One of the most common complaints I hear from practitioners is that they can’t get their patients to come in more than once per week, and therefore not able to follow their treatment plan. Their patients tell them they can’t afford it. One constant that I’ve noticed is these practitioners typically charge a follow up rate of $100 or more. If you are having patients complain about not being able to come in at your recommendations due to the cost, or if you get a lot of cancellations or no shows from these patients, I’m going to suggest a fix that may be offensive to many: Consider adjusting your rates. And by adjusting, I mean lower them. Gasp! Done yelling at me yet? Ok, let me explain!

One aspect we need to look at when discussing the topic of setting rates is how the patient approaches treatment cost. In this article, I go into where the patient is coming from when they are determining value. This in turn helps us understand where we can meet the patient at and what we need to do ourselves to get better commitment from them.

First, can patients really not afford acupuncture? Typically, the answer is no, they actually can. The patient is choosing where they spend their money, and it isn’t on themselves or on acupuncture. In fact, patients regularly choose to devalue your service and will instead spend money on going out to eat or buying more crap on Amazon. They are not prioritizing their health nor valuing you as a professional. While we can get cynical about this, we need to focus on solutions. The truth is you can mitigate much of this.

Cost-Benefit Analysis

The patient decides if they have the confidence that you will deliver the solution to their problem and if so, are they willing to invest in what you offer. Men tend to be especially frugal and err on the side of skepticism. But for any patient, if the cost of treatment is too great relative to the degree of confidence they have, then they will not go for it. Or, they will have a half-hearted commitment and end up cancelling or no-showing their next appointment. What you need to do as the practitioner is leave little doubt that you can help them, and that the risk to reward ratio is in clearly favor of the reward.

How to put the cost-benefit analysis in your favor:

The NUMBER ONE way to give patients confidence is to “WOW” them on the first visit. They must know what you do works, unambiguously and unequivocally. Luckily for you, acupuncture can easily provide that wow factor on the first visit, in a matter of minutes.

Psychologically speaking, your wow factor must provide enough objective and subjective results to give them more confidence in you being able to help them, and thereby being more willing to make the financial investment you are requiring of them; the amount of “wow” is in direct proportion to the patients’ ultimate level of commitment.

Here are some ways of WOW’ing the patient:

  • Drastically improved ROM
  • Significant reduction in pain
  • Significant increase in strength


All of the above are very easy with the EXSTORE system and, depending on the patient, distal acupuncture. For MSK/pain patients, the above results should typically be noticed immediately following acupuncture (or even soft tissue work), with some exceptions. And remember, you must be testing the patient before and after treatment.

If you think the above is an exaggeration, consider the following. Acupuncture works on 90% of MSK/pain patients. If you brought me ten patients with shoulder pain and reduced ROM, I know that 9 of those 10 patients will experience a 70%+ improvement in ROM and 70%+ reduction in pain, and for mechanical problems a 100% increase in strength. When you treat with that kind of confidence – and results – your patients will commit. If you aren’t getting those results, then you need to change that first. And yes, the wow factor is only a piece of the equation as you still need to get long term results. But the same skills that provide the wow factor are also needed for long-term results throughout the patient’s treatment plan.

When you get the WOW factor, you will see that it takes pressure off you in other ways too, such as having to “sell” yourself or convince the patient to commit to care. Your results speak for you. The wow factor gives you more confidence in yourself as well, which in turn helps you communicate with confidence. Your language and tone change. You believe in your product, so it is more natural to expect the patient to follow through with the treatment plan you have for them.

Getting the WOW factor alone will stop most objections and get patients on board to follow through with your treatment plan. But if you are still not busy enough and patients are constantly telling you they can’t afford to come in twice a week, then you need to consider adjusting your rates.

Like it or not, to an extent your rates must fall in line with the patient’s idea of how much they are willing to spend on their health. Even if they end up spending more by coming in more often and for longer than they first expected to, that is not considered in their initial cost/benefit analysis.

Don’t be worried about dropping your rates, as you will make up for this in the following ways:

  • Better patient compliance and follow through on treatment plans
  • Better results when patients complete a course of care
  • More visits overall
  • Fewer cancellations
  • More word-of-mouth referrals


Still, many practitioners have concerns about adjusting their rates. They think of their current patient load and factor the new rate based on that. In reality though, they will increase the number of patient visits per week to easily make up for it.

Another concern a practitioner may have is whether or not they will have the time to see patients more frequently. However, seeing more patients does not mean spending more time in the clinic. In fact, it is quite the opposite after you learn how to treat multiple patients an hour. When you have the techniques and workflow down, you actually work less. You spend less time with each patient, see more patients, and get better results.

Finally, keep in mind many practitioners charging $100 or more for a follow up visit may be able to do this depending on:

  • Percentage of cash paying patients versus insurance patients (basically, where the majority of their revenue comes from)
  • How many patients they need to see/what they need to live on
  • Demographics/where they practice
  • Offering treatment packages that significantly drop the price when the patient pays up front
  • How long they have been practicing in the community


In summary, this article is specifically for those practitioners who have a slow clinics, unreliable patient numbers, and constant complaints by patients of not being able to afford coming in more often. This is one solution that can work. Many of the busiest, flat rate cash clinics are not the most expensive and do not have the highest rates.

And finally, the above does not mean every time a patient complains about something, you need to change your practice or adjust to them. In no way is this article the only way you should determine what your actual rates should be or need to be. In the case I make, while lowering your rates may seem like a loss, as part of an overall change in practice model with seeing more patients in less time, lowered rates could actually result in a net positive cash flow for your clinic.

Do you have questions or comments? Email me at