Loo, Suzanne Ho-Miecznikowski, Stephanie Cordes, Brianna Dowdall, Leslie Solomonian, Kevin Rempel, and Emily Bennett!
