A Sea-Change – “guest” blog from Pam Chang

As some of you know, my business partner Pam has written some good stuff about our movement. She is also not a frequent visitor to CAN, so sometimes I try to “channel” her through. A few weeks ago we were driving to a Qi Gong class, Pam made some comments about how she felt the Community acupuncture movement was changing the acupuncture world. I liked the comments and asked her if she wanted to expand on them in a CAN blog. Here is her contribution:


Sea-Change in the
Acupuncture World

by Pamela O. Chang

I finished my acupuncture clinical internship in 2007, the only way I learned
to practice involved “10-Question” intakes, one patient per treatment room, and
about an hour per patient. We heard stories of famous practitioners with lots
of assistants treating ten people per hour, but all the practicing
acupuncturists I knew scheduled 1-2, maybe 3 clients per hour in 1-3 treatment
rooms. In the year since I’ve become a community acupuncturist, the acupuncture
world has changed radically. My guess is that in another 5 or so years,
community acupuncture will be as common as private-room treatments and
Americans will consider acupuncture as ordinary as, say, physical therapy or
flu shots. Granted, living in the over-enlightened San Francisco Bay Area, I
may just be out of touch with reality, nevertheless, here’s why I think
Community Acupuncture (CA) is about to go mainstream.

late 2006, when my business partner, Tatyana Ryevzina, started her CA practice
one afternoon per week, most of her clients were used to private-room
treatments and had never heard of community-style acupuncture. Nevertheless,
few had difficulty transitioning to lower-cost treatments in a group setting.
Within months, her community-treatment appointment slots were fully booked.
Within a year, she had added a second half-day shift for community-style
appointments and she was earning more from community treatments than from
private-room treatments. In March 2008, when Tatyana and I opened Sarana
Community Acupuncture, we treated about 25 clients weekly while open for 4
shifts (13 hours) per week. A year later, in a recession economy, we are
treating about 70 clients/week while open 6 shifts (19.5 hours). This month,
we’ve just added 2 more shifts (for a total of 26 open hours per week). I don’t
know how our growth rate compares to conventional private-room acupuncture
clinic start-ups or even to other CA clinics, but I see the success of our
clinic and the emergence of over 80 Community Acupuncture Network (CAN) clinics
in the past 3 years as proof that the CA model is viable and replicable.

viability, what persuades me that CA is here to stay are our clients. Our first
clients were mostly people from Tatyana’s prior practice, personal friends, or
people who had seen our posted advertisements. Now most of our clients have
been recommended to come to us by other clients. Some of the new clients have
heard of us from 2-3 different sources, possibly including on-line rating services
such as yelp.com or one of the local Parents’ Network Groups. Many of
our clients are fiercely loyal. They actively recruit their friends and family
members, classmates from exercise class, or fellow support-group members to
become our clients. And they loudly defend us against skeptics who suggest that
we are less effective than private-room clinics or that CA is merely a passing

also have more and more clients who find us because they are specifically
looking for either CA clinics or inexpensive acupuncture. One young woman
booked an appointment because, although she’d never had acupuncture, she’d read
The Remedy and thought she wanted to
be a community acupuncturist. Others have been to CAN-affiliated clinics
elsewhere and want to continue their CA-style treatments. This type of
feedback, along with the weekly outpourings of gratitude for $15-40
sliding-scale acupuncture treatments, shows me that lots of people want CA
clinics to survive, grow, and be an ordinary part of their lives.

have our supporters reached sufficient critical-mass to shift CA from an
emerging trend to a cultural norm? Malcolm Gladwell in The Tipping Point says that after about 5% of a population adopts a
new idea, that idea becomes mainstream. The idea of CA may not have reached 5%
of the general population or even 5% of the acupuncturist population, but in at
least one of the 4 San Francisco Bay Area Traditional Chinese Medicine (TCM) colleges,
it is reaching 100% of the most recent graduating classes. Since Fall 2008,
Berkeley has offered a community acupuncture seminar
and a CA clinical internship. ACTCM in
San Francisco invited local CA clinics to participate in
a TCM health fair this past winter, and ACCHS in
Oakland will include a guest lecture on CA in their
spring 2009 Practice Management class. In
Northern California, I am one of 8 CA practitioners I know who
received their licenses within the past 2 years. While the majority of
acupuncturists may remain oblivious to CA, our success is surely being monitored
by our former classmates.

our progress is being monitored by more than our classmates. Every month, it
seems, we get inquiries from acupuncturists or TCM students who want to know
how a CA clinic is run. Some come for a tour or a treatment. Others become
volunteers. Currently at
SaranaCA, we have 3 TCM students and 3
acupuncturists who help us with reception in exchange for learning the nuts and
bolts of CA. More established CA clinics, Working Class Acupuncture in
Portland, OR, for example, can hire acupuncturists and support staff,
giving them the opportunity to work alongside more experienced practitioners
without first having to buy into a practice. What this shows me is that CA
clinics are likely to become a significant post-graduate training venue for
acupuncturists who don’t feel ready to open their own practices. And because CA
is a comparatively low-risk, low start-up cost business – unlike cruise ships,
spas, HMOs, subsidized nonprofits, or even many conventional private-room
acupuncture clinics where new graduates might find work – more and more new
acupuncturists will be inspired to work in or open more and more new CA

this is how the acupuncture world has changed. When I started TCM school, for-profit
community acupuncture barely existed in the
US. When I graduated, it offered hope as a way
for me to practice acupuncture at a price my friends could afford. Now CA has
proven itself to be viable, replicable, desirable, and inspiring – an idea
whose time has come. It’s an idea that is spreading from
Portland, OR to Manchester, NH, Minneapolis, MN to Austin, TX
; into the halls of TCM schools and into the minds of new TCM
graduates. I think that CA is on a roll now, a roll that will continue until
the CA market is saturated, when CA clinics are as common as dentist offices
–and a whole lot cheaper! And for all this, I want to express thanks – to my
mentors and their lineages, to CA compatriots, to Sarana Community Acupuncture
clients and colleagues – it’s a wonderful life, living the change I want to

Author: tatyana

<p> I grew up in the Soviet Union and immigrated to the United States as a teen, living in New York and Chicago before moving to the Bay Area in 1998. I began as a Yoga instructor and as a practitioner of Ohashiatsu bodywork and have been practicing Acupuncture/Chinese Medicine since 2003. Before switching to community acupuncture practice model I had a sporadic and struggling private practice, worked as an herbal pharmacist, as an instructor and clinical supervisor at an acupuncture school, plus did a two-year stint doing acupuncture at a public health clinic, working with mostly HIV/HCV+ populations in San Francisco. </p> <p> My discovery of Community Acupuncture practice model (via Lisa Rohleder's Acupuncture Today columns) profoundly transformed my life -- not just my work life but many other aspects of it. I gained a vocation, a community of friends and the most stable and rewarding job I have ever had. I see community acupuncture practice model as the most sustainable and most fitting to my values. It makes sense to me from the point of view of healthcare access, social justice, spirituality, and as an antidote to isolation. In 2008, together with another stellar acupunk Pam Chang I...

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  1. Great post, Pam

    I mentioned this elsewhere, but as a student at AIMC I see the large impact CA is having.

    I was getting a treatment every week in the CA shift at school.  They give students same-day treatments for free.  A few weeks ago I stopped being able to get an appointment when I called the same day.  Then I started caling ahead for treatments (they still only charge $5 for students for that).  Now, for the last two weeks, I haven’t been able to get an appointment at all – even calling three days in advance.  It’s completely booked.

    I can tell you that we’re not booked like that in the rest of the student clinic.  It’s not uncommon to see a bunch of interns studying or treating each other, especially at the lower levels of internship, because there aren’t enough patients to go around.

    In fact, AIMC is adding another CA shift to handle the overflow.  I was only half-joking in the other post when I said if they’re not careful, CA just might take over the school clinic!

    Clearly this model is working for the patients in our community.

  2. thank you, Pam and Tatyana–

    sometimes it’s easy to forget how much progress we’ve made in how short a time. This is such a well-written reminder.