Incorporating acupuncture in a university-based family medicine center: lessons learned.

OBJECTIVES: To evaluate the utilization, financial costs, and benefits of incorporating acupuncture into a university-based family medicine center. DESIGN: Retrospective billing records review. SETTING: An academic family medicine center located within a university-based medical center. SUBJECTS: The entire population of consecutive patients seen in an acupuncture clinic from April, 2002 through October, 2006. OUTCOME MEASURES: Patient characteristics, number and types of visits, and charges and collections. METHODS: Analysis of de-identified, electronic billing records. RESULTS: During the 4(1/2)-year study period, 788 unique patients were seen, accounting for a total of 4953 visits. The most common clinical conditions treated were back pain, headache, and neck pain. Mean charge and collection per visit was $82 and $53, respectively. Mean annual clinic revenues and expenses were $58,653 and $74,223, respectively. CONCLUSIONS: The authors' experience with an acupuncture clinic within an academic medical center has been generally positive, but we have not been able to turn a profit within the first 4(1/2) years of operation. Advantages of including physician-acupuncturists include improved patient access to third-party payers for clinical services, and possibly better acceptance by physician colleagues and the larger medical center system. Physician-acupuncturists, however, tend to have higher salary and liability costs associated with their services. Incorporating licensed acupuncturists allows for improved access to patients as well as lower operating expenses. We postulate that patients are generally more willing to pay cash for acupuncture services provided by a licensed acupuncturist compared to a physician, whose services are generally expected to be covered by medical insurance. Our findings suggest that incorporating acupuncture into existing medical practices may benefit patients, providers, the clinic as a whole, and the larger community, but the profit margin associated with providing acupuncture in these settings is likely to be negative or slim.

Duke Scholars

Author Remy Rene Coeytaux Family Medicine and Community Health, Family Medicine