Clinic Stability through Change, Exit Strategies, and Removing Barriers

There's a lot going on in Philly right now.  I know some people have heard about PCA Mt. Airy, the second clinic that's in the works.  What most people don't know — and it's still not to be made public knowledge yet please kthx — is that I am also doing my best to put things in place for a move to Tucson in August.  Last night I got a call from the lead teacher at a free charter school (with goats!) saying that there was a place for my daughter there if I still wanted it.  Yes please, I screamed.

I know this all sounds crazy, and like there's too many plans for change happening, how can this possibly work?  You're gonna have to trust me on that, mostly.  Light some candles for me while you're at it too, please.  

One thing that has been hammered home around these POCA parts is that #1.  Clinics are most stable without a lot of transition going on, and what we want most of all — more than lots of money — is clinic stability and job stability.   But another thing that is constantly emphasized is that your clinic needs to be able to survive without your personality —  it has to be able to weather the storms of owners and punks leaving and getting sick and having babies, etc.  Some inspiring person somewhere said once or twice that the only thing we can actually count on in this life is change, so what I am really grappling with right now is how to brave all of this crazy change while keeping the clinic's stability in mind and holding out the big picture that I too ultimately want some stability in my and my daughter's life.  This is where the idea that the philly clinics need to be able to survive without my personality really gets important.  And the other question here is this:  when does personality become a barrier to patients?  I'll get to that later.  

Ideally, of course, patients are coming to your clinic for acupuncture, and to be in charge of their own body's healing process.  What's the reality?  How many of us have patients that we know disappear if we go out of town, and wait to get their weekly treatment until we get back?  The reality is that people get attached.  They get attached to certain chairs, and they definitely get attached to certain acupuncturists.  It's easy enough to say hey, I'm leaving town, go see Sarah or Billy please..  But the reality is, just like when Korben left, a lot of them will leave when I do.  Hopefully not too many.  Eventually they'll probably be back.   The clinic is still in a rough place from that transition — and now another big one is on its way.  

We are talking about this stuff pretty much all of the time right now, it feels like.  Or maybe it's just that I am thinking about it all of the time, I don't know.  We have strategies in place and will have more before the time comes for me to take my name all the way off of the schedule.  One of the things I am really excited about though is the fact that even after I leave, whether I end up still being part owner at both clinics or not, depending…, is that this Mt. Airy clinic #2 is going to be just another PCA.  It's not getting a whole new clinic personality — not that it's not a different clinic, of course, but that there are going to be certain very key elements that it will have in common with PCA #1 and that will stay that way  regardless of me and my personality.  Obviously people have opened second — and soon, a third WCA is on the way — clinics and that's not new.  What's new is the idea that these two PCA clinics with the same-ish name, logo, paperwork, connected by a common URL, POCAPoint, and practice fusion patient base could co-exist and cooperate in the same city *even without an owner in common.*  Honestly to me this feels like nothing less than removing a huge barrier for patients, not to mention just making things a hell of a lot easier for the new clinic.  Just like the local food co-op that has three branches around town — I'm probably more likely to go to one of them because I have already been to the other one.   I see brand new restaurants open up all the time up and down Germantown Avenue, and I see a lot of them fail.  Most recently, a second Iron Hill Brewery opened up  there, the first is in a town about 40 minutes away — and has been packed from day one.  It's so busy you shouldn't even bother trying to get a table there on a friday or saturday night.   All because people know the brand.  

I am so interested to see how this could work in other cities as more and more cities start to have multiple clinics.  There are the regional nodes, of course… Seattle is an incredible example.  How can people share resources and remove more barriers for patients?  How can we cooperate with each other within this cooperative on a very real, daily basis?  I only know what this looks like here now, of course, but I love the idea of clinics somehow welcoming new clinics to town by just being plain old clinics, getting the personality out of the way, sharing names and logos and websites and patient bases.  Maybe this will pave the way somehow for patients to get the idea that just like it's not about it being “Fancypants Clinic Name,”  it's also not about it being Ellen Vincent L.Ac or David Lesseps L F'ing Ac or whoever…  it's just about getting acupuncture.  And it will make us all be able to be more stable when the storms come, and travel and DO THINGS LIKE GO TO POCAFESTS!!!!!!  (BTW GO REGISTER NOW).  

everyone here is so fucking brave.  There's nothing easy going on around here, and honestly I know I couldn't be making any of these big plans without all of you.  I can't wait to see you all at POCAfest GO REGISTER PLEASE RIGHT NOW.  kthx.  

Author: ellengrover

is a punk at Philadelphia Community Acupuncture and POCA's current membership coordinator. Email her at

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Conference Keynote: Breaking the Ceiling

The theme for this conference is “Breaking Barriers”. You know, there are so many barriers to break in acupuncture that it was really hard to choose which ones to talk about for this speech. But since I’ve spent so much time talking about classism as a barrier, I thought it might be fun to shift gears a little and talk about numbers.


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  1. Responding to the ‘removing barriers’ aspect of the post. I’m interested in how POCA and “clinic success” and “regional nodes” and growing clinics where we feel like they’re missing can combine the kind of franchising idea you’re talking about with the idea of creating clinics that reflect and can be responsive to a different neighborhood/demographic. Maybe there’s certain “personality” traits of a clinic’s operation that grows out of it’s community but less so within a sister clinic. This relates to, for example, long-term goals and if we’re able to change the educational system so that more working class people and people of color want to and are able to get licensed and become community acpunks.

  2. I’m trying to say something here about how there’s something else we need to do besides the systems we share which are so important to creating access. Lisa talks about it so well in the “systems and relationships” part of “…Noodles”. The systems we follow ideally make space for deep relationships with patients, because they make it possible for people to get lots of acu from us over time but also because they get us out of the way and make room and healing space for our patients. But, there’s still particular ways which we all carry out these systems and lots of subtle or not so subtle ways we interact with our patients. I wonder if clinics that have more than one location have anything to say about their second clinic and if it takes something different to hold space for people there vs. where thy started.
    This stuff all relates to punks moving, too. I want to write a blog post about learning to be myself all over again with a whole new and very different community of patients here in southern New England.

  3. On the topic of patient retention when a punk leaves…

    Whenever I’ve gone to a hair salon that has multiple stylists, if my normal hairdresser went on vacation she would always make a point to recommend another stylist to me in the meantime. She would say something like, “John is great with curly hair” or “Tina has a similar style to mine.”

    I wonder if something similar would work in an acupuncture clinic with multiple punks– specifically recommending one new practitioner for each patient, and telling the patient why you’re doing it.

    It doesn’t take personality out of the equation. In fact it probably reinforces it, but IMO personality is always going to play a role in patient/practitioner interactions. And it may help the patient to feel less abandoned and more willing to try out someone new.

  4. Ellen
    Congratualtions on all the change and courage!
    After I now moved and have opened my second clinic, (Eventhough the first is closed.), the pull of personality from the old place is still present: 1) I still get calls looking for appointments and 2) I struggle with remaking myself and the new place respond to the new community.

    Balancing the needs of the community and business
    with those needs of your family and self

    providing reassurance to community, business, family and self

    tall order

    Maintaining the systems and allowing some focus on the course ahead

    trust in the change will reflect to customers trust in change
    (trust the force ellen)

    “just being plain old clinics”
    people are always drawn to quality and return to it
    cooperation builds

    Its so cool the perspectives you must have and will have

    Congrats again