Why I Let Go of the Sliding Scale (and What I Do Instead)
After 15 years of practice—and 8 years running a hybrid community acupuncture clinic—I can say this with full conviction:
I would never go back to a traditional, full-fee, one-on-one model. But I also wouldn’t return to the wide-open sliding scale I started with.
In the beginning, offering care on a sliding scale felt like the only way to make acupuncture accessible. I believed that healing is a human right, not a luxury—and I still do. I wanted to reach more people: those navigating chronic illness, trauma recovery, single motherhood, or caretaking. I had been in those shoes myself.
During one of the hardest transitions of my life—a painful divorce—I desperately needed support, but couldn’t afford it. That left a lasting mark. So when I opened my clinic, I led with mission over money. I didn’t care about profit; I wanted to create a sanctuary for healing.
And back then, offering a sliding scale seemed like the obvious, even expected choice. All the community clinics I had visited used one. I never questioned it.
But here’s the truth: just because something is common doesn’t mean it’s sustainable.
The Challenges I Faced with a Sliding Scale Model
Over time, the cracks began to show:
Inconsistent income. Even with a fully booked schedule, I couldn’t guarantee a paycheck. My rent and payroll were fixed, but my income was a guessing game. I had no clarity about how many treatments I needed to cover costs. Some weeks, I worked nonstop and still couldn’t pay myself.
Patients didn’t understand the scale. I was asking people to assign value to a service they didn’t understand. They didn’t know my overhead, student loans, or what it takes to run a clinic. I was spending too much time explaining the scale—at the front desk, over email, and even in treatment sessions.
It unintentionally devalued the medicine. No-shows and late cancellations became common. Patients didn’t always respect the value of what they were receiving.
It no longer matched my skill level. Over the years, I became highly effective. My outcomes were consistent. I had years of experience—but my price point hadn’t caught up. I was still operating on a scale designed for beginners.
I was burnt out. I was tired, overworked, and starting to resent my own generosity. Some months, I didn’t earn enough to take a paycheck. That’s when I knew something had to change.
The Healer’s Martyr Matrix
I had to confront a deeper truth: I was trapped in what I now call the Healer’s Martyr Matrix—the belief that to be a good healer, I had to sacrifice myself. That my worth was tied to how much I gave.
Letting go of the sliding scale model stirred up guilt. Was I abandoning my values? Would people think I was selfish or selling out?
But here’s what I came to realize:
Sustainability is what makes long-term service possible.
Only when I feel safe, secure, and supported can I truly show up for others. I had to rewrite the belief that I had to suffer to serve. I now prioritize sustainability, reciprocity, and nervous system regulation—for myself and my patients.
What I Do Instead
Letting go of the wide-open sliding scale didn’t mean letting go of access. It meant restructuring my offerings to create clear, boundaried generosity—a model that honors both the patient and the practitioner.
Here’s what I now offer:
Affordable care through packages. Patients committed to their care can purchase treatment packages at a discount. This rewards consistency and allows me to plan ahead financially.
Monthly wellness memberships. These provide ongoing support at an accessible rate and create steady income for the clinic.
Free acupuncture days. These aren’t just giveaways—they’re opportunities to build community and gather content for my marketing and social media. They feel aligned, not depleting.
A patient-funded scholarship program. Patients who feel called to support others can donate to a fund that helps cover treatments for those in financial hardship. This model fosters community care while maintaining sustainability. It’s healing, full-circle generosity.
The Results? Everything Changed.
I started showing up more energized and present.
Patients began respecting my time, my boundaries, and the value of the care they received.
And perhaps most beautifully—my clinic revenue became more consistent, spacious, and aligned with who I truly am.
I now run a thriving clinic rooted in both accessibility and sustainability. I’m no longer running on fumes. I’m building something that can last.
To Fellow Acupuncturists Who Feel Stuck…
If you’re offering a sliding scale or underpricing your services and feel exhausted, broke, or on the edge of burnout—please hear this:
You don’t have to suffer to serve.
You can honor your mission without sacrificing your wellbeing.
You can create a business model that uplifts both you and your community.
And when you do? That’s when the magic happens.
I hope this helps,
Dr. Michelle