Thought I'd kick off some discussion here. If you're a member, check out my post in the "Member Profiles" section, that will give you some background on where I'm coming from.
The tl/dr version: I practice in the midwestern US in an area that is not typically thought of as being super receptive to Chinese medicine or "alternative" health practices. I focus mainly on pain management.
I have a practice that is flirting with self-sustainability after about 2 years here - which I think is pretty good given the area and prevalent attitudes. So, how did I do it? Well, first off, I found that the typical acupuncture business coaching works in this area of the country about as well as a screen door on a submarine - that's to say it doesn't work very well at all. I did a couple of things:
I set up an office inside a shared medical space with an NP, an MD, and a massage therapist. I then talked to the NP and the MD to get a list of local docs who they thought might be open to referring pain patients for acupuncture and tried to meet with as many of those folks as I could - just to let them know I was in town and they had options besides telling their patients to drive an hour to Kansas City or catch a plane to California (which one ortho guy was actually advocating to a couple of his patients).
I'm sure some of you will find the second thing controversial. However, if I had to choose one thing I did that helped to put me over the top in terms of getting new patients in the door and retaining folks who were getting good results, it's this: I added a contract/membership/subscription service. The first month I offered it, I assumed I'd get maybe three or four people to sign up. I think I had ten or twelve in the first two weeks, and it has grown consistently since.
Here's how it works. Patients sign a 12 month contract at $60/month (had to make it affordable and attractive to them and profitable to me). We set the contract up with a credit card and auto-debit the $60 on the monthly contract anniversary. In return, patients can schedule any number of visits at whatever interval is necessary to bring their situation under control. Since acupuncture is a front loaded process, this turns out to be a huge benefit for them. A chronic pain patient who needs treatment 3x/week for a couple of weeks to get their pain under control can now easily do that without having to try to adjust their budget to accommodate a large up-front expense. When they transition to maintenance, it all comes out in the wash anyway.
It's a huge benefit to me because now people who need more frequent treatment initially are incentivized to do just that. Since maintenance is built in, people don't just fall off the wagon and then drag themselves back in 6 weeks later to start all over again, they keep up with their treatments and usually get much better. It also evens out the ups and downs of my income and makes it easier for me to plan financially for both business and personal expenses. The contract has termination clauses built in, I make sure to go over that with everyone before they sign, and I've only had one patient pull some foolishness on me (so far). Lastly, this aspect of my business has generated a lot of word of mouth - people in this area like the contract and they talk to their friends/family about it. I have found that people in the boomer and gen-x population prefer to think of it as a 'membership' while the younger set (millenials and younger) prefer the term 'subscription service' - so I have to adjust my language a bit to suit the audience, but otherwise it has been a big win.
If you work primarily with pain or other issues that require either more frequent initial visits or longer term visits (like fertility), and this type of setup is legal where you practice, I can strongly suggest you at least consider the possibility.