Midwest College of Oriental Medicine - Chicago & Racine

Dear Dr. William Dunbar, D.N., M.B., Ph.D., L.N.C., President of MCOM:

     I am shocked that three years after Lisa Rohleder first wrote about community acupuncture (CA) clinics in the publication Acupuncture Today, students at the Racine and Chicago campuses of the Midwest College of Oriental Medicine (MCOM) are unfamiliar with the fundamentals of a CA clinic.  I am saddened that MCOM’s students who ask for information about how to establish an affordable-group-treatment clinic are discouraged from doing so by your faculty and administration.  And I am angry that information about the Community Acupuncture Network (CAN) is withheld from them.  By failing to provide appropriate resources for students who wish to establish community acupuncture clinics (such as “The Remedy: Integrating Acupuncture Into American Health Care”), MCOM creates a scenario in which its graduates will not succeed.

     Over 80 acupuncture clinics in the United States currently follow the model established by CAN, an organization that has served as a springboard for similar clinics in the United Kingdom, British Columbia, and Israel…but, many students at MCOM have never even heard of CAN.  CAN has been covered by National Public Radio, Utne Reader, the Washington Post magazine, The Integrator Blogtelevision news reports, and dozens of local newspaper and radio programs nationwide…but your business management course fails to even mention CA clinics.

     I understand that your business class emphasizes to students that they should never charge less for an acupuncture treatment than a massage therapist would for a rub-down, because the educational requirements for an acupuncturist are far greater than for a massage therapist…and therefore (the logic goes) acupunks warrant a higher fee.  Has your business management instructor calculated that by treating 6 patients per hour, at a fee of $15 - $40 per visit, a community acupuncturist’s earning potential ranges from $90 - $240 per hour?  This exceeds what a skilled massage therapist can demand in the same amount of time…and what most of your graduates currently charge.

     MCOM has created a boutique-curriculum catering to the upper-middle classes of our society—with its inversely proportionate relationship between available income and potential consumers.  Milwaukee’s Harley Davidson is laying-off 1,100 employees over the next two years (70% of which are expected in 2009); your community needs these services.  The New York Times reported last week that over 75,000 jobs will be lost from eight major US companies.  With these lay-offs, families will part with their health insurance benefits and disposable income.  NPR reports that 1,000,000 Americans are currently losing their health insurance benefits every month

     Take a moment to step-away from the doctorate program, look beyond the high-cost private practice model you espouse, and listen to what is desired by your students and their patients.  (Recent community clinic surveys have clearly demonstrated our patients' appreciation of the services we offer: 1, 2.)  In our current economic climate of unemployment, financial hardship, and healthcare woes, the greatest opportunity for your soon-to-be graduates lies in serving the middle and working-class segments of our society. Our communities need us to be accessible.

     By not educating your students about the mechanisms of a community acupuncture clinic –such as the minimal space requirements, whether CA clinics can support the owners, whether hybrid clinics can be successful, how classism affects a community practice, etc. — you do a disservice to both your students and the communities they serve.  When interested students approach your faculty or administration with questions about the CA model, it is inappropriate for MCOM to suggest that practitioners in a CA clinic will not be able to repay their student loans…while mentioning nothing of the failure rate of acupuncturists who choose the private room practices MCOM champions. (66% of boutique acupuncturists fail within 5 years, according to the University of Colorado Health Sciences...but some recent estimates push that failure-rate closer to 80%.)

     Beyond the fact that community acupuncturists are making more money and achieving more successful practices than private room ‘punks, lies the single most important statistic: WE ARE HELPING MORE PEOPLE.  My small practice in Frederick, Maryland was seeing 70 patients per week within six months of opening.  The five-year-old Working Class Acupuncture clinic in Portland, OR sees over 400 patients per week, making it the single busiest acupuncture clinic in the nation: busier than all acupuncture-school-clinics coast-to-coast.  Furthermore, CAN estimates that between 5,000 to 7,000 patients every week receive acupuncture in CA clinics across the country.

     The point of our profession is to help people. CA clinics enable acupuncturists to help the most people; community acupuncturists are able to make a better financial living; and CA clinics are not only more likely to remain open, but also to employ staff and create jobs for newly graduating acupuncturists.  So why are you not answering your students’ questions about how to properly run a community acupuncture clinic?

     There are several MCOM alumni with active CA clinics who would love to talk with your classes about their practices: Linda Stengel and Christie Kern in Racine, and Bonnie Roads in Chicago.  Linda has been repeatedly asked by the students to come and speak about her experiences, but she was told by faculty that there “wasn’t enough time” (perhaps a lunch-hour discussion for interested students would fit into the curriculum).  And I have offered in two of MCOM’s alumni surveys to talk with your students about my experiences establishing and operating my CA clinic, The Turning Point…with no response from the school. 

     The business plan which I submitted--structured after the Community Acupuncture model--was named a winner in the Rockville Economic Business Plan Competition for Women Entrepreneurs in 2008.  I was interviewed about the Community Acupuncture model on WASH-FM’s Women of Vision radio broadcast.  Stories about The Turning Point have appeared locally, as well as in the Washington Post, the Baltimore Examiner, Baltimore Smart CEO magazine, Asian Fortune, and on NBC television.  The media have deemed our stories worth sharing.  Why are you reluctant, when MCOM’s students are so interested? 

     Most community acupuncturists do not believe that all clinics should follow the CA model.  Not all acupuncturists will want to become community ‘punks.  Many would not even be good at it.  Just as there exist many different models of medical practices—community clinics, spa-like centers, insurance mills, hospital-based practices, concierge medicine—so too will acupuncturists continue to diversify and meet the varying needs of their communities.  You may not like the many faces of our medicine.  But to withhold valuable resources, to misrepresent the financial viability of a CA clinic, to thwart the efforts of students who yearn to treat their own socio-economic class is oppressive.

     Other acupuncture colleges have begun implementing the Community Acupuncture model into their curriculum by inviting community acupuncturists to speak on campus as guests, offering small CA classes, and including “The Remedy” as required reading:

  • Academy of Oriental Medicine at Austin
  • Acupuncture & Integrative Medicine College at Berkeley
  • Acupuncture & Integrative Medicine College at Tucson
  • American Academy of Acupuncture and Oriental Medicine
  • Bastyr University, Seattle
  • Five Branches University, San Jose
  • Minnesota College of Acupuncture and Oriental Medicine at Northwestern Health Sciences University
  • New England School of Acupuncture
  • Oregon College of Oriental Medicine
  • Pacific College of Oriental Medicine
  • Southwest Acupuncture College in Boulder
  • Tai Sophia

     What can we do to begin that process at MCOM, where students are currently asking for CA information and from which alumni have already established successful CA clinics? How can we—as an organization, as alumni, as individual acupuncturists—help you to expand the business model discussion to include community acupuncture clinics?

     I have chosen to publish this letter at http://www.communityacpuncturenetwork.org for public comment and discussion. Readers (such as your students) may offer feedback either anonymously or with credit. Administrators from other acupuncture colleges  have participated in our Prick-Prod-Provoke dialogue…I look forward to your contribution, as well.

Sincerely, Jessica Feltz Wolfson, L.Ac.

The Turning Point, A Community Acupuncture Center ~ Frederick, MD

www.TheTurningPointAcupuncture.com

MCOM Graduate, Class of 2007

* * * This letter was faxed to the MCOM administration and also emailed to current MCOM students (with a link to the blog) to draw the students' attention to CAN.  While the hyperlinks may be redundant for those familiar with the CAN model, they will provide valuable new information for many students at MCOM.  * * *

This story was posted on January 31 2009 by Jessica Feltz.

Comments

  • January 31 2009 at 11:05 PM
    Nora writes:

    nice work

    I was quite impressed by your hyperlinking, Jessica (that’s a lot of work)!

    Nice content, too.  Tell it like it is, sis.

      0 likes
  • January 31 2009 at 11:30 PM
    Guest writes:

    thank you for sharing

    I hope your input will inspire change not only in our curriculum, but in our options and opportunities in student clinics as well.  As a 2nd year student, I would like to see MCOM student clinics expand into other communities besides Racine/Kenosha.

      1 likes
  • February 1 2009 at 11:09 AM
    rhayden writes:

    Ironic

    As an alum and former faculty member at MCOM, it’s ironic that there is no interest in CA; when i was a student, i did my externship (back in the days when NASCAOM - now ACAOM - still allowed them) at a community clinic which was started by MWC faculty.  It was non-profit, though. 

     

    I don’t see what schools would have to lose by at least presenting it as one business model out of many.  I presented CA in my classics of CM class when discussing pulse dx in Nei Jing (jingei—> CA, talk about a tangent, but it generated some interest) and even talked about it in herb classes at another school i taught at.  So i suspect it gets into class discussions here and there at schools which don’t get an “official” CA nod.

     

    Anyway, i’d be interested in seeing a followup. I know the admins there and they are not unreasonable people—so hopefully they will reconsider their stance.

      1 likes
  • February 1 2009 at 11:25 AM
    Jessica Feltz writes:

    Facebook Comments Reposted

    I posted a link to this blog on my Facebook page, hoping it would lead some friends over here to CAN.  I am reposting a couple of the relevant comments I’ve received…

    From a Milwaukee-area patient: Bravo. Very well written. And it drives home a very important point. Heck, I have health insurance and my husband makes a good living, but I was seeing an acupuncturist for awhile a year ago and had to give it up because the cost was astronomical for the amount of times I had to go. And that’s sad, because it really was helping me.

    From an MCOM student: Excellent posting Jessica and very well researched. I am truly inspired by all that you have done and all that you continue to do. Once I pass my boards and get my license, I would love to learn more about CA and how I can implement such a practice. Thanks so much for sharing this important information.

    I agree that the Practice Management class at MCOM stressed on a regular basis, the notion that we should not be afraid to charge a higher rate / or “what we are worth” rate for our services. It was presented in a way that led the students to believe that if we charged a higher rate, we would be recognized as a professional much more than if we charged a lower rate, as though we would have to justify our profession. It sounded as though a high price tag would be the magic bullet. It seems to me that the positive intentions of the acupuncturist and the relief the patient gets from a treatment are much more important than charging a fee that is out of touch with what most people can afford.
    I remember feeling uncomfortable about this high price tag business approach and immediately thought it would make acupuncture out of the question for the majority. (CA was not mentioned as far as I can remember as an alternative business model).

    I won’t repost comments from CAN members, ‘cuz they know how to find their way over here and do it themselves…

      1 likes
  • February 1 2009 at 4:15 PM
    KevinCampo writes:

    Thank you, Jessica.  A

    Thank you, Jessica.  A great letter.

      0 likes
  • February 3 2009 at 12:30 PM
    Linda inDetroit writes:

    Great job Jessica!

    This is fantastic and will hopefully open the lines of communication about community acupuncture. 

      0 likes
  • February 4 2009 at 3:19 PM
    Guest writes:

    Discussion invitation

    I would love to see some more thoughts on this.
    As a student, the experience and feedback is very accurate to my experience.
    I just figured I would get the information elsewhere if I wanted it.
    I am confident that appropriate changes will be considered to serve all populations better (clientele, students, practitioners).
    This comes to light at a vital time in history and is a gift.
    Let’s unite and discuss.
    Best to all students, graduates, practitioners, staff and administration.

      1 likes
  • February 6 2009 at 8:28 AM
    Jessica Feltz writes:

    More Comments from my Inbox

    From Christie Kern at Racine Community Acupuncture reports: “Hey Jessica! We’ve had some great traffic through our clinic this week! Today we had an MCOM student spend the day with us, yesterday an MCOM graduate (from Barb Kirt’s class) spent the day with us, and we have two more colleagues visiting next week! Gee, maybe there is something to this community acupuncture clinic thing! ~ As a matter of fact, I’d like to invite any MCOM students and graduates to come visit our Community Acupuncture Clinic in Racine!”

    From an MCOM student: “Thanks Jessica for bringing this to my attention. I had wondered about CA clinics when I first started this program but nothing was ever mentioned. I thought as I moved along in the program the subject would come up as to what type of practices one can choose from. This information has me rethinking my future which I have some time to do anyway. Also, thanks for the names of those with CA clinics in Racine; I think I will get in touch  with them for advice and maybe a sense of direction.”

    From an MCOM student: “I really feel like this has been requested so many times and met with such misinformation…. But, students are literally afraid to make requests to admin in writing for a change or topic to be considered, afraid of repercussions which are reality, as demonstrated in the past.”

    From an MCOM student: “I am certain the topic has been brought up many times on campus with instructors and administrators.  They are not unaware there is interest.  Don’t even believe that just because no one sat down to write him (Dr. Dunbar) a request he doesn’t know.  I have brought it up.  I’ve heard others being discouraged about the topic.  I sat in Dan’s class where it (Community Acupuncture) was bashed.    Maybe I didn’t have his ear at the time and your letter finally caught his attention so it’s time to do it again….Gigi literally discouraged CAN, practically mocked it like it’s a dirty practice, or, perhaps just one she doesn’t understand therefore has no frame of reference to discuss. Their personal prejudices and beliefs are a barrier to hearing the interest that is obvious on campus. I trust it will be discussed on campus from now on, even if it starts “underground”. I will look forward to hearing about people going to school and hearing positive or neutral facts about CAN in the next few years.  Thanks again.”

      1 likes
  • March 10 2009 at 9:36 AM
    Jessica Feltz writes:

    Follow-up with Kris LaPoint at MCOM

    Hi Kris,

    Christie Kern, Linda Stengel, and I are in receipt of the minutes from your most recent MCOM student council meeting:  <Some students have been receiving emails from a recent graduate concerning adding lectures on running Group Treatments in private practice to the Practice Management class. Group Treatments are, simply stated, treatments of a group of patients at one time, in one room for one thing such as migraines. Subsequently students receiving these emails (mostly 3rd years) and not knowing exactly what Group Treatments are and how they could be used in practice were curious as to the benefit of adding lectures concerning this topic to Dan’s Practice Management class. Group Treatment strategy does have some merit in regards to capital gains because you are maximizing your time and seeing many patients at once. However it does also have some serious concerns. We went over some of the issues presented in practicing group treatments. First and foremost one is walking a fine line in regards to HIPPA when running such treatments. Privacy is most certainly compromised and asking questions to get to each patient’s particular imbalance is impossible and unethical in this setting. Therefore the practitioner’s only real option is “cookie cutter” treatments because of the limited scope of what you can do in the group setting. This really takes away from what makes TCM so special and effective.>

    I want to thank you for talking with the MCOM student council members about community acupuncture!  The three of us have received emails from many students asking if the information which MCOM presented about CA clinics was accurate.  Racine Community Acupuncture and Partners in Health have also had numerous site visits from current students and past grads who want to learn more about the clinics.  Because we have all received inquiries from MCOM students/grads, I wanted to take a moment to clear-up some erroneous statements that were made. 

     “Group treatments” does NOT refer to treating a group of patients who all have the same presentation.  That would be impossible to coordinate!  The point of our clinics is to increase accessibility; our services would not be very accessible if patients with headaches were only allowed to come-in for treatment at, say, noon on Wednesdays…  (LOL) 

    Furthermore, I can’t even begin to imagine how an acupuncturist would treat only one complaint at a time.  The beauty of acupuncture is that it helps to heal the whole person: body, mind, and spirit simultaneously.  So when someone receives acupuncture for headaches, they may also begin sleeping better, feeling less irritable, and having more regular menstrual cycles.  We could never break-out their complaints and suggest that I’m only treating one problem at a time.

    The patients in our community clinics present with a variety of conditions, just like in a private room clinic: infertility, insomnia, digestive complaints, stress, asthma, dermatitis, back pain, sinusitis, etc.  We treat everything that was presented at MCOM’s classes…and then some!

    Each patient receives an individualized treatment, just like in a private room clinic. We use Miriam Lee, Dr. Tan, Master Tong, extraordinary vessels, heavenly star points, five element points, luo and xi-cleft points, command points, Korean hand points, auriculotherapy, and many other styles.  Many community acupuncturists have found Jingei pulse diagnosis to be an indispensible tool because of the rapidity with which a diagnosis and treatment plan can be formulated.

    Our treatments are not cookie cutter.  They are individually-tailored.  An audit of the thousands of treatments I administered in my first year of practice would support this statement.

    When you pause for a moment to consider the busy acupuncture clinics in the Milwaukee area, such as Curry Chaudoir, Art Rapkin, and Dr. Liu, you will note that they all treat upwards of 100 patients per week.  In Dr. Curry’s clinic, patients are treated in one large room, but there are partitions dividing the space between patients.  Dr. Liu spends very little time with each patient, and encourages his students to move more quickly also.  In the same way that these private room acupuncturists are able to treat many patients in a single day, so too are community acupuncturists.  The biggest difference between our practices, is that community ‘punks see the benefit of treating many patients at once as an opportunity to make our services financially accessible to those would could not have otherwise received care.  We lower our prices, because earning $90 - $210 per hour is enough for us.  The aforementioned private room punks—if treating 6 patients per hour at $75 per treatment—are earning upwards of $450 per hour.  Most of us find that obscene.

    Intakes are conducted in an area of the clinic that is separate from other patients, and they tend to be very brief.  We gather most of the information needed from tongue and pulse diagnoses as well as detailed intake forms.  Identifying the affected meridians and utilizing related treatments has proven very effective for our patients, and does not necessitate a lengthy interview process. 

    Regarding HIPPA and privacy, I find this government chart most helpful in determining our responsibilities: (http://www.cms.hhs.gov/HIPAAGenInfo/Downloads/CoveredEntitycharts.pdf)  That is, clinics which do not electronically transmit patient information (insurance billing, faxing, or video cameras) are not subject to the same regulations as those which choose to utilize electronic transmission of information.

    Do you know that Honora Lee Wolf and Bob Flaws have recently given the community acupuncture model their public stamp of approval?  You can read their blogs at Blue Poppy’s website: http://www.bluepoppy.com/blog/blogs/blog1.php/2009/03/02/recessionary-road and http://www.bluepoppy.com/blog/blogs/blog1.php/2009/03/02/why-community-based-acupuncture-is-the-m.   

    I am copying this email to students who have expressed an interest in the community model, as well as reposting it to the original CAN blog in the comments section (http://www.communityacupuncturenetwork.org/blog/midwest-college-oriental-medicine-chicago-racine).  We welcome your continued dialogue. 

    Warmest Wishes,

    Jessica Feltz Wolfson, L.Ac.

      1 likes
  • May 16 2009 at 12:31 PM
    jfritts writes:

    Milwaukee Area CA

    Hey Jess!

    It has taken me 3 years of struggling with my boutique-style practice to come to my senses.  In June 2009 I will be opening my own CA in Milwaukee!

    Thanks in a large part to your fabulous example and an enlightening visit to Linda and Christie in Racine the light is finally leading me to this amazing business model.  As you know I have always had a sliding fee schedule, but when you can only see 1 patient per hour it is just not monitarily and socially viable any more.

    I feel very sad for Bill, the school, and our fellow MCOM graduates who are still stumbling in the dark.

    Here’s to working in the light!

    Jan

      1 likes

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