Somewhere in the intersection of Cris’s blog on Boutique Acupuncture, Lisa’s Blog on CAN’s anger, reading over Dr. Tan notes and finding gems like a 72 yr old woman avoiding a pacemaker and getting off ALL her cardiac drugs, me without health ins., all the comments on the AAAOM forum about the FPD, several of my friends inviting me to events that I would have gone to when I earned more $ but don’t go to now (and don’t feel the need to go to), and 2.5 years of doing CA, I’ve lost my patience.
It’s gone for those who think acupuncture is an adventure (and they love herbs, tui na, etc and can’t give them up), who think AOM is “complementary” or “alternative” medicine, that their practice is OK because they bill ins, that they can make huge salaries and be big consumers at the expense of the planet and patients, or that practicing medicine is about them.
I’ve lost patience with acupuncturists who foist off information on nutrition, exercise, stress management, and psychological, emotional and spiritual issues unless patients want this information. I’ve also lost patience with those who think any of the big acu orgs are EVER going to give a damn about patients. I’ve lost patience with anyone who doesn’t get it that medicine is about relieving patients of their suffering and it’s our duty to do this for as many as possible. That is the contract between society and medicine.
Here’s how I got there.
Acupuncture school was a delight. We were special. We knew a different language that no one else knew. Spleen qi deficiency. Liver qi stagnation. The flow of Yin and Yang. I treated people in school clinic at weekly intervals. Sometimes I saw the same people back. Sometimes I didn’t. I had little idea if my treatments worked or not and I graduated from a 4 year program not knowing what acupuncture could do. I didn’t see it in 4.5 years of private room acupuncture, either. The prices were too high for most people to come frequently or for any duration of treatment. Then CA came along.
I could immediately see that CA was a business model that would enable many people to get the benefits of acu. It also could potentially be my sole means of employment, rather than the hobby it was as a private practice. Since I think health care is a human right, this business model was much closer to health care for everyone than the one I learned in school. I was still taking it on faith that acu would actually relieve suffering.
As a “good” medical practitioner should, I “read the literature.” For about 5 years I read Blue Poppy’s translated synopsis of the Chinese language scientific literature on acupuncture and Chinese herbs. The herb protocols were easier for me to replicate, although they usually called for raw herbs decocted daily, which none of my patients would do. My teachers had made it clear that raw herbs were the gold standard, powders second and patents close to a placebo. The acu studies were set up as a 10-day course of daily treatments with 2-3 days off and then another 10-day course. Usually cures were reported in 2-3 courses of treatment.
The model I was taught was weekly acu treatments, not 10 days in a row. Could I even use the protocol on a weekly basis and have any hope that it would help? How was this literature even relevant to my patients? I couldn’t rely on the studies as a guide to practice because I couldn’t replicate them. At going market rates, the most I could talk any patient into coming for acu was twice a week for 1-2 weeks then weekly for a few weeks. If they weren’t better by then, they quit because they weren’t willing to spend more money on something that didn’t seem to be working. I couldn’t blame them. I wouldn’t spend $65- $100 a treatment and more for herbs if I weren’t seeing results.
I still can’t replicate the acu studies in CA. I’m not open 10 days in a row. But I have learned a more effective way to do acu than TCM acu. Dr Tan’s Balance Method works – in 5-20 treatments for most things. Chronic, severe problems take weekly tx for months to years but one of the big things that gives me no patience is that PEOPLE WITH CHRONIC ILLNESS GET THEIR LIVES BACK with CA and I didn’t see this in private practice.
They hurt less or become pain free. They stop being depressed due to chronic pain and fatigue. They have more mobility. Some of them lower their meds or get off of them. Some avoid surgery. Some recover more quickly from surgery. Some with advanced cancer live longer and better.
It works for people without chronic illness. Acu can keep them going to their jobs, shorten recovery from injuries to get them back to work, eliminate sick days due to colds, bronchitis, sinusitis and GI flu. WM is finally admitting that stress underlies chronic illness. Acu deals very well with stress. This is preventative medicine and it really does treat most things fairly well – if people can afford to get enough treatments. I’ve seen for 40 years what ppl with chronic illness go through in WM. They can get their life back with weekly acupuncture. That’s not alternative or complementary, that’s HOPE and an IMPROVED QUALITY OF LIFE that they don’t get any other way.
So I don’t have any patience any longer for those who advocate acupuncture for face lifts, who don’t charge on a low sliding fee scale, who set up hybrid practices that alienate patients with limited incomes, and for those acupuncturists who won’t serve anyone but those who can afford $65 and up or who bill insurance paid for by only certain types of work. If you are really practicing medicine, you should be making your services available to the widest number possible. Before CA that was difficult. You have no excuse now.
I have no patience with acupuncturists who “love herbs and won’t give them up” to do a CA model because it appears there’s not time to diagnose, prescribe and mix herbs in CA. I have seen that many conditions don’t need herbs. Acupuncture 2-3 times a week in a group setting for 2-3 weeks and then weekly until better works extremely well for many complex, multifaceted problems. If you really think herbs are necessary, you will figure out a way to do them and still do CA. Medicine isn’t about you and what you love. It’s about relieving suffering.
I am out of patience with acu professional organizations that are promoting a first professional doctorate. They haven’t shown that the masters level practitioners are unsafe or incompetent so there is no reason to require advanced education – especially considering that the education we get now isn’t relevant to successful acupuncture, the cost is already too high and at least 50% of the graduates fail in business. CAN has been in existence for 2 years, proving that CA is successful for many practitioners and patients. Acupuncture Today canceled Lisa’s articles on CA. AAAOM, CCAOM and the NCCAOM all want the doctorate. When CAN, the only acu organization in the US that is advocating for patients, is mentioned it is disparaged, vilified and dismissed.
I have no patience for any of this any longer. If you are practicing any kind of medicine you should be about relieving suffering. Medicine is not about your ego, the white coat, to be called doctor, making tons of $, or to be able to think of yourself as special because you practice an exotic medicine.
CAN has clearly shown how to put patients first and also make your living and pay back your exorbitant student loans. We have shown you the statistics on numerous CAPs. We have shown you what works and what doesn’t work and why and how to do it. You get support and problem solving on top of that. It’s not easy to set up and run any acupuncture business but setting a CA is not much different than setting up a BA. The differences are in the results: you will be helping a lot more people; you will get a lot more experience and thus be a better practitioner; and you will, more than likely, be able to support yourself with CA.