A Guide to Understanding CAN’s Anger, for Any Member of the Acu-Establishment

I can really understand why many different people, reading this blog, would feel hurt, attacked, misunderstood, unfairly maligned, and on top of it all, bewildered. I can imagine that any representative of an acupuncture school or of a mainstream acupuncture organization might be wondering, why are these community acupuncture types so HOSTILE? If all of this anger doesn't make any sense to you, please read on.

(Note: I am not on the Board of CAN and I'm not presuming to speak for CAN as an organization. I did name this blog "Prick, Prod, Provoke", and I did help start CAN. But I am only speaking from my own perspective.)

The first thing you need to know is that all of this anger is not about YOU as an individual, or indeed about any individual; it has nothing to do with whether you or anyone else is a good, caring, honest, hardworking person. The anger is about structures, not about personalities. It's about the many economic disconnections of the acupuncture world. Some of those disconnections involve acupuncturists and some involve patients.

Let's start with the acupuncturists:

1) the disconnection between the cost of an acupuncture education and the typical income of an acupuncturist. According to a recent AAAOM survey, 73% of the acupuncturists surveyed brought in less than $80K gross, annually, from their acupuncture practices. Factoring in overhead and self-employment taxes, this suggests that 73% of acupuncturists are netting less than $40K annually. And while the sample size was small, it reflects my sense of my colleagues' incomes in the 14 years that I have been an L.Ac. A very tiny percentage are doing very well, and a very large number are earning almost nothing from practicing acupuncture. They rely on other jobs or their spouses' incomes to survive. Since I graduated from OCOM in 1994, I have seen the cost and the length and the requirements of an acupuncture education rise relentlessly -- and yet economic prospects for graduates today are no better, and possibly worse, than they were for me. There are still almost no jobs in the field. Most insurance does not cover acupuncture, and many more patients have no insurance at all.

2) The disconnection between institutions and practitioners. The most stable entities in the acupuncture world are not the small businesses run by acupuncturists (because 50% to 80% of acupuncturists are out of business within 5 years) or the state organizations composed of L.Ac.s (mostly tiny and underfunded) but the acupuncture schools and the regulatory agencies such as the NCCAOM, the ACAOM,  the CCAOM, etc.. Acupuncture schools run on federal student loan money taken out by acupuncture students; the regulatory agencies run, directly or indirectly, on fees paid by acupuncturists and acupuncture students. The heads of the larger schools and of the NCCAOM make six-figure salaries. Meanwhile more and more acupuncturists graduate from schools burdened with debt that they may never repay, and a majority watch their businesses fail. For most acupuncturists, our only choice if we want to practice is to take the huge financial risk of starting our own businesses; most of the jobs and the accompanying steady paychecks in the acupuncture world are within the schools or regulatory agencies. In other words, your income = our debt.

Income disparities of this magnitude are what create revolutions.

Now for the economic disconnections that involve patients: 

3) the disconnection between how acupuncture actually works and how you have told us to price it. A single acupuncture treatment almost never creates lasting positive change, especially for chronic conditions; what is effective is a course of treatment, which means frequent and regular acupuncture over a period of time. Even insurance that covers acupuncture almost never pays for a full course of treatment for any really serious problem, and it never pays for preventative care.  The going rate of $65 to $200 for a single acupuncture treatment virtually ensures that no patients with ordinary incomes will get satisfactory clinical results -- they will stop after one or two treatments because they can't afford to continue. And yet those of us who have attempted to price our treatments so that most people can afford them are regularly scolded for "devaluing the profession". Some of us have received threats and intimidation from other practitioners as a result of trying to price our treatments so that our patients will actually get results. It is hard not to draw the conclusion that money matters much more than patients to the acu-establishment.

4) the disconnection between who we are and who we can treat, according to the acu-establishment. Pricing acupuncture at $65 to $200 per treatment limits our patient base to those who are very well off or who have unusually good insurance -- and given what is happening with insurance, those two groups are increasingly not very different.  All of us have been encouraged to find "success" by treating rich people. The problem here is that most of us are not rich ourselves, and to achieve success according to your standards requires that we reject and abandon those people we are most connected to -- our extended families, our friends, our neighbors, the people with whom we have natural relationships -- in favor of the few people who can afford to pay the going rate. The solutions that you generally suggest to this problem -- dedicating part of our practice to charity, reducing fees for a few deserving people, using sliding scales that require income verification -- make us think that none of you have ever been on the receiving end of that kind of "generosity". Having to prove that you are poor enough to deserve help is humiliating. Acupuncturists magnanimously reducing fees for a few people does not solve the problem that we are concerned with, which is making acupuncture genuinely accessible to people like ourselves.

From our perspective, these disconnections look a lot like systematic discrimination -- unintentional no doubt, but systematic just the same.

 5) the disconnection between how simple acupuncture actually is, and how much we paid to learn it. Acupuncture and herbs are not the same thing. You can get excellent clinical results with acupuncture with a minimum of training in Chinese medical theory. After a little time working with real patients in the real world, most of us come to the conclusion that we could have learned what we needed to know about acupuncture, in order to help most people, in eighteen months of schooling, tops. Most of what we spent armloads of money to learn has no direct (or even indirect) usefulness to our patients. That curricula are designed and accredited in this way suggest to us that what patients need does not interest you.

Many acupuncturists have joined CAN because they feel it is the only place they can have honest conversations with other acupuncturists, without an atmosphere of competition and oneupmanship. Many acupuncturists have said that CAN is the only place that they have found real support and information about how to start a practice. CAN was designed to fill a lot of different gaps in the acupuncture world, particularly the gap between who we are and who we can treat according to conventional business models. As a result, CAN has also introduced acupuncture to exponentially increasing numbers of patients.

Oddly enough, CAN's stellar usefulness is another thing that makes me angry. I developed the community acupuncture business model and I helped design CAN. I had no real qualifications to do either of those things: no experience with business or organizing, no real web skills, some experience with acupuncture but not decades of it; no financial resources except credit cards, and no connections. It has not been an especially convenient time in my life, either, since I've been raising children. Everything I have done in terms of CAN and the (now international) community acupuncture movement would have been infinitely easier for someone within the acu-establishment to do; it has been a lot of work but there is absolutely nothing about any of it that is particularly complex. Any number of you have infinitely more experience, resources, and connections than I did, so why didn't somebody else more qualified do this a long time ago? It's really simple, and it's been needed forever.

The short answer is that it was a priority for me, and apparently not for you. I've started to think of myself, with my remarkable lack of qualifications to lead a movement, as a walking indictment of your indifference.

But the long answer is what really explains, I think, the intensity of my anger towards the acu-establishment. In 1999, I started treating a hospice patient with stage 4 lung cancer. He didn't really want acupuncture, but had agreed to it at his wife's urging. He would let me use only a few needles, most of them local; he wouldn't take herbs or change his diet. Almost everything I learned in school was no use at all with him. Over the course of two years, as I treated him, he stopped coughing up blood, regained much of his energy, and got kicked out of hospice. He credited the acupuncture. His lung doctor, the head of pulmonology at the local Kaiser hospital, called me to ask if I could explain why our mutual patient's cancer had apparently stopped spreading. And then I left my public health acupuncture job, and the economic structures to treat this patient disappeared. I was in no position to offer him charity care and he would not have accepted it; he wanted to pay me, but after having had cancer for the better part of a decade, buying groceries was a challenge. If he missed an acupuncture treatment, he started coughing up blood again. I developed the community acupuncture business model because I had to find a way to continue to treat him. His wife believes that regular acupuncture added five years to his life. Perhaps you can understand why I feel that making acupuncture widely accessible to people of ordinary incomes is actually a matter of life and death.

Since then, I have treated patients for whom getting acupuncture is a matter of being able to keep working the jobs that let them support their families. I have treated patients for whom getting acupuncture meant no longer thinking of suicide, because they are no longer crushed by chronic pain and depression. I have treated another patient with terminal lung disease who has stopped coughing up blood and no longer gets pneumonia, whose doctor visits have decreased from every three weeks to every six months. (His doctor said that his asbestosis was no longer a major issue: "I don't understand what you're doing, but whatever it is, just keep doing it.") I have done what I did because these patients' lives MATTER to me. My goal for this blog is for other acupuncturists to understand what's at stake -- people's lives. Honestly, in contrast to the real pain and suffering that so many people are dealing with, and the staggering untapped power of acupuncture to offer real help, the acupuncture profession's preoccupation with status seems petty, trivial, and appallingly selfish. People are suffering and we have the power to help them NOW. If we want to.

Please don't tell me that if we had more status it would help our patients, because the economy is in a nosedive and the healthcare system is going to follow it, straight down. It does not benefit our patients for us to achieve status within a system that is economically unsustainable. Please don't tell me things really aren't that bad, because acupuncturists can get jobs on cruise ships. Please don't tell me that my patient with asbestosis could afford to get acupuncture at market rates (twice a week, for the rest of his life, did I mention that he is raising his grandson?) if he really valued his health. Just as you may be bewildered by all the anger on this blog, i am bewildered that all the economic disconnections of the acupuncture world are not painful to you as they are painful to so many of us. You are in relative positions of power.  You could change all of this. If you wanted to. 

This story was posted on December 8 2008 by Lisafer.

Comments

  • December 8 2008 at 2:54 AM
    itayneta writes:

    Thank you

    Thank you Lisa.

    Like your book, this entry rocks. Many people in many areas feel the LQS kind of frustration about life, the world, the economy, healthcare, etc. But most of us cannot articulate it as well as this.

    While I would like to be granted the leeway to make my own mistakes with my practice instead of having to adopt the CA practice model wholesale, I appreciate everything that you’ve done and your passion to share it. Now I understand better where that comes from.

    Keep up the good work!

    Itay 

      0 likes
  • December 8 2008 at 10:36 AM
    Nora writes:

    Lisa, you kook…

    ...it sort of sounds like you’re challenging the acupuncture establishment to engineer themselves out of their own jobs for the sake of the health and well-being of the majority. 

    That would be pretty inspiring to see, actually.  

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  • December 8 2008 at 11:39 AM
    seattle jill writes:

    taking the time to create change

    Thanks for using all your intelligence and strength to create this wonderful movement. I have believed all you are saying about the AMA medical establishment too (that it is over priced and education is too expensive,etc) but never dreamed that there was such a wonderful alternative for acupuncturists. I am living my dream in a large part because of your vision.

    Maybe you feel anger has been motivating for you. Perhaps it does and  you can still be clear headed about what your goals for change are when you feel anger.

    I think that being clear with what you believe and being open to listent to others beliefs-to the point where they do not directly affect the outcome of your goals-is a more effective way to affect change.

    If Melonie can engage that woman from the school in a dialogue (which she did a pretty good job of in her blog after the initial discourse),  the woman from the school might actually listen and try to help make the changes needed.

    Many times I feel anger and frustration sitting in staff meetings at the community clinic where I work. They are worried about getting funding cut for these expensive tests that in the end really do not create health. I used to jump up and engage in heated debate. That got me shot down pretty quickly. Now I try to do research first and hang the results in the employee bathroom. It is a slower way, but I have gotten some of the doctors interested in (for instance) using essential oils for treating MRSA. I am actually treating one of the medical doctors in the clinic with acupuncture for his hypertension. Now he knows it works and send folks to me for treatment.

    I grant you that these are small changes when you are fighting for the big ones. Again, Lisa, I so appreciate what you have done-it has changed my life and it has been the vehicle with which I was able to get the acupuncture clinic started at the clinic and do treatments for so many people in need who would have never gotten otherwise.

    Jill

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  • December 8 2008 at 11:51 AM
    SarasotaCA writes:

    As usual Lisa, you inspire

    As usual Lisa, you inspire me.  Thank you for your post—it comes at a well needed time for me.  You do a great job in putting things into perspective.

    Thanks

    Melonie 

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  • December 8 2008 at 3:57 PM
    River Jordan writes:

    The Silence from our so-called acu-leadership is deafening

    ?

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  • December 8 2008 at 6:14 PM
    Justine writes:

    Putting things in perspective…

    Thanks for putting things in perspective, Lisa.

    It can sometimes be easy to get carried away in all the acupuncture profession related issues… but going back to the basics of helping other people have live fuller, healthier, longer, better-quality lives - that’s what we are really doing this for.

      0 likes
  • December 9 2008 at 12:54 AM
    tatyana writes:

    we have missed

    your voice here… thanks for this.

    -tatyana

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  • December 9 2008 at 10:47 AM
    crismonteiro writes:

    For all of the above reasons

    For all of the above reasons to be angry with the acu-establishment, I am. But I want to point out an observation regarding the recent participation of members of the acu-establishment:  they don’t seem willing to carry on a public conversation.

     

    Among those who have participated on the CAN forum are board members of AAAOM,  leaders from acupuncture schools, and other folks who regularly contribute to the “mainstream” acupuncture voices like Acupuncture Today

     

    In most instances, these folks have signed on to register their comments, but always with a caveat that they will not be returning to the site, or that we should contact them here or there.  Why?  We obviously have a very active reader/writer forum.  Why not engage despite the anger and the fracas?  Any member of the AOM community can participate on CAN anonymously if they desire, but the AAAOM requires anyone commenting on their forums to first have approval from the moderator… why?  

     

    We are asked to consider whether or not anger is productive again and again.  I believe it is, but in order for it to be so there must be engagement despite the emotions that are raised.  Because powerful emotions, like anger, are being raised it is even more important that we engage.  I understand that sometimes when emotions are raised it takes sometime or space to regain composure, but I would like to invite any of the folks who have already commented here on CAN, and then bowed out of the conversation, to take a break and then return to the forum.

     

     I would guess that many folks from the acu-establishment actually read parts of the CAN forum, but don’t participate in the conversations here.  CAN’s contributors are regularly unapologetic for voicing their true opinions and challenging those that they disagree with.  As common stake-holders can we try to get past the personal insult via sincere apologies for truly personal remarks, and then get on with addressing the issues raised?  

     

     

    Cris

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  • December 9 2008 at 12:50 PM
    donnajoon writes:

    Sobering and inspiring

    Lisa…your wonderfully written post saddens me, angers me and inspires me to continue to do what I’ve set out to do.  You rock…and you aren’t even trying to rock.  You are just living out your convictions, and are generous enough, (or mad enough!) to share with us how you are doing it.  Thank you.  Your posts and the comments of others here re-fuels me as I start to feel discouraged in building a new practice.  I read what you all have to say, and go about my work with a new force.  It re-awakens in me the fire that CAN started.  Again, thank you, Lisa, and thank you to everyone else who writes here.  We’ve got lots of work to do, and this is a great place to be reminded we are all working on it.

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  • December 9 2008 at 12:58 PM
    peoples writes:

    Will this get posted on AAAAAAAAAAAAOM?

    THis is a good follow up to Ben’s last response.   CAN is a tremendous resource for support, just like you stated.  We spend a lot of much needed time to commiserate, inspire, and preach to the choir.The discourse on AAAAAAAAAAAAAAAOM, was a great opportunity for a concert and the survey is an opportunity for us to provide some back up vocals.

     

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  • December 9 2008 at 1:01 PM
    korbenp writes:

    inviting and fierce

    We (people who make up CAN) are not going anywhere. We’re going to keep bringing acupuncture to more and more new patients. More acupuncturists will continue choosing a job with a modest and predictable income where they’re able to connect by WORKING with hundreds of people a week instead of being totally isolated.

    It’s really OK that engagement with people with vested or emotional interest in the as of yet “conventional"acu “industry happens slowly. I think it’s a good thing. What we’re doing represents a truly deep departure from the culture that has grown around that industry, including but not limited to it’s tacit understanding of class in the U.S., our fundamental role as healers and business owner, ideas about what comprises worth in ours and other’s lives, etc. But, all these departures actually represent returnings to the taoist origins of Chinese Medicine and thousands of years of thinking about how whats essential is RELATIONSHIPS.

    We just get to keep going with that in mind. But, it doesn’t men we don’t get to have high expectations of our collegues. And, of course, we don’t have to tolerate the oppression of our patients or our selves.

    We get to be inviting and fierce.

    Love,

    Korben

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  • December 9 2008 at 1:04 PM
    korbenp writes:

    dig it

    dig it

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  • December 9 2008 at 8:40 PM
    Lisafer writes:

    right back atcha

    girl -who -is-starting-a-new-business-based-on-an-unfamiliar-concept-in-the-middle-of-a-severe-recession. In DETROIT. Now, that’s kooky. In the best possible way.

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  • December 9 2008 at 8:43 PM
    Lisafer writes:

    Thanks!

    Itay. smile

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  • December 9 2008 at 8:46 PM
    Lisafer writes:

    You’re more than welcome,

    hope it’s helpful, please check your email if you haven’t yet.

      0 likes
  • December 9 2008 at 8:49 PM
    Lisafer writes:

    You’re welcome,

    Tatyana and Justine. smile

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  • December 9 2008 at 8:51 PM
    Lisafer writes:

    Thank you

    “You rock…and you aren’t even trying to rock.” 

    That might be one of the nicest things anybody has ever said to me. I’m just kooky, trying to keep up with Nora. 

      0 likes
  • December 9 2008 at 8:52 PM
    Lisafer writes:

    Will do

    I’ll post it with a link, now that should be entertaining, though as Cris and Jordan pointed out, people do not exactly seem eager to talk to us.

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  • December 9 2008 at 8:53 PM
    Lisafer writes:

    In general

    Jill, you annoy the hell out of me. However, one of your recent posts makes me feel that it’s all worth it:

    “Yesterday I looked around at the people lying in the chairs relaxing and at ease with each other. There were two hispanic folks-an elderly woman of Scottish descent, one white transgender person and a middle  aged black man who snored away for 2 hours. He comes for a place to rest cause he is a ‘marginally housed’ veteran with lots of pain.

    The thing that they all have in common is feeling of ease when they come to see me. ”

    Anything is pretty much worth it, for that. You made my day, actually.

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  • December 10 2008 at 12:55 AM
    David Lesseps writes:

    Yes

    Good God Lisa

    This letter should be posted all over the dark little places where our profession lurks.  With your permission, I will happily spread this around the various discussion goups, forward it to CSOMA, Acupuncture Today, etc, etc.

    Oh, and even if I don’t have your permission, I’m going to hang this on the bathroom wall in our clinic.

     

    Big Thanks for articulating how I feel,

    David 

     

    Circle Community Acupuncture

    San Francisco

    http://www.circleca.com

      0 likes
  • December 10 2008 at 1:53 AM
    Lisafer writes:

    Yes, please,

    send it any- and everywhere you want. Thanks. I would love to see any response—though, of course, my fear is that they’re going to say, “Well, so what if acupuncture can add years to somebody’s life? It’s way more important that we can call ourselves doctors!” Making an argument in terms of morality only works when people actually have morals.

    I did put it on the FPD forums on the AAAOM website, so I guess we’ll see.

      0 likes
  • December 10 2008 at 11:56 AM
    Nora writes:

    Yeah we’re crazy like foxes!

    Rabid foxes, of course.  (cue insane cackling!)

      0 likes
  • December 10 2008 at 2:41 PM
    Wadelp writes:

    buwahahahahahha!!!

    As usuall, great post Lisa!

    Wade

    http://www.qi-well.com

      0 likes
  • December 10 2008 at 3:42 PM
    peoples writes:

    Perspective patients are

    Perspective patients are eager to talk to us.  I just got off the phone with a new patient who sad “I’ve called around to other practioners and I want to know how you can afford to what you do?”  Ha ha ha ha…...After many other questions she made an appt and will be here in half an hour. 

     

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  • December 12 2008 at 7:14 PM
    seattle jill writes:

    annoyance

    I guess it is annoying to have someone who does not agree with what you say on a lot of points posting on this blog.

    You assume a lot about me due to the fact that I annoy you-that is where your anger gets in the way. We will never agree on some key points- that does not mean I do not appreciate what you have done.

    It has always been about the people who I serve (I have done phlebotomy as a medical technologist for the last 30 years and have made it a point to treat everyone who sits in the chair to have their blood drawn with respect and kindness).

    Glad to have made your day.

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  • December 12 2008 at 7:44 PM
    seattle jill writes:

    one other thing about annoying you

    I was given a slip of paper during a meditation/blessing I attended. On it was a simple statement

    “I acknowledge my reflections in the world”

    Just something for you to think about

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  • February 16 2009 at 8:47 PM
    akitchen writes:

    i needed that

    After having a really crappy day at work and thinking this just isn’t worth doing, I stumble upon your blog and now have a smile on my face.

    Thank you Lisa.

    Allison

      0 likes
  • March 4 2009 at 5:13 PM
    Eliciahealing writes:

    wow, how true.

    I  graduated acupuncture school in 2007 of course with grand hopes of how I would practice.  But now with the mountain of student loan debt to pay and really no way to build up clientele with no capital to start a business I ve seen myself interminably stuck and left to try and daily squelch the healing urge that got me into this work in the first place. I ‘m grateful to still be involved somehow by doing massage at a day spa and occasionally acupuncture, but its so limited compared to a community acupuncture set-up.  So, rage aside (man did I get dooped on that 6 figure education) God willing when the time is right when I find a space thats not 600,000. I will step in to fill that space in this community’s wellness with community acupuncture. Stand by with a tag for your map for Bismarck, Ndakota!!

      0 likes
  • March 31 2009 at 5:45 PM
    Guest writes:

    The Facts

    Lisa, you have your facts wrong. The majority of Americans DO have insurance- actually about 65 % are insured. In Oregon the 3 largest carriers, who cover about 70% of all insured Oregonians (Regence, Kaiser, ODS) DO offer an acupuncture benefit.

    The economics for the practitioner? In most professions it takes years to get a well paying job, and ours is not different, neither are the tuition we pay or anything else. No, there are not a lot of jobs, and we know that when we enter school, if you want employment, becoming a PT would be a better choice. Once you are in the field, you can earn a decent income within a few years; you need to acquire business management skills and in-network insurance contracts. Yes, I know many do not make it, usually the ones that don’t want to bill insurance, pay for advertising, or do what it takes. We have to give up the myth that you succeed because you are a great acupuncturist.

    I don’t feel hurt, attacked, or angry. I think you are not seeing reality correctly. Revolutions happen because you either find a critical mass of discontent (which you won’t because most peopel do have insurance ) OR you bring influencial people to your perspective, and it seems Obama just affirmed the current employer-based insurance system.

    You don’t have a revolution, you are just providing cheap care. I wonder why there is no working class dentistry, working class physical therapy, working class optometry, etc? What do you think???
    Regards,
    Angela Pfaffenberger

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  • April 27 2009 at 2:47 PM
    LarryG writes:

    all “Facts” and no shared meaning

    You are a culture leech.  What the hell is that?

    What you are failing to understand, which surprises me considering your self-professed knowledge of integral theory, is that in the inter-subjective world space in America, there is very little shared meaning between subjects when it comes to acupuncture.  There is no substantial culture that exists to support acupuncturists when they get out of school. Most people in this country have no real understanding of what acupuncture can do, how it works and how to use it.  They know few people that have actually tried it and have had a positive result.  The inter-subjective world space is filled with fear and doubt regarding acupuncture.  This is the bigggest obstacle any acupuncture graduate faces entering the world; the American interior world space has no reference point for acupuncture.  Lack of insurance coverage, the need for advertising, inflated failure rates of graduates….these are all collective exterior symptoms of a collective interior disease.  It is largely an issue of culture not structure.  That is the weakness of your post and the perspective you put forth here. 

    You claim that “Yes, I know many do not make it, usually the ones that don’t want to bill insurance, pay for advertising, or do what it takes.”  These practices have no actual subjective meaning, they are purely objective.  Acupuncture practice does not happen in a vacuum, Angela, it happens in a culture and you fail to consider that advertising acupuncture in a culture that has very little shared meaning of acupuncture between its subjects is mostly pissing in the wind. So the only option for acupuncturists is to leech off of the existing and stable medical culture, like you do. (or you can leech off the upper class spa culture, which I see you do as well, but I digress)  Advertising, billing insurance, doctorates, psychotherapy…all elements of the existing western medical culture.  This will work for some practitioners, but it won’t work for most. The ones that can most effectively culture leech will have the most chance for individual success.  How is your practice doing?

    Of course, another option for acupuncturists to consider is co-creating a culture to sustain acupuncture in the inter-subjective world space by providing it to as many people as possible.  As this happens, the inter-subjective world space in America will develop its own perspective on what acupuncture can do, how it works and how to use it. Hmmm, where is that happening?  And as we at CAN co-create shared meaning with the public, co-create culture, there will be a stable base of perspective to structurally support practitioners.  It’s kind of exciting, co-creating culture that is, when you stop to think about it. You claiming CA is merely about ‘cheap care’ speaks volumes to your apparent inability to consider cultural components to our profession.  In one sense, “Cheap” is an objective number, something you can put your finger on.  I’ll let it slide that what you consider cheap and what I consider cheap are probably two very different things, due in part to our economic circumstances, but also to our individual sense of values as well as the particular culture that we grew up in.  At it’s best, our revolution at CAN is about co-creating a culture for acupuncture with our patients.  That’s what all successful revolutions are about: embodying a new, more highly organized social structure with a new, more highly organized culture.  And that culture is co-created between subjects.  Pushing a structure where there exists no culture?  That’s where the profession finds itself now.  

    “I wonder why there is no working class dentistry, working class physical therapy, working class optometry, etc?”——Largely rational/scientific professionals that have not evolved consciously into a more full expression of worldcentric values.  As you should know, worldcentric values show care and concern for self, group and all groups.  Collectively, when these professions develop past early worldcentrism rational/scientific, we may see these very practices come into being.  That’s what is happening here at CAN.

    So, you can claim that “you need to acquire business management skills and in-network insurance contracts” in order to “make it” and that’s fine.  But even with these skills and contracts, it will always be an uphill battle for acupuncturists in America when our culture does not have adequete shared meaning to support these structural components of practice.  You may make a living, but if your concern is to make acupuncture available to everyone and make a living, which apparently it is not, then you will have to start to consider the collective interior world space if we are all to prosper, have access to care (and study) and do a little more than self-actualize. In fairness, I haven’t read your thesis.  However, I doubt it would display a more integral perspective than your brief post demonstrates here.

    Warmly,

     

    Larry Gatti

     

      0 likes
  • June 17 2009 at 4:15 PM
    Guest writes:

    Contemplation

    I have just come upon this article so I apologize for my late entry.  I don’t get out much and so obviously I’m missing some important conversations.  I must admit my first reaction to your posting was shock and sadness.  To some degree this may be a result of growing up in the sixties and my own observations of the outcomes of anger that seemed more important to vent rather than concern with results.  I want to respond as one of the people you are unhappy with and adjust some of the generalizations in your remarks.  I am a president of one of the colleges and my salary as president in the last 15 years has never topped $40,000, in fact it is presently under $30,000.  More than 90% of our graduates are in practice.  All incoming students receive counseling on their potential debt, so they choose to come into the profession knowing that as well as having a sense of the struggle they will face when they graduate in this health care field.  I have for decades supported various forms of group acupuncture settings to care for those with less resources and all of our students participate in such settings as part of their training in order for them to directly see its importance.  Many of our graduates have gone on to work in underserved areas in this country and abroad.  I have had my differences with the CCAOM, NCCAOM and ACAOM and they are well-documented, but I also know most of the leaders of the CCAOM and ACAOM personally and know that with all their faults, most are struggling mightily within the constraints of regulations, higher education requirements, the USDE, etc. to balance keeping their schools alive and functional.  I also know from being part of the history of the development of this profession since 1980 that there were many forces that had to be dealt with to get any sort of licensure for acupuncture, financial aid, etc. and those forces were and are beyond the control of any one school or organization.  I certainly applaud your energy to reach underserved people, I certainly applaud your warning to potential students to seriously consider the costs of the profession they are getting into and to choose wisely, I certainly agree there a problems in acupuncture education, patient care models, etc..  But I do not see how the feeling in your posts and the responses I have read furthers your ultimate goal.  If you took this feeling into the treatment room, you would not be able to have very effective patient care.  You know the feeling you bring to inserting needles and treating patients, why can’t that same healing force be brought to this conversation?  It indicates that potentially your anger is overriding your compassion and that if you ultimately want more energy for the patients you care about, a path to consider is bringing that sense of care to your words when talking to your colleagues.  I would be happy to meet you or any others eye to eye and face to face and explore the depths of what healing is about, for our patients and for our profession.  I watched similar energies split our profession apart years ago when the AAAOM and Alliance created their divisionary philosophies.  From my point of view, thankfully, that era appears to be over in that we can generally express our differences under one roof.  I will probably not keep up with this blog regularly, only because my plate is full with my program, patients and teaching - but certainly contact me directly if you have any interest in continuing this discussion.

    Sincerely,

    Paul Karsten

      0 likes
  • July 8 2009 at 10:03 PM
    Guest writes:

    Greetings Paul and

    Greetings Paul and others-
    Paul’s school, SIOM, I believe, is a serious place of learning for OM, the only school in the states requiring students to read and research in Chinese.
    But I concur with Lisa’s statement that an Acupuncture-only education, sans herbs, could be done in a year with a six month practicum, or some similar curriculum. This is in fact how the first wave of “masters” in the American scene got their start. The current “Masters” approach I have found to be a scam. The need for accreditation breeds a Potemkin village of false academic fronts, and oh yeah, a whole lot of debt.
    There is little hope of correcting this, in fact- the trend is set to create the Dr track as the professional norm. Unless this just rots itself from the inside out.
    Acupuncture alone is a useful technology for healing but one can no longer get a stand-alone acupuncture education in the states without wasting a lot of time and money just basically socializing (participating in unnecessary classes in order to appease social needs unrelated to patient relief).

      0 likes
  • June 11 2010 at 4:25 AM
    Michelle writes:

    now I am angry

    Angela, I do not feel the anger Lisa does concerning the state of the acupuncture profession but do recognize it all to be true.  I do have every right to be angry about it but it is just not what I have felt. BUT what you have to say here DOES ANGER ME!  Whenever I see someone who does not have any understanding of a person (in this case, our patients) I just have strong hopes that they do not have to experience what that person does to have some compassion. I hope this for you.

     

    I actually have been quite successful since I graduated and have been charging high rates to do house calls.  I believe my success has all been based on the results my patients get.  I did no advertising and have never billed insurance.  SO your idea of what it takes to succeed in my experience does not hold true.

     

    Since I graduated my passion has been to offer community acupuncture but where I live creates extra expense and many things that make it a bit more difficult (as is for all small businesses in my state) so it took some time to gather the resources to make it happen but I have done it.  For me not because I could not make it doing boutique acupuncture but because I recognize the need for affordable healthcare.  Your facts are absolutely wrong!  There are no working class dentistry, working class physical therapy, working class optometry, etc because insurance companies cover those things but most do cover acupuncture and like Lisa said if they do it is not enough.  I know first hand what it takes to choose alternatives to western medicine without any recourses in order to regain health.  I spent four years in a wheelchair and when I was released from the hospital after my illness I was put on social security at a young age and my insurance allowed me to see all the MD’s, PT’s… I wanted but not any alternatives.  As soon as I was out of the hospital I ran from all of those forms of care which left me in a position to have to pay for all of my care out of my pocket on a very low social security salary. I had absolutely nothing and the little funds I did have all went to my healthcare and food.  I spent every penny on alternative care from acupuncture to supplements, organic foods, massage, herbs… nothing was covered by my insurance.  I chose to put literally everything I had into my health and getting well.  I am an incredibly stubborn, strong willed and determined person.  Very few are as stubborn as I am and no one should have to be in order to be healthy.  I do not know what planet you are on but if it is earth you are totally disconnected from the people.  I have opened a community clinic not because I can’t make it otherwise but because it is what my community needs and in all my conscience I can not close my eyes to people who want to be well and healthy but just can’t afford it.  I know first hand your facts are part of the disconnect. 

      0 likes
  • March 16 2011 at 2:40 PM
    Guest writes:

    This is so brilliant. Your

    This is so brilliant. Your skills are obvious and irreplaceable.

      0 likes

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