by Malia Kirby

You have to have it in your blood, you have to grow up with the soil underneath your nails, the smell of the grapes in the air that you breathe. The cultivation of the vine was an art form. The refinement of the vine is a religion that requires pain and desire and sacrifice. -- Gustavo Brambila, Bottle Shock

As I sit here at my desk looking out my window at the smoky haze where the mountains used to be, I am reminded of an article I recently read in the September 30th issue of Wine Spectator regarding California's 2008 Pinot Noir. That particular growing season suffered from a hard frost that damaged a good portion of the vines, widely varying weather throughout the growing season, resulting in unevenly ripening grapes, and if that weren't enough, they also suffered smoke damage from the fires we all heard about over national news, which results in wines that taste like you're licking an ashtray. Lo and behold, after all of those obstacles, California Pinot Noir growers managed to pull it off and produce wines to be proud of with over 150 of them managing to score over 90 points.

Oriental Medicine, considering the current economic situation, is exactly like the 2008 Pinot Noir. Here we are, in the middle of an economy which may or may not be getting any better, the stock market rose and fell considerably over the course of the year, leading to businesses, banks, and fewer people having a steady cash flow, not to mention all the layoffs and downsizing with fewer jobs available for the unemployed. To add insult to injury, stats show that in times like these, one of the first things people cut out of their spending is healthcare and health-related costs. One would think that we'd all be crying in our drinks, wailing "Patients, why have you forsaken my practice," but that doesn't appear to be the case. Granted, a number of us are seeing some losses in comparison to previous years, but from the conversations I've had with my fellow colleagues and from what I've seen in my own practice, I'd say that considering the circumstances, we're all doing pretty darned well and should be patting ourselves on the backs for a job well done. Whatever it is we're doing, it must be right. I'd also especially like to point out all of our recent grads who are starting up their practices and still managing to make a go of it. Yes, I specifically mean you, new pracs. You, above everyone else, should be damn proud of yourselves, starting a small business from scratch and keeping it afloat.

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Perform quality work
So, how exactly did these masters of viticulture pull off wines scoring over 90 points? To start with, they spent every waking moment out in the fields with their vines, working even harder than usual to make up for disadvantages created by varying weather conditions and effects of forest fires. Precision work was the key to achieving vine balance, both in sugar levels and acid levels.

If incoming patient levels are less than they have been in the past, practitioners can take advice from the vineyard by focusing entirely on giving their all with each and every treatment in order to retain every patient possible and receive referrals. From my own experiences, the first day I treated patients under my own license, I had seven patients booked. One of them never came back due to the fact that I use moxa regularly, but the remaining six people I had booked that day were thrilled with how they felt after their treatments, one of whom began proclaiming to everyone she knew that I could cure anything that ailed them. Those six patients still book appointments with me and they're easily the ones who send me the most referrals, some of whom cross state lines for a treatment with me, even though they have practitioners of Oriental Medicine in their hometown.

Invest in yourself
Other vineyards focused on creating a better vineyard according the winemaker's point of view rather than an economic point of view. What does that mean, exactly? They reinvested as much time and money as they could back into the vineyard and back into the vines, ignoring the low tonnage. Financially, it looked as if they were failing miserably as account balances were lower than usual, but from the vineyard's standpoint, they were improving the year's skin-to-juice ratio, leading to better flavor, acid balance, and concentration, plus strengthening the vines in order to improve crops in years to come.

During times of economic crisis, we can all invest in our practices in two different ways. Whenever possible, we can and should attempt to drop as much of our own profits back into our businesses. Maybe this means upgrading on your ventilation system if you use a lot of moxa or perhaps greening up your office space and improving upon your energy efficiency. Other ideas might be looking into new clinic software that keeps track of your inventory for you, incorporating new marketing materials or redesigning those you currently have, or adding new ways for patients to pay for their treatments such as insurance billing or creating an office superbill template for patients seeking reimbursement from their insurance company. And of course, there's also the simplest route: dropping every last dime into our business bank account.

However, there's also another area of our businesses that are often overlooked: ourselves. I know I don't need to lecture any of us on this point, but in times of stress, we're more likely to get sick. It's incredibly vital that we take as good of care of ourselves as we possibly can in order to treat our patients to the best of our ability, and that means taking our own advice and walking the walk. Make sure you're eating a wide and varied diet with plenty of fruits and vegetables, get plenty of exercise, and incorporate stress-relief techniques into your life if you haven't already. Above all, do something nice for yourself. Get a massage and get treatments regularly. If this means you call up friends and set up a trade system, go for it (after all, who doesn't like free treatments and massage!). Maybe that means you write out a list of things you've always wanted to do but just never reserved the time for--and then choose one or more of those items to add to your life. The happier you are, the more likely you'll be pleased with your office situation, and healthier to boot. That's win-win for everyone involved.

Toot your own horn!
From here, in the spirit of being proud of our accomplishments, I'd like to ask our readers take a moment to enjoy a little self-promotion and share in the comments what they've done to build their businesses in spite of the current economy. What are you doing for your practice right now and how are those new additions helping you out?