Demographic Research Summary: Baton Rouge, Louisiana

Love Austin but not sure if it’s the best place to start your acupuncture practice? If that’s the case then I’ve got a city for you. At first glance you might not think it’d be a city that had much opportunity for up and coming acupuncturists, but if you take a closer look you’d find it is a place with plenty of potential. So, now that I’ve got your attention, let me introduce you to a hidden gem of a city: Baton Rouge, Louisiana.

Baton Rouge, the state capitol of Louisiana, sits on the eastern banks of the Mighty Mississippi. It is a college town with a current population of about 800,000 people. Cost of living is right at the national average with an annual household income of about $60,000. This rapidly growing city is in the process of revitalizing its once sleepy downtown as part of a long term plan to attract potential residents who are in their twenties and thirties (not to mention trying to keep the young professionals graduating from LSU in town). Appealing to the younger generation will help the city to continually maintain economic growth. And when looking for a place to start a business, potential growth is a definite plus.

At first glance practicing acupuncture in the state of Louisiana might not look appealing. After working for several years to complete post graduate work and earning a Master of Acupuncture and Oriental Medicine, most are not willing to accept working as an acupuncture assistant under the direction, control and supervision of a physician. And that is exactly what the great state of Louisiana asks you to do. You cannot call yourself an acupuncturist unless you are a licensed medical doctor. This statue appears highly restrictive though you do not have to practice in the same building as your supervising physician. The key to making this situation work for you is choosing a physician who believes in you and the medicine. Developing a professional relationship is the foundation of your practice and could be mutually beneficial regardless of whether you choose to rent a room on site or operate as a stand alone business.

No matter which route you choose, on or off site, the cost of doing business in Baton Rouge is reasonable. Given the right relationship with your supervising physician, start up costs for renting a space within the doctor’s office could range between $560 and $775. This also keeps monthly operating costs on the low end, $350-$450. The most expensive scenario, the stand alone acupuncture practice, ranges from $4620 to $5510 in start up costs with monthly operating costs ranging from $1275 to $1625 a month. Both estimates include rent, utilities, and monthly allowances for insurance and relicensing fees.

Though the statue seems harsh, it has created a market that has little competition. Currently there are only five acupuncturists operating in Baton Rouge several of which are MD’s specializing in sports medicine. That leaves a city of close to a million potential patients with very few options for alternative treatments and creates a wide open market. In fact, there are a few noteworthy observations about the cities current medical facilities that could provide an opportunity for specialization. There are several hospitals in the city, one of which is specifically for women along with several clinics for infertility. The city is also home to an IVF clinic that services many surrounding areas. Thus, the data seems to support the idea that Baton Rouge could support an Oriental medicine practice that specializes in women’s health.

Its also reasonable to think that the current population of Baton Rouge will be receptive to acupuncture and Oriental medicine. Though Louisiana is often considered to be a fairly conservative environment, East Baton Rouge Parish tends to be about 60% democrat and slightly more liberal than surrounding areas. The university culture also contributes to the belief that the community could be open to what Oriental medicine has to offer.

Overall the research clearly shows that Baton Rouge has tremendous possibility as a potential location for an acupuncture practice.

Summary Set 1: Regulatory Climate

In Louisiana there are two practitioner titles: Acupuncturist and Acupuncture Assistant. Acupuncturist is a title that can only be applied to an MD who has completed an additional 6 months of training in traditional Chinese acupuncture along with 300 hours of continuing medical education in acupuncture. Acupuncture Assistant is anyone with 36 months training at an approved acupuncture school that has successfully passed the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). Acupuncture Assistants “must be employed by and work under the physical direction, control and supervision of a physician or acupuncturist certified by the board”. ( retrieved on 7/22/09)

Though an acupuncture assistant is required to perform “duties, services and functions pertaining to acupuncture as assigned by the employer, they are not required to work on-site with the physician”. ( retrieved on 7/22/09)

To practice acupuncture in the state of Louisiana no additional written or practical exams are required. Practitioners do, however, have to be approved by the State Board of Medical Examiners. The initial fee for said license is $200. It should be renewed every year before its expiration for a fee of $25. No CEU’s are required to renew the license.

Acupuncture is defined as “treatment by means of mechanical, thermal, or electrical stimulation effected by the insertion of needles at a point or combination of points on the surface of the body predetermined on the basis of the theory of physiological interrelationship of body organs with an associated point or combination of points, or the application of heat or electrical stimulation to such point or points for the purpose of inducing anesthesia, reliving pain, or healing diseases, disorders, and dysfunctions of the body, or achieving a therapeutic or prophylactic effect with respect thereto”. ( retrieved on 7/23/09)

This statue does not allow anyone who is not an MD to practice without supervision and is restrictive to the average acupuncturist. The mandate to work under a physician keeps most acupuncturists out of the state. In turn, it has created a market with little competition. In order to establish a successful practice in the state of Louisiana you’ll need one thing: the right physician to work for/with. If the right business relationship is established and a climate of mutual respect is present then it’s possible to build an integrated practice that utilizes the strengths of both Western and Oriental medicine.

Because acupuncture assistants are not required to work on-site we considered two scenarios when looking at Baton Rouge: on-site practice and stand alone business. Within the given scope of practice both could work and both could potentially be profitable.

Summary Set 2: Demographics

A general picture of the make up of Baton Rouge was found in the vital statistics page from the Baton Rouge Chamber of Commerce. (

These demographics can be used as a baseline for further research into specific areas of the city. Because you are starting this process before finishing school, you will have more flexibility inadapting your defined skill set to met the specific needs of your target population in a way that will be service oriented and yet still profitable.

Doing a city search for acupuncturists in the area, it is discovered that there are five acupuncture clinics in Baton Rouge. ( These results indicate that Baton Rouge is not saturated with acupuncturists and it is reasoned that your practice will not be defined by any market competition factors. Upon investigating the listed clinics, it is noted that two practitioners are MD’s and two are NCCAOM acupuncturists. Three of these practitioners heavily specialize in sports related injuries and none have specific women’s related services. ( ,good, you included the extraction date.

Due to the regulatory control of having to practice under a MD’s supervision, the importance of integrating into the Western Biomedicine system should be accounted for.

This search revealed an interesting discovery of a women’s specific hospital. (

This would indicate at least a base level of women’s health issues awareness within the community at large. From this it is concluded, given the regulatory climate of practicing under an MD’s supervision and given the proven medical clinical studies of acupunctures effectiveness in a supporting role in treating infertility, a practice focusing on women’s health, reproductive health, and IVF support could be highly profitable and marketable. A projected target population would be white (not PC, but the truth), middle to upper income bracket, and ages 20 to 40+. An ideal location would be easy to access from major streets, close to medical complexes or hospitals, and within the target demographics. Using the statistics from (with in a 5 mile radius), an area in Baton Rouge that fits this targeted population was found at 6421 Perkins Rd: slightly more female (51.66%), income $50K or higher (47.66%), white (67.66%), ages 21-44 (approx. 26,000), and daytime work population (approx. 50,000). But will they spend money? According to this source, women spent $66,000,000 on clothing.

Baton Rouge does contain an IVF clinic. ( This clinic serves Baton Rouge, New Orleans, and even has clients from surrounding states. A possible scenario would be to begin making contacts with this clinic to offer supporting services for them and to develop a strong working relationship. Because you are still in school, emphasis on study and training in this area is highly recommended. Perhaps the clinic might even be willing to help pay for the rest of your school training as acupuncture and herbal medicine has clinically been proven to increase success rates of IVF.

Summary Set 3: Cost of Doing Business

Ultimately, the cost of doing business in the Baton Rouge Louisiana area is not prohibitive nor an impediment to practice. Acupuncturists in Louisiana must either practice in a doctor’s office or in a separate building, but under the supervision of a physician. Because of this I have constructed two separate cost analysis scenarios: one for a stand-alone business and another for the cost of setting up and running a business within the confines of a doctor’s office.

In scenario 1, the stand-alone business, the total layout for starting an acupuncture practice ranges from $4620 to $5510. These costs include all governmental and licensing fees, general liability insurance, moving expenses, and the cost of leasing space and setting up utilities. Most of these costs would apply to any area of the country, not just Baton Rouge. Ongoing costs range from $1275 to $1625 per month plus taxes. These figures include monthly lease payments, utilities, monthly allowances for insurance and relicensing fees.

In scenario 2, working within another practitioner’s clinic, costs were considerably less. While there is a monthly space rental, there are no lease payments, property taxes, or utility fees. Most spaces for rent did not require additional general liability costs. Startup costs are approximately $560 to $775 plus medical malpractice insurance. This includes all governmental fees, licensing fees, and monthly space rental. If the practitioner must pay to move equipment to the area this could range from the cost of gas to drive it in a private vehicle to $500 to rent a POD service and have the equipment and belongings moved to the chosen location. Ongoing costs range from $350 to $450 plus medical malpractice and yearly/monthly taxes.

It should be noted that Louisiana is one of the many states in which one must pay a state income tax in addition to federal taxes. It should also be noted that this cost analysis does not include the following. Reasons for omission are noted:

Medical malpractice
Could not find numbers for this cost online, did not receive return quotes in time to submit this analysis.

Equipment purchases and other supplies. needed in the course of running an acupuncture practice.
This analysis is designed to assess whether this location is feasible for the location of an acupuncture practice. These costs will be incurred regardless of location.

Specific numbers related to taxes.
In Louisiana there are several taxes to take into consideration, but as with any location, they are based upon the actual net income of the business. Taxes do require special mention however. Taxes include a corporate income tax, sales tax on all consumable goods, state income tax, federal income tax and federal withholding. None of these are unreasonable, nor do they deviate significantly from other locales.

Scenario 1: Stand-alone business

Startup

Governmental fees
From

  • $75 for LLC filing or $60 for corporate filing
  • $60 for commercial zoning clearance
    Possible $375 fee if property has to be rezoned.
  • $50 for occupational licensing in the city of Baton Rouge

Licensing fees

  • $200 to apply for acupuncture recognition in Louisiana
  • $50 for NADA certification

Renting space

  • $1700 - $2400 Deposit (1st and last month’s rent)

Setting up utilities
$700 estimated setup for electric, water, wastewater, internet and answering service.

Insurance

  • Malpractice
    Could not find any hard numbers on this
  • General liability
    $1800/year

Relocating from Austin Tx to Baton Rouge La

  • $500 if you use POD and need to move equipment.

Ongoing

Leasing

  • $850 to $1200/month (at $8-12/psf, the rate for the properties available in the area: South of I-10 on Perkins Rd.)

Utilities

  • $265/month
    (calculated with the help of Chris Miller, a commercial real estate agent in Baton Rouge LA: approximately $3000/year or $2-3/psf of space per year.)

Insurance

  • $150 per month (1800/year) General Liability
    (Estimate per Chris Miller, commercial real estate agent in Baton Rouge LA)

Re-licensing fees
$10.50 per month, calculated from the $125 yearly re-licensing fee.

  • $100 to re-license
  • $25 for NADA recertification

Yearly taxes

  • Corporate income tax:

4% / First $25,000 of net income / 7% / Next $100,000 of net income
5% / Next $25,000 of net income / 8% / Any net income over $200,000
6% / Next $50,000 of net income
  • Sales tax
    4% of all taxable (consumables) sales, due the 20th of each month
  • State income tax
    2% of income from 0 - $12,500
    4% of income from $12501 - $50,000
    6% of income tax from $50,001 and above

Scenario 2: Working within another doctor’s or practitioner’s clinic

Startup

Governmental fees
From

  • $75 for LLC filing or $60 for corporate filing
  • $50 for occupational licensing in the city of Baton Rouge

Licensing fees

  • $200 to apply for acupuncture recognition in Louisiana
  • $50 for NADA certification

Malpractice insurance

Space rental
$300-$400 is the going rate for a single room for practice (about 150 sq ft) in this area
From

Ongoing

Malpractice insurance

Re-licensing

  • $100 to re-license
  • $25 for NADA recertification

Yearly taxes

  • Corporate income tax:
    From

4% / First $25,000 of net income / 7% / Next $100,000 of net income
5% / Next $25,000 of net income / 8% / Any net income over $200,000
6% / Next $50,000 of net income
  • Sales tax
    From
    4% of all taxable (consumables) sales, due the 20th of each month
  • State income tax
    From
    2% of income from 0 - $12,500
    4% of income from $12501 - $50,000
    6% of income tax from $50,001 and above

Space rental
$300-$400 is the going rate for a single room for practice (about 150 sq ft) in this area
From

Summary Set 4: Political Climate

See attachment in email. I’m not able to open Alex’s document therefore I could not include it in this document.

Dear Bubbalicious team,

You did a spectacular job on this assignment. Reading these two documents (this one plus the political analysis) makes me very glad that Cat volunteered to present and sorry that I didn’t ask the whole team to make a presentation. In terms of the grading rubric, you did everything I hoped for and more: several sources well-documented, comprehensive analysis of the data, creative presentation of the chosen location. I like the style you wrote in—as a sort of demographics research consultant. I’ve made a few comments throughout. 20 points. A. And I’d like to keep a copy of this if I may for future classes.

Again, thanks for a job very well done.

Anne

Bubbalicious Group: Cat Calhoun, Tim Nicosia, Alex Sturman, Louise Lacoste July 26, 2009