we need to put together an ethics statement for POCA. Cris put out a call for volunteers recently but I don’t think we’ve exactly been deluged with eager applicants. In fact, I can all but hear the groans of “ oh no, not another committee” rising up from cyberspace. So I’m hoping to stir up a little more enthusiasm with this post.
Writing an ethics statement for POCA is a bit tricky. It brings up all sorts of interesting problems. As usual, it’s hard to find any models that are helpful to us in our particular situation. For example, a lot of corporate ethics statements are basically: Try Not to Eat Babies, OK?
As the Board of Directors was discussing this, Demetra brought up the Madison Principles, which are not the same as a code of ethics, but are actually helpful. And in reading them, I thought of a discussion I’d like to have that is kind of an expansion of the argument I had with Peter Deadman about best practices. In a way, ethics are like best practices: they’re the guiding ideal, the goals that you strive for.
Check out #4 of the Madison Principles. Use a Market Driven Approach: Cooperatives only work when they are market driven; the cooperative developer works to ensure that accurate market projections precede other development steps. Another way of saying this is that co-ops are subject to stringent limitations. They have to work in the real world, not just in the realm of ideals and goals, or they don’t work.
The acupuncture world in general has a terribly hard time with the concept of limitations. That’s what I was trying to get at in my original JCM article, and Peter Deadman’s response in some ways proved my point. Who knows, maybe he’ll get back to us with the blueprint of a model that transcends the limitations of our model and actually works in the real world, with real people, and maybe he or someone like him will want to spend a decade of his life road-testing and replicating that model until it’s fully believable. You never know, right?
I argued that by ending his article with a call for this non-existent model, he was displaying privilege without acknowledging it. One of the big challenges of writing a POCA ethics statement has to do with privilege, specifically the intersection of privileges we have with privileges — and resources — we don’t have. That’s what makes the process tricky and intriguing, and I’m hoping this is the part that will get some of you smart cookies out there interested in volunteering for the new committee. I have a couple of themes that I hope will make an appearance in the POCA code of ethics, that also have to do with this tricky intersection, and here they are.
1) POCA seeks to be a good steward of its social capital.
Part 1: this requires embracing the directive “put up or shut up”.
Put up or shut up is a phrase that commonly appears in sports, business and politics rather than in codes of ethics. It means do what you’re talking about, or stop talking about it. I like this phrase because I think it acknowledges how delicious and irresistible it is to talk about how things should be, and especially to tell other people what they should be doing. Everyone likes doing that and everyone does it to some extent. But in an organization like POCA, whose lifeblood is volunteer energy, it takes on a different and vital significance.
POCA has more social capital than any other acupuncture organization around, which is why we have been able to do so much in such a short time. But we don’t have a super-abundance of social capital, relative to our mission. We need to be careful about how we invest the time, attention, and skills of our many volunteers.
We have a kind of unofficial policy, but I propose we make it official in the code of ethics: nobody in POCA gets to demand that POCA do something if they are not personally willing to help with the effort. Nobody. If you've got a complaint, congratulations, you've got yourself a job!
We use this policy at WCA and it works really well, particularly in keeping a culture that is (mostly) free of complaining. You could say that WCA’s existence is partly due to implementing the directive “put up or shut up”. I am really good at complaining about the acupuncture profession; I’m enthusiastic, and I’ve had two decades of practice. At some point, starting about 10 years ago, I was moved to put up or shut up. I don’t know that I’m capable of shutting up, so I had to put up. I am happy with the results. I’d do it again. I don’t feel bad about recommending the same course of action to others.
Put up or shut up also means that POCA shouldn’t have anything in its code of ethics that it can’t back up with concrete, sustainable actions. If we can’t make it happen in a market-driven environment, we shouldn’t be waxing poetic about it as an ideal. For example, I wish we were able to open up access, across the board, to people who can’t afford $15 a treatment. However, to the best of my knowledge, every clinic that has tried to drop the low end of its scale below $15 for any amount of time has found it unsustainable. So we are accessible as we can be.
2) POCA seeks to be a good steward of its social capital.
Part 2: There are no martyrs in this revolution, we can’t afford it.
If you’ve been around the acupuncture world for any length of time, you know how fast most organizations burn out volunteers. There are all sorts of reasons for this that have to do with all the things I like to complain about in the acu-world, but it boils down to one basic limitation. If you’re not paying people to do things — and we can’t pay anyone to do most of the things that we do — then those things need to be inherently rewarding. We build social capital when people work together on projects that they feel good about. We build social capital when people have a sense of accomplishment — even with difficult work — and when people have fun.
We waste our social capital when people work on things they don't really want to work on because they think we SHOULD work on them. We can't afford shoulds, we're not rich enough for them. We can't afford to burn people out on work that they don’t find fulfilling. So if nobody genuinely wants to do something (and we can't afford to pay somebody to do it as grunt work), then POCA just isn't going to do it. And we’re not going to apologize or feel bad about it, either. It’s kind of a miracle that we are all here in the first place, and it’s important to remember that.
The “no martyrs” principle points back to the put up or shut up directive. We can’t afford to be the kind of organization where people make demands on other people that they won’t fulfill themselves; we can’t afford to hurl shoulds at each other. A code of ethics is potentially a tempting place to do that.
3) POCA seeks to include the perspectives of all of its members.
In considering those perspectives, street cred matters.
One of the challenges of a multi-stakeholder co-op is being inclusive of members in different categories. It’s just hard, there’s no way to make it easy. So if we have a lot of different kinds of views coming in, how do we figure out the balance?
I’d like to suggest that we keep our eyes on the bottom line. Patients need a stable source of acupuncture; practitioners need a stable livelihood; clinics need to be successful; and the organizations that serve and support us need everyone else to be stable enough to be good customers. It all comes together in successful clinics. So in weighing input and advice, it’s worth asking, where is this coming from? Is this input or advice coming from someone who has personal experience in a successful clinic, who understands what success actually takes? Is this member a long-term, devoted, savvy CA patient? Is this member a sustainably-employed punk? Or is this input or advice coming from a more abstract perspective? In other words, if Peter Deadman decided to join POCA with the goal of getting us to embrace the model of accessible acupuncture he wants us to use, the one that doesn’t yet exist as far as we can tell, how would we weigh the value of his input to the co-op? Should we embrace his perspective because after all, he’s a member?
I don’t think Peter Deadman is going to want to join POCA. But we already have quite a few members who, like him, appreciate and validate certain aspects of our model and our organization, but struggle mightily with other aspects. I think it’s OK, in considering member input, to ask ourselves what evidence there is that any given piece of feedback is likely to result in POCA having more successful clinics.
A code of ethics, like everything else about POCA, is going to be dynamic and evolving. We can count on that. I know there are people out there who think POCA could do a better job with certain things — if so, this call for volunteers is your opportunity to step up. Maybe you have some great ideas about how to navigate the difficult intersection of the real and the ideal. Let us know!