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Accessibility and Community Acupuncture Clinics
Posted: 26 January 2012 08:38 PM   [ Ignore ]  
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The full article appears in the Winter 2012 edition of American Acupuncturist. 
Author Mark Fox can be contacted at .(JavaScript must be enabled to view this email address)

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Posted: 27 January 2012 12:56 AM   [ Ignore ]   [ # 1 ]  
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That’s a really well-done article, and I’m happy to see these kinds of studies done about the CA movement. I do take issue with the assertion that “traditional working hours” are between 8am and 5pm, and that clinics that fail to provide many hours outside of these times are therefore not catering to the working class. At least in my city, service industry workers make up a significant percentage of the working population, and these people are well-served by daytime and afternoon hours.

I also question the statement that if most practitioners are open about 31 hours per week, they therefore treat the work as a part-time operation. Can it truly be that the authors don’t consider the administration of a clinic to take at the very minimum 9 hours per week? I feel they might be unconsciously assuming our clinics to be operated as doctors’ offices usually are, ie. with a full administrative support staff. If punks are running their own clinics, as many are, then they need to allow for many hours beyond needling for the smooth operation of the clinics as a whole. I’ve always appreciated the assumption within the CA movement that full time meant 20-25 needling hours per week, not 40 hours of needling. It’s much more conscious of the clinic management work required of the punk-owner beyond needling.

Thanks for posting!

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Owner/Punk, Yerba Buena Community Acupuncture, SF, CA

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Posted: 07 March 2012 05:39 PM   [ Ignore ]   [ # 2 ]  
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A question which has been nagging me since I first read this article was how hours of operation were calculated.  Did total take into account the fact that per CA 101, hours posted refer to appointment time, which extends the operational time by an hour (per day) beyond “posted” hours, e.g., 9am-1pm=5 not 4 hours.  (am sorry, my cursor is very erratic and I have now had to re-type above paragraph four times.  I hope this still makes sense.)

Wrote to Mark Fox, whose response is posted below (with his permission):

                      *********************

“There tended to be two ways that clinic hours reported their opening hours:

First, by giving specific times, e.g., Monday 9-12, 2-4.

Second, by having appointment calendars that show the time slots in which appointments were available.

The second case isn’t an issue for your question as we would have counted the total appointment times correctly. The first case is indeed a problem, as we would have assumed 9-12 = 3 hours and 2-4=2 hours, but some clinics may have really been listing the last hour for appointments, in which case we would have been under-counting the number of opening hours.

It’s not just a “detail”, it’s an important point (and one reviewers didn’t ask about) as it confounds the data—with the hours of some clinics being counted accurately and the hours of other clinics being under-estimated.

Here’s what I suggest:

If you want to write a query to American Acupuncturist about this, I can then respond and they can publish (hopefully) something that says the hours will have been underestimated.

or

I can re-do the opening hours data for a more recent time period, and relate it to the other data items (number of seats and practitioners) and make this available on POCA and elsewhere (I think that may be a more informative approach as it will help correct any under-estimate.  I can’t really suggest correcting our earlier data as the clinic websites will have changed since then, making it difficult for me to determine what were the opening hours at the time we originally collected this data).

or

Suggest something that you think would be a useful response.


I really do admire what CAN clinics are doing (I’m also a former CAN clinic client) and would like to remedy this in a way that makes sense to you.  So, thanks for bringing this to my attention.”

                        *****************

Any thoughts?

Do all POCA clinics follow clinic-hour suggestion set forth in CA 101/Mighty Wiki?  Just want to have similar under/mis-counts avoided in the future.  Maybe this is not as much a POCA problem as one of research design.

Marie in Maine

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Posted: 21 March 2012 06:34 PM   [ Ignore ]   [ # 3 ]  
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In regards to the questions and presentation of Mark’s research, it’s important to take a close look a the methods section of his article. The most important statement being “it was not verified with the clinics or with CAN”. There is nothing wrong with this methodology and it was clearly stated as appropriate in the article.

Excerpts from Methods:

“In mid-June 2011, a list was downloaded of all U.S.-based CAN clinics from the “Locate a Clinic” link on the CAN website at http://www.communityacupuncturenetwork.org/clinics Where. available, the first author and two research assistants independently collected the following information from the websites of CAN clinics: number and gender of acupuncture practitioners, hours of operation, fees charged and whether health intake forms were available online. Data on clinic capacity (number of recliner/seats and number of tables) were obtained from the CAN website. The CAN website was used for this information as it had more comprehensive information on capacity than did the websites of individual clinics.”

“One weakness of this research is that it was not verified with the clinics or with CAN that the information on these websites was up to date. Having said this, it is believed that the clinics themselves have incentive to make sure their details are up to date so as to provide clients with current information.”

Based on the resources Mark had available from the CAN site and individual CA websites, there is no way for him or his team to fully represent the number of hours of operation (treatment hours plus running the business hours). Each clinic makes their own decision on how to post hours on their site. Some may state hours of 12pm - 4pm and established patients know they can stay until 5 or 5:30pm. On the other hand some may state hours of 12pm - 5pm and patients know they need to be in the door by 4pm to get a full hour of rest time with the needles.

A lesson to take away from his article may be what an individual CA clinic website is communicating to a new patient. We are so lucky to have many existing patients that talk about how our clinics work with the new patients they send our way. But what about potential patients who don’t come by way of referral and may be confused by the way hours are displayed. Mark’s article gives us a perspective of the CA world that we may want to take under consideration as appropriate for individual CA clinics (search the forums for more discussion on the topic of clinic hours).

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