How To Sustain Your Practice and Build Lasting Client Relationships
A conversation on client retention with Steve Kippax, acupuncturist and herbalist.
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Welcome to a new practitioner profile, as part of our series where I interview complementary healthcare practitioners about their career paths, specialities and their wide range of work experiences. For precious editions I spoke with osteopath Kerry Dowson about her experience integrative osteopathy with breathwork, and acupuncturist Sean Cleere about his international career trajectory that brought him to running a busy multi-bed clinic in London today. I hope these conversations leave you feeling inspired, support you in your own career or simply give you new insight into what’s happening across this space!
This week we’re chatting to Steve Kippax. Steve started growing herbs when he was 13, began to study herbal medicine in 1980 and went on the become president of the National Institute of Medical Herbalists. In the late 80s he started studying Traditional Chinese Medicine, which became one of his specialities. With an impressive career spanning decades across private practice, the NHS and The Third Space and between the UK and China, I was keen to ask Steve about his perspective and different experiences with client retention.
Hi Steve, thank you for sharing your insights so generously! Your multi-faceted career has taken many interesting turns, and along the way you have combined your knowledge of acupuncture, herbal medicine and taoism in your 1:1 treatments, lectures and writing. That’s a wealth of experience in building your practice in different settings and fostering client relationships too.
In your 38 years of practice, how would you say that your approach to client retention has evolved?
When I first qualified as a medical herbalist in 1985 the way I had been taught was that seeing the patient after 2 or even 3 weeks was a usual initial timeframe, unless it was an acute condition. I started like this but fairly rapidly realised that for most patients contact and support is vital and that timeframe did not really provide that adequately. I therefore started seeing patients after 2 weeks – and for acute conditions, weekly.
Initially I would not be as definitive in my communication with the patient as to when I wanted to see them – leaving it more as to when they wanted to come and see me.
My own perception of my own practice changed too, initially I regarded myself as more of a “facilitator” whose intervention and working with the patient delivered the improvements they were experiencing. I shied away from the term “healer”. Even when explicitly told that I had helped someone I was loth to accept praise and was reticent to acknowledge my own ability. As my experience accrued, and my faith and belief in my own ability, I embraced being a healer and teacher and facilitator. I became more proactive and positive in all matters and specifically in scheduling future appointments. I now tend to tell the patients when I want to see them.
As my practice developed and I started to use acupuncture, the demographics of my patient list broadened and altered somewhat – e.g. I started treating more musculoskeletal issues. With acupuncture practice in the UK the usual appointment timeframe is seeing the patient after 1 week, the major observable effect of acupuncture IMHO lasting say 10 to 14 days. So having weekly treatments certainly for the first month produces a cumulative effect. In a very acute situation the patient might even need to be seen twice a week.
In China when I learnt acupuncture the patient would have a course of ten treatments which they usually completed in a two week time frame – so having a treatment every 2- 3 days. In this situation usually after the initial diagnosis had been made, then the same treatment plan / points were used. This was then reappraised at the end of that course. Obviously in certain patients, where indicated, the treatment was more fluid.
The best way to retain patients is paradoxically to get them better! Once they are better they tell their friends and your practice grows. Not only that but if the individual gets unwell in the future they will come back.
Do you have any strategies for keeping clients motivated to continue treatment, even when they may be feeling better?
I guess it might be a moot point as to whether or not people actually need treatment if they are feeling better. I think that it depends on the individual, age, health status etc.
Working for the NHS was an interesting experience. In my 2.5 days per week I was guaranteed to see 75 patients for body acupuncture / herbs and an indeterminate number for ear acupuncture. This meant that in our nine bed treatment room the team of three practitioners would have 15 minutes per patient to consult, diagnose prescribe and treat as opposed to private practice where there is always an element feast or famine.
Private practice is very different to the NHS. Wellness is an ongoing continually adjusting dynamic, in a very binary understanding if you are not getting better then you are getting worse – nothing stays the same.
One of the joys of particularly herbal medicine is the use of tonics. If under 30, then youthful exuberance is usually enough to maintain a reasonable energy level. Once past 30 then it is wise to take herbs, not because one is unwell but to maintain wellness - tonics! This form of ongoing herbal treatment is certainly one that I personally follow and recommend. My company Herbs Are Good as well as having a comprehensive selection of tinctures, also has seasonal kits that are available. While these are not quite as good as specifically tailored herbs for the individual, they are a good retail option without the need to have an appointment.
I am aware that some acupuncturists recommend patients coming in for seasonal balancing treatments which are of course beneficial. While I am happy to provide this for patients that want it, I am not personally a huge advocate of this.
How do you ensure that clients feel engaged in their treatment plans, and what’s your take on client communication after treatment?
People tend to value what they pay for. Hence some of the inherent structural problems with the NHS, it being perceived as “free”, which must be implicated in the obscene numbers of missed appointments that the NHS suffers with. Patient compliance and engagement occurs much more readily when they are paying for it!
Of course there is an onus of responsibilities of practice to provide a level of care and support. To that end all my patients have my contact details and are encouraged to contact me if they need to. My default position is that no news is good news.
How did your experience with client retention differ at the various locations and team setups (Gateway Clinic, The Third Space, and your own practice) you've worked in?
At the Gateway we had no problem with patient retention. The NHS has too may patients. We were booked for up to 6 months in the future.
At The Third Space I was an employee so, while I had the pressure from my employers and my personal professional reputation and pride, it was a slightly different situation. As joint Head of Medical Services / Head of Complementary Medicine I was responsible for the whole complementary medicine team and provision. Thus the practitioner role was a part of my managerial responsibilities, but not all of it.
My personal practice has evolved over my 38 years of practice. From allowing the patients to decide if and when they wanted to come back to see me, I now tell them when I want to see them.
Be positive, be supportive, be effective, be clear in your communications.
Finally, what's in store for you this year, anything you'd like to share with our community?
I will be pursuing my vocation, practising TCM. I have been teaching Tai gong – my own fusion of Tai ji and Qi gong.
If you do not look after yourself how can you look after others?
Do you follow your own advice?
Do you exercise?
Do you practice Qi gong / Tai ji / Yoga / Meditation?
Do you eat a sensible diet?
If not, why not?
Live in harmony with your beliefs.
Be well.
Be happy.
Steve