Koha Days at Christchurch Chiropractic

I’ve always been a bit uncomfortable conceptually with ‘for-profit’ businesses using ‘Koha’ payment methods.
To me, Koha is something that I am used to paying at events, organised by charities or other volunteer organisations, where everyone involved is basically donating their time, and the Koha is simply to help with the added costs for venue hire, food, sound equipment, printed materials, etc. so the organisers aren’t left too much out of pocket, apart from the time they’ve willingly given.

While I was at chiropractic college, it was interesting to be introduced to the concept of ‘box on the wall chiropractic’ where there were no set prices, people paid what they thought it was worth, and this was put to the students as a way of actually making more money than with set pricing, as people often feel guilty that they might be under-valuing the service, and end up paying more. This was similar to the Maori concept of Koha, we were told. I didn’t entirely agree, given my own personal perspective of what Koha meant from my experiences with it, but I understood the ‘box on the wall’ concept, and indeed, if it was about making money, seeing many patients for fairly short visits, that would be a good business model. It’s part of what in the USA is termed ‘cash based practice’
Is cash based practice a good healthcare model? Possibly not…
But, it is a good way of making money.
And the ‘box on the wall’ model certainly pretty good promotion, which sounds all about community, when it’s a business, making money, just like everyone else’s business.

Now, why am I talking about Koha days, exactly?
Well…

Back in February, when the tenth anniversary of the Christchurch earthquakes rolled around, I decided that I wanted to do something for Christchurch, on what was a pretty solemn day for many here. I decided that I would see everyone for no charge that day, to elevate the mood or however you want to think of it, in what small way I could. If they weren’t OK with accepting that as the gift it was intended to be, I encouraged them to pay it forwards in some way, or make a donation to City Mission, because they’re the people on the ground, supporting people through rough times, every day of the week, not just when there’s a crisis.

On that Monday morning, Cliniko, the web-based practice management software I use, just wouldn’t connect, which wasn’t too much of a drama because I wasn’t charging anyone anything- I didn’t need to process payments, although typing up some notes would have been handy, and saved me doing so at the end of the day. After a couple of hours not being able to connect, I thought I better look into what was happening, and checked the Cliniko facebook page, where sure enough, there was a post apologising for the outage. There was an upgrade that went pear-shaped on the Sunday, and they were going hammer and tongs to patch things, having called in additional tech help from elsewhere around the globe. A couple of pretty bad days at the office for them!
I read some of the comments, and man was there some bile… People were mad, and not very understanding. I looked at that stuff, and thought “Boy, the Cliniko team are already having the worst day, and dya know what, in the grand scheme of what happened 10 years ago, and all Christchurch has endured since, all these cranky comments about a website not working, looks like pretty small change.”
While I was on the Cliniko facebook page, I happened to notice in the ‘about’ section in the sidebar, that they donated 2% of their subscriptions, from practitioners like me, to charity every year.
2% doesn’t really sound like much, but if there are 52 weeks to a year, it amounts to around a week per year working for charity.
Something in that idea really resonated with me, and I thought it was interesting that I was learning about this while doing a day for charity myself! So I figured that seeing I do four patient-contact days per week, I would do another 3 days for charity myself during the year.

So I did another one the next day.
This time, I called it a Koha day.
The quake anniversary one really was pretty spur of the moment stuff, that second day, I took payments, letting patients know all funds were going to City Mission, suggesting people pay what they could manage, be that the usual price, less if that was a stretch, or more if they were able. At the end of that day, I had $495 to donate, which I direct credited to City Mission’s account.

I thought that it might be nice for the crew at Cliniko to know that they’d inspired me to do a week per year for charities, particularly following a day where they were pretty stressed and hearing they were doing a terrible job from so many people. In that email I was careful to explain that for me this wasn’t about promotional activity, it was about the act itself, of giving my time. I’ve never been particularly comfortable with the amount of salesmanship and self-promotion that seems to be second nature for a lot of chiros, and I guess I probably err on the side of doing way too little of my own trumpet-tooting, that’s just not really who I am.
I got a really nice reply from Joel, the founder, saying that they were proud of their work for charities, and he pointed out that, if they hadn’t said anything about their donations, I wouldn’t have been inspired to do the same; that I should be proud of supporting the charity I’d donated my time towards, and that patients would probably actually like to know.

So, it’s weird how things work sometimes:
Without Cliniko crashing that day, I might well have just done a one-off quake anniversary thing, and still be waiting to stumble on inspiration for a good way to give back, many months later.
And without that email where I talked about this for me totally not being about promotional activity, I wouldn’t be writing this blog post, because Joel’s reply made me examine my motives, and discomfort with marketing and promotion in a more general sense, and realise that it’s actually OK to feel good about telling people about this charitable work.

The last week in September was Mental Health Week. I’d been wondering when I might get around to doing the next couple of Koha days, and I decided that was a great cause, given the state of things in this post-COVID world we inhabit. Across 2 days, through Koha payments, I donated $1500 to The Mental Health Foundation.
There will be another four Koha days next year, they may occur during four different months, or they might all be in one week.

How do you book in for one of these?
Well, that’s not how it works! It’ll just be a normal day at the office apart from the fact payments go to a charity, nobody is aware beforehand. Given the way the others eventuated, I may not necessarily know myself, until the day before. When it feels right, it happens.
There won’t ever be a sponsored facebook post about this, but I’m glad I’m ok with telling people, because it’s worked out great for two important charities thus far, and many more to come.