This post is partly for Eric, who wondered if he was being held to a higher standard than other toaster applicants, and also for everyone else who is thinking about the questions posed by the Toaster Tour. I am already beginning to suspect that many of the people we would like to interview may intentionally or unintentionally misunderstand what we are asking, especially when it comes to the criteria of Replicability, so I’d like to be a little bit clearer.
Earlier this year, I was on the other side of the interview process with none other than John Weeks of The Integrator Blog. (Look for that interview to be published later this summer.) One issue he was acutely interested in was how many other community acupuncture clinics were anywhere close to replicating WCA’s patient numbers. I reported that several were breathing down our necks (Manchester, Tucson, Berkeley, I’m looking at you!). John looked relieved, and then explained why he was asking, with a story about how mainstream medical doctors initially dismissed popular interest in integrative medicine. They attributed the success of the Lifestyle Heart Trial to “the Ornish effect.” Meaning, they didn’t believe that Dean Ornish’s principles and systems for reversing heart disease were actually successful by themselves, or likely to be widely adopted on their own merits; they thought it was all about Dean Ornish’s extraordinary personality and charisma, and if you factored those things out, everyone could just forget about lifestyle therapy for heart disease. Because somebody with a lot of drive and personal charisma can usually accomplish whatever they want to. It doesn’t matter really what it is; what matters is how badly they want it.
Early on in WCA’s evolution, we heard a lot about that. People didn’t call it the Ornish effect, they just suggested that what we were doing was only successful because of us. It wasn’t our systems, it was our personalities. (Those of you who know Skip and I really well, will you please stop slapping your knees and hooting. I can hear you through cyberspace and it’s distracting, OK?) They also suggested that community acupuncture would never work outside of quirky, laid-back Portland Oregon. It’s been easy to disprove the naysayers on both counts; nonetheless, there’s something really important here about the idea of the charismatic, driven, successful super-practitioner — and its implications for the profession and the creation of jobs.
It took me a while to understand that the acupuncture profession is so enamored of this idea that almost nobody questions it. That idea is so pervasive and compelling, so glamourous (in the archaic sense of “delusively alluring”), that it facilitates many of the other illusions of the profession. When you’re focused on what wonders a really amazing individual can accomplish, it’s much harder to think clearly about the less glamourous and much more important SYSTEMS that provide a stable and lasting foundation for a business, a profession, or a community. A lot of people still don’t understand that what we’re trying to do with community acupuncture is to dispel the glamour of the individual practitioner, for a number of compelling reasons that I won’t get into here. What I mainly want to say is:
One exceptional individual is not enough to create a replicable job. Even if he has, apparently, replicated it once. Because a replicable job is actually not about the individual who created it, it’s ultimately more about the unglamourous arithmetic — the income stream that supports the job. To the degree that the income stream is dependent on any extraordinary attributes of an individual, the job is probably unstable and not really replicable.
So if, back in the day, WCA had only been able to hire Moses (our first acupunk employee) because all of the patients who paid his salary were just overflow patients from me and Skip, or were attracted to the clinic only by our reputation, Moses’ job would not have been replicable. It would have been just a reflection of our glamour. (Ellen, no guffawing, please.) These days, of course, WCA is full of patients who don’t care which acupuncturist they see, and who have absolutely no idea who owns the clinic. Every so often I get a patient who asks me if I’m new there, and how I’m liking my job. I love that. And Moses’ job has been replicated into John’s and Cortney’s and Joseph’s and Gabe’s jobs. Maybe more importantly, Moses’ job has been replicated in other parts of the country by people who really didn’t know me or Moses all that well. All of the community acupuncture jobs are in a sense replications of Moses’ job, and until a bunch of them happened, it was not necessarily clear that I deserved a toaster, either.
So Eric, I swear I’m not being any harder on you than I am on us. You are clearly an extraordinarily resourceful, determined, motivated, and probably very charismatic person, and in this game of job creation, that kind of counts against you. It’s almost like trying to prove a theory with the scientific method: your theory isn’t valid unless somebody WHO ISN’T YOU can get the same results with your methods. It’s not 100% certain that you have created a replicable job until someone who isn’t you has used your methods and also created a replicable job; or until the replication process is entirely dependent on systems and not personalities.
I’m reiterating this because I know a lot of people are going to try to dodge the criteria of Real, Relevant and Replicable in their interview answers. I chose those criteria not because I wanted to be difficult, but because one more time, I am just trying to talk about the hard numbers. Focusing on individuals — including, focusing on the responsibility of individuals to create work for themselves through self-employment and independent contractor positions and whatnot — obscures the big picture that we really need to look at here. The degree to which acupuncturists need to be amazing and extraordinary in order to make a living is actually the degree to which the profession is failing. It’s also the degree to which our leaders are failing to lead.
I’m not saying that people shouldn’t work hard. Ask any of WCA’s employees, we’re all about hard work. But that’s different. You can and should be able to work hard for a stable income without being a star. It’s on a different scale, but it reminds me a little bit of some conversations I had when I tutored some kids from a very low income neighborhood. If you asked them what they wanted to do when they grew up, a bunch of them would say that they wanted to be pro basketball players, or rich and famous musicians. Of course that was totally unrealistic; one kid in ten thousand has that kind of talent and drive. The degree to which superstars were their only models for adult success was the degree to which those kids were oppressed and deprived. Not enough people from their neighborhood grew up to get good, solid, unglamourous jobs as accountants or nurses or mid-level managers. For a variety of reasons, the economic foundations of their neighborhood had been destroyed, and what society offered them instead was a lot of illusions. I think the acupuncture world never had any economic foundations to begin with, and compared with those kids, most of us L.Acs have enormous amounts of privilege. But still. In our situation, it’s our schools themselves that are telling us that if only we had our act together, we could be a pro basketball star and we wouldn’t have any problems with those pesky student loans. That’s the solution — for ALL of us to be pro basketball stars, even though the evidence shows that’s impossible. That’s not a grown-up solution, and the essence of the Toaster Tour is that we’re asking the profession’s leaders to act like grown-ups. Keeping a whole bunch of people focused on the illusion of superstardom is a good way to keep them from demanding some basic economic dignities. Such as real, replicable jobs.