GUEST BLOG: Investigating an Innovative Acupuncture Service Model by Dr. Kim Tippens, ND, MSAOM

strong>Investigating an Innovative Acupuncture Service Model: Characterization of community acupuncture clients

Kim Tippens, ND, MSAOM

Maria Chao, DrPH, MPA; Erin Connelly, MA

strong>Background

span style=”font-size:small;”>Acupuncture has become more popular in the United States with an increase in use from 2 million in 2002 to 3 million in 2007. However, acupuncture is utilized by a limited segment of the population—users tend to have higher income and education and be of either Asian or non-Hispanic white ethnicity. The lower cost of treatment of the community acupuncture model may allow a broader segment of the population to afford acupuncture. It may also allow for more frequent treatments, which in turn could improve the effectiveness of acupuncture.

span style=”font-size:small;”>The 2007 National Health Interview Survey collected data on acupuncture use in the United States.We compared national acupuncture users with clients at the Working Class Acupuncture clinics in Portland, Oregon to see if there were differences in socio-demographic factors, health factors, and frequency of seeking acupuncture treatment. Over six weeks, we distributed surveys to new and existing adult clients at the two Working Class Acupuncture (WCA) clinics. Surveys collected data on client demographics, socio-economic status, health behaviors, access and utilization of health services, and satisfaction with the CA model. Of the 500 surveys distributed, 478 were returned.

span>WCA clients are primarily white (87%) and female (72%)

span>25% uninsured

span>29% unemployed

span>77% with annual household income of less than $55,000

span>69% completed a college degree or higher level of education

Compared to a nationally representative sample of U.S. acupuncture users, WCA clients had higher educational attainment and lower household income. Clients of WCA clinics represent a broader socio-economic spectrum compared to national acupuncture users but are more homogenous racially. Availability of accessible, low cost treatment is a primary reason why Portland clients choose CA services.

span style=”font-family:’Times New Roman’;”>Clients of WCA were similar to acupuncture users nationwide with regard to self-reported health status and medical reasons for seeking acupuncture treatment. WCA clients are also more likely than national acupuncture users to receive frequent acupuncture treatments (> 1/month). How the frequency of treatment affects various health conditions, including preventive, chronic, and acute conditions, is an important topic for future research.

Study findings suggest that local community acupuncture clinics improve economic access to acupuncture though racial/ethnic barriers, beyond economic factors, remain a challenge. Continued monitoring of the community acupuncture movement is warranted to examine issues of access, patient satisfaction, and clinical outcomes of affordable acupuncture.

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Survey of CAN clinics

Skeptics in the acupuncture community say that CA clinics can’t be successful.  A variety of reasons are cited – prices too low, patients want one-on-one attention and wouldn’t like treatments in a room with other people, Dr.

Responses

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  1. removing more barriers

    Thank you for your presentation at the CANference Kim! This is critically important work, figuring out how to lower not only economic barriers, but ethnic and racial ones.

    There is a perception out there that people don’t want to be bothered with surveys, especially where they either have to give, or collect, racial and ethnic data.

    It’s obviously very politically charged these days in the era of color-blindness where there is a significant portion of American society that pretends not to notice a person’s race, as if the country has entered a post-racial world.

    However, for those of us dedicated to expanding access to everyone and truly planting seeds of peace in the world, collecting this data is important. I look forward to working with you.

  2. demographic research in POCA clinics

    Do I remember Kim stating in one of the break out meetings that she is working on another survey, and that she will be developing a new survey for those clinics that notified her of their interest?

  3. what is white?

    Hi Robert,

    Your questions is like a puff of wind that begins to clear the fog of race identity – something which in another time and place should make absolutely no difference at all, but here on Planet Earth in 2011, is still hugely important.

    As I understand it, “white” is a largely subjective assessment made by the society at large. Due to the intense pressures for individuals to conform to the norms of “white” society – including horribly damaging skin bleaching  practices with toxic chemicals amongst young people in India now for example, many who might otherwise report as being members of another race/ethnicity, may choose to report themselves as white – whether in official government surveys, or in research such as Dr. Tippens’ study at WCA.

    However, with Latinos/as there is an effort to count people identifying them as such, as there is usually a separate question on most demographic surveys specifically asking whether the person is of Hispanic origin.

    In the end analysis though, demographic surveys are just tools which can be used in different ways by different people. Presumably the goal of most surveys that measure race is to help understand the obstacles and challenges for achieving social equity for all people. 

    I’m not sure though if I’m missing the essence of your question, as “race” is so complex and layered like an onion. I’d be interested to hear what Dr. Tippens has to say at some point and I’d encourage you to participate in her research at your clinic because racial equity is an important principle of POCA.

  4. thanks

    I’m thinking in generalities as well as specifics. I’m curious about the demographics of Portland wrt those for WCA.  How much of the #s reflect the general demographic of Portland vs other possibly bigger cities (which tend to have high concentrations of acupuncturists) with possibly more diverse populations?

    In terms of specifics for my situation: I’m in South Florida and my patient base includes a large number of Latinos (many of whom would likely self-identify as white, though there may be cultural factors which drive their choice of identity – social status, upward mobility, etc).  There are also many Caribbean people in my practice who are from Guyana or Trinidad but whose heritage is largely South Asian mixed with African diasporic.  So things can get complicated from that standpoint.

    It would be interesting to survey my practice demographics at some point, though i’m not doing huge numbers right now (40’s mostly so far this year, though up from last year).  I’m actively considering moving the clinic closer to my home, which is in a less affluent and more mixed neighborhood.  I get patients from my local mosque who say that they have difficulty in getting out to see me.  So i’m thinking the demographics will shift if i move the clinic.

    Anyway, some thoughts, not terribly coherent but possibly will become moreso in time.

     

  5. full of questions this

    full of questions this morning, sorry.

    How does the higher educational / lower income mix play out in terms of class? If you have an upperclass education and are making $30k a year (or are a 99er or whatever), where does that put you on the class spectrum?

     

    Another thing that comes to mind is displacement from one class to another; for example, i have a number of originally upper class patients from various countires who are here for political or other reasons and have moved downward economically since arriving.  Others are uninsured here but may have full health insurance in their home country; some are getting acupuncture until they can scrape together enough money to make it back home to see a doctor.

     

    Anyway, i’m avoiding work more than anything right now — writing ACAOM standards, who can blame me?  CAN is much more interesting.

  6. Excited about the possibilities

     

     Looking forward to extending the surveys to other CA clinics!Dr. Kim Tippens made an awesome suggestion for increasing the diversity of a clinic’s patient base. Hire/Find help that is racially diverse 

    Jade Community Acupuncture, Winona, MN

    acupuncturewinona.com

  7. More stuff to think about

    “Race is a specious classification of human beings created by Eruopeans (whites) that establishes social status using white as the model of humanity for the purpose of establishing and maintaining power and privilege.”

     …from a Healing Institutional Racism weekend seminar run by the People’s Institute Northwest….

     

  8. If so, include us!MM

    If so, include us!

    MM Dobson

    Summerville CA