POCA’s Got a New Book!

Well, a new and improved version of an old book. As a lot of you know, rewriting The Remedy has been on my to-do list for at least a year; that book came out in October 2006, just in time for the very first community acupuncture workshop at WCA. An awful lot has happened since then, and whenever I had cause to think about The Remedy recently I would just cringe. The biggest problem with it, of course, is that there was nothing in it whatsoever about POCA.

So I am relieved and happy and grateful to announce that this issue is finally fixed. A great many volunteer hours went into editing, formatting, designing, and preparing our new version for release. Thanks to Gloria Jacobs, Annie Tessar, Sean Nolan, and Wade Phillips, we have an e-book that you can read RIGHT NOW; and we will have a print version very soon. The first print copies will be available for purchase at POCAfest — hot off the presses, just like the original Remedy at the first workshop back in 2006! After that, we'll be offering the print version in the POCA store — including a discount for wholesale copies in bulk.

This is the first book published by POCA itself, and all proceeds go directly to POCA. It's called Fractal: About Community Acupuncture, and you can read it on your computer, your phone, your IPad, your tablet, your Kindle or almost any other device with the free Kindle app. (Because I'm a good citizen of Portland and I love Powell's Books, my next job is to get this book available on the Kobo — I'm going to start working on that next week, I promise.) Now you can buy it on Kobo,or buy it here. For $2.99!

And here below, to give you an idea of what the new book is about, is an excerpt: the prologue and the introduction.

Prologue: The Spoiler

How do you know if you want to read this book? You might never have heard of community acupuncture, and you’re wondering if it’s worth your time to find out more about it. You should be able to figure that out by reading this prologue, which sums up the story by starting at the end. Community acupuncture is a Thing now, a significant Thing to a lot of people, because it helps them. But it wasn’t always a Thing. This is the story of how community acupuncture got to the point of being a Thing that needed to have books written about it (and documentaries made, and newspaper articles published, but that all comes later).

Acupuncture is a Thing that works. Nobody really knows why; it is very, very old. Mainstream culture in the US doesn’t quite know what to do with acupuncture. Nonetheless, it is a Thing that works. It works for a very long list of problems: allergies, asthma, anxiety, all kinds of pain, depression, poor digestion, chronic health conditions, and stress. It doesn’t always fix these problems entirely, but more often than not, it helps. Sometimes it helps spectacularly – so much so, that it is usually worth trying.

Unfortunately, a lot of people can’t try it, because it’s become too expensive.

Once upon a time – for much of its history – acupuncture was a very cheap therapy, used by poor people. It was practiced in a group setting, so if you got acupuncture, you probably got it in a room with other people who were getting acupuncture at the same time. This changed when acupuncture began to be practiced widely in the West. It became an expensive therapy, marketed to people with a lot of disposable income. Also, acupuncture practice became individual: if you got acupuncture, you probably got it alone in a little cubicle.

At the same time, it became very hard for acupuncturists to make a living. If you tried very hard to treat mostly rich people, you might be successful. By far the best way to practice acupuncture, though, was to have another source of income (like a spouse with a good job) so that you didn’t have to worry about making money.

I went to acupuncture school when I was very young and I didn’t know what I was getting into. The family I come from is not rich; they’re a mix of working-class/working poor/just barely lower middle-class. I fell in love with another acupuncturist. Neither of us wanted to get a good, non-acupuncture job; both of us wanted to be acupuncturists. I also wanted to be able to treat people like my family. I was in big trouble.

The solution I came up with was to redesign the business model and to go back to what acupuncture looked like when it was a therapy for poor people. My partner and I opened a clinic in a working-class neighborhood where we treated people all together in a big room instead of individually in little cubicles, and we called it “Community Acupuncture.” It worked. We made a living. Our neighbors got a lot of acupuncture.

That was over a decade ago. Now community acupuncture is a Thing. There are hundreds of clinics that do acupuncture this way and hundreds of thousands of people getting acupuncture who previously couldn’t afford it. Community acupuncture seems like a good Thing, a Thing that should grow and be available to millions of people because, after all, it is a Thing that works. Health care is an expensive, dysfunctional mess. Community acupuncture is cheap, simple, and effective.

Those of us who care about community acupuncture have been trying to make it available to as many people as possible. This is hard because acupuncture is not a Thing our culture understands. This is not just because acupuncture comes from Asia and involves theories about Yin and Yang. It’s because acupuncture is quiet and uncomplicated and not designed to make a profit.

This book tells the story of how community acupuncture became a Thing, and what kind of Thing it is, but most importantly, explains how we think more people could get it. Because that is the most important thing.

Community acupuncture, as a Thing and as a story, is like a repeating pattern. Another word for a repeating pattern is fractal. The same elements keep showing up. We want you to be able to see the whole pattern – and even if you are not all that interested in acupuncture, the pattern suggests some notable things about business, human nature, and our society in general.

When we first opened our clinic, lots of people told us, “This won’t work.” Patients won’t want to get acupuncture in a group, because they want to have their acupuncturist and their healing space all to themselves. They don’t care if somebody else can afford to get acupuncture; they only care about themselves. This will never be a real Thing, it will only be one tiny little clinic that is run in a funny way.

It turned out that some patients think like this, but a whole lot don’t. Many patients don’t mind sharing their acupuncturist and their healing space. Many patients do genuinely care about whether or not other people can afford to get acupuncture.

When we first tried to get other acupuncturists to think about using our model, lots of people told us, “This won’t work.” Acupuncturists don’t care if people can afford to get acupuncture; they only care about how much money they can make. They want to have acupuncture all to themselves. Community acupuncture will never be a Thing.

It turned out that some acupuncturists are like this, but a whole lot aren’t. Many acupuncturists do care about whether people can afford to get acupuncture. Many acupuncturists find tremendous joy in helping as many people as possible.

When we created the Community Acupuncture Network, an organization for community acupuncturists, lots of people told us, “This won’t work.” Community acupuncture may be a Thing for a few acupuncturists, but it will never be more than a handful. Acupuncturists are competitive and secretive. They won’t help each other; they won’t share information; they don’t care if other acupuncturists can make a living. They want to keep what they know all to themselves. Acupuncture organizations fail because acupuncturists can’t work together.

It turned out that some acupuncture organizations are like this, but the Community Acupuncture Network was not. Many acupuncturists did help each other. They did share information. And, with each other’s support, a hundred or so community acupuncture clinics got off the ground.

When we realized that we needed to include patients in a more formal way, we created a cooperative called the People’s Organization of Community Acupuncture. A lot of people told us, “This won’t work.” Nobody’s going to join a cooperative. They don’t care about the future of acupuncture; they don’t want to think about how the economics of acupuncture can be sustainable. They’re not going to give their time, their attention, and their energy to a coop; they want to keep their time, attention and energy all to themselves. All that people care about is whether it is a Thing that is available to them when they feel like using it. They don’t care if anybody else can have it in the future.

You see the pattern.

We did a lot of work to make community acupuncture into a Thing. It was fun work, because it was creative and hopeful. Health care in this country has been constructed to appeal to the worst impulses in people: fear, greed, and the desire to evade responsibility for ourselves and each other.  Everybody knows it’s broken. It’s discouraging to try to fix it. But community acupuncture is the opposite of fear and greed; community acupuncture is all about the willingness to take responsibility for ourselves and each other. At every step of the way, working on it has made us feel whole, more connected to ourselves and to each other.

Community acupuncture is a Thing now because a lot of people were able to see past what’s in it for me? A lot of people wanted to share instead of keeping it all to themselves. At each stage of the pattern, we had to push past resistance. Why are you dropping your prices? You’ll never get anywhere that way. Why don’t you just focus on your own clinic? You can’t make any money off other community acupuncture clinics, so why put energy into helping them? You’ll never get anywhere that way. Why put all this energy into trying to make a cooperative, into trying to make infrastructure for community acupuncture? You’ll never get anywhere that way. Our culture has a very hard time thinking about things collectively instead of individually.

Community acupuncture is a Thing because a lot of us are stubborn and refused to listen. We decided that it made more sense to think about acupuncture collectively, not just individually. And it turned out that we did get somewhere: we got to a much better place collectively AND individually. We got to the point that hundreds of thousands of people could get as much acupuncture as they wanted. We got to the point that a lot of acupuncturists could make a living. We made clinics and we made jobs. We’re going to make an acupuncture school.

This is where you come in.

If community acupuncture is a good thing for you, if it is a benefit to you as an individual, whether you're a patient or an acupuncturist, that’s because a whole lot of other people didn’t just think about what’s in it for them. So now we are asking you to think about more than just what’s in it for me? Yes, you can use community acupuncture however you want; you don't have to care about it as a Thing if you don't want to. But please remember that the only reason it's here for you is that is a lot of other people DID care.

So what can you do? Take the time to read this book so that you can see the whole pattern. When you get acupuncture, think about all the other people who need it. Get connected to the rest of us and join the People’s Organization of Community Acupuncture. You can help us make this Thing more of a Thing, for a lot more people.


In 2006, I wrote and self-published a book titled The Remedy, Integrating Acupuncture into American Health Care. I had an idea that I was really passionate about and I thought I’d toss it out into the world to see what would happen. In the past seven years, I’ve learned a lot about what happens when an idea that had mostly only lived in my head (and a few other people’s heads) starts to take shape out in the world where everyone can see it.

It’s fascinating watching an idea become reality. It takes on substance a little at a time; it fills out and gathers dimension. It solidifies and accumulates detail, edges, aspects. It sprouts tendrils in unexpected places. In the case of this particular idea, it turned out that when it became reality, it took the shape of a fractal.

What’s a fractal? If you’ve ever eaten broccoli or cauliflower you’ve encountered a fractal (and ingested it, to boot).

A fractal is a complex, repeating pattern, in which every part is a miniature copy of the whole. Fractals are everywhere in nature: broccoli is one of the most familiar. (Romanesco broccoli is one of the most spectacular.) When you cut up a head of broccoli, you can see that the individual florets are the same shape as the stalk; it’s the same pattern repeated at different scales. Snowflakes work the same way, as do leaves, blood vessels, lightning, ferns, peacock feathers, rivers, and mountain ranges. The initial pattern appears to be random but becomes remarkably consistent as it repeats itself at different scales.

What does affordable acupuncture have to do with rivers, mountain ranges, ferns and broccoli? And why should you care? This book is going to try to answer those questions.

In The Remedy I first wrote about community acupuncture.  Since then it has turned out to be a kind of living organism and a fractal, though I would never have realized it if Cris Monteiro, my friend and fellow community acupuncturist, hadn’t pointed it out.

In 2006 there were a handful of community acupuncturists, treating about a thousand patients. Now there are hundreds of community acupuncturists, treating hundreds of thousands of patients. If you read the original Remedy, you can see the basic pattern, or a sketchy outline of it, but there’s no indication of how the pattern would repeat itself over and over until it became a flourishing three-dimensional fractal — or what that might mean for acupuncturists, patients and health care.

One of the ironies of the original Remedy was that I wrote about community acupuncture from an individual perspective. The community acupuncture model came into being in part because I had some very specific needs, based on my history and my circumstances, and that was what most of the original Remedy was about.  It turned out that the model met other people's needs even when their history and circumstances were different; it opened up access to acupuncture for all kinds of different people.  In the years that followed, we discovered that community acupuncture doesn't work very well when you approach it from a narrowly individual vantage point. If you focus on one broccoli floret in isolation, you can’t see the fractal.  It came into being because of the needs of an individual, but its growth wasn't about any one individual at all.

So we're putting the original Remedy out of print, and this is the replacement. This book is for anyone who is interested in the community acupuncture movement – patients, potential patients, acupuncturists, people who design organizations, or curious onlookers. This book does not have a lot of technical information about acupuncture; if you are an acupuncturist looking for that and how it relates to community acupuncture, there are two books that might help:   Acupuncture Is Like Noodles (2009) and Tungsten, or Acupuncture in Large Quantities (2013 pending). More good information can be found in the online forums of the POCA Cooperative.

This book is about the community acupuncture movement itself and its fractal growth.  After seven years, the original Remedy was desperately outdated, in part because it was just a proposal for something that is now actually happening. This book updates the original Remedy and incorporates elements of other things I’ve written over the last seven years (blog posts, conference speeches, and articles) to give a better sense of the big picture.

As community acupuncturists say at the end of a treatment when we’re taking the needles out and our patients are getting ready to go back out into the world: I hope it helps.

Author: lisafer

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The theme for this conference is “Breaking Barriers”. You know, there are so many barriers to break in acupuncture that it was really hard to choose which ones to talk about for this speech. But since I’ve spent so much time talking about classism as a barrier, I thought it might be fun to shift gears a little and talk about numbers.


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  1. Lisa, reading this on a Saturday morning with a cup of coffee, what a wonderful way to start a day. I may not be sitting in the clinic right now, but that is where my heart is. I love my job. Can’t wait to read the rest. Thank you!

  2. I remember reading the Remedy in one sitting, refusing to go to sleep. I got on line to sign up for your seminar, wondering if you were going to have enough interest to even have it. Well, it was sold out already and I had to wait for the next one. Can’t wait to read the new one. The first one changed my life.

  3. I had a similar experience of reading the Remedy on the weekend of the the very first Working Class Acupuncture conference in 2006 in Portland. I think I did not sleep a wink that whole weekend and cried a whole bunch. I could feel my whole life turning in a huge way and I wanted to be awake for every moment of it. Thanks so much, can’t wait to read the rest of this new version.

  4. Lisa, one of my favourite things about your writing is how you continually re-explain and re-frame stuff that I think about all the time in ways that make me go “Yes! What?? Of course!” Your writing makes me love my job even more.

  5. One of the many Things I like about community acupuncture is that it is DIY – Do It Yourself – in a field that was not Doing It for hardly anyone. CA re-invented acupuncture which is having a huge ripple effect. I am old school and will wait to buy the hardcover!

  6. This paragraph towards the end nearly made me cry because it sums up exactly why I love what I do and why I love working in a community acupuncture clinic.

    “…giving people the option of trying something positive, giving them back a choice, is itself empowering. And we also believe that equalizing access is beneficial not only to lower-class people and people facing chronic health problems, but to everyone. A society where access to positive choices is more equal is one that values fairness: a healthier society.”

    There are many pieces of Chinese medicine that I find edifying, but all pale in comparison to this piece.

  7. When I attended my first CAN training 4 years ago, you asked us to introduce ourselves to you and to the group, and when it came my turn, I said, “My name is Brent, and you screwed up my life!” Of course, my tongue was lodged squarely in my cheek as I said it, but I had just read The Remedy and that was what did it. I too read it in one sitting, and from there, going back was no longer an option. You and Skip then proceeded to “screw up” my life even more, a habit you have both continued in the time since. That’s something for which I thank the powers every day. CA truly has become a THING, and it’s a thing I couldn’t be more grateful for. Congratulations on another groundbreaking step.

  8. I have recently inherited my husband’s under-used Kindle fire (after leaving my Kindle on the plane coming back from the BDC workshop!) and this is the first thing I’m putting on it! So excited to read it 🙂

  9. Congratulations on the publication! It is interesting to think about the fractal metaphor, as acupuncture like both noodles and broccoli. Also thinking about Things as gatherings or matters-of-concern.