(Note: This letter also appears in its entirety in the ‘Dear Board’ forum for CAN suscribers. The current board felt it was important for all CAN readers – members or not – to have access to this letter as well, outside of the forums.)
Dear Friends and Colleagues,
I am deeply disappointed that circumstances prevent me from being there with you for this important meeting. I would have loved to see good friends again and to spend time meeting new ones. I would also have loved the chance to speak with you at length about the work and direction of CAN. Since I cannot, let me offer these few thoughts to you as I step off the Board and out of the leadership of our organization.
I am one of the three founders of CAN. I sat at a table with Lisa and Lupine, dining and drinking a beer, and we created the entity that has become CAN. With their input and collaboration, I drafted our By-laws. The first Un-bored Meeting was held in my house in Sacramento. Of the three of us, I am the only one not connected with Working Class Acupuncture. It is probably also important to note that two of the three founding members of the Board of Directors (Lupine and I) are not acupuncturists.
I take you through all of this, not to lay claim to any authority or wisdom, but to suggest that CAN enjoyed a variety of perspectives from its very beginning. Each of the three of us came to the venture from different points of view and with different ideas in mind. Despite that, we found it very easy to work together. As the group has grown (both the Board and the membership) so has the variety of our ideas and goals. I regard that as a very healthy thing. There are, however, some patterns to our development that deserve mention. For now, I will speak about four distinct patterns.
First,CAN has quickly become an organization consisting primarily of practicing acupuncturists. While two of the three founders were interested lay people, the organization has gone in quite a different direction. For me, at least, community remains as important as acupuncture. When the two are joined, they have great power. While our structure provides for memberships for interested non-acupuncturists, we have done nothing to encourage their participation. Our forums, our gatherings, our every expression speaks to and about practitioners.
I believe that it is critical to rethink this trend. Community acupuncture is not really defined as a practice that treats more people, with a relative lack of privacy. Community acupuncture is about creating a style of acupuncture that promotes health in ways that are appropriate to an identifiable group of people. The acupuncture works better when folks receive it together. A community acupuncturist is not someone who treats a lot of people and so actually makes a living (as attractive as that idea may be). A community acupuncturist is someone who has an intrinsic connection with the people who get treatments. She or he is someone who augments community by the practice of a healing art and augments healing by connecting to community. A community acupuncture network is not a network of practitioners who have found a better mousetrap. It is a network of persons, practitioners and other people, who have found the power of acupuncture in their communities. Part of the genius of WCA is that they break down the barriers between practitioners and patients. CAN should do something like that as well, as a matter of ethical and intellectual honesty. We need to be about the whole network, not just the practitioners. If we manage this, we will discover where the real power for change lies – always in the people.
Second, CAN has allowed itself to be closely tied to a single model of the practice of acupuncture. Very many of our on-line conversations have focused on understanding and replicating the undeniably brilliant insights of Lupine, Lisa, and Skip in creating Working ClassAcupuncture. The power of their vision and the success of their clinic has provided a compelling example of what can be done. It has also earned them a flotilla of frightened detractors from within the more traditional acupuncture community. Let me suggest that CAN is not necessarily an arm of WCA or its business model. CAN is the outgrowth of an idea, the notion that acupuncturists should stop trying to be like western physicians who distinguish themselves from their patients (communities). Instead, the original insight of WCA and CAN is that practitioners must relate to and identify with their communities. The first time Lisa spoke to me about WCA, she began by describing herself as a working-class person. She wanted to provide acupuncture for people like herself. It was from this point that she found her way to a sustainable business model.
I submit to you that there are other communities as well. Our broad society is made up of lots of different kinds of communities. In addition to the well-to-do, for whom traditional acupuncture practice may be just fine, and working class folk, who are well served by the WCA model, there are also communities of poverty (urban and rural), communities of disability, communities in prisons and other institutions, military communities, etc. CAN should be looking for and fostering appropriate sustainable models for all of these. If you are a working class person living in a working class community, then by all means you should imitate WCA. Plagiarize every detail ofthe practice with, I am confident, the blessings of the WCA corporation. If you are part of some other kind of community, then you have a different task. Your creative calling is to find a way to bring acupuncture into your community in a way that is effective for those who receive it and economically sustainable for you.
Third, CAN has somehow become a business school for alternative acupuncturists. An incredible proportion of the energy of our organization is devoted to discussing and defining the details. Most of our members have come here to learn how to make a living doing acupuncture. Their revolutionary vision consists in the discovery that the traditional white coat clinic idea has not worked for acupuncturists, except in very rare situations. They are frequently driven to community acupuncture by economic desperation. They come here to find out exactly how to do it. They seek detailed information about every aspect of community practice, often without realizing how much more they need to know about community.
I insist that we need to balance the mechanical information with robust discussions about what it means to be an acupuncturist IN a community rather than FOR or TO a community. What does it mean to connect with those who come for treatment? Bringing in lounge chairs and reducing your prices to a sliding scale will not ensure success. Creating a practice that
lives and breathes with its community will. Look closely at what our successful friends are doing. Their success derives, not from slavish adherence to a business model recipe, but from engagement with the actual people who come for treatment.
Fourth, CAN remains incredibly conservative. We have tended to accept the rules and status quo of the traditional acupuncture world that we claim to have divorced from. We still define practitioners, qualifications, patients, education in the same old ways. We are even building a new organization of professional acupuncturists based on the models of the old AOM Alliance, AAOM, and successor AAAAAAAAAAAAAAOM. In short, we are working within the same old box, rearranging the deck chairs or, (and here you may pick your own cliché).
I urge you, rising members of the Board of Directors, to crawl outside this box, or at least lift the lid and peek outside. There may be other creative new ways to do things. The old acupuncture world is falling apart before your eyes. If you imitate its vision, you will emulate its failure. This is the time to do something different.
I conclude my too-lengthy tome with several very concrete suggestions for the Board.
Develop the non-practitioner side of the organization. Get your patients involved in the conversation and let them interact through the website with other patients. It will change the dynamic of the organization for the better. And get some non-practitioners back on the Board of Directors.
Begin to identify the institutions of traditional American acupuncture and start trying to replace them. You can create your own training and education systems, your own licensing and certification systems, your own networks for supplies and materials, your own insurance companies, and your own communications media. You will need to create your own regulatory and governance structures. The times, they are a-changing.
Remember that you are the leaders and your job is to lead. Many of your colleagues have come to CAN just for a little business help. It is your task to provide that, but also to help them join the revolution. Help them see that the old architecture of American acupuncture is collapsing under its own weight and there is no security there.
Keep your heads and your eyes up. It will be easy to look at the ground around your feet, easy to get caught up in details and minutiae, easy to forget what brought you here to begin with. Don’t look back, or spend too much time adoring some of your founders, as adorable as they are. Look forward to a future that can be yours. Don’t sweat the small stuff, but look for the big picture. You have something to build and none of us can see clearly yet what it will be like.
I close with my thanks to all of you and my promise that I will remain available to assist you and this movement in any way that I can.
Michael R. McCoy, Ph.D.
CANBoard of Directors (ret.)