Interview with Jimmy Yen Spence: Hello, everybody, and welcome to another Golden Podcast, where we have interviews with world-class TCM community leaders, discovering their stories, habits, psychology and all their secrets that led to their success. I have the honor of being here today with Jimmy Yen, Jimmy thanks for being on the show. Jimmy: Thanks for having me. Spence: I'm excited to chat with you, you can maybe hear it in my voice because we have a mutual friend Kirsten Karchmer. I respect her so highly, she's brilliant and about as motivated as they get. I was chatting with her on the phone about practice management and things, and she's like, oh, my god, I'm learning so much from this guy and you should talk to him and you should have him on the podcast, he's perfect. So, here we are, I'm excited to chat. This is me and Jimmy's first time getting together, and he's going to help us understand a bit more about how he's operating and running his practice and clinic, which is going to be interesting. Just a little housekeeping, if you haven't subscribed to the Golden Podcast, you can do it on our YouTube channel or you can get updated if you're on our Facebook page and stuff as well and obviously on golden.cabinet.ca. Jimmy, if I get anything wrong, just let me know. You're currently in Cedar Park - is that Austin or somewhere close to Austin? Jimmy: Yes, it's a suburb in Austin. Spence: Okay, great. Jimmy got his Biochemistry degree in 2000 at the University of Texas Austin, Masters in Oriental Medicine 2004 at the Texas Health and Science University and we were licensed the same year. You and I licensed the same year. Your professional achievements, I love this part, he claims to be – this is pretty lofty – but he claims to be one of the top mistake makers in the acupuncture profession. That to me means you've learnt more than anybody probably. Jimmy: Hopefully. Spence: Experience, you have started at the Texas Institute of Health in Waco for a couple years after school and then you went to the Hill County acupuncture and herbal clinic in Austin for a couple years after that, and then, I'm not sure if this is when you opened your own or not, but an Acupuncture and Herbal Clinic in Cedar Park is clearly yours from 2007 on. And Achieve Integrative Health in Cedar Park, this might be the newer venture, I'm not sure, but we'll get you to clarify all that. Awesome! So, in the tradition of these Golden podcasts, I'm going to kind of hand over the mic to you, and selfishly like I said, I like to hear background stories. What got you into Chinese medicine, was there early influences or was this, I mean you look quite young to me, I don't know, but give everybody a little background. Jimmy: I'm actually older than I look. Thanks for having me on this, and actually what you're doing, gathering and interviewing all of these successful acupuncturists is a great thing, because we need more of it, we need more successful acupuncturists out there helping because the acupuncture profession needs that big help. Actually, I was having lunch with a student and she was just trying to get the logistics about what's the reality of the acupuncture business because that's not what's taught in school. Obviously, what I told her, it kind of shocked her, so, she's like, well, I'm glad I'm having lunch with you now before I graduate. Just a little bit about me, there's not much, I don't have a big story about why I got into acupuncture. I'll just tell you my short story. I do have a story of how I started my practice, and I think that could be very beneficial. Let’s start with my personal story. When I was in UT, my dad who was a computer programmer, he said, hey, I’m going to study acupuncture when I retire. So, he told me, oh, there’s actually a school here in Austin, Texas that can teach acupuncture, can you go get some information for me. So, I went to get information for my dad and that’s how I got my foot in the door into acupuncture. Now, growing up, my dad has always been a health nut, he’s always been into nutrition because he had some health issues during his thirties, which he resolved just by changing his diet. And ever since his thirties, he is 76, he just turned 76 a couple weeks ago, he’s been basically treating himself with nutrition, Chinese medicine, acupuncture, so he did end up going studying acupuncture, but not to treat other people, but really just to treat himself and treat my mom. So, kind of selfishly, but that's what he did. So, you can say nutrition and natural healing has been in my life growing up, and so it was a natural transition, because I was studying for biochemistry, I was going to become a vet and then I just went the other direction and Chinese medicine. On a side note, a big reason that I stayed and studied Chinese medicine was at that same time I met my wife. Spence: Oh, I thought so. Acupuncturist are great people, you know. Jimmy: I met my wife and then I was at that crossroad. And then I met this woman and I was like, if I go to vet school, I'd have to go to a different city completely, three hours away and/or I could stay in Austin and pursue this girl. And so, you know, we've been married for 16 years now. Spence: It worked out. Wow, hey, acupuncture, this decision made by a woman, yeah, yeah sounds about right, good job. Jimmy: That's really how I got into the acupuncture field. Feel free to stop me, otherwise I will ramble. Spence: It’s okay. I love your city, I've been down to the conference there that college puts on right after the South by Southwest music festival. It’s in that hotel, I love watching the bats come out from under that bridge, it’s crazy. And I hear Austin's changed a lot in the last few years. I got to get back down there, it seems like Austin and Portland are these hot spots for acupuncture and Chinese medicine activity and I love it. Anyway, now you have gotten through your school and you've met the love of your life, you decided to get into practice, you said you got a bit of a story there. Jimmy: Yeah. I mean, sharing some personal information is all about transparency, so when I got married with my wife just so happens something happened, her parents lost everything. They didn't even have a penny to their name, so that's what I got into when I got married to her. Right off the bat, I knew we would have to support them for the rest of their life right. And thankfully, I was hired by a physician in Waco, that's the Texas Institute of Health, and I was there, they hired me to set their acupuncture department, but I was living in the Austin area, which is about an hour and a half away. My wife just started her new job and so everything was brand new and I had to commute drive an hour and a half one way. So every day, I was driving three hours and I did that for six months. Now, I love driving, but when you don't see the sun for six months, it gets kind of tiring. Spence: Podcasts don't cut it after a while. Jimmy: Exactly. As I get up early just to drive there and to get on time, be there at 8 o'clock, and then I would leave late, I wouldn’t leave till 7 or 8, and so I never saw the sun. So, after six months, it got tiring and, yeah, I decided, okay, let's open a practice in Austin. So. I did. Spence: You were motivated. I mean, what you were handed right out of the gate, you've got to support people, it was a lot. So, there's big motivation. Jimmy: Yes. Before I got the job, I wasn't making a salary, so my wife, she started her first job and I think she was getting paid 35,000. So, she was supporting four people starting off at 35,000. We pinched our pennies, and one thing I like to tell other acupuncturists, like for my wife and I, we kept our expenses down to $2,000 a month. We did that for one year, and yet, we were still able to save. That's another whole story I wish I can talk about later. And so I came back to Austin, decided to open a practice, I contacted another acupuncturist and I partnered with another acupuncturist and we open our practice in Austin. And at that time, I still didn't know any business, so I didn't know how to build a business. We were only open for eight months and we made about $8,000 that month. Spence: 8,000$? Jimmy: Yes, 8,000$. We were not profitable, the partnership didn't work out and so we split, and then again, I was at the fork in the road again, what do I do? We just tried this acupuncture clinic and it didn't work, and I've still got a 100,000$ in student debt, plus, my wife is struggling because she's the only breadwinner and she has to support four adults. And so, I was at a fork in the road and I had a choice. One of her friends, my wife's friend was a nurse anesthetist, I don’t know if you know what that is. Spence: Sure. You are actually using the Canadian pronunciation of that specialty. I believe that Americans called them anesthesiologists. Jimmy: Yeah, and they make great money starting out. Your base salary is 140,000. I was like, okay, acupuncture - no money. It’s time to change careers. Actually, at that point, I gave up on Chinese medicine. Spence: Okay, I think everyone listening have been there. Maybe. I gave up and I actually had to first get my nursing degree. I didn't have a nursing degree because you have to get Bachelor’s in nursing. The nursing program takes four years and I didn't want to wait another four years. So, they actually have a program in Texas Tech in Lubbock Texas, where they condensed four years into one year, and so it's accelerated program. It’s non stop. I applied for it, I got accepted and I moved to Lubbock Texas, but you understand, my wife was still in Austin. That's eight-hour drive. Spence: Eight hours? Wow. Jimmy: Yeah, so basically, I did that for a month, and then after a month of being apart from my wife, she and I decided it's not worth it. It's not worth the money that I potentially could make to be apart, because it's not just going to be one year. After one year, I have to work two years and then I have to go to master's program for another two years, so that's four years that we were going to be apart. Spence: And money. Jimmy: Exactly. And initially, I was looking for the money. I chose that, and then we discussed it and we're like, this is not worth any money. At that point, it was another fork in the road. It's like, okay, let's come back to acupuncture, let's see if I can do it by myself and make it work this time, and that was what I decided. I was like, this time, there is no room for failure. I cannot fail at all. I can't, because I already still have the debt and we still have the parents to support, which is like, okay, I have to make it work. If I have to not sleep, I'm going to make it work. That was 2007 and that was when I started my practice, my current practice right now. And I hit the ground running, I worked 80 hours a week. I did health screenings every week for one year, and in 13 months, I grossed 100,000. It was at that time I was like – Spence: I can make this. Jimmy: I did it. The next few years, I kept on doubling my practice exponentially. So, I evolved, my practice was called the Yen Acupuncture & Herbal Clinic, which, a side note, don't ever name your practice under your name. Spence: If you ever want out. Jimmy: If you want to expand. Going through all the way to 2010, I was doing really good. It’s all relative, it’s compared to everybody that's around me. My practice grew to 300,000. I was personally taking home $150,000. Spence: So sorry to interrupt you, but I have a sense of where you're going here, and it's a common story, and you'll maybe back this up, that in those first three years or so, there's that exponential growth curve that's just so amazing. And if you put your nose to the grindstone and you're the primary breadwinner of the family - that really can happen. You don't have to be primary breadwinner but motivated. Correct me if I'm wrong, but this is what I have seen, it's really after that five year mark or so where you start to be tested, because that curve doesn't continue like that. Jimmy: No, it doesn't. Spence: And growth is much more calculated and educated after that. Jimmy: It didn't for me. I don’t know other people's reasons, I know my reasons. So 2010, I was living large and I rested on my laurels, that's what happened. I got complacent. I was like, hey, I'm doing better than most acupuncturists all around me. It's like, hey, I've already hit the top. And so I tested out a theory. The theory was, oh, can I not do any marketing and sustain my practice. I tested that out for two years, I did zero marketing and I sustained my practice for two years. You know, sustained it at 300,000, as taking home $150,000. And then two years later, that was 2012, you start to see the plateau. In stats, I'm a stats guy, so when you have a plateau, there's only two directions you can go, one is up, one is down, but plateaus usually mean down. That's what happened, I saw my stats started to go down, and I was like, oh, shit, I better start working again. Spence: Yeah, the word of mouth wasn't enough. Jimmy: Exactly. That's another thing, my experience, word of mouth, number one, does not build a practice. Word of mouth gives you the best patients, but it can't grow your practice either. Spence: It's a long-term plan for sure. Jimmy: Exactly. You always have to do marketing, that's a myth. Everybody glorifies word of mouth as it's the only way, it is the best way, it doesn't grow your practice and they can barely sustain it. It sustained up for two years for me, me doing no other marketing, just word of mouth, but that's not the reality. So, my stats started going down, and, oh, the two years, just basically the growth stopped. I stopped growing. I felt good because I was only working 28 hours a week and I was making good money. I’d say, now, okay, this is awesome. And later, I found out it was because my purpose wasn't big enough. And that's why I stalled. Now, I have a bigger purpose. And going back to the exponential growth, I tried to get that exponential growth, but I did it the wrong way. This is about me making mistakes. Like, there's all these shiny objects around, and so, I tried those shiny objects. I tested them all out. I tested two big expensive shiny objects, one in 2015 and one in 2016. 2015, the shiny object I tried was called Medical Integration. Basically, I hired a physician and I hired a practitioner to work for me as employees. And it works for some people, you know, but it just didn't work for me. And there's a lot of issue reasons why, but I did that for one year, so it wasn’t like I tested it, I dived in. I did that for one year and actually ended up, yeah, I still gross. I mean, gross doesn't mean anything to me. I still lost money, I lost like 50,000 that year. And if that wasn't enough, hitting my head, I like to hit my head against the brick wall, so I tried another shiny object. Spence: I just heard something today or a woman said something like, you got to make the same mistake three to four times so you actually get it. So, yeah, there you go. Jimmy: You got to wait till the blood is running down your eyes, then you start seeing, hey, you are hitting your head against the wall. Spence: Halleluiah. Jimmy: Well, I didn't see blood yet, I started banging my head even more. So, in 2016, I did something called Functional Medicine. And I went all-in like, I let my associates do the acupuncture part, I went a 100% in Functional Medicine. I joined a coaching program, that's one of the top coaching programs for Functional Medicine in the U.S. Cost me a 100,000 to join, and I did a full-blown. I didn't lose as much money, but that almost tore up my practice, that almost killed my practice. Because Functional Medicine, the height was this, the theory that I was testing, can you work less and make more? I was treating less people, I was averaging about 135 to 140 a week, and if doing Functional Medicine, that cuts it in half. That cut it to 60 to 70 patients a week. Spence: Still a lot. Jimmy: Yeah. That was grossing the same, but my expense went through the roof. So, I was actually taking home less well. And so I did that for one year, tried it out, didn't work. I had to spend 2017 to rebuild my practice because I went from 140 to 70. Now I have to pump it back up to 140 again. So, I spent the whole 2017 making up for the mistake that I made. But, thankfully, in 2016, blood got into my eyes, but now, I'm more focused, no more shiny objects. Spence: Timeless principles from here forward, right? Jimmy: Exactly. Spence: Okay, you know, I have a bit of an idea of how you got your year clinic structured, you have a couple of associates, and I'm not exactly sure what your front acupuncture assistants are and that's a question that I had actually, but is that kind of how you move forward now, you brought a model that helped you grow in that more traditional whatever, we'll call it traditional model? Jimmy: Yeah, in 2014, I was still straight acupuncture, before I started diving into these shiny objects. So, in 2014, I was straight acupuncturist, straight TCM, and I was able to get my practice up to half a million. Spence: Just you on your own or…? Jimmy: No, no, me and another associate. Spence: You are busy. Jimmy: Myself, I maxed out about 140 patient visits a week, so yeah, that's crazy busy. It was me, two acupuncturists and some support staff. So, I'm going back - that was a proven system because I already did it. I’m going back to that system. But I'm simplifying it, I've also simplified my past system so that any acupuncturist that comes to join my team or any team member that joins my team can actually just be plopped in and start running pretty soon. So, that's what I'm focusing on now. Spence: From what I see somehow, there's a chief acupuncturist and then there's -- what do you call them -- staff acupuncturists, is that the right term? Jimmy: Yes. Spence: The staff acupuncturist, is that more of the apprentice or the junior or…? Jimmy: Yeah, like a junior associate, the chief acupuncture is a senior associate. I do that just so it doesn't create competition among associates because they are compensated based on their patient visits. Spence: Does the junior do the acupuncture for the senior, like, do they manage the case, and then the staff acupuncture is more of the technician or do they handle separate cases and there's different fee structures? Jimmy: We treat all our patients together because the patients don't belong to either acupuncturist. It belongs to the clinic. Everybody has their job, and so the junior acupuncturist, they do the easiest part of an act of a treatment. The easiest part is the acupuncture. Spence: Putting the needles in. Jimmy: Putting the needles in, that's the easiest part. The chief acupuncturist, he does the most difficult part, which is the communication. The communication with the patients, the closing of the plan, that's the most difficult part. And also, managing the patients, making sure we retain the patients and also we get new patients. Spence: Right, so case manager, yeah. Jimmy: Yeah, case manager, part of the chief acupuncture is like, case manager, he still treats too. He still treats majority of the patients. Spence: Oh, he does, but the technician comes in, that's their way. Sometimes, like a couple of times a week or…? Jimmy: Both of mine are full-time. All my boys are full-time. Spence: These patients might see some of the follow-ups with the technician and every so often, and then the senior every four week or something? Jimmy: The chief acupuncturist does all the initial exams and also the re-exams and we have something called ‘pulse re-evaluations’, he does all those. And then the staff the junior associate does, just the needling part. Spence: And you are a herbalist or that's more of the work you're doing there now? Jimmy: I have finally managed to create my system where I only treat about ten percent of my patients. Spence: Treat meaning? Jimmy: Acupuncture or herbs, it doesn't matter. The main reason I'm doing that is because I'm opening a second practice actually in a month. Spence: Congratulations! Jimmy: Thank you. I want to be where you are at. Spence: Oh, yeah, really? You're about to be there, so we'll see how that goes, we'll chat a lot more soon. Jimmy: Yeah, definitely. I'm going to be at the my second location and getting that one up and running, and then I'll hire associates to manage that. Spence: In the same way? Jimmy: Yes. Spence: That’s great. Are the fees to the patient any different if the staff acupuncturist is doing the needling or the chief or you? Jimmy: No. Spence: No. It’s just, this is the way the clinic treats and that's your fees. Jimmy: Yeah. Because again, if you create different fees, it creates a different perceptions from the patients. I want the patients to walk in -- I mean, just the way that we dress, I was wearing a white coat but that was because it was cool in here, but we don't wear white coats. If a patient walked in to our clinic and my team just stood out in front, they would not know who's the acupuncturist. That's the perception I want to create. I want patients to know that it doesn't matter for the front desk, the front desk is involved in their treatment, everybody is involved in treatment. We all come as a team, so when we're doing their initial exam we're telling them, our team is treating you, not me. I'm not the person treating you, our whole team is. We work collectively as a team, so some days, this acupuncturist may treat you and then the other one may treat you another day, but we do the exact same thing. Spence: Right. And we'll check in on you and we've got a system. Amen to that. You call them front acupuncture assistants, we've referred to them as our administered staff or our reception, the same thing basically, but they may be one of the greatest keys in my humble opinion to growing up practice, because a) that's where treatment starts or the support and care at least starts. It shouldn't just be someone hired because they can answer a phone and like take money or something, it's they need to connect with the patient, make them feel welcome and ready and open them, so our treatments behind the reception are more effective. I absolutely love that. It is a team effort, and that's one of the benefits I love of having a clinic that has multiple associates, because so many people in our industry go at it alone for their whole life and they never get that sense of that teamwork. And it's your results differ with patients. Jimmy: Oh, yeah, definitely. I play tennis also okay, and the tennis, it seems like a very physical sport, but if you ask all the professionals and like the coaches I've had before, they'll tell you 60 to 70% of tennis is mental, it's in the mind. And then in our business is even more. I would say it's probably 90% mindset. So, it's, how can you shift or how can you influence or elevate a patient's mindset? That starts from the front and the date, from the time they call you on the phone to the time they come in and there’s your staff, are they smiling, excited to see them - that makes a huge impact! Spence: Yeah, even rewind back to online reviews or testimonials, that is where the psychology and connection for that patient starts, and that's where a word of mouth may actually be a benefit long term after you've been in business how long. Your word of mouth may be the only thing you need, that's why I said maybe it's a longer term plan. Jimmy: Yeah. A word of mouth is very important, I don't want to put that down and say it's not important. I'm just saying there's a misconception that people think that you only need a word of mouth to build a practice. That's not true but you definitely need a word of mouth. That can help you build slowly if you want to do it in 20 years or something. But if you want to do it quicker, you need more than word of mouth. Spence: Before we go on to a couple of the things that you said you wanted to chat about, that I wanted as well, but we've already started diving into that, structuring your clinic - what are some of the ways beyond word of mouth that have bee effective for you in bringing in new patients? Jimmy: My number one what really helped me build my practice was what I call ‘health screenings’, like you go to a fair, you set up a booth and you do whatever you want to do and you get patients right then. That has been my number one, because like I said, my first year in practice, I did one every single week. Spence: Really? Jimmy: Yes. Spence: You’ve got to search for those. Jimmy: Yes. You really just need to find one and you just talk to the other vendors because they do the same thing. You just ask them, hey, when's the next event, and they'll tell you. So, health events was how I built my practice. That is the most efficient way and the quickest way to get what I call instant new patients, because I signed them up right then at the event. I make them prepay for it and they're a patient. Spence: You give them an event deal or something like that if you book today urgency? Jimmy: Exactly. So, that’s number one right. I've done almost everything. The only thing I have not done is radio. I haven't tested radio out, but I've done TV, I've done newspaper, I still do newspaper. The newspaper that I advertise in right now I've done it for 10 years straight. I'm the only acupuncturist in there. I mean, there are other acupuncturists that come and go, but they usually stop because they don't get patients from it. But I get patients from it. It's all about, -- I don't know if you're familiar with Dan Kennedy -- it's all about copywriting. So, newspaper is another one that's very effective for me. I've also done Lunch & Learn, so, going to corporations and going to doctors’ offices to talk to them, and today at lunch, I was talking with that acupuncture student and she was considering whether to do like a doctorate program because she wanted to learn how to communicate with physicians. She thought that doing the doctorate program would help her do that. I said nope. A lot of what's being taught right now is all you need research to talk to doctors. Most acupuncturists think that, okay, you need to go to their office and go, you know, this is acupuncture, it has been proven to work, blah, blah. I've got a minimum of -- I know of seven off the top of my head physicians that refer patients to me constantly. I have never given them any research at all. And when I go into their office, they don't ever ask me for any research. Maybe it's just me, but the number one question that they asked me is do you get results with X. Spence: From the physicians that I know, basically they need to know something safe and if there's some feedback from patients that something's good or has benefited them in some way or that they like and trust you as a person, that's where relationships are super important, old-school marketing, which I think needs to desperately make a comeback. But the physicians that I know, you might actually upset them if you try and make them think that they need to be studying a bunch of research papers because they can't even read through all their own that apply to their field, and they're going to just do everything they can to pick it apart, find out how it’s underpowered, find out, oh, this is retrospective cohort, just everything that discounts it. So, what do we think, be a likable and trustworthy guy, if they've got patients that tell them this works for them or you've got a couple of case studies and you have a beer with them - is that how it's worked for you? Jimmy: Yeah. You actually hit it, a couple of great points. One of the biggest things, as I said, the number one question physicians ask me is, do you get results. I have had a few physicians ask me where the research is, but those physicians are the ones that don't refer me patients. Spence: Academics. Jimmy: Yeah. The ones that do, they don't care about the research, they want to know do you get results with this, this, this, and it's like what you said, they have to like you and know you. So, you have to have certainty, you have to present exude certainty number one in our medicine. I asked my associates this when I interviewed them, on a scale of one to ten, how confident are you in Chinese medicine. And if they tell me anything less than ten, there's a problem. I'm thinking, why are you in this field. Number two, on a scale of one to ten, how confident are you in yourself. I mean, most people are not a 100%, which is okay. But that's what physicians are looking for, they're looking for your certainty in your medicine. yeah I follow a Grant Cardone, I don't know if you know him? Spence: No. Jimmy: He's a great salesperson and he says people, will buy from you not necessarily because they believe in your product, people will buy from you if they know that you believe in your product. Spence: If you'll buy your product. Jimmy: Exactly. So, that's the same thing. If do you have certainty in Chinese medicine, if you don't, the physicians, they'll see it. So, they're looking more for that than anything else. That's how I got these physicians to refer patients to me. I don't present them all the – Spence: Big slide deck and stuff, yeah. I would love to add one caveat to that and I fully agree, but, in my opinion, I think it's important to be confident and certain where you also can't help. Jimmy: Yes, that's a great point. I put a post on Facebook, what's the difference between confidence and certainty. There's a difference. Confidence and certainty are not the same thing, at least in my definition. Confidence in my opinion is knowing what you know. Certainty is knowing what you don't know. So, I’ll go into the physician's office and I'll tell them, I don't know if I can help that, but this is what I can do. Spence: What I do know I can help with. Jimmy: Exactly. So, I do tell them what I'm confident and what I know, and what I'm confident and what I don't know. That's a great point. Spence: I think too many people in our industry lean on that World Health Organization list that is long, and yeah, it might help with X, Y or Z, but if you've got experience in it, it might help with one or two of the side effects of the medication that they take, or it might help with one or two of the symptoms that are common with that condition. Like, it's not curing epilepsy, it's not curing everything. And that's common for newer practitioners that don't have experience, because I remember coming out of Chinese medicine and going, this is so brilliant, I am pretty sure I could help anything with this. And maybe you can't help, but knowing what you can and can't do, I love that. That's great. So, you just literally cold-called physicians? Jimmy: Yes. We cold-called them and get them in. Like, my second office, we already have I think six lunch-and-learn schedules for physicians’ office, so week before I open. Spence: Nice. Everyone please listen, because I think even though my last podcast with Michelle, which is fantastic was about Facebook ads, I think everyone should listen, events, going to healthcare conventions or conventions period - what did you say, Lunch & Learns, and it was newspaper advertising. You have built a huge practice and one that's going to bloom into another clinic, so, to me, you're reiterating some of these timeless principles that we need to focus more on, and really choose what you're going to do and just keep doing it with consistency and fervor and be that guy or that person or those people within whatever marketing realm that you're in and keep on keeping on. Jimmy: Like I said, I've tested all marking, I don't knock something until I try it. Because that's just not what I do. I call the social media marketing shiny new objects. I'm not saying it doesn't work. Like Dan Kennedy says, every marketing works, it's just you don't work. It's not the marketing that doesn’t work. Dan Kennedy even teaches about this. He teaches about the old-school marketing, because everybody's so into these shiny new objects and they're wasting a lot of money. I know because I did it. Remember, I made most mistakes. Spence: I've spent a lot of money on that stuff too. This is not for me. I tested it out, I spent ten grand on Facebook marketing, I got zero back. I've spent thousands on Google AdWords, got zero back. I'm not saying it doesn't work, I just don't know how to make it. See, it's not the marketing, it’s because I don't work. Spence: And maybe some marketing doesn't work for some people or it doesn't resonate, it's like acupuncture doesn't work necessarily the same way it would for these five people at the same condition. Jimmy: There's so many variables, the copy, the location, I mean, I know it works because I know other acupuncturists around here that have it and it's worked. I don't know why I just haven't figured out for me, but here's the thing about those shiny new objects, it cost a whole lot of money to test it out. I mean, the experts will tell you, oh, you can test it out with just a few hundred dollars, oh, yeah? A few hundred dollars, later it turns into a thousand dollars. You're just like, oh, we're still testing to find the right words while blah, blah. Right now, if anybody knows of a really proven track record, Facebook marketing or Google AdWords, please let me know, because I will hire them. I'm looking for them. Spence: Well, you should talk to Michelle maybe, but it sounds like you've got your lane and maybe that's a problem too that some people have is they spread themselves too thin or they don't give anything enough time, like, where we finally got to a point in our clinics is we have the year kind of laid out and we've basically put that together slowly over the years and now we basically got kind of an initiative almost every month and it changes a little bit and there's some that are underpinning the whole year. But you've got to give things a chance to blossom, and if they feel good, the people at my clinic and maybe it's because of who I've attracted, they like our dollars going back into the community. You know, our marketing dollars more maybe even being spent on community outreach or actually creating relationships or more timeless old-school, and I love that. You do mind stepping into – you are based on stats? Jimmy: Yeah. Spence: You manage your practice based on instead of theory and feelings - can you give a little bit of a rundown there? And then I want to get into some pay structuring. Jimmy: No worries, anything, I’m a 100% transparent. Running my practice, I run it, I measure everything through stats. We used to track a whole lot more, but it could be a full-time job, so we've condensed it down and so we look at different stats. I'll just give you some examples, like clinic stats we look at obviously patient visits per week, revenue per week, we look at revenue per visit and also revenue per patient. We also look at retention, we also look at conversion like a lead comes in, let's say someone calls on the phone, that's a lead. So, my front desk, this is part of their stats, and so how many of those leads like ten people call in, how many of those ten people did my front desk get them prepay, not just book prepay for their first visit. Spence: You get people to prepay? Jimmy: They don't book for free. My time is valuable. They prepay over the phone to book their initial exam. That's the stat right there. That's a lead conversion stat. Spence: I bet you get no no-shows. Jimmy: We get very little no-shows. Spence: You know, as a clinic grows, that is a problem. And that is a solution. Everyone listen to what was just said. Jimmy: That’s the reason why I created it. I was tired of no-shows because we had to block off a whole hour for them. Spence: We are not double booking. Jimmy: Yeah, if they don't show up, that could have been seven more people I could have helped. And I blocked off the whole hour just for them. That's one conversion and then so they get on the books, and then the next one is how many IE, what I call Initial Exam show rate, how many people were scheduled, initial exams were scheduled, how many actually showed up. That's another conversion, because we need them to show up. Even though they prepaid, which increases their odds significantly to show up, they need to show up. And then from the front desk, the third stat that we track for them is appointment kept percentage, like 140 people scheduled this week, how many of those showed up. So, that's another stat conversion. Those are my three main stats from my front desk and they are bonused, their pay structure is in bonuses based off of those three stats. And then we have the acupuncturist part, it's retention. Retention is how many visits does one patient end up lifetime come to our clinic. And we have what we call ‘rate of response plans’. After the patient comes to the initial exam, we do initial treatments, three to six treatments, we call that rate response and how many of those are closed. These are the acupuncturists’ stats. We do those initial rates of response and then after those are done, then we go into the care plans and then we have a care plan conversion, so how many of those care plans were converted. So, those are other stats for my acupuncturists. Again, their performance is monitored based off of those numbers. Managing by stats means you take emotion out of business. You look purely at numbers, facts. When I hire people I told them, I manage people through stats and let me give you an example, so that in this situation you said, hey, I've been working hard, I feel like I've been working hard, man. I'm busting my ass, I deserve a raise. I will tell them, well, let's look at your numbers, let's look at your stats. If your stats show me that you have been producing results because that's what stats show, are you producing results or not. It's black or white, either you produce it or you don't. So, I'll look at their stats and I'll say, okay, hey, let's see are you producing results. If you are, you're 100% correct, you deserve a raise, here's your raise. But if you're not, then it's right here black and white. Hey, I feel like you're working hard, but business is not based off a feeling, business is based off of numbers, stats. Your stats don't show me that you're producing results, which means that clinic’s not getting money, so where am I getting the money to pay you for the raise. Spence: Yeah, that transparency has to be there. Jimmy: Well, like I said, I'm very transparent with my whole team, with everybody. And there's a reason why, it's kind of a stupid reason because I got tired of trying to remember who did I tell what to, why don't I just tell the truth to everybody. Spence: And bullshitters have the best memories. Jimmy: Exactly. I'll just tell the truth to everybody so I don't have to worry about what I told whom. Spence: That makes so much sense and I love that, but there is a component, maybe when a clinic gets to a certain size or depending on what you kind of expect from your staff on contribution that isn't necessarily quantifiable, like contributing to the blog on the website or writing or attending these events or giving a Lunch and Learn or whatever it might be or just being a motivating factor in the culture - what are your thoughts on that? Jimmy: Everything is quantifiable. You probably heard this, if it can't be measured, it can't grow. And measurement means quantifiable. Spence: Is that Keith Cunningham or something? Jimmy: A lot of people say that. Jimmy: Keith's Cunningham is from your neck of the woods, that man is brilliant if you ever had a chance to see him speak. Jimmy: All my mentors told me that from the very beginning. You have to be able to measure everything and based on what you're just you're telling me, I do have those. Those are what all call KPIs (Key Performance Indicators). All my staff has keep KPIs, like they have to meet minimum KPI. And one of them could be, lets say, you’re posting on a blog, well, your KPI is you have to post one posting on the blog per day, one post per day - that's the requirement. If you don't meet these KPIs, you don't qualify for the bonuses. Spence: Right. So, how do you pay acupuncturists? I think Kirsten told me that it's against state law to commission a health care provider, is that right? Jimmy: It depends on which state. Spence: Texas obviously, you guys are from there. Jimmy: I don't know if it is. Spence: She didn't say law, I don't know what, but it's different maybe than from where I am. Jimmy: Yeah, and there's a way around it, because it's not commission. So, I pay all my employees actually the same. I pay them a base salary, everybody gets a salary, everybody's full-time and their bonuses are based on points. They earn points based on what they do. And those points have a value, have a dollar value. Every week, they accumulate points. It’s not a direct commission. Spence: I get it. I think that a lot of acupuncturists would especially with the allergies to business that are so common, a salary, even a base lower salary is -- because a bottom line is no one knows how much money it costs to run a clinic, money and time, so a base salary is quite comfortable. Sometimes it’s salaries guaranteed, it's a job. One of the best pieces of advice a guy gave me once many years ago, he's like when I was asking for advice on associates and pay structuring and everything, he is like, you know, I think I see one of your main problem, Spence, is that you think everyone else is thinking like an entrepreneur and most people just want a job and be happy in their career. That changed everything for me. So, a base salary and then bonusing up from there. The bonusing is the way to take away the complacency that can naturally come from any human being with a salary. Jimmy: Yeah, and it’s the motivator. Not everybody wants the same thing, so when I hire associates, I ask them what do they want. I do the same process like I do for initial exams for new patients. I'm asking what I call the life effect what do you want, what do you see yourself five years, ten years, do you want to make a lot of money or are you just comfortable how many patients do you want to treat, or you want to treat this amount of patients, I ask all of this. To see if it's something my clinic can't provide. So, my bonus structure is structured that if you work hard, you're going to make a lot of money. I'll give you an example, one of my associates, he's not even been with me for a year yet, probably six months, maybe six months, it’s first year in practice with me, not in practice but first year with me, and he’s on the projection of making sixty thousand his first year with me. In Texas, that's huge, he's taking home sixty thousand. That means if you had your own clinic, you would have to be making at least 150,000 in your own clinic to take home 60,000. Spence: At least. Jimmy: At least. Spence: That’s from being pretty generous, but yeah. Sixty thousand dollars, I would I'd like to see statistically how many acupuncturists are making that after five, ten years of practice on a yearly basis. Jimmy: Not many. Spence: Because there are more clinics like yours and mine and people that are putting out the effort to create clinics and that are going to mature into properly run businesses. That's good just to hear what an expectation kind of might be. You look at what teachers and other professionals earn and it's somewhere between 50,000 and a 100,000, I mean, that would be probably a good guesstimate if you're working your ass off, if your things are pretty easy and you don't have to do a lot. Awesome. I'm going to dive a little deeper with you, I don't know if it's going to be on a podcast or just you and I. Jimmy: I got a lot of questions for you too. Spence: Well, this will continue, and we come up with some ideas we put out a little course or something because this is such essential stuff and there's so few of us that have put in this amount of time and are actually attempting to grow and properly run companies. But, like you're structuring this, so at some point, ultimately, you will be able to sell it and I assume so. If you don't have an exit plan in your clinical practice, then you just have a job for the rest of your life, which is fine if that's okay with you, and thankfully we can do this till we get old. You know, maybe you don't want to forever, but anyway, I digress, we'll chat more. I just think it's such essential stuff that people may not even get right now, but they will if they want to grow something. On a more practical level on your website, you said something along the lines of you've got this new patient offer or something for February - is that a way to just stimulate a little bit of growth or can you tell people a little bit about what you're doing there? Jimmy: Yeah, but that doesn't really work. I put it in there, but we really haven't gotten anybody from that. Spence: Do you find the sales and discounts unless they're properly placed to someone who's -- I brought in a philosophy to our practice, instead of discounting too much right off the bat or something to try and get people to buy into a series or a program, well, if you come to see me for this amount of treatments, these next couple I'll give them to you, you know, or whatever to reframe it in, no, I'm not devaluing the treatment, but I will reward you for your consistency and dedication. Jimmy: Yeah, I've heard of that before but I've never tried it. I can't say how it would work. I've always done the discount, and I do discounts a little differently also. I mean, I charge for every single service and I discount them all. Because for me, I want things so simple. When I was doing Functional Medicine, I was closing five to seven thousand dollar plans. I had a 50% closing rate for that, which in Functional Medicine is really high. But what I found out was, it took me to do it. I was like, that's not going to work. I'm not looking to be the best acupuncturist, I don't really care if people know my name. What I want to create is the Mayo clinic of acupuncture. And I want my clinic to be known, not me. I don't really care if I'm famous or not. I need to create a system that any acupuncturist off the street could come in, learn to be able to close, I have stats, so I know, this is not guessing. I have stats. For me, last year, I closed 91%, and my associate before, she closed 70%. And she wasn't confident, she was at 8 out of 10 in confidence in TCM. She's still closed 70%. Spence: That's awesome. Jimmy: My current chief acupuncturist, he's 10 out of 10, he's closing a little above 80%. Spence: And these are your programs? Jimmy: Yes. I'm happy with that, with the 80:20 rule, I'm happy with that. If you can close 80% and I don't have to do anything, I've got it. Spence: Yeah, of course you do, that's great. That brings up or highlights probably one of the most important things in growing any business, any clinic, any anything, is having the right people on your team. Jimmy: Yes, that is the hardest part of growing a business. It is finding the right people to get on your bus and then finding them the right seat. Spence: Exactly, getting them to help you understand the seat that you need to almost build for them, because ultimately, you are always a guiding force. I want to help you manifest the life you want, so please, get clear on that, and then we'll work together. I've brought coaches in to work with my staff, I know if they're happy, they will treat the patients like gold. In essence, my team is my patient or my client, so I want to take care of them. I can't always be doing a lot of that, but I mean, that's ultimately the big picture too, HR is a lot. Jimmy: Yes. I love that part. Spence: Well, if you've got a great team, it's great, because if you've got people like I in Yinstill and everyone there, I would be super happy to go hang out with or catch a show or have a drink, they're great people and that’s how we hire. We hire by character, not by some sort of decoration or past experience or whatever it is, that's kind of our process. Jimmy: That' great. Spence: I'm just looking at the time here, we're at an hour, you've probably got, I don't know, 100 patients to treat in the next few hours before you go home. You are in Texas, so you're done. Jimmy: I don' work on Fridays. I don't treat patients on Fridays, I mean, I work seven days a week. Spence: I always correct people that too. I worked 24/7 almost. But I enjoy it. David Foster, the famous pianist, composer, someone asked him once in an interviews like, oh, you're so successful, why are you still slugging away in the studio and working with people so much. He's like, I don't want to be on a fucking golf course, this is what I want to do, this isn't work, this is who I am. So, if you enjoy the business side, I love it. I feel like that's a way we can help more people, I can help more people, and it sounds like the same for you. So, it’s altruistic.