Ginger in New England

     I’m sitting in my kitchen looking out the window at the three little raised garden beds in my backyard. The beds are empty, the trees are bare, and the row cover I had put out to try to extend the life of my green onions this winter has blown into a corner of the yard, where a feral neighborhood cat is napping on it. I am wondering again, as I do each year at this time: what will I plant in my garden come spring? For some reason I plant a garden each year even when I know that the majority of my produce will come from the farm I volunteer at, and the local farmers market. I care a lot about buying local, seasonal stuff whenever I can, and even though organic is also important to me, I would rather eat a non-organic apple grown here in RI, than an organic one from across the continent. My commitment to having some sort of garden, and its commitment to me, is to bind me to this place I live in. Part of that commitment is an ongoing process of understanding the conditions in my yard: soil, pests, new seeds, new varieties of plants and all the different things that affect what will grow and how well. It’s not enough for me to just want a garden; I also need to learn about the climate and landscape, and even with a lot of understanding gained over time, there are still no guarantees that I’ll succeed.


     Starting a garden is similar to starting a community acupuncture clinic, with both there is a difference between wanting to do it and understanding how to create optimal growing conditions for any particular landscape or climate. Wanting to provide lots of treatments to lots of people, to have a stable practice, to work with others, and to develop clinical skills rapidly and in many areas: these are necessary conditions for a successful community acupuncture clinic, but they are not sufficient. The number one “growing condition” that any thriving community acupuncture practice requires is realizing that at its heart, community acupuncture is not about pleasing ourselves; it is about doing what needs to be done. Providing acupuncture to people who otherwise would not have access to it at all, tens of thousands, maybe millions and millions of them is what needs to be done.


     In this way community acupuncture is like a victory garden, and the rest of the acupuncture profession, by contrast, is like a botanical garden. The acupuncture profession botanical garden is concerned with the preservation of exotic species, and with the distinctions between “true species” and cultivars. This garden requires funding from philanthropists, and foundations, and connections to universities with research grants; these relationships are part of what makes this botanical garden special, and unique. The botanical garden charges admission, and its mission combines education, enjoyment, and preservation. A victory garden, by contrast, is designed to enable citizens to provide food for themselves when resources are limited or diverted. During WWII an estimated 20 million victory gardens in the U.S. were able to produce the same amount of food as commercial growers would have. Communities pulled together to work these gardens, with some even forming their own cooperatives. Ironically, after the war ended very few gardens were planted and food shortages were experienced.


     It is in this same spirit of pooling resources, crowd-sourcing labor, and doing what needs to be done that community acupuncture has emerged. Until community acupuncture arrived, the only route acupuncturists in the US could see for more patient access to acupuncture was through insurance coverage. The profession surmised that gaining access to the insurance system would require that acupuncture prove to be on par with allopathic medicine, with some sort of parallel educational standards, or through “legal” status as independent medical practitioners of a stand alone system of medicine (this was attempted through legislative maneuvers.) Neither of these strategies have worked, despite considerable expenditure of time and money; perhaps because they prioritized connecting to doctors, schools, lawmakers and the insurance industry over connecting with actual and potential patients. Community acupuncture provides an answer to the foundational question that any practitioner trained in a healing modality wonders: who am I serving? Community acupuncture is a call to immediate action. There are clear steps to take. It quickly begins producing effects: on practitioners, on patients, on clinics, on communities. A solution that requires legislation, legitimization, and funding is a long way around compared to a solution that immediately starts providing care for people who need it and won’t otherwise get it. Community acupuncture effectively harnesses the work of individuals to meet the needs of the collective.


     Sometimes practitioners decide to try community acupuncture because their private boutique practices are not able to sustain a living for them. Most acupuncturists in the US are in private practices, working as sole proprietors, and most of their income derives from a combination of treatments given and products sold (though some of them supplement this with teaching at acupuncture schools, or teaching CEU courses). According to surveys done by a national professional organization, most acupuncturists are working fewer hours than they want to, and making a lot less money than they thought they would. Navigating the pressures and pitfalls of a solo business is challenging. A community acupuncture practice, while still challenging, is much easier to scale up, and there is evidence that the bigger a community acupuncture clinic is—the more acupuncturists that it employs and the more patients it treats—the more stable the operation through the normal ebbs and flows of any business (and therefore the more stable the income). But simply wanting this kind of stability for yourself cannot sustain a community acupuncture practice; you have to want that stability for the community, and at some point the clinic really begins to belong to the community. It takes less energy to let that happen, and to simply steward what gets set in motion, than to force a clinic to conform to an ideal in your mind. It’s like gardening; you have to be open to changes that you never planned on.


     Climate zones, topography, soil quality, drainage, rainfall, season: all of these are external factors that affect what will grow and how it will grow. I’ve been thinking a lot about the acupuncture profession, and life and culture in general, here in the US and around the world. In the UK, where a community acupuncture and multi-bed clinic movement is also growing, there are very different growing conditions. The UK has a nationally funded healthcare system. College and university education is much less expensive in the UK, much of it subsidized by the government as well. Studies show that people living in countries that provide more equitable and inexpensive access to healthcare and education are generally more satisfied with these systems than we are here in the US. I wonder if this general level of satisfaction has an effect, like climate or landscape do, on the growth of the community and multi-bed clinics in the UK, or on the overall goals for the acupuncture profession.


     The cost and inequitable access to healthcare and education in the U.S. also affect the growing conditions for acupuncture and community acupuncture here. In a sense, the cost of acupuncture education and the cost of healthcare together form a pinnacle of dissatisfaction for the average American trying to either get treatment, or to join the profession. The community acupuncture movement in the US was born from leaping off this pinnacle and into action If the same conditions for dissatisfaction to not exist in the UK (or not to the same degree), what motivates acupuncturists in the UK to make the shift to the multi-bed model? What goals are multi-bed practitioners seeking to meet? Who are they seeking to treat? Do these different “growing conditions” mean that different things will grow? Only those working in place, can really determine what is needed; but I still wonder what the two movements will end up looking like in ten years.


     In its first six years, the community acupuncture movement in the US, used the downward momentum of the leap from the pinnacle of dissatisfaction to fuel a robust movement of clinics, some 177 of them thus far, that in 2011 delivered 500,000 treatments and grossed $4.5million. Perhaps the community/multi-bed movement in the UK has not grown as fast because the overall level of dissatisfaction is lower – that is, that there is less far to leap, and therefore less momentum. There are other growing conditions that differ from the U.S.; for example, how the multi-bed acupuncture movement situates itself in the landscape of the National Health System, as an un-regulated practice. If and when the regulation changes, I imagine that the community and multi-bed practitioners could well be at the fore of leading acupuncture into the NHS, with their experience of scaling up and treating many more people than the typical private practitioner—though I don’t know if that’s a goal of either ACMAC or the broader UK acupuncture profession. But even in the UK the healthcare climate appears to be changing, with increased use of vouchers and reliance upon private sector services for specific needs or conditions.


     The community acupuncture movement in the US is not just moving away from a pinnacle of dissatisfaction; the downward movement is also characteristic of its grassroots goals. Community acupuncture is a movement that has deliberately stepped away from the usual trappings of professionalism in healthcare. Instead, community acupuncturists (or punks, as many of us call ourselves), are cultivating a new professionalism, one that reflects values of inclusiveness, and collaboration with our patients, rather than unnecessary status-mongering and information hoarding. You see these values reflected in the way our clinics are set up, what they are named, where they are located, how the punks dress, speak, and interact with patients and each other. By rejecting many of the values of the professional class, the community acupuncture movement has been able to create a new culture that appeals to a much wider range of people, primarily those in the middle and working classes. This “downward mobility” has not just brought with it a refreshing challenge to the assumptions previously inherent in our profession; it has made acupuncture a lot more relevant to a lot more people.


     There’s a farmer I know who started growing ginger here in New England a few years ago. Each year that he’s grown it, he’s been able to increase production and yield, as he learns how to provide these tropical plants what they need in this temperate climate. Why does he grow ginger? Is it because it’s novel, and creates a niche market for him? Is it because he loves ginger? or because he’s concerned with how much petroleum is burned to bring ginger to New England from the tropics? Is it an economic reason, an esthetic, or a whimsy? I don’t know the answers for this farmer, but I think that questions like these need to be considered when undertaking an innovative and potentially risky business choice, one that may very well change one’s entire perspective of everything, including the task at hand. Who knows what will grow best with changing planetary climates and access to resources once thought to be infinite? The most meaningful work provides us a means to put values into action, and these values directly shape the work sometimes despite growing conditions, and sometimes with them. Although arguably not essential, growing ginger in New England requires a vision of what is possible. I admire the farmer for his innovation, and I admire him equally for the knowledge and skills he has that help him produce crops like potatoes, leeks and squash. But I admire him most of all because he feeds people.
 

This story was posted on March 9 2012 by crismonteiro.

Comments

  • March 10 2012 at 5:41 AM
    Charlotte Whitestone writes:

    Hi Cris
    I like your article and I’m glad you’re going to be with us in Brighton soon. It’s always interesting trying to figure out what makes movements tick in different parts of the world. You’ll meet lots of UK multibedders when you visit, including the pair who opened the first clinic, so hopefully it will become clearer what we are up to over here.
    I would point out though that it isnt true that the multibed movmement over here has been slower to take off. There have been around 85 UK ACMAC clinics to date, some of which have closed, but in a country with a population of 60m compared with America’s 300m, this represents growth just as quick if not quicker than in the US, when comparing number of clinics at least. The difference lies in the number of patients being treated, with American clinics generally treating a higher volume of patients than over here.
    Anyway, I’m off to my clinic in a while to do my Saturday shift, and I’m looking forward to it as usual.
    See you soon Cris
    Charlie / Charlotte Whitestone
    ACMAC

      0 likes
  • March 10 2012 at 11:02 AM
    crismonteiro writes:

    Hi Charlie,

    There is something very interesting to me about the proportions as you mention.  While there are only 2x as many clinics in a population 5x as large, the US clinics did between 10 and 20x as many treatments.  (I’m approximating the total # of UK txs at about 20 or 25K based on the ACMAC survey results).

    Can you or any of the other ACMAC practitioners guess why these differences in magnitude exist?

    ~Cris

     

      0 likes
  • March 10 2012 at 1:14 PM
    Charlotte Whitestone writes:

    Hi Cris
    I can only surmise of course, but I think it has a lot to do with the existence of the NHS. Even low-cost acupuncture is perceived as private medicine here, which it is, and many people wouldn’t dream of accessing medicine that doesnt come via their NHS doctor. If doctors refer to us, patients will come, but doctors are more likely to refer within the NHS. There is quite a lot of acupuncture happening on the NHS, free of charge, given mainly by physios. It is generally dry needling but patients neither know nor care about the difference generally.
    Charlie

      0 likes
  • March 10 2012 at 1:28 PM
    Charlotte Whitestone writes:

    Cris
    Some more thoughts:
    We arent very good at engaging with our patients and they remain passive consumers of our product. This is something I would like to talk about at the conference, and hope y’all can share with us some of your wisdom in this area. Brits are too reticent by half.
    Community was crushed to some extent by Thatcher, rampant capitalism and loads of economic growth for ages. Now everything’s gone to economic pot and the Tories are squeezing public spending massively, and trying to radically reshape the NHS, community is suddenly going to become much more important.
    No doubt more thoughts will arise as soon as I close the computer
    C

      2 likes
  • March 10 2012 at 4:12 PM
    korbenp writes:

    Great conversation started. Can’t wait to here back from Cris and Skip and Lisa’s trip. Beautiful post. I especially love your framing of our momentum and direction as a measure of a very conscious and powerful diving/downward mobility we’re undertaking together.

      0 likes
  • March 10 2012 at 4:27 PM
    Nora writes:

    Good discussion, Cris and Charlie!  I’m so excited about this trans-Atlantic cross-pollination (just to continue the metaphor).  I would be curious to hear how our Canadian cousins’ experiences line up with all this, since they also have nationalized healthcare, but different licensing situations (and: are they more or less reticent than the UK cousins?)

    Certainly it seems that increasing inequality and “austerity measures” are recurring and dischordant themes all over.  I’ll be so glad when Thatcherism and Reaganism are distant memories for all of us.

      0 likes
  • March 10 2012 at 4:37 PM
    Nora writes:

    Charlie - I’m also wondering if you have any sense about how many of your patients self-refer because they’re trying to avoid mainstream healthcare?  I have no idea what percentage of our patients are typically uninsured (Lisa—or anyone—do you remember what Dr. Tippens’ survey said about this?)...but I know a goodly number of the folks who come to see me, who may not be particularly “alternative” in any other regard, are actively avoiding going to western MDs because they assume they will be prescribed medications, and they don’t want to have to take pills for the rest of their lives.  They frequently have other experience-based reasons for avoiding the mainstream healthcare system too, such as: hidden costs; mind-numbing bureaucracy; long waits for visits and follow-ups; discrimination based on race, nationality, sex, gender presentation, weight, and age, to name a few.  Etc.  Of course a better healthcare system (and better training of personnel) would minimize much of that, but I imagine many of those problems also exist within the NHS…

      0 likes
  • March 11 2012 at 8:19 PM
    crismonteiro writes:

    Hi Charlie,

    When I think about the situation in the UK with more physiotherapists, midwives, osteopaths, nurses, GPs,and podiatrists trained and practicing some sort of acupuncture than the total number of acupuncturists, it seems that despite the great work of the British Acupuncture Council to educate and regulate acupuncture (even though it still remains an unlicensed profession at this time) the public may have some serious misconceptions about who you all are, and what you all do.  Those misconceptions present a large barrier to patients seeking and receiving care from acupuncturists, even in affordable multi-bed settings. 

    So, what I see are two basic paths—one where acupuncturists try to legislate and educate their way into the minds of the public and one where there is a much wider path around the acupuncture already happening inside the NHS.  On the first path, ideally, the government recognizes that acupuncture is safe, effective, and well suited to serve the public, irrefutable studies show amazing efficacy for a wide array of (reimbursable) conditions, and the public embraces the “fully trained” acupuncturists over those with fewer hours of Chinese medical training, albeit many more hours of western medical training. 

    The second path goes via the third place.  Here is an excellent blog by Alexa who runs East Nashville Community Acupuncture about the role our clinics may have in the lives of our patients beyond being a place where treatments are performed. (paste the link in your browser to view the blog)  https://www.pocacoop.com/james-restons-appendix/post/the-community-acupuncture-clinic-as-a-third-place

    I know that you folks definitely “get” the third place thing, and I’m eager to check this out for myself during my visit.  ;]

    Seriously, I think that the current situation for acupuncture in the UK presents a bunch of inhospitable growing conditions that would take, in my opinion, a lot of effort and a lot of time, to overcome.  What if multi-bed clinics could cultivate a totally different way for people to interact with and around acupuncture?  That is essentially what we’ve done here.  Our cultivation methods go beyond the business model, or clinical model, and go deeper to the root of what ails us in our communities-separation, economic strife, a breakdown of social networks, and feeling powerless to change bigger systems.  How to sow the seeds of connection, sustainable and local economies, interdependence, and independence?

      2 likes
    • Demetra
    • Lisafer
  • March 12 2012 at 2:21 PM
    Pauline writes:

    RE community acupuncture and NHS. I thik we in Canada run into the same challenge. The real challenge is to educate people about acupuncture to get them in the door. Even though it’s affordable, nothing beats FREE healthcare, and it takes a while for word to get out that we treat a lot of stoff better than western med.

      1 likes
  • March 13 2012 at 8:36 AM
    Nora writes:

    Hey Pauline, it seems like you’re saying that some things do beat free healthcare (i.e. something that’s effective, affordable, and less alienating), but of course it takes awhile for people to try it.  And is it also your experience that the most effective way to educate people about acupuncture is in fact to “get them in the door” and give them acupuncture?

      0 likes
  • March 13 2012 at 5:15 PM
    Pauline writes:

    Absolutely! But, I can’t count the number of times a new pt has said “Oh you don’t have to treat my reflux/arthritis/whatever because my doctor is already treating that. So a lot of people still make their own mental divisions about what we do. Or, they’ll stop treatment till they get the results of some medical test. I’m never sure how to respond to that one.What I think they are saying to me is the doctor will know best how to treat this. And, of course, he costs $15 less than I do.
    I really thing you US folks have a bit of an “advantage” over us with universal medicare( although non-existent or overly expensive health care for the poor and working class is hardly to anyone’s advantage.) And as in the UK, our neo-con government is planning cutbacks to the provinces for healthcare, because their hidden agenda is to get the system privatized. DId I say stoopid, stoopid, stoopid?

      0 likes
  • March 14 2012 at 12:42 AM
    Lisafer writes:

    Hmm. I am remembering, back when we started WCA, that a lot of acupuncturists told us that patients would NEVER pay cash for acupuncture, no matter how little the cash was, because now that insurance covered acupuncture, everyone expected that acupuncture would be covered by insurance. There were lots of stories about why all cash practices were doomed. This was in 2002, when the economy had not yet crashed, and there really were more insurance companies that were, at that point, starting to cover acupuncture.

    Similarly, people told us that no way would there be a demand for our services, because Portland was saturated with acupuncturists. I don’t remember what the numbers were back then, but today, there are 800 acupuncturists in a city of about 500,000 people.

    I didn’t listen to any of it, because basically, I wanted to do this more than I wanted to do anything else. I still am not sure that any environment, any growing conditions, are more important than the plant’s own desire to grow. I ignored our environment altogether and I am pretty sure that is a big part of our success.

    I think if you magically transplanted the NHS and its acupuncture services to Portland overnight, it would not make much of a dent in our patient numbers. Does the NHS offer unlimited acupuncture to patients just for stress? How about for prevention—when the patient has no symptoms at all, but just wants to stay healthy? Can you get as many visits as you want for any possible condition? Can you stay and nap as long as you want? Are they open evenings and weekends? Can you get same-day appointments with staff who are genuinely happy to see you? Can you get an NHS acupuncture appointment as a date with your boyfriend, or as a way to spend time with your grandmother? Unless you can answer “yes” to every one of those questions, you could not persuade me that the NHS would be any real competition for WCA.

    We are a business. We give people what they want and we have fun doing it. Our business happens to be healthcare.I think if you start off by thinking, “we are providing healthcare to people who need it”, you are putting yourself in a mindset that is too passive, and also a little too grim, to succeed. It’s true, a lot of people don’t realize yet that they want or need acupuncture. But our business is to help them figure out that they do. No government agency could ever compete with our level of customer service, convenience, friendliness, flexibility, creativity, and plain fun. I think it would be great if there were free acupuncture services available through the government—but I don’t think it would overlap much with what WCA does. People might do what they already do now—use their limited insurance benefits to pay for acupuncture when they can, and when the benefits run out, or they can’t get an appointment, or the hours of their covered acupuncturist are ridiculously limited, they come back to us.

    You gotta do what you want to do, and not pay so much attention to what everyone else is doing.

      4 likes
    • Skip
    • bottley
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  • March 14 2012 at 12:45 AM
    Lisafer writes:

    Also, I love the image of leaping off the pinnacle of dissatisfaction.

      0 likes
  • March 14 2012 at 5:11 PM
    Pauline writes:

    First of all, socialized medicine does provide as many visits as a patients wants. And it’s true that the provision of healthcare is grim, serious business.It’s intentions are not prevention, but reaction to disease. Our system, unlike the British and French, trains too few doctors, so sometimes there is a wait to get in, and there aren’t enough specialists. DOctors are paid way more here than in France and UK, and are very jealous of their territory. Generally they’re more interested in running a business than providing a service, but the system is gradually changing that.
    Anyway, I am happy WCA has done so well. The CAN model and it’s assumptions don’t all fit in all countries because of socialized medicine. Or, at least some modifications are required.
    I agree it’s wise to, in some sense, ignore what else is happening and expect that people will love CA once they get in the door. Because they do. Getting them in in large enough numbers is the challenge.

      0 likes
  • March 14 2012 at 6:42 PM
    Lisafer writes:

    Socialized medicine provides as many visits as the patient wants for ANY condition? That wasn’t the impression I got from Charlie in the UK. What I’m trying to get at, is that the backbone of WCA is regulars. Many of those regulars don’t have a diagnosable condition, or they do have a condition, but it’s one that there’s no evidence that acupuncture would help. (Example: Gary in the documentary with asbestosis. There are no studies saying that acupuncture can help asbestosis, even though we know it does.) So you’re saying that in Canada, socialized medicine would pay for Gary to get acupuncture twice a week for the rest of his life? If I tell him that, he is gonna immigrate.

      0 likes
  • March 14 2012 at 7:36 PM
    Pauline writes:

    No, socialized medicine in Canada and UK won’t pay for acupuncture. But he can go see his doctor twice a week if he wants, and if no one tells him acupuncture will help, he won’t go. In fact, if he asks his doctor, whom he’s likely to ask first, his MD will likely tell him not to waste his time on acupuncture for that condition. SO he’s not likely to cross my threshold till everything else fails him and he has been told by at least two other people to try acupuncture.
    Now, he could immigrate to France and get free acupuncture from an MD, as only MD’s are allowed to practice acupuncture in France. Tell to pack his bags. The wine is cheap, the bread is wonderful.

      0 likes
  • March 14 2012 at 10:07 PM
    Lisafer writes:

    As far as Gary, he also could see his doctor twice a week if he wanted to—he’s one of the last lucky few with good union insurance—and I think he actually did do something like that before he started getting acupuncture. And his doctor definitely did not recommend this. He came to see us because he saw other guys his age going in and out of the clinic. In fact he watched us for a couple of years before he came in.

    Historically it was our experience too, that doctors weren’t familiar with what we did and didn’t refer to us. And I’m sure a lot of people still don’t come to us because their doctor says not to. But oddly, now that we are busier, we get a lot more referrals FROM doctors who found out about us because one of their patients found us on their own and then went back and told them how great it was.

    I think you can always put a lot of energy into all the reasons more people don’t come in for acupuncture. No matter where you live, there will be plenty of reasons. Part of why WCA is so busy, though, is that we never do that. We don’t worry about competition, we don’t worry about who doesn’t know about us, we don’t try to educate patients, we just think about how much fun it is to poke a lot of people. As far as we can tell, we are responsible for how many people we see or don’t see. Nothing to do with external factors, other than maybe the occasional blizzard.

      0 likes
  • March 15 2012 at 10:14 PM
    Naomi writes:

    I jumped into this conversation 2 days ago with a response to Nora on Canada and reticence… but I wasn’t signed in so I lost my whole post, and I went to bed, where I should have been before I started writing it.

    I’ve often wondered about free healthcare accounting for the slower growth of CA in Canada. Though I think we are just getting going here; time will tell.

    Anyway, I hear you Pauline. I hear a lot of those things too (compartmentalizing what acu can do and can’t do.) But I think enough patients just get it on a basic level: they notice that they feel better when they come in regularly and not as good when they don’t. I have some that really don’t communicate that much but then one day they’ll mention that their sleep (or whatever) is much better, etc. etc.

    And yes, I don’t think they think of coming to get acu as anything like going to a doctor. It’s just a place to come and relax and feel better. There are some, as Nora mentions, who want to stay away from meds/reduce dosages, etc.  I still don’t see them thinking of this as very medical.

    So I see it as just reaching enough of these patients - most of whom are going to go through periods of coming more regularly and then being away for a bit as life gets busy or whatever (and our hours are still far from what I hope they will be) - for the clinic to be usually full or nearly full. And reaching enough of the patients for whom the help we provide is really crucial…

    As far as reticence goes, yeah, I’m reticent. (I’m a Swiss/Brit in Canada, not to fall back on stereotypes). CAN/POCA has helped a lot though, to get me to a place where I’ll comfortably tell people what they need to do in terms of treatment frequency. And while me talking up community acu might not sound like someone more expansive talking it up, people get it. I don’t do much handing out cards in the grocery store (shop)line (queue) and probably never will. (Not sure if that’s what you meant by reticent, Charlotte.)

    Good discussion - and I am often trying to send friends and relatives in England to multi-bed clinics. I would be interested in hearing a breakdown of fees and how they relate to common everyday expenses… 15 pounds still does seem a lot to me, but maybe it’s just been so long since I’ve lived there. I know the rents are high - as are ours here in Toronto.

     

      1 likes
  • March 17 2012 at 7:39 PM
    crismonteiro writes:

    I agree with Naomi that most of our patients don’t consider what we do as healthcare in the same sense as they think of their GP, or the hospital.  In our clinic’s welcome letter we explicitly state that we are not doing primary care, and that if they have medical concerns they should see an MD.  This is not in our welcome letter because of liability, after all our license/practice act in no way makes us out to be doctors.  [But unfortunately a good number of acupuncturists would like to see themselves as such.] Defining ourselves by what we do, rather than what we don’t do (primary care) is important.  Hopefully we impart what it is we do not long after the patient reads the welcome letter.  I think once we get someone into the group room, set the needles, and the px drifts off into an acu-nap, it gets more clear.

    I can see why acupuncture has tried to model itself after the dominant medical model, be it managed care, or even physios and nurses doing acupuncture through the NHS.  Acupuncture needed a way to arrive on the scene, and the scene is a giant industry, whether it be for profit, or government funded.  I don’t find fault with trying to access the systems through which patients access care.  And I actually applaud any acupuncture being given through a free healthcare system.  Acupuncture is useful even when applied outside the context of TCM theory or a holistic paradigm. 
     
    If the goal in countries with socialized medicine were to get the national health systems to include acupuncture more widely, what would acupuncturists want it to look like?  We already know a little bit about how the PTs and MDs envision it.  Would we as a profession be willing to bargain and negotiate away “parts of our medicine” just to get it out there more?  I dare say we ought to. I’m sure others disagree.

    Acupuncture is one of the few “health” modalities that requires/allows people stop and disconnect from all that’s happening outside of them, and re-connect with what is inside.  And it’s this kind of re-connection that is where the health comes from.  It’s not just about taking away someone’s back pain, or allergies, or hot flashes.  That’s part of it.  The connecting part is so much larger, and that part happens so much easier in the community setting.

    What is it that our current models of healthcare lack?
    Think back to “healthcare” before managed care, or before the NHS, or insurance companies, or any of that.  That kind of healthcare was your family taking care of you when you were sick, or laying you out in the living room when you died.  That kind of healthcare is where women birthed children together, or provided abortions for one another.  We’ve made some real leaps in understanding the role of hygiene in health.  We also have so much more with the marriage of science and medicine, but I’m not sure it’s more health. 

    We’ve been led to believe that institutionalized healthcare, whether in hospitals, universities, or doctor’s offices, is safer and better than what we can provide for ourselves.  I’m not arguing for DIY open-heart surgery, but I do think that we’d all be a lot healthier with a sense of having more control day to day over our bodies.  This of course requires a lot of responsibility on the part of individuals.  It also would require a lot more responsibility on the part of all institutions that educate, employ, govern and protect.  Healing is something we do on our own, health care is the support we seek and can find to make that happen.  So if we are moving towards “institutionalizing” acupuncture or community acupuncture what kind of “institutions” do we want to build?  If we are envisioning CA as a different path than the current incarnation of institutionalized healthcare, what’s different about what we do?

      3 likes
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    • Lisafer
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