Fun and Games


A couple of weeks ago at the Big Damn Clinic workshop, Demetra and I gave a presentation called Why Worker Owned or Doing It Together.  We presented an overview of different ways and whys to work collectively, and collaboratively, and took a quick look at the idea of worker owned businesses.   The resource list for the session are now in the BDC wiki, but since there are many more of you reading this here than who attended the BDC weekend- I thought to post some more thoughts on these subjects here to be discussed further.  A lot of people were excited by this material and so as we continue to explore these ideas: worker ownership, collaborative business practices, our collective values and interests, there will be more questions and more to share with each other.  Here are a few more thoughts on the subject:

Catching Fireflies and working collectively

Starting a CAP as a sole proprietor for me at times felt lonely and isolating, not to mention risky.  As a boutique-er converting my practice to a CAP, I discovered a few things as soon as I started to see 30+ people a week, which happened pretty quickly for me.  What I learned early on was:

what people coming for acupuncture wanted or needed was way beyond what I could provide ALONE, and that I needed to make sure I set my clinic up to minimize the possibility of something going wrong, so that I could focus on making things go right.

Hiring a front desk person (part-time at first) addressed both of these issues, and made them less scary because instead just thinking and worry about doing everything or not being able to do everything there was now someone else to do some of that (hopefully not the worrying part so much.)  Of course bringing someone else on came with its own challenges: communicating to them the task that needed to be done was actually easier than communicating specifics about how I wanted it to be done.  An example is explaining the sliding scale to patients.  There are good and bad ways to do this to make the sliding scale an effective tool, because of the collaborative nature of the discussions on the CAN forum I had at my fingertips scripts that other’s used and the advice of dozens of other people in the same situations I was running into.

The CAN and now POCA blog and forums can serve our collective needs for support in getting our practices going.  The wealth of information in the posts are there because of a mutual desire to help each other out, to streamline the process of getting up and running, and scaling up after.  What a contrast to the competitive “my master is smarter than your master” mentality I had run into in the acu-world previously.   Another thing about the forum is that it’s dynamic.  There are older archived blogs that are great to browse through not only because of the gems contained there, but because of the perspective some of these blogs provide in how far along the movement has come.  Think back to the blogs about the horrific state of the profession, and forward to the momentum gathering behind us as we launch the first stages of fund raising for POCA Tech.  The forums show us again and again that we’re not alone in our challenges, and that our collective energy when collectively directed can accomplish amazing results. 

Each time I read something on the forum or the blog that is new, or that reflects the experiences I have running and working in a CAP a little more light gets shed on the moments of feeling challenged by this work.  That energy is something like catching fireflies in a jar at night.  It’s so amazing to see, but if you forget to let them back out again it’s not such a happy thing.  I think the forums might be similar-  there is a lot of light to gather there, but this light needs to keep circulating to keep illuminating the way for others.  (So hey- if you’ve got something to share, please do.)

A Box of Light Bulbs—collaboration is cool, er, hot…

At the first CANference Lisa’s Keynote speech recognized  Tungsten as the right atomic number for a punk who during 4 or 5 weekly shifts, does 75 to 125 treatments.  Atomic numbers (if I remember my chemistry correctly) are important in understanding the way different elements react with other elements.  Atomic numbers are about the ability of the nucleus of the molecule to attract or repel other elements.  The electron cloud of particles swirling around the nucleus is equally important in determining the bonds any particle can make with another particle.  So atomic number is not just about the number of particles or the number of treatments a punk can do, it’s about the way we attract and bond with patients, co-workers, and our co-hort punks across the continent. Does Tungsten in a punk just serve as an element that sheds brightness or does it need to go beyond that?

In incandescent light bulbs, Tungsten is used to make the filament, the thin wire that glows when electricity is run through it.  Tungsten wire is also used in certain welding processes because it is the hottest burning pure metal. When you need to join different kinds of materials together with strong bonds, it turns out that Tungsten welding is the way to go.   If punks at Tungsten are like wire filaments in light bulbs, shining and clinics are more like light fixtures or welding machines; the mechanics of these things being fairly straightforward ways to channel electricity to a point of delivery that either glows, or burns under controlled conditions so the channeled energy remains safe and useful.  A clinic needs Tungsten in light bulbs as much as it needs ways to join together all the different parts of running a business. 

Shop talk at the BDC weekend workshop was like looking at all the ways to piece together a lighting system for our clinics, or weld together infrastructure for getting bigger.  The WCA folks talked about being one clinic in three locations, or the systems they’ve come up with to efficiently and effectively get a box of light bulbs plugged into sockets, connected along one long power cord.  John presented on job descriptions as an element of the system that make lines of communication, and a division of labor clear.  We spent some time discussing “administrative modules” in our small groups.  But there is not one single right way to run a business and the systems used by BDCs are evolving even as TTDC and MDC are considering them.  If we were traditional businesses we’d hire some swank consultants to figure out “the best way” to run our businesses.

In the community acupuncture bootstrapping mind-set things get done by DIO—Doing it ourselves, and then by extrapolation into fractal realms, by doing it ourselves together.   I suspect that it’s not just the reality of not having the cash flow, or the inclination really, to hire a HR consultant but also by necessity of understanding these systems from the inside out so that they can be tweaked to our particular business culture, which strongly reflects a set of values.  Here again is that fractal, that holographic part of community acupuncture;  our values extend out into the systems we use to run our clinics as much as then furrow into us as people.  The values we hold as punks treating lots of people, the space in our hearts we have for being with pain, these things are also business skills in our world.  We wouldn’t want our clinics to depend on one person who runs everything anymore than we would want our patients to depend on any punk for healing.  The acupuncture works on its own if you can find a way to deliver it, just like the clinics have a growing and healing energy of their own, if you can cobble something together to let it out into the world.

Just in the way that treating in a clinic requires being able to handle the flux and unpredictability of our patients’ lives, a BDC requires that the clinics can handle the flux and unpredictability of our own lives. We’ve figured out ways collaborate with our patients to make seeing 6 of them per hour doable, the back side of that is to collaborate with one another in the workplace to make sure that we can keep up with the collaboration happening on the front end.  The bigger end of the fractal looks like POCA, POCA Tech, and the planet POCA. The smaller fractals look like a punk at Tungsten, a clinic with systems, a group of punks talking on a blog or forum. Anywhere you try to plug into community acupuncture, as a punk, as a business, as an organization, there are elemental qualities reflected.

Skin In the Game

Cooperative businesses, specifically a worker owned cooperative, provide a challenge to a common notion that the business owners have the most skin in the game, or the most to loose if the business fails. If we instead recognized that in any business that requires all of its workers to invest time, care, and work into its success, then we can see that it’s not just the owners who stand to loose when a business folds.  In the case of our clinics there are many other stakeholders who depend on our existence.    There is a lot about capitalism that we’ve learned to accept as “truth” or “the way things are”, or “human nature.”  But if we lived in a world with a different frame work for valuing innovation, or risk taking, or investing in the future or the lives of other people we might measure success in our society by how much social capital we generate, how many sustaining relationships we have in a lifetime, how many jobs we create, how much suffering we alleviate either directly or for standing up for things that lessen human misery, like clean water, or trees.  What kind of insanity is it that the measures of success in our businesses and culture are how much stuff we accumulate, stardom, and how many numbers are on our bank statements?

It wasn’t necessarily by conscious design that our clinics have turned out to need an alternative to traditional capitalist structures, but may it’s just inherent in the holographic nature of any business that works to eliminate isolation by building relationships and all the accompanying social capital that comes with that. A cooperatively run, worker-owned business acknowledges that everyone has a stake in the success of the business, and if the business fails lots of people loose.  It’s realizing that in order for our clinics to be useful over the long view they have to be able to sustain themselves with out us.  It’s the same as acknowledging that everyone on the planet has a stake in the ability of planetary systems to keep working.  Coop models are certainly not new but we’re needing them more than ever, and it looks like they may be a good fit for our clinics as well as our larger organization.  Coops help us to see that we all have skin in the game and that it’s all one skin.

Download the resource list from our breakout session for some real live examples of cooperative businesses.  A really wonderful read on the subject of worker owned businesses is John Abram's Companies We Keep, which describes the transition of South Mountain Company, a business he started and owned until it transitioned to worker ownership 25 years ago.  This book has other great stories of other businesses that have made this transition as well.

As part of an ongoing conversation just starting here in Providence about making our shop worker owned we’re all getting together next month to play the game of Co-opoly.  (6pm on Oct. 19th at my house you are ALL invited).  I found out about the game on the internet of course and ordered a copy of it to play after I read about the game having one playing piece that the group moves around the board together.  In Co-opoly you either all win or all loose, and you do it together.  You can buy Co-oply here:   ….and yes they have a sliding scale!

Bring your game set when you come (back) to RI in June and we’ll all play at POCA Fest!

p.s. Today the CoOpoly people sent me a newsletter that linked to this good article about coops.


Author: crismonteiro

I've always thought that I would live to be 100 years old and now that I have an actual idea of what it might be like to inhabit this body for a century I want to be damn sure that Community Acupuncture is around to help me through my days and in the end, on my way. In the meantime, I am passionate about getting shit done, and also having fun.

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  1. One of the things that’s been occupying my mind since the BDC workshop, as I create job descriptions, is how to get out of the mindset of a hierarchy and to think about how the various responsibility-holders work together cooperatively instead, and what that creates in terms of social capital for those people and the clinic. There is so much more depth to things when we look into that aspect, and it’s really energizing to realize and experience that.

  2. Thank you Cris! More than anything, the vision of working cooperatively gives me this beautiful reassurance that the clinic and the people in it are going to be loved and protected. It’s not all on my shoulders. We can all work together to take care of one another. I just ordered a copy of “Companies We Keep” and can’t wait to read it!

  3. Kim,
    I thinking hierarchy can be useful to set up lines of communication or delegation, but am intrigued by the ideas of choosing a common path, and making some of the bigger decisions collectively. It’s going to be yet another leap to get to that next stage, if we decide to go worker owned at PCA, but I’m excited to explore it more and to actually experiment and experience it, instead of thinking, and reading and writing about it.

    It’s interesting to me to look back on the steps it’s even taken to get to the point of considering a cooperatively run shop. I’m grateful to have this experiment of us figuring out how POCA our coop works too.

  4. Alexa,
    When I first had this feeling that my fate, and the clinics’ fate, and the fate of those working at the clinic were all linked up, and that all of us understood that, it was very reassuring. It wasn’t until 4 years in that I really could say that I felt that. It took the right set of circumstances and the right set of people to allow that feeling to emerge. Now I feel like that feeling helps steer things more.

  5. Thanks Chris…love the fractals analogy – you had me at ‘Tungsten’! Will be sure to check out those links.