Marinating in the CAN

“Three years seems to be a big turning point in people’s understand of how CA ‘works’. Can you explain this a little more, or maybe others with some years under their belt can chime in? What changes in those three years?”  For me: everything.

I cringe at many of my early posts, and when I stumble across them I’m tempted to hit the delete button. But they serve as a good reminder (for me) that few people “get” CAN right off the bat. The wisdom and experiences of these posts seeps-in slowly, like a gentle rain.

  • My first two years of discovering CAN (2006-07) were very cerebral.

I spent hours poring over the threads and reading the books (the Little Red Book and later The Remedy). I visited Linda Stengel’s clinic in WI and talked with her about her experiences. And I daydreamed endlessly about what my own clinic would look like. I spent months writing a business plan: reading biz books, talking with accountants, my local Economic Department, the SBDC, and working with a mentor thru SCORE.

I lived my clinic in my head. I fantasized about beautiful décor, elaborate treatments, and the enthusiasm of an endless stream of patients. I dreamed of a world in which we (acupuncturists) all just got along, even suggesting that we adopt a more Gandhi-like attitude towards our peers.

  • My clinic opened just before 2008. That’s the year my hands got involved.

In Bill Buxton’s book “Sketching User Experiences,”  he writes about a ceramics professor who divides the students of his class into two sections. He tells one half of the class that their final grade will be based exclusively on the volume of their production; the more they make, the better their grade. The professor tells the other half of the class that they will be graded more traditionally, based solely on the quality of their best piece. At the end of the semester, the professor discovered that the students who were focused on making as many pots as possible also ended up creating the best pots, much better than the pots made by the students who spent all semester trying to create that one perfect pot.”

I spent much of this year chasing after that one perfect pot. Newly graduated, I had difficulty with the short intake, especially when the treatment room was slow. I feared that I was short-changing my patients by not delving into the ten questions, because that’s what was hammered into me for five years at school. I felt apologetic for not offering cupping or guasha. (You can even see me cupping peep’s on a video about CA. Aack!)  I wanted to offer brief snippets of lifestyle advice, because I had paid so much in time and money to learn it and shouldn’t I just *do* something with that knowledge?!

Little did I understand that the things I thought my working-class patients were “missing,” were the very things which served to dissuade them from receiving acupuncture in a boutique setting. That became most clear to me when I tried to introduce sliding scale massage. I thought it would be a perfect fit: the massage therapist could offer the body work which I don’t, for an affordable rate, at the same place. Easy-peezy….NOT. It was confusing for people to stop and figure-out how much money they had, and how much time they had for acupuncture/massage, and how they wanted to fit it all together. They simply wanted to get poked and sleep in peace.

As my hands got busier with needling, I learned to trust them more and released my ideas of what a perfect treatment was “supposed” to look like (according to my schooling). I watched as patients felt better with frequently repeated treatments. I witnessed as they sent their friends and family in droves, and I began to understand that what I offered was perfect in its simplicity. I stored my cups and spoons in the attic, packed-up my massage table, and added more chairs in the clinic.

  • 2009: the year I got pissy. 

First at the FPD. Then at my alma mater. And most recently, at my former classmates.

When I first read Lisa’s articles in ‘06, I thought she was offering charitable services to the underclass. Over time, I grasped that a CA clinic needs to serve the majority of people in my community (the working class) and it needs to be sustainable (the underclass can’t afford $15 treatments with consistency). As I better understood my patient base, I realized that I would be taking care of my friends, my children’s friends, our neighbors…the people who hold space in my heart.

I see how effective this medicine can be when it’s kept simple and accessible. To do anything else (such as raising the educational standards, preventing interested students from learning about CAN, or suggesting that simple services are sub-standard) serves as a barrier to people receiving effective health care. When barriers arise that could keep the people I care about from receiving the services that they need, I get pissed-off.

I feel like I’ve sunk into this experience a little backwards: head first, then hands, and finally my heart. But I think I’m starting to get it. And I can understand how difficult it must be for newbies to “get it” when we have over 3800 threads and almost 20,000 comments hidden inside the forums. That’s a lot to immerse in and sift through, especially when you consider that many of the early posts reflect ideas we’ve since discarded.

Malcolm Gladwell, in his latest book “Outliers”, writes that achieving excellence at a complex task requires a minimum level of practice, and experts have settled on 10,000 hours as the magic number for true expertise. Gladwell quotes neurologist Daniel Levitin as follows: “In study after study, of composers, basketball players, fiction writers, ice-skaters, concert pianists, chess players, master criminals, this number comes up again and again. Ten thousand hours is equivalent to roughly three hours a day, or 20 hours a week, of practice over 10 years…No one has yet found a case in which true world-class expertise was accomplished in less time. It seems that it takes the brain this long to assimilate all that it needs to know to achieve true mastery.“

10,000 hours. 20 hours a week…for 10 years. It’s interesting for me to reflect on how my attitudes have changed in the past few years. What about yours?  Even CAN has evolved: remember the hybrid failures?

I wonder what the next decade will bring…

Jessica Feltz
Author: Jessica Feltz

<p> I learned about Community Acupuncture while studying at the Midwest College of Oriental Medicine (MCOM) in the Spring of 2006 when Lisa Rohleder's first article about her clinic appeared in Acupuncture Today. Coming from a middle-class background myself, I was the only student in my acupuncture class to have not experienced the healing benefits of this medicine prior to beginning studies at MCOM. I couldn't afford it. And my family couldn't understand what I was doing by investing in an education that they didn't perceive to be financially sustainable. </p> <p> The Community Acupuncture model is a perfect fit for me, balancing social justice and taoist simplicity with the patient's innate ability to heal him/herself (with a few gentle nudges from strategically placed needles). I am grateful every day to have found CAN and the love it brings into my life. I want to share that joy by spreading the message about how we can create a new health care experience in our communities through each of our very small efforts...and how those very small efforts can in turn change the world. </p> I enjoy my two sons, my 4 cats, and big stacks of books.  I own and operate...

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Responses

  1. “The wisdom and experiences

    “The wisdom and experiences of these posts seeps-in slowly, like a gentle rain.”

    Amen.

    One day, I want to read your book. If you want, just glue together all your posts. I’ll pay for it!

    I’ve been on CAN 2 years, have had a CAP for 5 months, and am looking forward being fully steeped myself. I’ll let you know next year.

    The pot analogy is just beautiful. The more you do something, the better you get.

     

  2. Thanks for your wonderful

    Thanks for your wonderful answer to this question, I was really hoping for responses when I asked it, I felt a little invisible for a minute there, but I think it may be that the changes can be hard to put into words, and require a lot of thought.  It was a great idea to make it a blog.

    I’m 1 1/2 years in CA practice plus a year or so of planning, and I feel like I’m on the border of an important change that’s similar to what you discuss here.  It’s helpful to read other’s experiences when I think of where I’m going.  I know that I and my practice will change throughout the years, it helps to hear the experiences of those who have gone before me.

    I think going into this “backwards” head, hands, and then heart is necessary (or at least not a bad thing) in order to get all the work done of getting a CA practice up and running, and when you think about it, for people who stick it out with CA our hearts probably were in it from the very beginning or we wouldn’t have done it, but it takes years to realize it and truly practice from our hearts.    

  3. No expert here

    Your words validate many of my experiences. Recently, a friend who runs a belly dance/massage/QiGong/TaiChi studio across the hall asked if she could participate in one of our Free Days by setting up a massage table? I was a bit flummoxed by her question, immediately thinking “NO”, but not quite sure how to express that to her in a way that wouldn’t hurt her feelings.

    Finally, I just told her that I was trying to do one thing well, not ten different things, and without going into a long speel, I said that acupuncture and acupuncturists in America have a collective identity crisis and CA is one response to how to make it simple, understandable, and digestible to everyone in America – that acupuncture works. It needs no exotic overlays or extras.

  4. and while that’s marinating…

    When I first read Lisa’s articles in ‘06, I thought she was offering
    charitable services to the underclass. Over time, I grasped that a CA
    clinic needs to serve the majority of people in my community (the
    working class) and it needs to be sustainable (the underclass can’t
    afford $15 treatments with consistency). As I better understood my
    patient base, I realized that I would be taking care of my friends, my
    children’s friends, our neighbors…the people who hold space in my
    heart.

    It’s all true.  But if you are still reading this post Jessica I would like you to discuss the following, “(the underclass can’t afford $15 treatments with consistency).”  

    I thought I opened my doors to everyone…but I did not.  There are many people for whom $15 a treatment paid regularly is not possible.  I had this kindly explained to me on the phone by a woman on disability who lives this life.  But my practice is in an area where sending them to a free tx facility is not possible. 

    When I offer to negotiate the service fee, I lost her.  Even those for whom I offer to treat them for free, most only stay for 1-3 times then they move on.  It’s frustrating to be reminded that my door is only open “just this wide and no more.”  

  5. Hi Tess ~

    I had a conversation with a woman last week who is gainfully employed in a professional position.  She was talking about how all of her co-pays add up: $10 here and there…even though I talked with her about paying what she is comfortable with, I could see that it was still a reach for their budget. 

    That’s why the jump on the bottom of the scale (from $15 – $20 as the minimum) still leaves-out so many potential patients. 

    Our scale opens-up acupuncture as a possible treatment strategy for millions of individuals…but not for everybody.  And suggesting that people pay less than our sliding scale minimum can be a turn-off for people who perceive that we are then offering charity.  Lisa writes about this in The Remedy: “It was unthinkable that they, being working class, should in any way be on the receiving end of charity.”