Integrative Populism

A primary motivator for proponents of the first professional doctorate in the acupuncture profession is access to and acceptance within the western medical care model.  This infuses the existing dominant medical paradigm with their own essence and relabels it “integrative medicine”.  While a collective professional inferiority complex is outside the scope of this piece, we would do well to consider the notion of integrative medicine.  Combining medical modalities in the delivery of healthcare is not inherently wrong; it is just that the approach is misguided.

A key problem with the integrative care model is that it employs a top-down approach to health care delivery, meaning that integrative medicine usually caters to those members of society that are financially stable or well off and have health insurance that covers CAM.   Insurance coverage is essential in receiving care at most or virtually all supposedly integrative health centers.  Otherwise, cost is prohibitive.  However, an integrative approach to medicine need not require that every hospital have an acupuncturist lurking around the corner.  Rather, all health care workers should be informed as to the appropriateness of any medical intervention and refer accordingly.  Working this way would dramatically reduce healthcare costs.  Western doctors should begin to see the vast numbers of people that seek their care and have no diagnosable biochemical disease (stress) as their version of red flag patients and refer them to community acupuncture clinics, a facility that they know the majority of their patients would be able to afford and benefit from.  This would unclog their appointment books, relieve their own stress and do more to promote a conversation between western and eastern care than staffing a couple of acupuncture “doctors” in hospital settings.  This would be a step toward true integrative medicine. 

By seeking inclusion in an exclusionary medical delivery model, the acupuncture profession keeps itself outside the reach of most who would otherwise desire their services.  What the profession needs to adopt is a bottom-up, egalitarian approach to care delivery.  As acupuncture is a low cost, side effect free treatment modality that does not rely on high-tech diagnosis, intervention, pharmaceuticals, or an extensive knowledge of western medical information, it only makes sense to render care outside of western treatment facilities by non-western trained individuals.  Of western medical knowledge, all that is required is a sound understanding of red flag situations where referral to a western care provider, be it physiological or psychological, is the correct option.  This does not mean that there is no place for an acupuncturist at a hospital per se.  However, working outside the confines of insurance and hospitals, pricing services at a rate that most people can afford, the profession erases the main obstacle to greater usefulness for the masses; namely, cost. 

A populist approach to acupuncture care delivery, in which the majority of people are met on their own terms and healthcare insurance is disregarded, promises to provide quality care to the people who need it most.  Is that not what medicine is about?

Oh yeah.  Acupuncturists just might make a living working this way.  That wouldn’t be such a bad thing either. 

LarryG
Author: LarryG

CA punk for 12 years. AZ License #600

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  1. Wonderfully written.

    This Inferiority Complex carried by so many members of the acupuncture profession, what do you suppose is its origin? 

  2. unclogging systems

    The integrative approach to medicine is a great idea. I  believe in the integrative approach in all parts of our lives. More information, resources, opinons; these all add to our experience of living.

    Working around medical doctors for the last 30 years has given me a different perspective of how ‘allopathic’ medicine is practiced. I believe (and have had western md’s corroborate this belief) that most things that doctors see in their practice are undiagnosed. This does not mean the cause of the illness is or is not stress (although I believe most illnesses are due to some emotional component-isn’t that what we are taught in acupuncture school?). What it means is if doctors were to refer out to us the things they could not diagnose, we would be getting the bulk of their business (hmmm-might not be such a bad idea).

    Here is a revolutionary thought (my favorite kind); why not have the western medical paradigm shift to acknowledge the ‘diagnoses’ of stress or grief as causative agents of real symptoms and then have them refer to the acupuncturist for treatment, instead of throwing costly and often toxic pharmaceuticals at their patients in an attempt to control these symptoms. If the acupuncture is not helping to resolve the problem ( ie high blood pressure), then try the drugs. We could work together to help people achieve optiimal health in the least toxic and least expensive way.

    I support the idea that western doctors get a better education that includes more of the paradigm we work with and have acupuncturists continue to have some western medical training (as it now exists in most acupuncture schools-NOT by requiring more expensive education) in our training. The cost of education needs to be radically changed for all of us. Western mds graduate with horrendous debt too.

    The cost of healthcare in all of its forms needs to be changed. Too many people are declaring bankruptcy from having to use the western medical system.

    Let us not give up the breadth of our education to fit around a model that is not workable in any way, but let us support changes in the system so that our education is affordable and healthcare in all its forms is available to all.

  3. buzz words

    i experience “integrative medicine” as a buzz phrase that has classist implications in this country and implies something highly sophisticated, special and better than… i was once asked to work in an “integrative medicine clinic”, but i turned them down because i found out that  i would have to charge clients $120 per visit and give 1/2 of that money to the clinic. just didn’t seem like there would be that many patients that would benefit from that arrangement.

    i think acupuncturists are all doing integrative medicine to some extent, because we are almost always working with folks who are unter the care of a western md.

    a good (and non-triggering for me) example of true integrative medicine is NADA. it’s been around long before “integrative medicine” was a cool and special thing that you had to have insurance to obtain. it’s basis is community and healing in group setting with needles and the most simple of set ups. and most of the time it is free care, provided by people who are not acupuncturists. that’s integrating for you.

  4. taking the sting out of the buzz (yuck yuck)

    I guess I have had the good fortune to work in community clinics most of my working life (while in medicine).  The Country Doctor Community Clinic (where I work) is a low income clinic devoted to bringing health care to the underserved. We have sliding scale-down to zero for homeless people. Unfortunately, the acupuncture clinic cannot give free treatments because there are no grants out there to support my salary (and a woman has got to eat- ya know?)

    Some of the people I treat I have known for years because I have been their phlebotomist before I was their acupuncturist. It is a really nice community-something I have only just become aware of since reading that great posting from the soon to be ex board member. But I digress.

    My vision -that I am having the good fortune to try and realize- is that we create a true integrative approach. Let us work for that vision. Bringing the medical model around to providing health care at reasonable cost. The standard (expensive) model of health care is about to go boom anyhow-most of the doctors I work with agree on this. If we could create truly integrative health care that provides for all-regardless of their income-oh what a beautiful world it would be!

    So, lets redefine integration-it really is a good concept-we just need to own it.

  5. Just curious, Jill. 

    Just curious, Jill.  Since you are charging for acupuncture in this space and the other services at country doc have a sliding scale down to zero, would it be a better use of the clinic space you use for you not to be there and replace it with additional affordable western care, which is indeed quite rare.

  6. Today, I received this

    Today, I received this e-mail from Marilyn Allen (see below). It looks like AOMA, Lerner, etc. are trying to line their pockets with this endeavor.

    Maybe CAN should introduce CA to WFM.

    To All Licensed Acupuncturists:

    An exciting initiative is underway that has the potential to greatly increase employment opportunities for acupuncturists and Oriental medical providers nationwide. There is a revolution happening in corporate healthcare and Whole Foods Market (WFM) is at the forefront. With spiraling medical costs, WFM sees the acupuncture and Oriental medicine community as a solution for cost containment. This is a fantastic point in the development of AOM in America and we can be a part of it.

    This initiative has two significant impact points: one, for the provider who chooses to be qualified to serve in the network and two, for the outcomes data that WFM will generate from this project. Both have the potential to powerfully demonstrate acupuncture’s role in the American healthcare system. Corporations are being crushed beneath the rising costs of healthcare, and AOM is a natural solution. This is a tipping point. This is an opportunity to change the landscape of healthcare in America.

    To prepare AOM providers, AOMA and Lerner Education are cooperating to create a network of qualified practitioners for the occupational medicine field. Fred Lerner, DC, has educated acupuncturists to serve in the worker’s compensation system of California for more than 20 years. He is highly qualified to teach and assess the competencies of AOM providers in occupational medicine.

    The first opportunity to participate in the AOMA Occupational Acupuncture series will be this November 14-16, 2008. At this inaugural series, Margot Roth, the Director of Global Risk Management for Whole Foods Market and Dan Foust of Gallagher-Bassett will be there to launch the program by presenting their vision of changing the healthcare landscape. The AOMA Occupational Acupuncture three-module series will be offered over three, 3-day weekends: Nov. 14-16, 2008; Jan. 16-18, 2009; and Feb. 20-22, 2009. For more information, including registration, go here: https://www.aoma.edu/continuing-education/seminars/.

    Join us at the tipping point!

    Sincerely,

    William R. Morris, Ph.D. (c), L.Ac., President, AOMA
    Margot Roth, Global Risk Manager, Whole Foods Market
    Fred N. Lerner, D.C., Ph.D., President, Lerner Education

  7. oh, please

    just give us a thousand bucks and we will teach you how to treat  ONLY when they get hurt at work. and then you can treat the employees who work for a certain corporation if you sign up on our SPECIAL EXCLUSIVE list.

    i would rather treat folks from all sorts of jobs / walks of life whenever THEY want to be treated and not spend a thousand bucks to have a chiropractor tell me how to do it.

    i am sure that you learn some useful things in those seminars, but this whole thing seems like a ploy to get people to sign up for their class and their network. they’ll give you of paperwork to do and tell you when you can and cannot treat people and how much you should charge. no thanks.

  8. “The Tipping Point!” They wish!

    On the other hand, sidestepping those pesky insurance companies, we might keep this onthe back burner for ideas later on.  I happen to have a contact with WFM’s competition down south, so we may be able to put together a CA package for these companies that just might fit some of the newer CA folks.

  9. Talking about insurance, did

    Talking about insurance, did you notice that one of the qualification standards for providers in the network is evidence of professional practice insurance? That probably explains why Marilyn Allen of the American Acupuncture Council (AAC) sent the above e-mail out to practitioners.

    So whether or not this network benefits practitioners and/or WFM employees, it WILL financially benefit AOMA, Lerner, and AAC.