|The start and development of a holistic healing center can be both a
traumatic and enlightening experience. In an attempt to minimize the
former without detracting too much from the latter, I would like to
share with you some thoughts and ideas that may prove useful to those
of you who have just begun or are planning to put together a center.
Much of what I have learned has been echoed by other holistic
physicians to whom I have talked. They also went through the oft
times painful process of birthing a multi-disciplinary center. The
commonalities that follow are what the novice should be familiar with
in order to avoid "re-inventing the wheel", i.e., gleam these pearls
of wisedom from ones who have been there and done that so that their
mistakes are not repeated by yourself.
(1) Start your center or retreat from a business perspective and make sure it is on solid financial ground before extending too much into the spiritual realm of operating on faith and good intentions. Since we live in the real world of bills, mortages, and litigation, it is prudent to proceed, at least initially, with a left brain emphasis on the organizing and operational aspects of your endeavor. Formality and linear function can be de-emphasized at a later date and the intuitive and abstract allowed a greater role.
(2) Strongly recommended is the writing down of everything discussed among the principals so that misunderstandings are averted. To rely entirely on verbal agreement is an error. Memory is tenuous at best and what I think I heard you say may be considerably different from what you thought you had told me. Besides detailing the nuts and bolts of business arrangements between members of the group, I would encourage that all areas of importance be precisely spelled out: job descriptions, marketing plans, office/center policies, mission statement or philosophy of practice, to name just a few.
(3) One early consideration is the choice of practitioners who will be part of the center. Although much can be said favorably for youth and enthusiasm, we found it advantageous to have individuals who were seasoned veterans in the world of business. Such persons realize that overhead is more than just rent and utilities. To understand and appreciate the considerable costs involved in the initial start-up as well as ongoing expenditures is to avoid fractious and prolonged discussions over finances.
I recall an instance of a pragmatic/theoretical conflict in our first year together as a center when we were in the midst of overhead excess and trying to curtail expenses. As cold weather was approaching, several therapists had requested that we replace the existing gas heaters with electric ones, citing their concern that the noxious fumes given off by the old gas heaters would increase pollution and thereby not be good for the health of patients (many of whom had environmental sensitivity) or themselves. There ensued a lengthy debate on the pros and cons of purchasing new electric heaters, much of it centered around the cost of buying and operating them. Resolution only came about after information was presented that electric heaters produced electro-magnetic pollution which could be as determental to health as the toxic fumes from gas combustion.
(4) A complete budget is essential. This should include everything from ":slip & fall" insurance on the premises to office and cleaning supplies, furnishings, and bookkeeping. And should there be salaried employees, as is almost unavoidable given how IRS defines contract labor, the myriad of taxes/withholdings can be quite alarming to someone not versed in such aspects of administration.
(5) The decision of whether or not to participate in managed care is one not easily arrived at, especially in this day and age. There are certainly arguments on both sides although I favor the "fee for service" route. It has been shown that Americans are very willing to pay out-of-pocket for alternative health services. This coupled with the freedom from the bureaucracy and cumbersome paperwork involved with becoming and being a provider for an HMO, PPO, etc., makes it very attractive to go outside the system. Your gross revenue may be less but so will your expenses and headaches!
There are endless other intricacies involved in making a holistic healing center work. The more information and experiential feedback that can be gathered prior to the creation and development of a center, the smoother the eventual launch and sailing of it. I would definitely advise seeking out others who have been down the same path, successful or not, and pick their brains thoroughly. Believe me, you'll be glad you did!