So You Want To Be Employed as a Punk?
If you think you’d like to work in an established community acupuncture clinic as an employee punk, here are some points to consider. In full discloser I will say that I do not claim to be an expert, but rather, an employer with some experience hiring (have hired 5 different punks) and a former employee of an established community acupuncture clinic. I have also discussed the matter of employment with many others who have struggled to find a good hire and with several applicants who weren’t quite prepared for this work. I invite other clinic owners to chime in below on anything I may have missed, and with their own experiences in the hiring process, and for employees to share about their experience in getting a job as an employee punk.
First, I would like to begin with a brief quiz to help you assess your level of knowledge, interest and preparedness for this work:
1) Before applying for a job at an established community acupuncture practice, it’s a good idea to read which of the following?
a. Points for Profit
b. Acupuncture is Like Noodles
c. The Remedy
d. The POCA forums, in depth
e. Why Did You Put That Needle There?
f. Any of the above (preferably all of the above!), except A
2) You view community acupuncture as:
a. a great way to make acupuncture affordable and accessible for as many people as possible – people from all walks of life
b. a nice thing to do for poor people
c. a way to treat people who can’t afford regular private treatments
3) Do you have knowledge and training in treating conditions with distal points? For example, when a patient needs to be treated sitting in a recliner chair and has low back pain or hip pain – something that can’t be needled directly without removing clothing or lying on a table – would you know how to treat it and think up a point prescription within a minute or two?
b. no, but I’m currently studying practicing it
c. not at all
4) How long should it take to do an intake on a first visit?
a. 5-10 minutes
b. 15-25 minutes
c. 30 minutes
d. 60 minutes
5) How does the thought of giving 80-100 treatments within a week (within 20 booked appointment hours at a pace of 4-5 patients/hour) make you feel?
a. Overwhelmed and exhausted – I could never do it, nor would I want to do it
b. Cautiously optimistic – it sounds difficult, but I bet I could work up toward it
c. Enthusiastic – I want to treat the whole wide world!
6) How would you feel while needling a patient in a room filled with 6 other people napping with needles when someone else signals you that they want to leave and 2 follow-up patients walk into the room and each take a seat, waiting for you to get to them next?
a. focused on treating my patient and grounded – I will stay with the patient, then take out the needles of the person who is waiting to leave, then get to the next 2 patients in the order of their appointments
b. stressed out and flustered – I have to work faster
c. irritated that I’m being asked to handle so much at once
d. I’d just run out of the room and quit
7) A patient comes in for their first visit for low back pain and they’ve had acupuncture before with someone who did cupping, moxa, electro-acupuncture and magnets, all in one treatment – in a private room on a table, needled on their back. They act skeptical when your intake takes 5 minutes and you bring them to sit in a chair, and put all their needles in within 5 minutes. They ask if you will do pressballs, magnets, moxa, etc. What do you do?
a. Let them know, with confidence, that the needles will do the work –there are distal points away from the area of pain that are very effective
b. Tell them you’ll do cupping, moxa and magnets for $20 extra
c. Tell them you can see them in your private practice for a private treatment where you can give them all the bells and whistles for $90
8) You see a patient for the first time, and they book their next appointment with Joe (one of the other punks who works in your clinic). You are:
a. Crushed and angry – I’m really awesome at what I do, and that person would be dumb to see the other punk instead of me
b. Worried – did that patient think I was a bad needler? Or bad at communicating? Or not like me? Or think I smelled bad?
c. Pleased that the patient is booking an appointment when it is convenient for them so they can get the care that they need, when they need it
9) As an employee punk, I can probably expect to earn something in the ballpark of:
d. $100,000 a year
10) You see a job posting on the POCA website for a position being offered at a POCA clinic. You decide to:
a. read through every detail and give serious thought to whether or not you qualify for the desired position and think it might be a good fit for both you and for that clinic, then respond in the way the potential employer requested (i.e. send your resume via email)
b. skip right to the contact info and call up the potential employer
Here are the answers: 1 – f; 2 – a; 3 – a or b; 4 – a; 5- b or c; 6 – a; 7 – a; 8 – c; 9 – b; 10 – a.
Although that quiz was by no means comprehensive, I think it touches upon some of the fundamentals of employment. In particular, some of the basics you would want to seriously consider when thinking about potentially applying for this type of job are:
-Do I want to treat a LOT of people – could I work at a pace treating 6 people per hour, or give 75-100 treatments a week on a full-time basis? Most clinics ask that a new punk begin with at least 3 or 4 patients per hour, and then work their way up within some time frame (usually a couple of months) to 6 per hour.
-Do I believe I’d be doing enough by doing strictly acupuncture –simple treatments without adjunctive techniques? Would I be tempted to suggest or do I believe that patients aren’t going to get enough by being needled only, without even trying it?
-What do I believe to be my role in this work? Will patients be coming into the clinic to see ME, for MY work and MY skill? Is the magic in the way I insert and manipulate the needles, or are the needles, the patient’s body and the space to rest doing the work? What’s more important, my patients seeing me, even if it means they can’t come as frequently because of their schedule not quite matching mine, or patients making appointments with whoever is available based on what is convenient for them and will get them in with the frequency that is ideal?
-Do I want to work in an established clinic, or would I rather start my own clinic? Am I open to taking the directions and suggestions of a boss? Am I teachable and eager to learn? What can I bring to the table? Am I open-minded to doing things differently than I was taught in school? How might my role change the dynamic of that clinic, for better or worse?
What I think many potential hires may not realize is that being an employee at a community acupuncture clinic is a REALLY BIG DEAL. As an employee, you are a large part of a clinic’s potential continuation of success (both in terms of social and financial ways) or difficulties. It is one of the most critical decisions a clinic owner makes, and a substantial investment of time and energy for an employer to train the new punk and ensure a smooth transition into the clinic. Getting to know the procedures and protocols for how things are done in the clinic – not only how to treat people in a chair in a timely fashion and do intakes in a timely fashion, not only how to effectively communicate with patients about treatment plans and answering their (sometimes difficult to answer, sometimes weird) questions sufficiently and chart notes appropriately, but also how to do other tasks that may be necessary to keep the clinic running smoothly such as helping out at the desk, answering the phone and making appointments, or cleaning, restocking items, etc. all take time to get used to. Some of the tasks that need to be done are not fun (i.e. re-stocking the cotton balls and needles at the end of your shift or charting treatments for every patient). But as with all jobs, these things must be done. This is being part of a team with your employer and other co-workers and everyone has to pitch in. Not every part of every job is glamorous or desirable and it takes a lot of work to keep every aspect of the clinic in order.
In particular, an employer will want to get a sense that the person they are about to hire exudes a healthy balance of confidence and humility- that the new punk will seem knowledgeable, compassionate and on the ball with patients, open to taking suggestions and unafraid of asking questions that will help them to learn better skills and improve. An employer wants to see that the person applying for the job really cares about this specific type of work, is really interested and enthusiastic about the nature and purpose of community acupuncture and treating lots of people, and that this person is someone who will be welcoming to every kind of person who walks through the door. The applicant’s heart should really be into doing THIS work, and willing to work hard and participate in helping out with some of the run of the clinic tasks, too.
It occurred to me recently that perhaps the people who are interested in working in established clinics don’t really know what it’s like to own a clinic or any kind of small business, what it’s like to employ someone and/or haven’t worked for any sort of business except for a large one. I was the same way when I was first employed at a clinic. Your boss is going to care about you SO much. You are going to mean a LOT to this person who hires you – in so many ways. When a punk opens a clinic it takes a HUGE amount of time, effort, sweat, heart, soul, motivation, discipline and, of course, a significant chunk of money and waiting for the money to return on the initial investment. Initially the clinic runs with a punk working solo or perhaps a partnership, and this initial arrangement takes time to get used to – it takes time to get used to treating lots of people, getting into a rhythm and routine with work day in and out, working on the various projects required to keep the clinic humming along smoothly. Eventually it becomes really busy and the time is ripe to hire someone. It’s an exciting time, but also a challenging one for the owner. The punk owner is trying to keep afloat while things are super busy, better than ever, but possibly a tad stressful, and so finding the time and making the effort to speak with potential hires and then hopefully select and train one is challenging. It is also challenging to “let go” and let that new person jump in and to trust that they’ll be “doing things right,” at least right in the sense of what is the standard of care within the community acupuncture clinic. Of course, what is right may be subjective, but still, there are certain parts of the job that are truly necessary and non-negotiable (i.e. treating patients with respect and courtesy, being honest and trustworthy, showing up on time, not making exceptions for treating certain patients more specially or lesser than others, taking an appropriate amount of time for an intake and treatment, setting boundaries and limits). Certain tasks may need a little practice at first, but it is understood that there is a learning curve and a goal in getting them to happen within a specified period of time. It is also hard to sometimes persuade the patients to give a new hire a try. Some patients will be perfectly happy to swap around and just come in whenever it’s convenient for them (which is awesome, because when a punk is hired it usually is to open more hours and make it more convenient for patients) but some patients will be very reluctant to try someone new. The employer may hear feedback from some of the patients about the new punk, good or bad – the person seemed confident, or not; the person had a gentle touch and warm demeanor, or not; and that will set the stage for whether or not they see that punk again or not. Communicating treatments plans is also a challenge – many new hires come in with little experience giving an appropriate treatment plan and this takes some getting used to – many of us who opened clinics even stumbled along with this at first – remembering to suggest one, especially one that is appropriate, each time a person is in for a first visit or when re-evaluating a course of treatment. If communication about a treatment plan isn’t given or isn’t clear, patients won’t know what to do and when to return and the schedule will start to thin out. There is a lot for a new punk to learn and a lot for a punk owner to trust the employee to do well.
Beyond the challenges of the technical acupuncture and care issues, there is also a new person in the office, which can take some getting used to for the clinic owner, and for the new punk it can take time to get to know the new space and settle into a routine. For the punk owner it is almost like having a roommate move in when you’ve been living on your own for awhile. You’ve been used to having everything done the way you set it, and then this person comes in to help out and suddenly things aren’t located exactly where you left them, or you find opened needle packets on the side table in the treatment room which is something you ordinarily never do; or you notice cotton balls mixed into the biohazard container; or all the pens are gone from your desk. Stupid little things. But it is an adjustment. Never mind the fact that the MOST important part is making sure your patients are given top quality care from someone who cares – so any of these things that are problematic need to be discussed and resolved a.s.a.p. so that both parties can get on with the more important things. However, should this carelessness occur repeatedly after warnings are given, it is possible the hire may not be able to continue – especially when it involves things like safety factors (stray needles on floors and chairs, again and again) or straying from clinic fundamentals (taking too long with patients).
Now, I’d like to address the actual hiring process and what most employers are looking for from potential employees. Just to give you a bit of my own history, I have had the opportunity to hire 5 different punks, 2 of which are currently working with me, one for over a year and the other for 9 months (they’re both awesome- the patients love them, they are hard working and dedicated and love the medicine – and it makes us work together like a team and the whole clinic feels more stable – it is quite fantastic, and they know how much I care about them – and this can happen when a good employer-employee-clinic-patient dynamic happens). Each time I have posted on CAN/POCA advertising a position and emailing a few local community acupuncturists asking them to pass the information onto anyone they think would be interested I have been incredibly lucky to have found someone to take the position within DAYS (Less than a week! I think this is due a lot, in part, to the location of my clinic being quite close to an acupuncture school and many acupuncturists in the area. Most other clinic owners have not been this lucky.). There were multiple people asking for the job in each case. The approach from the various applicants is worth discussing.
First, in my want ad I asked people to send me a resume and to email me regarding their interest in the position. Interestingly, a few people just skipped right over those requests and called me directly, and failed to send me a resume at all (I will also say that there were times when I wasn’t hiring at all and people inquired by calling me out of the blue, and I know other punk owners who have actually had acupuncturists walk in and ask if there was a job available – these approaches are debatable. When a punk is at work with patients there is a good likelihood that having a serious conversation about hiring is not the right time, and is rather distracting – which is why walking in or randomly calling probably isn’t the best approach). Even if I knew a potential hire (someone asking for a job who I’ve met before) I would still like to see their resume and know their history a bit before chatting with them, so that I can ask questions that may be relevant and learn things about them I might never find out if we skip right to talking. I personally wouldn’t close the door on someone just because of this response being different than the one I requested, but it wasn’t exactly following instructions, which, as an employer, I hope a potential employee would be willing and able to do. It also helps me identify right away if someone probably wouldn’t be a good candidate. Why waste either person’s time if it is quite clear it isn’t a good fit?
Once I’ve reviewed a potential employee’s resume I respond to them by calling them on the phone when I have time and am not distracted (not in the middle of a shift of inbound patients). Getting to know a potential hire’s viewpoints on why they want the job is always quite interesting and telling. If the potential hire’s interest level is really, clearly, about their own needs, front and center, with little regard for what they have to offer or what the clinic’s needs may be, the answer will be “no.” I need to hear that the person is interested in practicing community acupuncture specifically, for the sake of treating a lot of people, helping a lot of people, feeling useful, doing this particular kind of work. I need to know that the person knows something concrete, real and truthful about community acupuncture, and the more the better – not that they just heard from a classmate that they would get to treat a bunch of people in recliners for a low price. I want someone who has done some homework, some scoping out what this work is about, and why they feel it matters. Just wanting a job is not a good enough reason to be hired. Just wanting to make ends meet practicing acupuncture is not a good enough reason, nor is just wanting to try out this type of work to see if it would be something they like.
Being a job applicant with a chance of getting the job first and foremost depends upon meeting the criteria specified in the job description. First, treating people in recliners. If you haven’t had any experience at all and have no training at all, then it is unlikely an employer can take you on. If you have been dabbling with learning and are ready to do some serious studying and get your hands dirty and work on it, hard, then you may be considered. The dream applicant has experience, but it’s not something that every employer expects or every employee who landed a job had when they applied. Usually an employer will be willing to work with the potential hire on getting up to speed, but there has to be a sense that this person is going to work hard and take this seriously and do their part to learn as much as possible as soon as possible. The same goes for every other task laid out in the job description that is required.
There is a period of time for training and orientation and in my clinic this usually takes a couple of weeks first of the punk shadowing me around and then a couple weeks where they are on their new shifts while I am in the clinic out of view and there only to back them up if they have a question. During the orientation part I give them handouts with clear-cut instructions and information on what to do in certain scenarios and how specific things are done in the clinic. I expect them to ask questions if they have any, to take notes to make anything more clear, and to review and become familiar with it so they are relatively knowledgeable about how to do each of those things within a few weeks. After a couple of weeks of successfully poking patients and keeping things running smoothly with not much interference from me, we’re hopefully both confident enough and I leave the clinic and they’re on their own, and I’m just a phone call away. This is perhaps a different approach than some other clinic owners take, but leaving the new hire to work has to happen sooner rather than later because otherwise the employer is really just working lots of overtime (most likely) and the new hire needs some freedom and to be trusted to keep things going smoothly. It’s good for both parties to have this arrangement. What is worth knowing is that even though this training period and overtime is only for a few weeks, it is really only in getting the basics down (the punk isn’t completely up to speed yet, most likely, and things still need smoothing out) so more effort is to be made and the employer hopes this effort will have been worth it and that punk will work out and stick around for awhile. Taking a chance on someone who may decide within a few weeks or months that they aren’t into it and want to leave is a huge disappointment and can leave the patients feeling that there is a sense of instability within the clinic, too. Of course there are situations where life things happen and it may be out of one’s control in keeping up the commitment, but it is hoped that the job applicant is looking for work they will continue with for some time. Therefore as a new hire you want to be sure that this is something you really want to do and feel like you can commit to, and that you think the potential employer is someone you will feel good about working with. You want to be honest with yourself and potential employer about your interest and availability for this position and willing to work hard and be committed.
Whew. I think that may be it, but there certainly may be other points I missed. Hopefully any of you who are thinking about taking on this type of work will have felt this was useful, and those of you who may hire some day now have a better idea of what this process is like.