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Viewpoints: Massage Reduces Nonspecific Shoulder Pain, Improves Function
While seemingly universal, pain and stiffness in the shoulders can be a significant cause of disability. Often a pain that does not go away on its own, shoulder complaints tend to linger, sometimes for 12 months or longer.
Treating GERD and Incontinence: Focus on Trigger Points
Gastroesophageal reflux disease (GERD) is defined as the regurgitation of stomach acid in the esophagus. Previously, it was thought that GERD was caused by a hiatal hernia, but recent trials suggest the cause is an inability of the hiatal sphincter to contract normally.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Older Patients, Stroke Risk and Manipulation
The first population-based study in the United States to evaluate stroke risk following spinal manipulation – and the first involving older adults – suggests that "[c]hiropractic cervical spine manipulation is unlikely to cause stroke in patients aged 66 to 99 years with neck pain.
God and the Chiropractor
My wife went to church last Wednesday night and brought home a CD of the pastor's message. As she handed it to me, she said, "You should listen to this; you'll like it." Our family regularly goes to church and our faith plays a major role in our lives.
What Do You Know About Physician Compare?
Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
Pain Is Only a Piece of the Puzzle
More often than not, when a patient presents to the office, it is for a pain complaint: headache, neck pain, low back pain, sciatica, carpal tunnel, etc.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
How We Can Help the Injured Brain
The majority of patients with mild traumatic brain injuries recover within seven to 10 days. If concussion signs and symptoms continue beyond seven days, the diagnosis changes from acute concussion to post-concussion syndrome.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Managing Tibialis Posterior Tendon Injuries
The tibialis posterior is the deepest, strongest and most central muscle of the leg, with fibers originating from the tibia, fibula and interosseous membrane.
News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Striking a Blow to the Medical Monopoly
The U.S. Supreme Court has issued a landmark ruling in North Carolina State Board of Dental Examiners v Federal Trade Commission.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Keep Seniors Safe: Age-Proofing the Home
I want to give Dr. Claudia Anrig kudos for her Dec. 1, 2014 column, which highlighted safety issues youngsters might encounter in the home.
Joint Supplements for Athletes (Part 2)
A fairly recent discovery in nutrition supplemental medicine has proven to be a breakthrough in maintaining athletic joint health. Research suggests a combination of undenatured type-II collagen and tetrahydro-iso-alpha acids helps revitalize joint function and performance in athletes.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
April, 2002, Vol. 02, Issue 04
Building a Successful Spa: Step Four -- Budget/Financing
By John Fanuzzi
In the past three issues, I've covered some of the creative aspects of opening a successful day spa. If at this point you know your theme, location, and have a feel for the size of the spa you have envisioned, it's time to get down to some of the more concrete business stuff - such as an evaluation of site demographics; startup cash requirements; cash flows and projections both for startup and for operations; and sales goals with break-even points for each profit center within the business.
Before you go to the bank or to money partners, a business plan should be prepared.You have to sell your idea. The more homework you do, the better chances of success. The banker surely will want to know:
Even if you don't need financing, it is still good to go through the planning process, just as if you were going for a loan.
To determine the size of the project and the money required, I recommend building an interactive spreadsheet, one in which you create input boxes that will generate formulas of cash flows for each profit center. The summary of cash flows for each profit center will then flow into a master summary sheet. This gives you a tool for dialing in all of your scenarios and break-even points, and determining the size of the project. It will also become your daily performance sheet after you open your spa; by monitoring the actual numbers, you can see where your strong and weak points are and readjust your cash needs accordingly. This way, you can make adjustments before it's too late.
Here is an example of a startup sheet:
In this scenario, the startup treatments are only five per day, even though there are four rooms with a potential of 32 treatments per day, at the normal eight hours worked per day with one-hour sessions. All of the numbers in the boxes are changeable. All of the other numbers are the result of a formula affected by the numbers in the boxes.
One important thing to know is the break-even number of treatments per day and month. The key numbers will feed into the cash flow sheet, which gives you your cash requirements. Create an entry sheet and a cash flow sheet for each profit center. Some of the profit centers might include front desk and retail, facial room, wet room, fitness, nails, and guest rooms.
The final page (see below) is a summary sheet, into which all the totals from the individual cash flow charts flow into a master cash chart with required startup amounts. Many businesses do not even break even for the first 1 1/2 to 2 years, so that must be figured in when you do your startup numbers.
It is always good to set goals and post and chart your daily numbers, so your entire team can work together toward a goal. The daily keeping of performance will help you make the proper adjustments to stay on target.
If you've done a good job on your creative planning, this financial planning will bring your ideas down to earth. After you know your cash needs, and after you have a commitment from your banker or investor, you will be ready for some serious design work, which will interface with the budget you have just created.
That brings us to next month's topic - design. In the meantime, have fun!
Click here for previous articles by John Fanuzzi.
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