Burning Out Or How to Make Sweet Sweet Love to Your Clinic

**Warning most of all below is intended to be taken with a sense of humor. Please don't take it too seriously**

You know there’s rumors going around about how CA owner burn out. If you think of the numbers it is pretty scary. People get tired seeing 8 patients a day, how do you not get tired seeing 30 to 40.

I think it’s time to address it head on. What is burn out and how can we avoid it as CA owners?

First, we fight against the workaholic tendencies of our culture. I was reading a book by Gabor Mate (all his books are awesome! Read them. Thanks Lumiel) and it said if you were to choose guilt over resentment. Always choose guilt. Guilt is you doing something for yourself. Resentment is soul suicide. You need staff. You can’t see high numbers without it. Or rather you can see high numbers, but you can’t without really taxing yourself.

This took a little for me to admit to myself. I mean I’d like to be proud and workaholic and say I saw 140 patients a week by myself. Or somehow there’s rumors of that. But that is simply untrue. I saw 140 a week with staff helping.

And for a while, I really didn’t want to admit it. I really didn’t want staff around. I am quite an introvert. It takes me a while to get comfortable with people. And…..also…..umm….I don’t like having someone watching me, it makes me feel like I should be on good performance. If I am just by myself I like to do tai chi movements randomly in the back (which really helps me), or eat, or ………….(deep dark secret) read comic books. And well…it’s just kind of embarrassing to have someone else doing “work” while you’re reading comic books…

But really! Why do we have to accept our workaholic culture that demands us be BUSY all the time so mindlessly?! If I can see *$*@X*!!ing 30 or 40 patients a day, why can’t I just do acupuncture and read comics? My mom’s not staring over my shoulder judging me.

And there’s the key. Why do we burn out? Because we can’t sit still. Because we can’t let other people do things. Because we have to do it all, ourselves. Or think we can.

What my clinic needs, what my community needs, and what I need is for me to read comic books during the day. wink Because if I have staff and don’t have to answer the phone, book appointments, make change, do filing, send out postcards, sweep, make new files, enter checks, and etc.etc. I am not going to burn out. I will have a more sustainable practice, a more sustainable life, and I will be able to do this for much longer. My clinic will not fall apart if I feel a little tired, have a fight with my boyfriend, decide to fix up a foreclosed house, decide to plan a wedding, have a kid, or stay up all night reading comic books, because I can read comic books during the day. Get it?

Second, we allow ourselves the humanity to not love the clinic 100% of the time. I think I have mentioned this before in the forum posts. There’s a natural high when you open up a clinic. It’s like making a leap of faith off a cliff. You take lots of risks and make lots of decisions. There’s a lot of adrenaline. But at some point, you start growing out of the infatuation stage.

I know so sad. Ahh, the first date, the first time you held hands, the first kiss you feel like you can never get enough of each other. You’ve found your true soul mate who will love you and accept you forever including all your faults. Ahh, the first day I opened my clinic, the first patient, the first 4 patients an hour, the first 6 patients an hour, their first 60 patients a week, the first free day, the first 80 patient week, the first 100 patient week. We have had a lot to celebrate.

But what happens after you get married or cohabitate for a few years. What happened to all that magic? Then you have to deal with all the little annoying habits like snoring, not squeezing the toothpaste from the bottom, the not putting dishes in dishwasher, the always ordering of meat lovers pizza, the always leaving the socks in the shoes, the always not unrolling the socks before tossing it in the laundry. My clinic is the same way… wink

Then it’s just putting files away, getting new files out, new patients, crazy patients, vacuuming, more vacuuming, dusting, patients getting better slowly, more dusting clinic starts to seem a lot like work.

Am I burning out because I just don’t love my lover the same anymore after a couple years? Really…I hope that’s not the word you use for it. I think there’s developmental stages. And after you lose the flame you develop techniques to keep the embers burning forever. I think it’s the same thing for the clinic.

Keep on celebrating. Just because you have treated 100 patients before doesn’t mean you shouldn’t celebrate this week. Just because you have had a free day before doesn’t mean you shouldn’t celebrate. Keep the fire burning!

And yes you can hate your clinic on the days it’s inconsiderate of your feelings and orders that meat lovers pizza again for dinner without asking you. You don’t have to love it 100% of the time. And you can lose interest for a little while and take up belly dancing and rock climbing, but don’t forget about it forever.

P.S. The next time someone ask me to tell them all my secrets and rock their clinic I will say:

You begin by whispering sweet nothings in their ear, then run your finger down their neck, while planting sweet kisses on their jawline.

Third, we get out of Hydrogen mode into Tungsten mode. I think Lisa’s opening speech about Breaking the 100 Patient Barrier is someone all CA people should be required to read. Especially, the ones by themselves or struggling with burn out. And Jessica's post on her free day.

We don't burn out doing 30-40 patients a day, because you know what? We're in tungsten mode. We have systems for handling 6+ patients an hour. We treat patients by letting the acupuncture work without having to spend a half hour deciding our treatment plans. We don't spend all our time and energy trying to be gurus that do everything for our patients. We are just acupuncturists.

This is how you make sweet sweet love to your clinic.

This story was posted on May 5 2011 by mitylene.

Comments

  • May 6 2011 at 11:05 AM
    tessmcginn writes:

    Good post…

    One of the ways I keep from burning out is enjoying the fact that I was wrong about something I was sure I was right about.  

    I think I don’t like doing health fairs, they are a waste of time.  The one I did a month ago was that way.  They wouldn’t even let me bring needles into the building to show.    

    But I did one yesterday that was not.  Because it was the right fair to do (yes it does exist!  I was wrong!).  A local and large corporation one of my patients connected me up with.  I treat people who work there already.  The health fair organizers scheduled 30 ppl for 15 minute treatments.  I did some good acu-parlour tricks, getting rid of headaches, wrist pain, lowering blood pressure, feet pain gone etc.  

    “Did you see her? ”  I got 2 calls from those folks even before I arrived at my clinic for an afternoon of 31 patients in 3 hours (not my usual number but it was great anyway).

    And the help thing is key.  I have time to enjoy my kids, I dropped my Friday shift which I was afraid would hurt business.  It has not.  

    It looks like my income is going to go up by at least 40% this year.  That also keeps me from burning out.  Large numbers of patients do not intimidate me anymore.  Figuring out how to pay my rent at work and mortgage at home does.  It is good to figure out how to keep those number in check which I suspect how many will get burned out.  It’s the income/expense balance sheet that can drive feeling badly about how you are doing.

    Keep up your good spirits, you have alot going on and I wish you well in your marriage and new home. 

    Tess Bois 

    http://www.oneworldacupuncture.com 

    One World Community Acupuncture

    Fitchburg, MA

      0 likes
  • May 6 2011 at 11:21 AM
    David Lesseps writes:

    I love my clinic

    And I love reading fantasy novels in between patients.

     

    David L f’ing Ac (my earned title)

      0 likes
  • May 6 2011 at 11:40 AM
    Demetra writes:

    Love it!

    Awesome advice as usual!

      0 likes
  • May 6 2011 at 12:46 PM
    MMDobson writes:

    I don’t have staff yet,

    But am getting close - I am not so much resisting it as waiting for the point where I can justify it.  And that is soon.

     

    In between patients I color in a coloring book or do origami.

    MM 

      0 likes
  • May 6 2011 at 3:45 PM
    Justine writes:

    Just the right timing for this post-

    Hey Jade,

    Nice post.

    I’ve been grappling with the idea of having desk staff for some time now - I’d be happy to save a few bucks, and I don’t like the idea of having someone around if it’s not that busy - but some days are just so busy that it can be exhausting and somewhat stressful carrying the load on my own.  This past Monday I had one of those days - 35 treatments, me doing the treating, the scheduling, the money, the everything - finally got me to put a post on Craigslist to see about hiring.  Actually, I find the 35 patient days easier and faster to pass by than the 10-15 treatment days, of course - I would so much rather be busy than bored, and it really keeps my qi moving.  But I have a lot of fear about having a desk person.  What if I don’t really like having them here?  I want to be able to do what I want without a desk person there to “entertain” if it isn’t super bus.  I don’t want to think they will be bored if it’s not super busy.  But I thought about it, and of course, it energetically opens up more room for more patients and things to go more smoothly, and for me to not be wiped out by Friday (which… I am).  And I can get them to do the stuff I hate doing (answering the phone… dusting… going to the post office).  Just the thought of having someone else do that for me makes me breathe a sigh of relief.  So I think it’s time.  I’m glad I’m not the only one to have concerns about a desk person.  I think going it alone only works for so long.  Having another hired punk has been helpful, of course, but drowning in admin stuff gets old after awhile.  It will be nice to turn some of it over to someone else - and keep the lovin’ feelings aflame smile

    Justine Deutsch, Acupuncture Together of Cambridge, MA

      0 likes
  • May 7 2011 at 9:25 PM
    jenniferwoolf writes:

    Good timing here too

    I just sent a text to Andy a few days ago about hating to go to work, or something like that.  I am COOKED.  Sitck a fork in me, or whatever that saying is.  I’m so done.  Meanwhile, the clinic keeps kicking, numbers keep growing, we’re gearing up for another business loan… It’s a funny place to be in.  One hand full of life and the other begging, “I need a break!

    Mostly what’s working for me is pulling my attention - okay, dragging my attention- back to center, back to ground.  Me working with the main complaint like a jigsaw puzzle, thinking and turning the pieces over in my mind - that’s what gets me all hot and bothered about CCA right now. The other thing that is helping me a lot is drawing much stronger boundaries and not giving away every last ounce of me to every last person who asks for it.  I’m a lot happier and more productive, and patients like that I smile again. 

    When I focus on puzzle-solving, which is the part of acupuncture that has always captivated me, it feels like I can see patient after patient in a perfect, free-flowing stream of energy.  I get in the zone, happily. 

    There are some fabulous workers at CCA and they do a great job taking care of the basics.  And one even brought me a coffee this morning smile 

    I’ve been actively working at getting my attention on the clinic while I’m there - and getting my attention off the clinic when I’m not.  That helps me a lot.  I need some down time.  Instead of doing the 20 public speaking gigs I did last April through June, I’m doing 10.  I’m not writing articles or teaching classes.  I’m just poking people, one after another.  It almost feels like a vacation!

    I have taken my feelings of burn out to mean some things needed to change, and by that I do not mean me into some other career (though I did have that thought a couple of times, which was super scary!)  I also recognize that my personal life being in complete upheaval for the past year while CCA was in the first year of operation probably had a lot to do with me hitting the wall recently.  This blog entry was, indeed, perfectly timed.  Thanks.

      0 likes
  • May 7 2011 at 11:35 PM
    mitylene writes:

    Don’t have to entertain them…

     

    I was recently feeling guilty about not entertaining them then I thought: 

     

     

    Ah! I am trying to be responsible for the world again. Why is it that I feel like I have to entertain my receptionists and keep them busy. And I had a beautiful Friday afternoon that was busy enough and we really chatted and bonded. And it was wonderful.   

      0 likes
  • May 8 2011 at 8:31 AM
    Nora writes:

    Thank you, Jade. 

    The honeymoon was definitely over for me this past winter.  I don’t think it had anything to do with Community Acupuncture per se,
    except that we take our practices seriously as small businesses, and being a small business owner takes a lot of energy and perseverance.  For me, part of feeling burned out was the long, cold winter making everything feel like a huge slog.  Part of it was just being tired from opening two clinics within two years and moving cities and moving house, and then moving the second clinic in the heat of the summer.  Another part was not making good winter-exercise contingency plans.  And part of it was feeling frustrated that the clinic wasn’t growing at the pace I wanted it to (even though I didn’t really have the structures and support in place that would allow me to be as busy as I wanted to be).  I did commit to a meditation practice, which helped keep me going, and helped me start to face the fact that, as much as I told myself I *should* be able to do everything myself, the reality was, I wasn’t able to – at least not well, or not with a song in my heart.  “Maybe Jade can, but I can’t.”  ;^)

    What helped the most, however, was sporadic phone conversations with other CANers, and in particular, the CANference.  It helped SO MUCH being around people who were grappling with the same basic issues, frustrations, even resentments – but who were still fundamentally deeply enthusiastic about Community Acupuncture.  I took the energetic infusion I got from that weekend and came home and started Taking Care of Business.  I looked at the numbers, which *felt* low, but only because my set-point (my atomic number?) had changed; the first quarter of the year had in fact been markedly busier than the previous quarter, and dramatically busier than the same period last year.  I recognized that I couldn’t sustain any more growth without staff, and that even if it meant not paying myself for awhile, staying “safe” was not worth the burnout.  I took the leap and hired a receptionist/bookkeeper, and have been working to make other systems run more smoothly.  I started actually doing marketing again.  I still feel a little tired from pushing to get all this behind-the-scenes stuff done, but I feel *motivated,* and much more engaged.  I’m talking with the landlord about taking over some square footage next door so we can have a bigger, more “third-placey” reception area.  Of course, now that I’m ready to be really busy we’ve had a couple of really quiet weeks.  But I’m so much happier to go to work, I can’t imagine that other people won’t pick up on that, and be happy to be there as well.  I’ll keep you all posted.

    P.S. Still laughing about the meat-lover’s pizza, and loving the comic books.  It’s hard to do other things in-between patients!  I always bring my knitting just in case.  

      0 likes
  • May 8 2011 at 11:24 AM
    Clayton Willoughby writes:

    Never feel guilty

    about comic books. A lot of us spend time surrounded by numbers, big issues and responsibilities. Good stories are important, just as important as the real world. Don’t believe me? Stop by a church sometime. 

    It’s not all about capes and bad guys either. It can be about magic (Promethea), the power of story (The Unwritten), personal experience (Persepolis or Maus) or things you love (Tezuka’s Buddha). 

    When I was young I used to ask what music people listened to, now I just ask what they read. Any picks for me?

      0 likes
  • May 8 2011 at 1:32 PM
    alexa writes:

    Great post

    Thanks Jade - this is just what I needed to hear this week!  I like to do crossword puzzles in between patients smile

      0 likes
  • May 8 2011 at 2:21 PM
    David Lesseps writes:

    OMG!

    You are such a nerd!

     

    David L f’ing Ac (my earned title)

      0 likes
  • May 8 2011 at 3:27 PM
    alexa writes:

    Oh yeah

    Like reading fantasy novels isn’t the least bit nerdy

      0 likes
  • May 8 2011 at 7:17 PM
    David Lesseps writes:

    no.

    It’s not.

    David L f’ing Ac (my earned title)

      0 likes
  • May 9 2011 at 7:32 PM
    suzzanne.lohr writes:

    Prefectly timed smile

    Thanks, Jade!  I have to admit I need to stoke the love fire here at Little Bird these days.  Honestly, it has nothing to do with patients.  I am dying to see more people.  I feel so much better when I am rocking out all day (and yes I still take time to read the internets and indulge some nerdiness). I am dying to have more punks, and a receptionist.  I hate calling people and I think I might even like to work with others!

    My love is faltering because I am trying to reach Tungsten and am having the worst time getting there.  I have gotten a realtor to help with finding space and he is slow as molasses. But I guess slow is better than crappy.  He is dilligent and is looking hard for the cheap mega space that I pray actually exists here in DC.   I hired a new punk and am having a hard time getting him to commit to more shifts.  He is great and fast!  I just want him to work more and can’t put forth a full-time job offer until I get a bigger space. Ugh!

     It is all one giant contingency plan that hinges on a new space.  Plus, my family is going through some really, really awful stuff right now.  (I think this is actually my sticking point.  I have zero time to think about the clinic. I just want to make sure my family doesn’t fall apart.  It is bad.)  

    Tungsten, where are you?  I am open and ready and praying for office space, a bitchin’ receptionist and a couple of full-time punks to hire.  It has already rained, it has already poured, the water is coming up over my banks and so far I have kept my head above it.  Universe, bring it on.  Throw me a branch in the form of office space.  I am ready to love the hell out of a bigger better Little Bird.

     

    Little Bird Community Acupuncture

    Washington, DC

    http://www.littlebirddc.com

      0 likes
  • May 10 2011 at 6:18 AM
    crismonteiro writes:

    Some weeks it just seems like

    it’s meat-lovers pizza everyday.  Hang in there—your branch is coming downstream. 

      0 likes
  • May 10 2011 at 10:20 AM
    Guest writes:

    Ready to help you move!

    I must publicly proclaim myself a proud patient of Little Bird since November of last year, when I first discovered CAN.  As comfy as her tiny space is, from the very beginning, I have been unable to stop fantasizing about a BIG, BIG Little Bird!  I have been hoping and praying since then that Suzzanne finds a bigger space and more acupunks (Frank is a great start!).  I am extremely proud of her for setting up the first CAP in the nation’s capitol no less.  Suzzanne, I am here to pack boxes, drive trucks through DC traffic, vacuum, dust, and help set up in your new space when it comes!! (Did I mention I have 10 years of experience of frequent moving?)  HANG IN THERE!

      0 likes
  • May 10 2011 at 10:41 AM
    Jessica Feltz writes:

    Sooooo glad we’re getting together on Friday!

    Maybe we should cruise the hood for vacant signs…

      0 likes
  • May 10 2011 at 4:00 PM
    David Lesseps writes:

    Helen

    If this forum had a “like” button, I would have just hit it so hard I’d break it.  Thank you so much for posting here.  I think I speak for all CA acupuncturists, when I say that comments and gestures like the above from patients like you are sweet sweet music.

    Thank you!

    David L f’ing Ac (my earned title)

      0 likes
  • May 11 2011 at 12:24 PM
    suzzanne.lohr writes:

    You are the best!

    Thank you, Helen!  I am so blessed to have such a wonderful community of patients and punks.  I feel the brach getting closer! i love you all so much smile

    Little Bird Community Acupuncture

    Washington, DC

    http://www.littlebirddc.com

      0 likes
  • May 13 2011 at 9:17 AM
    keithananda writes:

    LOL - this is me visualizing

    LOL - this is me visualizing you putting in ST36 with one hand and holding Storm of Swords in the other hand then rolling along on your stool to the next chair, like the way you see people walk down the street reading wondering how they don’t bump into a lamppost.  ha!  or maybe you’re just holding a storm of swords in both hands.

     or… maybe it’s time to introduce ‘Acupuncture Story Hour’ ( ahem , trademark) , where we have someone come in and read aloud to the peeps.

      0 likes
  • May 13 2011 at 9:21 AM
    keithananda writes:

    LOL

    novels, crosswords, origami, knitting… am i the only one charting in-btwn patients?  i feel like such a square.  fuck it, i’m bringing my soccer ball today.

      0 likes
  • May 14 2011 at 5:01 PM
    MMDobson writes:

    I like it!  Acupuncture

    I like it!  Acupuncture Story Hour, can I use that?

    MM 

      0 likes
  • May 14 2011 at 8:14 PM
    David Lesseps writes:

    hmmm…

    House of Stark Community Acupuncture does have a good ring to it…

     

    David L f’ing Ac (my earned title)

      0 likes
  • May 16 2011 at 9:31 PM
    Whitsitt writes:

    again with the wizard thing!

    David - you really need to check out Patrick Rothfuss if you haven’t already.  Really great story that happens to be fantasy.

      0 likes
  • May 17 2011 at 1:26 AM
    David Lesseps writes:

    yup

    I’ve read Name of the Wind and Wise Man’s Fear.  I hope I don’t have to wait 4 years for the next installment.

    I gave S&L and copy of Name of the Wind in April.  Hope they get hooked.

     

    David L f’ing Ac (my earned title)

      0 likes
  • May 17 2011 at 9:49 PM
    Whitsitt writes:

    smile

    I’m glad I was late to discover Name of the Wind… I only had to wait about a year for Wise Man’s Fear.

    What I hope is that Rothfuss makes a truckload of money from his books and actually gives it to Nathan Fillion to buy the rights to Firefly from Fox so they can make more episodes (something he said in an interview).

      0 likes
  • May 18 2011 at 6:40 PM
    suzzanne.lohr writes:

    ha!

    That is the best.  So nerdy.  Just hope no one turns on you wink  So much intrigue.  And dragons.

    Little Bird Community Acupuncture

    Washington, DC

    http://www.littlebirddc.com

      0 likes

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