【学会讯息】Fees across the UK

马伯英按：这篇文章是2011年9月BAcC发表的全英针灸价格研究报告。根据这一报告，中国医生的收费太便宜了。他们在贫困地区最低也要34镑！我想供会员参考。上次会议我就讲过，适当提高收费也是度过经济危机的一条可考虑措施。这一报告是一个理论支持。

SAM MAY

How do acupuncturists' fees vary across the UK? This was the research question for a survey I conducted last year for my dissertation at the College of Integrated Chinese Medicine, to provide some basic information, for the benefit of both the profession and the public, on the cost of acupuncture treatment in different parts of the country.

To establish the survey sample, an analysis of the 2010 house price index for local authority areas in the UK was made. The sample comprised BAcC members - 81; in total - working in the wealthiest and poorest areas of the UK, as well as those working in areas with house prices closest to the national average. In this way a three-tiered sample was established, to enable an effective relative analysis of treatment fees in the UK.

The 'upper tier' of the sample covered the boroughs of Westminster and Kensington and Chelsea, with an average house price of £1,056,638. The 'middle tier' had an average house price of.£225,579 (the national average at this time was £224,064) and included the following areas: Reading, Craven, Cornwall, Canterbury, Bexley, Hambleton, East Cambridgeshire, Mid Suffolk, Daventry, Maidstone, South Lakeland, and Adur. The 'lower tier' had an average house price of £112,318, and included the following areas: Falkirk, Renfrewshire, Sandwell, Lincoln, NE Lincolnshire, Boston, Mansfield, City of Nottingham, North Lanarkshire, Kingston upon Hull, Stoke-on-Trent, Burnley. This lower tier is not entirely representative as interestingly there were no BAcC members practising in many of the poorest local authority areas in the UK, which include remote parts of Scotland and Wales.

The main results from the survey, showing the mean cost of treatment for each sample tier, are indicated in the table below:

	Mean house price (£)	Mean cost of initial treatment session (£)	Mean cost of follow-up treatment (£)
Upper Tier	1,056,638	72	63
Middle Tier	225,579	50	37
Bottom Tier	112,318	41	34

There was, however, quite a range of fees within each tier, as indicated in the next table:

	Mean house price (£)	Mean cost of initial treatment session (£)	Mean cost of follow-up treatment (£)
Upper Tier	1,056,638	45-150	45-130
Middle Tier	225,579	30-90	15-65
Bottom Tier	112,318	0-70	25-44

The bottom of the range in the bottom tier reflects that one acupuncturist from this sample offers free initial consultations; apart from this one case, the lowest initial treatment fee charged in the bottom tier is £27.

There was no correlation in the results between the number of years an acupuncturist has been in practice and the amount that they charge for treatment

Additional information was gathered in the survey, concerning level of experience, overheads, number of patients, duration of treatment sessions, number of patients being treated at any one time, and the factors that influe acupuncturists in determining their fees.

There was no correlation in the results between the number of years an acupuncturist has been in practice and the amount that they charge for treatment; the highest fees charged it each sample tier were not attributed. The most experienced acupuncturists that tier, and similarly the lowest fees charged were not attributed to those with the last experience.

There was also no correlation in the results between the number of patients seen on a weekly basis and the amount charged for treatment. The majority of acupuncturists from the sample – 65percent – see less than 20 patients weekly, and 39 percent of the sample see less than 10 patients weekly. Four acupuncturists from the sample were treating two or more patients simultaneously but were not charging significantly less than the mean charge for treatments in their sample tier.

The majority of acupuncturists from the survey sample – 67.2percent – were practising in a clinic setting, with 32.8 percent maintaining a home practice, and 26 percent maintaining practices in both settings. Those who work from home only generally did not appear to charge much less than average.

The main factors involved for survey respondents in determining and/or changing their fees and considering the cost of overheads in their practice. The number of yeas they had been in practice and any specialist training that they had done were also considerations.

One of the main implications of the results is that the cost of acupuncture treatment in the poorest areas of the UK is relatively high. A possible explanation for this is that acupuncture treatment might only be pursued by people with relatively higher incomes in poorer areas, meaning that the majority of people in those areas are unable to afford treatment. Further research in these local authority areas would be required to substantiate this.

However, the survey also revealed evidence of acupuncturists offering concessionary rates to those who are unable to afford the standard cost of treatment, indicating that treatment may not be as exclusive as the main results suggest. There is also evidence for the growth of more affordable multibed clinics across the UK. The ‘Association of Community and Multibed Acupuncture Clinics’ (ACMAC) listed 48 member clinics in the UK in November 2010, and by June 2011 the total number listed had risen to 62, amounting to a 29 percent increase in seven months. Further research into concessions and multibed clinics across the UK is required in order to ascertain the full extent to which treatment is affordable to those on lower income.