Understanding CAN’s Anger, Redux

Thanks to Keith for pointing out that there was a recent comment on this post:


I have just come upon this article so I apologize for my late entry. I
don’t get out much and so obviously I’m missing some important
conversations. I must admit my first reaction to your posting was shock
and sadness. To some degree this may be a result of growing up in the
sixties and my own observations of the outcomes of anger that seemed
more important to vent rather than concern with results. I want to
respond as one of the people you are unhappy with and adjust some of
the generalizations in your remarks. I am a president of one of the
colleges and my salary as president in the last 15 years has never
topped $40,000, in fact it is presently under $30,000. More than 90% of
our graduates are in practice. All incoming students receive counseling
on their potential debt, so they choose to come into the profession
knowing that as well as having a sense of the struggle they will face
when they graduate in this health care field. I have for decades
supported various forms of group acupuncture settings to care for those
with less resources and all of our students participate in such
settings as part of their training in order for them to directly see
its importance. Many of our graduates have gone on to work in
underserved areas in this country and abroad. I have had my differences
with the CCAOM, NCCAOM and ACAOM and they are well-documented, but I
also know most of the leaders of the CCAOM and ACAOM personally and
know that with all their faults, most are struggling mightily within
the constraints of regulations, higher education requirements, the
USDE, etc. to balance keeping their schools alive and functional. I
also know from being part of the history of the development of this
profession since 1980 that there were many forces that had to be dealt
with to get any sort of licensure for acupuncture, financial aid, etc.
and those forces were and are beyond the control of any one school or
organization. I certainly applaud your energy to reach underserved
people, I certainly applaud your warning to potential students to
seriously consider the costs of the profession they are getting into
and to choose wisely, I certainly agree there a problems in acupuncture
education, patient care models, etc.. But I do not see how the feeling
in your posts and the responses I have read furthers your ultimate
goal. If you took this feeling into the treatment room, you would not
be able to have very effective patient care. You know the feeling you
bring to inserting needles and treating patients, why can’t that same
healing force be brought to this conversation? It indicates that
potentially your anger is overriding your compassion and that if you
ultimately want more energy for the patients you care about, a path to
consider is bringing that sense of care to your words when talking to
your colleagues. I would be happy to meet you or any others eye to eye
and face to face and explore the depths of what healing is about, for
our patients and for our profession. I watched similar energies split
our profession apart years ago when the AAAOM and Alliance created
their divisionary philosophies. From my point of view, thankfully, that
era appears to be over in that we can generally express our differences
under one roof. I will probably not keep up with this blog regularly,
only because my plate is full with my program, patients and teaching –
but certainly contact me directly if you have any interest in
continuing this discussion.
Paul Karsten
Andrew (not verified) also had a good response. Here’s mine:
Dear Paul,

thank you for responding on the blog. So far, you are the only person connected with an acupuncture school who has responded, so I appreciate that. I would, indeed, like to continue the discussion — on the CAN blog, so that other people can be part of it. Community acupuncturists are spread all over the country — and the world — and so a face-to-face meeting in Seattle would leave a lot of people, who are very invested and who feel as strongly as I do, out of the loop.

You wrote: I must admit my first reaction to your posting was shock and sadness. To some degree this may be a result of growing up in the sixties and my own observations of the outcomes of anger that seemed more important to vent rather than concern with results.

I have a bunch of things to say about the sixties, and about anger, but since you brought both those themes up again at the end of your post, I’ll put my responses all in one place.

You wrote: I am a president of one of the colleges and my salary as president in the last 15 years has never topped $40,000, in fact it is presently under $30,000.

The amount of your salary doesn’t change the equation: your income = acupuncture students’ debt.

You wrote: More than 90% of our graduates are in practice.

What does “in practice” mean? I know an awful lot of acupuncturists who are “in practice”, seeing a handful of people a week, working other jobs to support themselves and to pay off their student loans — many of them would be thrilled to be earning $30,000 a year doing anything related to acupuncture. Do you have data on how many of your graduates support themselves by doing acupuncture? Do you have data on what they are earning?

You wrote: All incoming students receive counseling on their potential debt, so they choose to come into the profession knowing that as well as having a sense of the struggle they will face when they graduate in this health care field.

Again, what does “counseling” mean? Does it mean, “you were warned, if you fail in practice, don’t blame us?” Does it involve telling them what a wonderful career acupuncture is, and how insurance reimbursement is just around the corner?

You wrote: I have for decades supported various forms of group acupuncture settings to care for those with less resources and all of our students participate in such settings as part of their training in order for them to directly see its importance.

That’s great, but do you understand the difference between what you are describing and what CAN is about? It doesn’t sound like it. “Less resources” than what? Than the tiny percentage of people who have insurance that covers acupuncture? Than the equally tiny percentage of people who can afford to pay for acupuncture at market rates regularly, out of pocket? This sounds to me like the prevailing assumption in the acupuncture world that if you can’t afford to pay market rates for acupuncture, you must be indigent, suffering from mental health problems, substance abuse, etc. Which is ridiculous. The problem is not that potential patients have “less resources”, it’s that acupuncture is much too expensive.

You wrote: Many of our graduates have gone on to work in underserved areas in this country and abroad.

When almost nobody in America can afford enough acupuncture to have any real clinical effect, how do you define “underserved”?

You wrote: I have had my differences with the CCAOM, NCCAOM and ACAOM and they are well-documented, but I also know most of the leaders of the CCAOM and ACAOM personally and know that with all their faults, most are struggling mightily within the constraints of regulations, higher education requirements, the USDE, etc. to balance keeping their schools alive and functional.

The CCAOM, the NCCAOM, and the ACAOM are the ones who created the regulations. I hear this excuse a lot: nobody is responsible for this bureaucracy, it just has a life of its own, we’re all victims! I’m not buying it. If you participate in a system — not to mention perpetuate it– you’re responsible for it. The CCAOM got behind the first professional doctorate of its own free will, paving the way for even more regulations and requirements.

You wrote: I also know from being part of the history of the development of this profession since 1980 that there were many forces that had to be dealt with to get any sort of licensure for acupuncture, financial aid, etc. and those forces were and are beyond the control of any one school or organization.

Don’t you see that the problem starts with how you define “this profession”? If “this profession” were not trying to join the ranks of other upper middle class professions, a lot of these forces would not have come into play in the first place. And if you’re thinking, there’s no alternative except to define acupuncture in upper middle class terms, you might want to look a little more closely at what we’re doing. And what NADA has done for decades.

You wrote:  I certainly applaud your energy to reach underserved people,

See below, sixties, anger, etc.

I certainly applaud your warning to potential students to seriously consider the costs of the profession they are getting into and to choose wisely, I certainly agree there a problems in acupuncture education, patient care models, etc..

You are trivializing our concerns.

But I do not see how the feeling in your posts and the responses I have read furthers your ultimate goal.

Forgive me for being blunt — but are you white, male, and a Baby Boomer? With a middle class perspective (if not a middle class salary)? Because if you are, that would definitely explain why you don’t see it. If you are none of those things, I apologize. But oddly enough, I have gotten virtually identical advice from a number of white male Baby Boomer acupuncturists with middle class perspectives, so you can see why I might wonder.

I have listened to a lot of acupuncturists who fit that description wax nostalgic about the sixties, bemoan the lost idealism of their generation, tell me they understand exactly where I’m coming from, explain that they used to have a vision just like mine (or they still do — they treat poor people once every other week for an hour or something!), and then instruct me about how I really need to be kinder, more compassionate, less confrontational, and more accommodating. To them, of course.  If I weren’t so tall, they’d probably pat me on the head. (Even without the pat on the head, though, you managed to insert a nifty bit of condescension, what with telling me not to take my anger into the treatment room. Nice touch.)

It sounds like you think we share a culture, and have the same reference points. We don’t.

I was born in 1968, but I’m not a child of the sixties in the way that white male Baby Boomers seem to think. My parents were too poor to be hippies or even liberals; they missed most of the political and social upheaval because, like lots of other working class people, they were too busy just surviving. No mind-expanding experiences, no free love, no idealism for them; no dropping out of college, because they weren’t there to begin with.  The primary way the sixties affected us:  my family provided cannon fodder for the Vietnam War. Not so conducive to nostalgia.

But even so, when you write about growing up in the sixties and my own observations of the outcomes of anger that seemed more important to vent rather than concern with results, I think, wait, what? That’s making a lot of people and their work disappear, a lot of justifiably angry, ultimately very effective people with a tremendous amount of hard-won results. There were hugely beneficial legislative and political outcomes from the anger of African Americans, immigrants, gay people, women, and labor leaders in the sixties.  Are you saying you would prefer a world without the gains of the civil rights movement? Whose sixties exactly are you talking about?

And, this is really important, the community acupuncture movement is not the child of the white, middle class, liberal sixties, anymore than I am. If you think these are “similar energies” to the conflict between the AAAOM and the Alliance, you have no idea what we’re up to. We’re not idealists. We’re not liberals trying to do good in “underserved” communities; we are fighting for access to something we need in our OWN communities. You and your liberal contemporaries set up the acupuncture profession in such a way as to make that very difficult for us — not to mention that you keep doing it.  For us, and for other people: how about, if we’re going to talk about professional compassion, you tell me why L.Acs have undermined the NADA acudetox technicians for decades?

I don’t have any hopes of convincing you. I’m writing this mostly in an effort to clarify some things for the movement itself, and I guess in hopes of avoiding any further advice about what to feel and how to be from the people who created the problems that my friends and I are now trying to solve.



Any of the rest of you have anything to add?
Author: lisafer

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  1. Underwhelmed

    “Underserved” also sticks in my craw.  Euphemisms generally do.  I also wonder about the “overserved” and the whole yin & yang of that situation…health care crisis, anyone?

    I’m still searching for the etiology, but in the meantime here’s something; I particularly like ‘But “underserved” has come to be a standard placeholder for unspeakable (and thus unexamined) realities…’

  2. Yuck

    This guy is totally full of it. How could he care about the students that he is “educating” when he knows damn well that they are not making a living as acupuncturists?

    Where is his compassion for all of his students in debt and the potential patients that they could have helped?

    He danced around all of the important points and you called him on it. 


  3. Given this notion:

    “I would be happy to meet you…and explore the depths of what healing is about, for our patients and for our profession.”

    It seems fitting that Mr. Karsten join CAN.

    In this way, he would certainly be in like-minded company should he continue to participate in the many conversations on these very topics underway within this site.

  4. Healing force……hmmmm

    “If you took this feeling into the treatment room, you would not be able to have very effective patient care. You know the feeling you bring to inserting needles and treating patients, why can’t that same healing force be brought to this conversation?”  I wonder if Mr. Karsten could open his eyes alittle bit if he could talk to any one of the 400+ patients who regularly come to WCA each week to experience the “healing force”?  This is also the same “healing force” that inspired LAC’s across the country to think in a new creative and exciting ways about how they could deliver acupuncture to the masses.  Conversation is good, but action that delivers life changing results to so many people each week speaks louder.  -Joseph 

  5. So lately I’ve been

    So lately I’ve been contemplating more about our “profession’s” numbers due to the health care crisis /(debate? wtf?) in our country.   The 2006 census bureau estimates place the number of physicians (allopathic, not incl. osteopaths) in the U.S. at some where around 800,000.  Yup,  for a population of roughly 300 million, this is about 1 doctor for every 375 people, or as the CB puts it, 267 doctors for every 100,000 people.  

    How many acupuncturists are there nationwide?  Roughly 20,000 – 25,000 , let’s just say 25K as a nice round number.  So right now that’s 1 acupuncturist for every 12,000 people, or about 8.33 acupuncturists for every 100,000 people.  mind-boggling?  yes.  and how is it with these kinds of possible numbers that there is such a high attrition rate in the first 5 years after school? why aren’t more acupuncturists making it?

    So let’s say the acu-educational status quo/ profession growth rate stays the same ( as it has been over the last decade or more ) , “we” basically grow at a maximum current rate of around 2500 LAcs per year.  In ten years, this makes our profession numbers grow to 50,000, but that’s without any attrition.  So ten years from there are 40,000 acupuncturists for 350-400 million people.  not much different.

    So what’s my point?  Well, some would argue that the AMA via western medical schools have kept the numbers of practicing doctors in the U.S. down, by limiting numbers of graduates thru different means.

    So maybe there’s a parallel here with acu-education and maybe not. Even with or without any alien conspiracy on the part of the acu-educational institutions, the overall picture for acupuncture in our country remains static, and 8.33 LAcs. per 100,000 isn’t going to do shit in the short term or the long term for making this medicine mainstream.  I don’t care how many acupuncturists go on Oprah, or how many acupuncturists get hired in hospitals (haha, right) or how many CAN punks see 100+/week, it’s still a drop in the bucket.

    Recently I took some heat because someone I went to school with heard from someone who heard from someone who thought they got an email from me saying i was against acupuncture being included in medicare and how could i be against the possibility of all kinds of people getting acupuncture once it’s available thru medicare (the ‘insurance will save the profession’ argument)…etc, etc.– which is a whole nuther argument–  but my point is this, insurance or no,:

    there are not enough acupuncturists to go around.

    I’ve been wondering how many more acupuncturists there would be given the current educational requirements of 3 years, if

    schools slashed their tuition by 50% and sustained themselves on twice the volume vs. large stafford loans…in other words, the power of smaller amounts.  One pillar that sustains social business.  Affordability.

    imagine, what if an acupuncture education suddenly became affordable?  say in the range of 5,000/year (maybe even less) versus 12,000-15,000 /year.  students could work and not have to take out loans and not be 50-100K in debt upon graduating, and actually have a shot at surviving long enough to grow a practice to sustain themselves, their family,  and their community.  radical idea?  yup.  but in a time when 50 million americans don’t have insurance, and many more have junk health insurance, and this medicine we practice is inexpensive to deliver in many regards, and there are only 20-25,000 of us compared to 800,000+ doctors,  why wait for the empty promise of Big Insurance that will most likely never happen? extraordinary times call for radical simplicity.

    if any school had the foresight, the guts, and the inner fortitude to offer a truly affordable education, the results could be astounding.  Is their any school out there willing to be radical, just like it was “in the 60’s” ?   I’m optimistic there’s at least one, but i doubt it. Only time will tell.  and  people still ask “they (CAN) are so angry, why are they so angry?”



  6. When I was getting started

    When I was getting started last year, I shared my copy of The Remedy with the former head of my school.  I was sharing my excitement about “the revolution.”  He liked the book, and was impressed with Lisa’s points, but he wanted me to examine the fact that I seemed to be coming from a place of anger.

    Yes, he too is a (beyond) middle age, upper middle class, white man.   

     I finally felt that all my anger in school was being justified.  Even my other classmates laughed at me when I would get on my soap box and say, “If we add any more western medicine, when I we going to have time for Chinese Medicine…..and…..how much longer are these programs going to get?


  7. One of my favorite things about this blog/site is that it’s ok to be angry. Anger can be a powerful tool, with focus and discipline. Mr. K suggests all dialogue should have the same soft feeling as inside an acupuncture clinic. That makes about as much sense as suggesting that acupuncture treatment is only about 3-4 years of book learning. Well I’m starting to digress.

    Keith, I like the idea of acu education at half cost, but I’m not sure the math would work unless the time was also halved. A big part of current problems in higher education both in acupuncture and beyond are bloated and escalating costs, sustained by student loans. To charge less, schools would need to be more organized and make better use of resources. And I don’t think student numbers could double unless the time commitment was reasonable, 18 months or so, and the program was clearly laid out, tight. Not welcome to the magical world of TCM, and various theories, and various stuff to memorize, and some biomed here, and more biomed there, and oops now we’re getting redundant, sometimes disjointed, and insert another opinion there, and wow this three years was surprisingly tiring. I’m optimistic about education but things would need to be restructured.

  8. Lisa, your intrepid exposure

    Lisa, your intrepid exposure of classism in our profession, particularly
    on this forum, makes a lot of people VERY uncomfortable. I include
    myself in the ranks of the uncomfortable from time to time, but that
    doesn’t mean the curtain shouldn’t be pulled back. Just like in
    capitalist systems, when you are working for social justice, nice guys
    finish last. I love it that you don’t try to be “nice” to Karsten, et al, you just speak the unvarnished truth. Keep on kickin’ ass.

  9. What?

    Two things:

    #1 Mr. Karsten doesn’t make tons of money being the president of an acupuncture school, however I am very sure he did not graduate from one $150,000 in debt.  Maybe this would change his views slightly.

    #2 Treating people in clinic and being rightfully angry about injustice and irrationality are two different things.  Having a wide range of thoughts and emotions are necessary to being human and being human is necessary to relating to patients and THAT is what promotes healing.


  10. more of the same, please

    Lisa, I love “your intrepid exposure of classism in our profession”, it rocks my world, and I love that other folks read it, get it, add to it, spread it around and join you in using it as one of the building tools for revolution.


    Anyone ever heard of liver qi stagnation?  I think bottled up anger is far more damaging to dialogue/healing/discussion/change than anger clearly and appropriately expressed.

  11. <>

    To do this you’d have to roll back the hour requirement for licensure in many states; Florida, for example, has a 2700-hour requirement.  AFEA has an 1800-hr acupuncture-only program but in order to get its graduates licensed in Florida, there’s an additional 660-hour herb program plus some other stuff.

    The other option would be to create an acupuncture tech designation but it would be an uphill battle and you’d likely have to demonstrate to the legislators some need that isn’t being met under the current licensing structure.

    I agree the programs are bloated, but when you have a board exam that tests everything from Akabane to Wen Bing you’re faced with having to include a little of everything somewhere in the program.  I think if we had a board exam that tested for basic knowledge and safety issues rather than trying to include every practice approach out there, it would make a significant difference in our ability to tighten up the programs.

  12. “you’d likely have to

    “you’d likely have to demonstrate to the legislators some need that isn’t being met under the current licensing structure.”

    I wonder if they’d accept the testimony of all of our patients as sufficient demonstration?


    (great discussion, y’all)

  13. It only takes one to make a change….

    Restructuring/retuning/tightening up can already be done on the school level, and is done regularly by the schools for the things they believe need to change.  I don’t believe the willpower or impetus is there for drastic change, because  the acu-school system isn’t seen as broken by the people driving the train.  It’s like a 100-car train with multiple locomotives rolling down the track,  there are different engineers taking turns driving with a whole lot of passengers, and it doesn’t stop on a dime to change tracks because of the momentum.

    I do not believe that the costs for school will change anytime in the near future (unless there is one school owner who gets radical and restructures prices as an example of what can happen for the greater good).   Even though many schools recognize the tenuous position they are in financially mostly because of Big Loans, the scary idea that there may be an education bubble isn’t enough for them to radically change course and think of sustainability without Ed loans.

    If the bubble pops, everyone is screwed, so why worry about it, why change?

    And we have a general system in place that says that acu-education can’t be completed any sooner than 27 months.  i pretty sure this is one of the ACAOM regs.

    But I am not aware of any ACAOM regulations that determine pricing structure of an AOM education besides possibly one about schools not raising their prices for credit hours by more than a certain percentage each year ( and i’m not 100 % positive about this one ).

    Schools seem to set their pricing structure based on what everyone else is doing, including other grad programs at non acu-schools.  There’s a theory I have many people believe that any “Masters program” in anything should be expensive, even beyond what it actually costs to educate a student, probably because of class and status issues, which are latent and nonlatent, and just because any school can charge what it wants because it is a business and it determines the price of its “product”.  And I have a corollary that I have heard some people say that an acupuncture education is currently a bargain.   

    So why not drastically change the pricing structure at schools?  As a prospective student, I would wholeheartedly consider a move across the country for a less expensive school.  In fact, that’s what I did.  At the time I went to school starting in ’03, Tucson had 2 of the least expensive schools in the country, both with good programs.  It was a huge factor in my decision. 

    But some schools are doing o.k. with their bottom lines, even in a tough economy.  so why change?  it’s not broken, right?

    So even if we’re stuck with a 3 year program right now everywhere, why can’t it be less expensive and potentially attract a whole lot of new students? CA clinics have been, for the most part, very successful even in tough economic times by lowering prices and creating accessibility.  So why can’t the schools do it ?



  14. lots of loans

    Pick, poke and prod…….

    Aside from the fact that acupuncture school teaches you much that you don’t need to know to treat patients, and that there are many flaws in the education and health care systems,  I continue to be stuck by the fact that students line up and sign up for acupuncture school fully knowing that they may have loan debt around $50-100,000.  I mean, what are they thinking?

  15. so true

    i wonder that all the time… for me, I had to face the hard truth that i was seduced by the excitement of learning something exotic, and didn’t give any hard thought to the ramifications for my family… and we are seriously stressed about the debt. i was utterly irresponsible, and agree that people are in charge of their own decisions. the problem is, until the market is stressed enough to drop prices, how do people get to practice acupuncture?


  16. thanks for the love, comrades

    I’ve been thinking about how some words and phrases have magical power — at least, over certain people, at certain times. Or maybe it’s not the words, it’s the ideas. I think the most interesting part of this conversation is where that magic is no longer working. I think historically the phrase, “your anger is overriding your compassion”, when spoken to an acupuncturist, is supposed to make her collapse into self-doubt and then shut up. Similarly the word “underserved”: that is supposed to summon a desire to do good, but only in carefully limited ways.

    The basis for this magic is the power to make us forget who we are and make us want to be someone else — ideally, the person who is speaking the words to us.

    But that power can only operate if we already want to forget who we are — and there are plenty of reasons that we might (see earlier post about self-esteem and the pyramid). But it’s much harder to forget who we are if we have a community who knows who we are and will support us in being who we are. If we have that, then we can start to have conversations that reflect reality, we can use words in a way that allows us to get to the truth about things — which is what we are trying to do here.

    As opposed to just slinging around magic phrases until we get what we want. As far as I can tell, this has been done for so long among white American acupuncturists that the whole process of discussion needs to be recreated. In my experience, most of the time that white American acupuncturists are talking about the profession, they are using words that don’t mean anything at all — at least once you strip them of their potential magical power. These words simply establish and re-establish the bureaucracy and turn people’s minds off. And prevent them from taking any kind of meaningful action.

    That’s what I think. Or maybe I just watched the new Harry Potter movie and am unduly influenced.

  17. context

    I wonder about how that decision gets framed to people as they are making it. Here is a quote from the CCAOM’s website (under FAQ’s for career counselors);

    How much can an AOM practitioner expect to earn?

    There are approximately 20,000-25,000 AOM licensees throughout the
    United States. While current data concerning the income of these
    practitioners nationwide is not available, recent estimates have
    suggested an annual salary range of $30,000-$60,000. It is not uncommon
    for practitioners to earn in excess of this amount, with reported
    salaries in some instances exceeding well over $100,000.

    Check out that phrasing. Doesn’t it make it sound like it’s not uncommon, hell, not even unlikely, that you might earn $100K per year yourself? If you think that, it doesn’t seem so irresponsible to take out a loan of $150K. Because wouldn’t that be a reasonable investment in such a great career?



  18. load of bull

    I remember reading this load of bull several years ago – obviously it hasn’t been edited.  It reads like an artless exercise in deceptive languaging. Current data not available….so let’s just go with recent rosy guestimates and fudge it big time!

  19. that’s exactly right…i

    that’s exactly right…i read some language just like that! and i thought, whatever, i’ll live on 20,000 a year and pay off the loans in 2-3 years. on the 25 year plan now, and still quite worried.

    but it would have been QUITE a lot smarter to interview some graduates…and not the faculty…

    prospective students, think very carefully…

  20. During my entrance interview

    During my entrance interview for PCOM I asked the then president how much I could expect to earn.  He seemed a little thrown, he just started babbling hypothetical math about seeing four people an hour at $60 a treatment.  I remember feeling pretty scared by his non response, but I convinced myself it would work out okay.  I don’t think a more honest answer would have changed my mind, but I came from a theatre background where almost no one succeeds.  Students deserve a more honest answer, not everyone realizes they are taking such a risk joining this field.

  21. I am going to disagree with

    I am going to disagree with what Mr. Karsten says about anger: “…If you took this feeling into the treatment room, you would not be able to have very effective patient care. You know the feeling you bring to inserting needles and treating patients, why can’t that same healing force be brought to this conversation? It indicates that potentially your anger is overriding your compassion and that if you ultimately want more energy for the patients you care about…”

    When people are being unjustly treated, anger is compassion. When a system does not serve people, when a system is about profits and self-serving motives, and not about serving people, it is appropriate to fight the system. This angry energy helps to change things. This angry energy, when there is enough of it, can topple power structures that are harmful… from apartheid, to insurance companies making health care decisions, and any other big power acting against (or even ‘not for’) the individual.

    The right brand of anger offers hope, empathy, compassion, and the energy to bring about change.

  22. Ha! Next time some a-hole

    Ha! Next time some a-hole says my practice is like “the wal-mart” of acupuncture, I’m going to tell him I have no interest in treating the “overserved” market.

  23. Quote from Acu Professor

    I had a teacher in acupuncture school who told us “There’s a special place in hell for people like me – training you all in a field that you can’t make a living in.”

    I appreciate the honesty, but this came at the end of my 3rd year, so it was a little late. She was having remorse about teaching us TCM when she herself had to quit practicing acupuncture and go back to doing her old job (web design?) to pay the bills.


  24. I just heard that one of my

    I just heard that one of my former clinic supervisiors has left the acupuncture profession to return to her previous career as a hair dresser…

  25. Too trusting

    “. . . what are they thinking?”

    They’re thinking that schools are run by honest people who are trying to help people, not screw us over for money.  We’re too trusting. 

    While it is true that if you do your due diligence and actually talk to a good sampling of alumni, you’d probably run the other way screaming.  The problem is finding all the embittered former LAc’s.  If you ask schools for contacts to alumni, they cherry-pick the most successful grads, many of whom made/inherited their money before going into acupuncture, have a sugar mama/daddy at home, or have somehow managed to survive and thrive.  btw many of these “survive” people are guru types that got in on the action in the very early days, found that they were the only game in town, and who themselves paid pennies for their education compared to what we paid.  

    Ask yourself the same question about the stupid doctorate programs.  I know of more than a few DOAM’s that wish they had just saved their money and not wasted their time.  What did the schools promise these people?   The same thing they promised us, that success is just around the corner, and that they aren’t just doing this for the money.  Ha!

    Yeah, joke’s on us, until jerks like this guys start talking about how it’s “outta my hands”, and “what, oh what can I do?” as if they are also victims of this system.  Then it starts to sound a lot more like we got hustled, that they KNEW we were screwed from day one.  Immoral at best.  Blaming the victim does not absolve the criminal.  

  26. Thanks for this.  I started

    Thanks for this.  I started writing something similar but didn’t get a chance to post.

    My anger comes FROM THE CLINIC ROOM.  And from my community, who mostly don’t have access to health care (big thanks to that public service dentist who I saw 7 years ago!)  Anger is a healing energy.  It moves boundaries and opens that space we keep talking about holding so healing can happen.  Our patients are angry, and they know why we’re angry too.  The ones that aren’t angry are usually so overwhelmed with just surviving that they don’t have the time to pay attention to their anger.  So far, it seems like getting in touch with that anger is a huge part of the healing process.

    Clearly, Mr. Karsten is living in a different world full of rainbows and fluffy unicorns, where the rivers flow lemonade and we should all just smile and feel the positive energy.

    I’m reminded of an old Funkadelic tune: “If you don’t like the effect, don’t produce the cause.”

  27. Conversation

    Dear Lisa,

    Thank you for your comments on my entry to your blog. I also read through a considerable number of the responses that were added to your entry.

    Overall it appears that blogs are effective when everyone generally agrees with each other, but are a poor forum for discussing complex topics when there is potential for disagreement. This is especially true when the primary intention of the blogger is to find what is wrong with someone’s entry.

    A good deal of the responses were relatively unprofessional in that they and you know little to nothing about myself, the Institute I work at, or the graduates of our program. Therefore your generalizations sound like any good American politician where they mainly want to give sound bites to put down what they perceive as their opponent, regardless of the truth of the matter.  Discussing the history of the development of this profession, its problems and possible solutions would best be done in a direct conversation and your deferral to the blog format for cost reasons is a cop out since the technology exists for all of your constituents to listen in and respond to our discussion via the internet.

    Your comments indicate that if there is anyone crying victim it is you, the big bad schools caused all your troubles and you are not indicating any personal responsibility for checking out the cost of education before you entered, checking out the profession you were entering, or choosing to leave the schools that were not preparing you properly. Frankly you should let your needles do the talking since many believe that your efforts in the community acupuncture model are making a difference, but your simplistic rants are marginalizing you from many who would otherwise support your efforts.

    Personally I think we actually agree on the basics. I suggest the motto “Don’t get mad, get even”. So how to do this. Certainly with the community acupuncture clinics. But there is another option as well. But before I get to it I will also say that yes, our graduates are successful. We don’t have many. We only take about 12 students a year and have a little over a 100 graduates total and we know what almost all of them are doing. And their responses to our surveys are that their education was worthwhile and they are doing well in practice. They work in private or multidisciplinary clinics, in public health facilities and hospitals, some have started community style acupuncture clinics, some are providing care in other places around the globe, some are working as Chinese medical translators or spending years in China in advanced study.

    Like you, I was also unhappy with my education when I graduated from acupuncture school, and when I looked around at what is being done in acupuncture education. Many of us were. What we decided to do then was form a school that would be based on what we thought was important to learn, knowing what we now know from being in practice. Therefore we went small with a clinic based training that pointed every topic and every teaching experience towards what we felt was clinically relevant, what would help patients.

    So where do you and I agree? We agree in the moment of intention when we insert a needle into someone. That moment is shared by practitioner and patient as a moment to benefit/harmonize qi. We agree that everyone who wants to experience being needled should have access to it. We agree that everyone who is going to make a life work of putting in needles should be able to make a decent living at it and pay their basic expenses.

    So what do I think you should do now? Instead of complaining about the acupuncture institutions you think screwed you or the system you think is so evil, start your own CAN acupuncture school. There were several blog entries hinting at this. Turn the ACAOM requirements into something that fits your mission. I consulted with many individuals/groups that were starting schools that had missions that were different from the norm on how they could use the system to manifest their vision. It is possible if you have the fortitude and vision. You could make a low cost acupuncture program that gives legitimate competition to the ones you are pissed off at and could then highlight a different way of doing acupuncture education. There are many innovative ways you could make the curriculum requirements work to your advantage and provide the kind of education you think a practitioner should have. Sure, the hours appear to be more than needed, but you can work out ways to meet them that are advantageous to your students and patients. And by doing that you impact the larger system by creating the change you want to see.

    It is over a 100 here in Seattle today – maybe the hottest day in history here. If you still want to continue just shooting down whatever is written to you from someone interested in acupuncture education, then I will pass on further comment. But if you really want to look at how you could make an educational approach that could knock the socks off of some of the established approaches to education – that could get interesting.
    Take care,

  28. yes, that’s interesting

    I’m not sure we agree on the basics, but your reply was better than I hoped for, so I think it might be worth figuring out exactly what we do agree about and disagree about. A couple of things:

    When you wrote: “technology exists for all of your constituents to listen in and respond to our discussion via the internet”, what do you mean? I’m kind of a Luddite, and I didn’t know that was an option. 

    About the blog: I agree that the Internet is a brutal medium for communication. Nuances can definitely be lost, people can misunderstand each other. But that isn’t what is happening here, mostly. I’m not interested in flame wars or arguments for the sake of arguments, I don’t care about winning points. In the original entry you commented on, in my reply to your comment, and in a lot of other blog posts, I’m deliberately being as provocative as possible because I think there are concrete, real world benefits to being provocative.

    So, first, I actually don’t think I paid too much for my education, I graduated from OCOM in 1994, and I think I took out a total of $25K in student loans. Tuition was only $7K per year, school was essentially part-time (at night) for 3 years, I worked the whole way through. I do think I could have learned what I needed to know in 18 months, but the cost of my education is not what I’m upset about. What I’m upset about is how I was taught to think about acupuncture  — which is what people are still being taught to think about acupuncture, and which has led to lots of people graduating from school these days $100K in debt. And I have reason to think that provocative blogging is a pretty good strategy (at least in conjunction with a larger organizing strategy) to deal with what I see as the problems.

    Very simply, I was taught to think about acupuncture without any context. No social context, no moral context, no economic context. No context leads to bad decisions, as well as to paralysis. I’m lucky that I got some really good training in critical thinking as an undergraduate, and though it took me 7 more years, I eventually applied some critical thinking to the acupuncture profession — and developed some solutions that allowed me to both be an acupuncturist and have some integrity.  Awhile after that, I discovered that a whole lot of people had the same problems with the field that I did — only worse, because they had way more debt. I found out that there is virtually no critical thinking in the acupuncture world and that a great many people are paralyzed.  A lot of people knew that something was really wrong, but they couldn’t name it and they couldn’t do anything about it. There is so little context in the acupuncture world that it is extremely difficult to even think about the problems, let alone to solve them.

    I discovered that when I shared my process of critical thinking in public, it released at least some people from paralysis. Enough of us got together and we began to be able not only to discuss context but to create context. I don’t know if you know what I am talking about, but part of the reason I’m writing this is that some other people do know exactly what I’m talking about, and some other people will begin to know as a result of reading this. The more we could discuss and create context, the more liberated we became to act.

    So I provoke because I know it helps people to think. And helping people think helps them act. We get a lot done around here.

    Here’s a point I wonder if we agree on: the acupuncture profession in the US is an abject mess.

    Something else I learned as a result of thinking critically in public: part of why the acupuncture profession in the US is an abject mess is a lack of leadership. Makes sense — how can you have leadership without context? I tried in every way I could think of to engage the leadership around the problems I saw, that other people saw, that I knew (and know) are real.  It didn’t work well. When I got any sort of responses from any sort of leaders, they were generally aimed at getting me to deny the problems.

    You don’t know me, either, or you would never compare me to a politician. I have a serious handicap in social situations: I hate bullshit.  It makes me crazy. I infinitely prefer real enemies to fake friends. So what you wrote about my simplistic rants marginalizing me from people who might support me? That’s the idea.  I can’t compromise, which is why I wouldn’t make it as a politician. I try to keep people with whom I might need to compromise about issues that really matter to me as far away as possible. Because it’s better for everybody.One good way of doing that is provocative blogging — when you put everything out in the open, you get to watch what happens, and you also learn who to trust. Calling the system evil, in public, has made it easier for a lot of people to trust their own instincts (about the system, and about everything else), and then to open community clinics.

    My inability to compromise is part of what helps release other people from paralysis. I don’t know why that is, but it is. So if you think a face to face conversation might lead to compromise, where the Internet only polarizes — please don’t think that. I’m like this all the time, not just online. I can provide references to that effect, believe me.

    I agree that having a school would help us. It’s something lots of us have been discussing for a while. But having a school is not more important than the larger thing we’re doing, which is trying to get out of this mess, together — trying to find our way out of a system that we really do believe is evil.  That’s not Internet hyperbole, and if you think we’re just whining, you don’t understand what we’re doing. We want to get to the place where acupuncture in the US isn’t a mess. That requires some fundamental rethinking of acupuncture.

    So, are you saying you want to help us get out of this mess? Are you offering to help us figure out how to set up a school? We don’t want a school just to compete with other schools, or to carve ourselves out a little niche in the profession — we want a school that helps us get out of this mess. I think whether or not our conversation goes forward depends on whether we agree about the magnitude of the mess.

    Regardless, though, thanks for writing back.


  29. I found out that there is virtually no critical thinking in the
    acupuncture world and that a great many people are paralyzed.  A lot of
    people knew that something was really wrong, but they couldn’t name it
    and they couldn’t do anything about it.
    ” – yep, that was me, except i was also trying really hard to create my own context, the kind that made sense to me by volunteering, working in public health, floundering around working 4 jobs. lisa’s speaking out about what she thought could be done literally saved me, i am a very different person now than i was a mere 3 years ago. integrity has a lot to do with it, among other things, like being able to enjoy whay you do, help lots of peole and pay your bills every month.

    as someone who works in an acupuncture school, i must say that it is not that hard to convince the students and even a lot of the faculty and administrators that community acupuncture is useful and should be taught in their schools, but the context is completely out of sync with what community acupuncture represents. there is  no awareness of the bigger picture of what a self-hating monster the acupuncture profession has become, no interest in addressing the real issues – they are preparing students to take tests, throwing in as many (mostly useless) extra classes as they can get away with and not talking about how an acupuncturist might attempt to serve most ordinary people in their community. i am basically going to work every week feeling like i am teaching my students to despise their school without ever saying so. so fundamental re-thinking will take some time. we are working on it, not just talking about it.

  30. To Clarify

    Just to be clear here:  Most of your original post was about the system in general, with this reply you switch gears to it only being about your particular school.  Most of the anger and combative comments are directed at schools in general, not your school in specific. We’re ripping into the “profession” as a whole, with special emphasis on the educational piece, as it’s the first step in the process, and some could easily argue, the most damaging.
    What’s with all the passive-aggressive vitriol?    You make provocative comments about the CA movement, and then take it personally when we start truth telling about the educational/institutional establishment.  I don’t care that your school and you personally just happen to be the nicest cog in a broken machine.  A broken-down car with fantastic wheels will only get you as far as you can push it–hardly worth the effort.  I’m glad you’re hand-picking the 12 people per year who can actually do this for a living in the way that it’s being taught now, but if you’re really interested in ACESS, you’re going to need to pick up the pace a bit. . .
    Not to put words in Lisa’s mouth, but my sense is that we want to tear the “profession” down, to “reboot” it.  I looked into starting a school, and yes we _could_ do it.  (I could also buy a McDonald’s franchise or seek to be the manager of the local Wal-Mart, but that wouldn’t really be tearing down the system, would it?)  However, the current regulations–most of them from the NCCAOMXYZ. . . etc–do make it financially difficult, the regulatory bodies have a vested interest in making it difficult.
    Here’s the rub:  these boards, and schools, and commissions, all of you know each other, by your own admission, personally. It’s not unusual for an NCAJDJFITJWJHKVFwhatever accreditation officer to become admin staff at a school, and vice versa.  You people all act as if there’s some restrictive “boogie man” out there imposing his will upon you.  That’s just not the case.  Again, this ain’t about you or your school or your family or your pets, or whatever.  This is about the system you are a part of, and therefore help perpetuate.  An incestuous system that does bad things to good people, a weird sort of bad cop–victim cop routine.  People who helped get those reg’s on the books now crow about how they’re powerless to change them.  Show me the math on that.
    Just to re-iterate, it’s great that your school cares so much about it’s grads and entering students, but you’re a teeny tiny minority.  What’s more, your model for educating and training these practitioners is not conducive to getting acupuncture anymore mainstream or even accessible, which is THE main goal of the CA movement.  We want MORE people doing this, we want models that set people up for success, we want as many people as possible to get acupuncture.  That’s not going to happen with a handful of regional schools graduating a dozen practitioners per year.
    I’m not suggesting that you go away, I’m suggesting that you not get smarmy and self-righteous about yourself/your school when we point out valid problems with the system as a whole.  Sorry that you happen to be a participant in those problems, but there it is.  Either you’re interested in giving us ideas, or you’re just interested in defending yourself.  The former is quite appreciated and useful, the latter is neither.

  31. Glad to read Paul’s reply. Spot-on about reasonable, nuanced discussion. This site provides ample space to vent frustrations, but it can quickly become even more frustrating not to be able to discuss professional issues in a critical, even-handed way. Lisa, I’m not sure how your definition of critical thinking became intertwined with provocation. Perhaps provocation gives people a chance to connect with their own emotions and intuitions. Or it can polarize, inflame, set up targets, make things seem black/white rather than gray, flatten the complexity of issues. I’ve always learned that detachment and allowing complexity and gray space are needed for critical thinking.

    Yes, critical discussion can give the acupuncture profession context. But why limit context to the socioeconomic picture? Acupuncture is about more than money and needles – there’s the body. Interdisciplinary perspectives on the body can be interesting and useful, and there are lots possibilities for making acupuncture education more well-rounded. Which could easily take more than 18 months. I’m reminded that there are many valid ways to practice acupuncture. A quicker, cheaper school where you learn to fire off needling protocols and ease symptoms does sound like a tech program or nursing. An interesting option, considering that acupuncture can incredibly useful. But there’s also plenty that could be said for private treatments and learning in greater depth about internal medicine and the mechanics of the body. Although there’s always room for improvement, I’m happy with my three years of school and debt. Wasn’t mislead by the system or anyone, and not planning to take up hairdressing.

    So no, I don’t see the field as rotten to the core, and Paul K. as the one shiny wheel in a total wreckage. There’s plenty of work to be done, to each their own. Writing this post to acknowledge to myself and anyone else that it’s ok to believe community acupuncture is interesting and useful, and so are other styles of practice. Critical thinking is important, and so is quality discussion. A quick acu certificate could be good for healthcare, but spending more time and money to learn more can be worthwhile on many levels.

  32. Acupuncture schools have become incredibly expensive…

    can we all agree on that?  Acupuncture as it has been in practiced in the United States is incredibly expensive; acupuncturists cannot afford to be treated with acupuncture if they paid the full price.  So few people receive acupuncture-even if they have heard of it at all- mostly because it is inaccessible and not affordable.  Most acupuncturists (the statistics will back me up on this one) do not stay in practice even one year after graduating because their are no jobs and most do not know how to go about creating one.

    Once we can all agree that these are the truths of acupuncture in the U.S. then we have something to discuss.  But once we all agree on those issues as being fundamental to the survival of acupuncture and acupuncturists, it is clear that one of best solutions to these problems is to increase awareness about acupuncture by making it accessible and affordable…intrinsic to the business model by which most of operate, not just a few “bleeding hearts.”  Acupuncture does not need more private practice acupuncture, we NEED community acupuncturists.  If the class issues make you queasy then put your own thinking into the model, ignore all of us “bleeding heart” do-gooders and encourage people to open large volume low cost acupuncture practices “just like Walmart.”  I know that irritates some, but it really is the only way.  AFFORDABLE acupuncture, try it and you’ll see.

  33. love that new Harry Potter…

    I think that what you’re talking about is what’s refered to as “reification.”  When people repeat the same nonsense enough, it shores up structures that wouldn’t stand on their own.

  34. replying to Natalie and Paul

    This conversation has been going on for years – since before this website was born.  Paul, you admit that you are a recent contributor to it; I’m intrigued that in spite of this you seem to feel entitled to make demands about how the conversation happens.  (I also think it’s really funny for people to tell other people “don’t be so angry” – does this ever do anything besides make people *more* angry?)

    It seems that both of you think that the conversation that happens here is without nuance or subtlely.  I disagree.  As one of the long-time participants, I really appreciate the many subtle and moving posts thoughtfully written by my many colleagues, including Lisa.  All of them have challenged me to think more deeply about my practice, and its purpose.  I thank you two as well for your contributions – even when I disagree with you.  However, I will say that for those of us that have been participating in this conversation, and practicing this way, for a long time, many of us are no longer interested in spending a lot of energy engaging certain points anymore – we’re too busy treating patients.  So, practice how you will, run your schools how you will, debate those points on other blogs – knock yourselves out!   Just don’t expect our blessings, validation, or silence.  And don’t ask us not to be so angry.

    I’ll sign off with a link to an op-ed piece that’s been making the rounds lately, about the place for anger in creating social change (just as food for thought, not to draw any particular comparisons):




  35. nuanced anger

    Thanks for your critical thinking Nora, Lisa and others. My only contribution to the discussion at this point is to attempt to make a distinction between anger and wrathful compassion. 

    Anger divorced from wisdom and compassion – does not lead to happiness according to my tradition. I agree that this country is better with the gains of the civil rights era, as someone pointed out above, but even with concessions from the U.S. Supreme Court regarding racial, etc. justice, the struggle goes on. Yes, we have laws on the books now, but clearly, there is still a long way to go before there is real, lasting peace amongst all people.

    What was and is missing? I believe that we can act with powerful intention to draw attention to, and ultimately to correct injustice without fomenting hatred. Neither does anyone on CAN, nor the distinguished NYT columnist, Mr. Herbert, appear to justify hatred against white policeman, or the American acupuncture “elites”, for lack of a better term. However, the line between so-called righteous anger and hatred is incredibly fine. Impatience breeds contempt, and verbal violence is only a step from physical violence. Once those seeds are planted in our mind, it’s only a matter of time – this life or another – before they are acted out. 

    The larger problem is not external, ultimately it is our own mind. That doesn’t mean we should just sit around and stare at our belly button, charge $200 for acupuncture facials and ignore the pitiful lack of access to health care, including acupuncture, that exists in this country. As you sow, so shall you reap. Karma happens!

    Perhaps, I am only expressing what is obvious and tacitly implied in your posts. I make no assumptions whatsoever about the degree of mindfulness with which individuals on CAN, or anyone connected to this discussion maintain an inner awareness of the delicate threshold between compassionate wrath and anger. 

    These are only my own delusional thoughts in a crude attempt to make sense of how to learn from the many past mistakes I’ve made.



  36. Slightly off topic…but really only slightly.

    I just had the following conversation with one our excellent front desk staffers.

    Nancy: Do you remember Julliette X from your former private room practice?
    Me: Sure, it’s been a while but I remember her name.
    Nancy: She just burst into tears on the phone.
    Me: (furrowed brow)
    Nancy: She was resigned to start treatment in September because she thought she’d have to save up the money to come in. When I told her about the sliding scale, she cried.
    Me: And what did she say after crying?
    Nancy: “I’d like to make an appointment for later this week”. This isn’t unusual…you have no idea. At least once a week someone bursts into tears because they can afford this.

  37. assumptions

    Ah internet communication and the potential for missed connections….rereading my words I realize that when I said this:

    “I make no assumptions whatsoever about the degree of mindfulness with
    which individuals on CAN, or anyone connected to this discussion
    maintain an inner awareness of the delicate threshold between
    compassionate wrath and anger.”…

    I really meant to say that I do assume most people are fairly aware of the distinction I am attempting to make. I just haven’t seen it articulated.

  38. Yep I noticed that article when it came out. But, well, that’s about racial discrimination. Not debating when high volume group acupuncture is appropriate, and when private treatment is more appropriate. Except oops, that kind of question is not allowed. Anger is no problem per se. The issue is whether the discussion is open to questions, even where some might already have assumptions. Nuances and interesting writing are well and good. But if assumptions and provocation rule out certain kinds of nuances and questions, that’s not what I’d call an open discussion.

    Did I reach this point of view by sitting and sifting through blogs? No. Maybe TMI, but just so you understand I’m an actual person and not just a talking head detractor: I went to planned parenthood. And they respected my privacy, and I appreciated that they fully respect all of their patients’ privacy. And my nurse took her time – she really wanted me to understand my body and the details of her work with me. That’s a very different message and experience than, say, ‘come rest here with needles at x frequency… and that’s about it.’ Sure, there could be a more elegant way of putting it. But there’s a reason that doctors and patients complain about time squeezing by HMOs/insurance companies. Some schools and orgs offer group treatments for pain management, and private treatments for internal medicine, women’s health etc. One example of another model for acupuncture.

    Anyway, I very much agree Nora that at a certain point, you have to choose where you’re willing to spend energy. I recently noticed Kristen Porter’s article archive at Acupuncture Today. From the early days of the community acupuncture movement to nonprofits, AIDS, integrative medicine, and many perspectives on public health. I don’t have all the answers to how I will shape my practice and keep myself busy, but I’m happy to find perspective.

  39. ns009, you’re repeating the same old tired memes:

    “in CA you don’t have time to talk with your patients” & “you are giving up your privacy in a CA clinic” – which my experience tells me are patently false.

    You can try to put an elegant spin on this hokum, but it won’t change its function as a distraction from the bottom line.  That is, community acupuncture clinics are simultaneously addressing the largely ignored issues of access to care for the majority of our fellow citizens and creating legitimate options for sustainable work as acupuncturists.



  40. ns009 – the above post (especially your comment about HMOs) just shows how much you don not get what community acupuncturists are doing. did you read “Acupuncture is Like Noodles”? if not, do it. did you ever actually go and get treated in a community acupuncture clinic? if not, do that too. then, perhaps you could attempt what might qualify as nuanced discussion. like nora said, we are pretty busy treating patients, so we have limited time and energy – there are other ways for you to get that much needed perspective. i hope that you do.

  41. I’m also angry, despite all of my faults…

    I entirely understand your reasoning, that acupuncture is different from other modalities of health care in that it requires ongoing treatment to be effective. (Although, a front and back treatment, with appropriate liniment, a TDP lamp and some moxa can knock the treatment course WAY down) I understand that $60 to $100 per treatment is prohibitively expensive for most people. I hear many of you saying that you are angry about superfluous western medicine classes that added to your debt burden, but in fact you rarely use it in clinic. I actually find the western training to be quite useful. It’s not useful in diagnosing, (although sometimes, it is) but it is useful in gaining patients’ confidence. It’s useful when I can talk the same talk as their doctors and explain alternative options. Knowledge is power, but only when you use it.


    When I was in school, I thought that taking insurance would function as the equalizer because I was in a large city with lots of community and low cost acupuncture clinics for those populations that either a) didn’t have insurance or b) couldn’t afford cash rates. I see now that those of us who bill insurance are in fact at the mercy of the insurance companies to pay us what they see fit, and this is to make no mention of the people whose insurance doesn’t cover acupuncture at all. So indeed, billing insurance and having a private practice is self limiting and creates more obstacles rather than less. The system is broken all around.



    When I initially visited your site, I was turned on by the rhetoric. I like ‘justice’ and ‘revolutions’ and ‘doing something’ about inequality as much as the next guy. I’ve also done a lot of serious soul searching to figure out who I am, where I came from, where I want to go, how to get there and why I want it.



    What I don’t like is the derisive terminology such as BA (Boutique Acupuncture) and the failure on the part of some of your more vocal members to authentically examine themselves before parading their self righteous stories and opinions all over the forums of WCA and CAN. Anyone who can afford a babysitter while in grad school smacks of middle class. Anyone who can afford to take a few years off from life in the States to study Buddhism in India strikes me, at least, as middle class. This may be my own interpretation of the terminology, the semantics, or the intent or my own experience with working class people, but it turns me off. I was initially attracted to your movement and to your ideas but upon digging deeper, the comrades at WCA and CAN seem more like a bunch of people drinking the same Kool-aide than actual free thinking individuals.



    I had restrained from posting several times while perusing your blogs over the past few weeks. However, I can’t hold back any longer after seeing Nora’s post titled ‘Responding to Natalie and Paul’. I understand that you take the article you posted about Henry Louis Gates Jr. as a message about righteous anger. But if you seriously think it’s an appropriate analogy to a bunch of white people with master’s degrees in Chinese medicine angry about the profession they chose, or the system they bought into or the student loans they incurred is remotely relevant to the hundreds of years of systematic discrimination and oppression Black people have endured throughout the western hemisphere, in my opinion, you are sorely mistaken. Beyond mistaken, you are appropriating something that is not only not yours, but that you don’t even understand. Explain to me, how those of us whose personal values, familial or otherwise led us to higher education, through ‘whatever means necessary’ is anything other than a world away from institutionalized racism? We are the products of racism. We are the consumers of modern day slave labor in the form of migrant farm workers. And, while the forums on this website generally do a good job at staying clear about classism and not confusing it with racism (although they are intimately and intricately intertwined), I can not sit blithely by and not post my own two cents. There are a lot of students that read this site, people still in school, and although it is not my intention to dissuade them from joining CAN or the WCA or doing CA without CAN’s blessing or support, I must raise my voice against what I see as mob hysteria. This site is a safe place for people who agree with your mission and your club. And your mission is easy to agree with. There is nothing wrong with wanting to treat more people, to make acupuncture more accessible, and to do it in a way that you don’t have to have a day job to support your acupuncture habit. Having said that, this is not a safe place – because of your reactionary anger – to contest the rhetoric. There is nothing wrong with practicing Boutique acupuncture as you so insultingly call it. Indeed, I think that when I open my community style clinic, I may name it just that. The Acupuncture Boutique.



    When Paul Karsten initially questioned ‘the anger’ at WCA, I interpreted his message as being threatened by it and an attempt to control it. However, after days of reading your blogs and forums, I see that he has a point. “Your simplistic rants are marginalizing you from many who would otherwise support your efforts” Sure, I see the classism, I hear your message. But I also think that simultaneous CA style acupuncture alongside “BA” clinics or integrative clinics, or L.Acs with Hospital privileges, or the continuing effort to design a proper and indisputable double blind placebo controlled clinical trial that would propel the medicine forward in the minds of the western medical establishment, continued efforts at the legislative level to make acupuncture accessible to those on medicare or those with L&I claims are all equally beneficial in the big picture and in the long run. I’m just not drinking the Kool-aide.

  42. How about Boutique Community Acupuncture?

    now that’s funny! 

    I think naming your acu practice Boutique Acupuncture whatever would suit your current mindset of contradiction well.   Someone beat you to it in Sacramento.

    unsafe place?  hardly.  sure the conversation can get heated with strong opinions.

    but, c’mon, seriously,  it’s an internet forum — talking about the
    pros and cons of delivering acupuncture in a certain way, with a myriad
    of surrounding issues — for crying out loud.  you make it sound like
    the Brute squad’s going to show up at the door.  pleeeease…

    we all have issues to examine and work on, me, you, all humans, 
    yup, it’s true, we’re not perfect, many would say that’s one purpose of
    being alive.

    to me, it sounds like your eyes have already been opened by your own
    experience in practice, but you’re just not quite ready to fully
    embrace your next step.  sounds like the lifeline from your
    acu-education has been unravelling for some time, but you’re still
    holding on to some final strands.  you’re almost there though,
    kool-aide or not.

    good luck to you, Guest not Verified!




  43. Howdy, Guest!  Yes, I was

    Howdy, Guest!  Yes, I was afraid that someone might think I was making such an analogy; and I appreciate your anger in thinking that I had, because that would be stupid and insulting, indeed!  That is why I said “not to draw any particular comparisons.”  Perhaps that was not clear enough; if so I apologize.  I just noticed that there was another public conversation taking place about the uses of anger, and thought that some of what Herbert says about it might be interesting, if not instructive.
    Notice that I’m not hiding behind anonymity, here; any fuckups I make are public.  You see my name there, you can click it and find out about me: how long I’ve been around, where I practice, etc.   Come on down for a visit next time you’re in Detroit.  Forgive me if, when you do, I insist that you submit to a treatment before I submit to a lecture.

    I absolutely think it’s wise for you not to “drink the Kool-Aid” about Community Acupuncture, what with the bitter taste of the insurance Kool-Aid still in your mouth.  No one is asking you to do so (no one asked me – or forced me – to).  Fill your boots with whichever other flavor of Kool-Aid you want.  But if you want to come derail here anymore, have the courtesy to sign your name.

  44. mob hysteria?

    i guess CAN now has enough members to qualify as a small mob – YAY! you are totally right, guest – this site exists mainly to further a particular mission and vision for acupuncture and to support others who want to participate in it. we do not have any interest in discussing the merits of boutique acupuncture, insurance-based practice or doing acupuncture in in a hospital setting (i gather that there are plenty of other forums that do that). there are reasons some of us judge the boutique model, and i think they are pretty obvious to you, the frequent CAN visitor. most of us are critical based on experience. we are not hysterical, just commited and focused.

    and i must agree with nora that it is kinda rude not to say who you are when you post a reponse to specific person.


  45. Guest wrote:
     “Anyone who

    Guest wrote:

     “Anyone who can afford to take a few years off from life in the States
    to study Buddhism in India strikes me, at least, as middle class.”

    Are you referring to me? Of course, I’m just an egocentric maniac in assuming that you are referring to me, but in any case this does describe my experience. Actually, I’ve taken more than a few years off from life in the States. Probably about 8, doing nothing particularly productive from a materialistic standpoint.

    What’s your point about labeling that middle class? I never claimed to be part of any particular class. Am I supposed to feel guilty because I had money and opportunities that others didn’t when growing up? Do I not belong here, trying to support a movement for greater social justice in healthcare because my background and experience is uniquely my own and not identical to everyone elses?

    Aside from recognizing that it is merely my karma that people will take verbal swipes at me in public (I sincerely thank you for helping me clear that karma away), I’m wondering what I’ve said that offends you. Feel free to contact me off the forum (phone?) and I will listen intently to what you have to say.

    May all beings abide in the spirit of  true inner peace,

    Jordan Van Voast


  46. and i guess you were referring to me…

    Dear Guest,


    Yes, my husband has a job for now so I was able to finish grad school and have a baby. I will make no appologies for that. I am fortunate in many ways. That does not mean that we did not have to take out significant loans to do so. 

    You though, have no idea where I have come from or my experiences in life. Class, when examined deeply, is not simple. 


    But that has nothing to do with the opinion that I hold regarding the schools fleecing students, marginalizing the profession, and not working to make acupuncture accessible to everyone in the US. Regardess of class, the problem is obvious to anyone who opens their eyes. I think you probably know this is true on some level or would not have reacted in the way that you did. 


    Regardless, I would like to agree with everyone who has already posted, sign your name, not doing so is cowardly.



  47. abstract/concrete, complex/simple, etc.

    There’s a lot in your post, Guest, but there’s one thing I want to address in particular, because it relates to some of ns009’s comments further up the thread which I have been meaning to respond to. I went away for a couple of days and came back to find that I apparently mix mind altering Koolaid and organize hysterical mobs. I’m trying to come to terms with all this power. Could somebody — one of my biddable minions out there — please tell my kids about these new developments? They have never taken me this seriously. Why can I not use my powers to make people clean the kitchen? What good is having a mob anyway? I ask you.

    Seriously, that’s relevant to my point. You wrote:

    “I also think that simultaneous CA style acupuncture alongside “BA”
    clinics or integrative clinics, or L.Acs with Hospital privileges, or
    the continuing effort to design a proper and indisputable double blind
    placebo controlled clinical trial that would propel the medicine
    forward in the minds of the western medical establishment, continued
    efforts at the legislative level to make acupuncture accessible to
    those on medicare or those with L&I claims are all equally
    beneficial in the big picture and in the long run. ”

    The thing is: other people in the acupuncture world are working on those things. They have been for awhile. They’ll probably keep working on them forever. I don’t know if integrative clinics and double-blind trials and efforts at the legislative level are beneficial in the long run, they might very well be for all I know, but they’re not what I care about. I helped start this blog and this organization and this community because I wanted to work on the things I care about. Why is it somehow the job of this blog and this organization and this community to support and endorse and give equal time to all those other things? Seriously, I don’t get it. If you want a blog and an organization and a community that are even-handed and inclusive and supportive to everybody and everything in the acupuncture world, go create them. You and ns009 and everybody else who wishes we were nicer around here. Really, you could do that — you could champion community acupuncture as one of many options in a friendly, polite, collegial way. You would be so much more evolved than we are! 

    The thing is, my anonymous friend, I have been an L.Ac for fifteen long years and I do not see much progress in the realm of hospital privileges or BA clinics or studies or anything else intended to propel acupuncture forward in the minds of the western medical establishment. I am not impressed with the results that I see from all the other initiatives in the acupuncture world.  You know what, I’m not even impressed with CAN’s results, and I’m pretty sure that in 3 years or so we’ve managed to exponentially increase the number of people who are getting acupuncture. I look at what we’re doing, and I think, OK, that’s more like it, but we’re still not anywhere near what I really want. But it is genuine progress, and I don’t see that anywhere else. What I see everywhere else doesn’t look all that different from what it looked like back when I graduated: acupuncturists banging on the same closed doors.

    I think all those things you are excited about are closed doors. Dead ends. Holes to pour your time and energy down. I’ve had fifteen years to come to that conclusion. And so I made a decision to do something different with my time and my energy, and you are looking at it. I don’t like complex, abstract things, I like concrete, simple things. That’s why this site is kind of single-minded, because I want to get shit DONE. I don’t want to just talk about it all forever. I don’t want to check the credentials of people who also want to get shit done to make sure they’re as working class as I am (WHAT?) before I let them say anything. This site is not actually all about talking and who gets to say what and how they say it — yes, I know it’s a blog. You and ns009 sound like smart people, but you also sound very abstract, and I’m very wary of abstract. Not because I’m afraid of people disagreeing with me (last time I checked, lots of people disagreed with me, somehow I manage to get out of bed in the morning, terrifying though the prospect is) — but because I’m just sick of all the talking that goes nowhere. Obama is not going to reform health care and include acupuncture if we bring “more voices to the table”, whatever the hell that means.

    Part of the reason for the rhetoric is that it helps me get stuff done, and as I wrote above, I have reason to think it helps other people too. Before I assembled all these Koolaid -addled groupies to agree with me, I spent a long time listening to people telling me that I was devaluing the profession by treating the people who live in my neighborhood. (You know what, i still get hate mail to that effect.) Being snarky about the profession creates some mental space for me to be creative. I’m snarking for me, not because I’m trying to persuade or even browbeat the people I’m snarking at. I KNOW they’re not listening. Sometimes being insulting helps me think, and sometimes being nice is paralyzing.

    I got tired of waiting for anybody to give me what I wanted. I decided to do the work I wanted to do on my own terms. You can do the exact same thing. If disagreeing with us helps you get moving in that direction, great! But please, don’t hang around here disapproving of us any longer than you absolutely have to. Go do something real.  And once you’ve done something real, then we might have something to talk about. Hell, if you do something real enough, you might end up with your own mob. If you can figure out how to make them clean the kitchen, will you let me know?

  48. Jebus!

     Lisa- I’ll get to the dishes tomorrow!




    Mal: Well look at this. Seems we got here just in the nick of time! What does that make us?


    Zoë: Big damn heroes, sir.


    Mal: Ain’t we just.

  49. Pissing in the kool-aid

    First, it’s got to be damn near impossible to generalize about the background and class status of the hundreds of CAN members given how ANONYMOUS the internet really is.
    Though you are on to something — less than 9% of Americans have masters degree, so getting there does put you in a small, some might say elite, class of people.

    It sounds like you are grateful for your masters education, and the “power” that the knowledge gives you over (?) your patients. You might also try wearing a stethoscope and a white coat to help your patients trust you more too.
    But really — if you dig into the stuff on this website — you’ll find alot of people here could give a rip about their masters status, class status or whatever. Lots of them would give up their oh so special acupuncturist status if that would make it easier for more people to give acupuncture, if that means more people can get acupuncture.

    And that’s the bottom line. The schools, accreditation organizations, and the other barriers to low-cost acupuncture are just that. barriers. One of their main goals is to be gatekeepers for acupuncture to keep it “professional”… even if that means making it almost impossible to deliver acupuncture to as many people as need it. That’s why some of the fiery insistence on how to do CA right is so important. It’s the only practice model that is sustainable for lots of acupuncturists AND lots of patients — and somebody’s got to keep that torch lit.

    And by the way, your anonymous attack on the self-rightiousness of people on this board smacks of… well… self-rightiousness…

  50. more nuanced reply


    i’m working on a much more nuanced reply but for the meantime (and since i have to go get ready for a clinic warming party where we will give some free treatments (horror!) to introduce more folks to acupuncure–couldn’t resist an indulgent, self-righteous story!) i would just like to say that if you are a guest, without actually joining the site and having access to the forums, then you have been able to read maybe 1/1000th of the discussion that has transpired here–some real soul-sourching and reflection going on for YEARS, actually, not weeks.

    and since it may have been Kelly and I that started the Kool-aid thing, i think a better analogy is that we’ve taken the red pill and you all want to keep eating the blue one. (Matrix, for those too busy poking to have a life, ya’ll–ha!!) once you’ve “seen” you just really can’t “unsee” and man, it can really make you mad!!

    so who’s really living the unexamined life here? 

    sweet! another simplistic argument! but really, i know this has been true for others and has come up in real discussions and i’ve really been thinking about it. be back later–bwahahaha!


    Good health is not a measure of adapting to a sick society.

    When the power of love outshines the love of power, the world will know peace.

  51. oh yeaaaaaaaahhhhhhh!

    I agree that the Matrix analogy is much better than the Kool-Aid one.  “Drinking the Kool-Aid” of course refers to the mass suicide of the followers of Rev. Jim Jones at the Jonestown compound back in the 1970s.  If we were all “drinking the Kool-Aid” here, we’d be blindly following a leader to our demise.

    Personally, I pay pretty close attention to what Lisa has to say because she helps me be a better acupuncturist.  By better, I mean that she has helped me to get clear about what I’m doing so I can see more people and do right by them.  I’m not following her blindly.  She has a proven track record to back up her ranting (busiest acupuncture clinic in North America, right?).  I don’t agree with everything she says.  Sometimes she pisses me off.  That’s a good thing, because some of the assumptions I’ve had have been b.s. and getting pissed off and questioning why has been a good learning experience.  Lisa’s intentionally inflamatory style has been good at digging into those unexamined, yet all too obvious, places.

    Who’d want to drink Kool-Aid from her filthy kitchen anyway?


     Holy crap! Always with the dishes! I’ll admit you folks are clever in your nagging me to do the dishes. Pulling in Guest (not verified) to obliquely critisize my dish washing behavior was a nice touch. But I ask you: isn’t doing the dishes twice a month enough?




    Mal: Well look at this. Seems we got here just in the nick of time! What does that make us?


    Zoë: Big damn heroes, sir.


    Mal: Ain’t we just.

  53. only if

    only if you add moxa and linament and cups and estim and tui na manipulation and hara diagnosis and non-insertive…and someback shu points, damnit!

    you know she only has to say the word and this mob is headed your way, buddy.


    Good health is not a measure of adapting to a sick society.

    When the power of love outshines the love of power, the world will know peace.

  54. CANers, I

    CANers, I apologize, this is just way too long again, but you know how I am
    with my righteous, unexamined rants so here goes:

    Hi guest, I’m actually glad you spoke up although I find some of the
    incongruities you present kind of baffling. I’m glad to hear that you’ve “also
    done a lot of serious soul searching to figure out who I am, where I came from,
    where I want to go, how to get there and why I want it.” What makes you think
    we haven’t done that as well? I see us as strongly opinionated free thinkers joined
    together with a common goal.

    I prefer the term private practice over boutique. Because in many aspects
    that’s what it is—private: for the patients, the practitioners, and, as a
    result, for the profession. Privacy—do people really want it? Look at physical
    therapy and cardiac rehab—lots of people together in the room, talking about their condition,
    doing stuff together—it’s encouraging and supportive. And I will say again, I
    know of several private practitioners that are good, good people and are
    helping the patients they have and working with good intention and a good
    heart. I know some of them get great results and some wish they could get
    better results and are often aware it is because their patients cannot come as
    often as they’d like tehm to. I do not know a lot about the rest of their practices
    because they keep that information private, mostly. The culture discourages
    asking these questions or at least isn’t very forthcoming with answers

    And I don’t know for sure, but venture to say that once you are actually
    practicing in a CA, if you eventually do that, you may understand first hand
    the anger thing a little better. It’s not theoretical. It comes from our own
    personal experiences and from real life connections to people.

    Need to clarify one point immediately, not from Nora’s post specifically but
    from some others and I have made in the past:

    We’re not comparing ourselves, lots of “white middle class master’s
    degree holders” (a huge unfounded generalization but for what truth there
    is in it, exactly one of the reasons we ARE fighting to change the profession
    so that it CAN be more integrated in many ways…) to African Americans
    fighting for civil rights. The comparison is for our PATIENTS, and for the
    rest of us besides the top 10% economically, who aren’t able to access healthcare
    due to an immoral system built on greed. Once again, it’s about a lack of equal
    access to a basic human right of healthcare. And, no, we are not making a
    comparison in terms of magnitude and are always pretty careful to say
    so–although the trend of patients slowly dying due to lack of primary
    healthcare is starting to look pretty dire. I always identify as having no
    grounds to talk about *experiencing * racism because I am a white
    American. But I can examine the similarities of all oppressive systems;
    look at ways to create social change, battle injustice, and work within my own
    life to stop perpetuating inequality. So can you. We all find the way that
    feels right to us, and for a lot of us here, it’s through the actual work we do
    every day. The forum is where we come to talk about it, but it’s not the whole
    ball of wax.

    Perhaps a less loaded comparison would be the struggle for women’s rights.
    (Or an even more simplistic argument might be around smoking. ten years ago,
    everyone smoked everywhere; it was just accepted). At different times, women’s
    feet were bound, we were enslaved, exploited, unable to be seen, heard, not
    able to own anything, not paid for the work we did to support our families, and
    especially not allowed to vote, or have access to power.

    Women in this country and others got together in small groups, privately at
    first, and were what? Angry! Angry at the inequality, the ways it limited their
    lives, their health, their well-being. Yup, got good and angry, and got LABELED
    as good and angry, and then did something about it. And now (at least mostly,
    at least in America and some other places) i, my sisters, your sisters,
    mothers, daughters, live better, healthier, and safer lives because of it. I
    want healthcare access for my friends, my community and myself. I’m angry that
    it’s causing a lot of unnecessary pain and suffering to not have it. I’m trying
    to do something to change that and I know that we’re all getting to live
    better, healthier, safer lives because of this change.

    Whatever the issue, social justice requires people (of whatever background)
    to see a moral injustice and be willing to challenge the philosophies and
    systems that perpetuate it. And, really, upending the reasoning that holds it
    in place, exposing the immorality for what it is, speaking the truth and
    changing attitudes is the only way these changes ever get started–if it’s
    deemed acceptable then why change it? Women are still exploited all over the
    world but look at how we tend to react now: it’s wrong, immoral, and
    unacceptable…this did not happen until people got angry and started agitating
    for change.

    One reason why i think it may sound like simplistic rants here is because we
    are keeping it simple on purpose, telling the truth, boiling it down to facts,
    the unvarnished, not gray area truths: not enough people can get acupuncture,
    not enough acupuncturists can make a living doing it, it’s supposed to be
    healthcare but almost nobody knows about it. You make the arrogant assumption
    that we do this from a lack of genuine reflection rather than because of it. So
    i direct you again to the forums, to our own blogs, to our own websites, to our
    actual clinics, to our patients, to the times, as andy pointed out, that our
    patients cry with relief, and then get their lives back because of the CA
    clinics that have been set up. We’re not trying to drive you away but invite
    you to see what’s really going on here, beyond reading a few blog posts.

    My anger has to do with wondering why were we letting people suffer so much
    in the first place? I just joined a profession that for over twenty years has
    been moving in a direction, that despite all the good that may have come from
    it and how much we all love it, has left too many people suffering. I feel
    responsible for changing that. If I can point out other broken systems, I have
    to have the courage to look at our own and do something about it.

    Lisa said it better but I have to echo it: 
    We “parade our self-righteous stories and opinions all over” here
    because, you’re right, it is OUR forum, it IS our club, and that’s why it’s
    here, so we can support each other in doing THIS, not arguing about doing THAT.
    Those of us that are practicing this way are done with figuring that part out.
    We offer insights and opinions from our actual, examined, reflected upon
    experiences to others that are considering it. We hope it helps, and if not, no
    problem. If it doesn’t fit for you, okay. And mostly we like each other’s
    self-righteous stories and opinions! We celebrate them, in fact, because that’s
    the point of having a place to share them.

    What i’ve noticed over the past few years here and in real life discussions
    with folks about CA, is that some people pop in for a few weeks, read a tiny
    fraction of what’s going on, don’t visit a clinic, aren’t actually doing it,
    are not having the actual experience of getting angry from their patients’
    stories and being dissed by the profession (you admit that you only changed
    your views on insurance after actually experiencing it, right?), having these
    ideas bump up against their comfort level for whatever reason, taking it
    personally (always have to wonder about this) and then retreating into their
    own “self-righteous” dismissal of CA as a bunch of angry people (deja
    vu–those angry feminists! they’re ruining it for everyone!) Our anger is our
    passion is our action is our vocation is our medicine is our willingness to
    work for a solution that is just and moral and creates better lives for all of

    Are you (or others) going to Dr Tan forums and asking why he insists on not
    using or endorsing using Kototama, or e-stim or non-insertive style? Argue that
    he’s really not being inclusive and professional because he’s not allowing a
    more balanced discussion of other forms of practice at his seminars? Or is it
    his right to advance a medicine he feels is the best, most useful way to help
    people get better and focus solely on that? Especially on his own forum, and at
    his own seminars. You’re okay with that? Because it’s still kind of within the
    system and because it isn’t so angry, right?

    So what about this anger is making you so upset? If you agree it’s a broken
    healthcare system—of which the acupuncture profession is a part, and dying to
    be even more of a part, then you must agree that people are suffering because
    of it. And does that really not make you mad? If not, why not?

    The other reason these discussions may seem simplistic is because we are
    speaking truth to power after being told to sit down and shut up for a few
    years–increasingly lately, as it appears CA isn’t going away and is really
    starting to shake people up. Oh, but its always hidden behind the request for
    nuanced arguments or polite professional tone. 

    Speaking truth to power never feels very good to those with the power. So
    they ask us to be more polite.

    The thing is, polite hasn’t really worked because no matter how nicely we
    say these things, the reality is that many people don’t want to hear the actual
    words we are saying. And no matter how politely you want us to say it, no
    matter how many individuals within the system are good people who got into it
    with the right intention, or how much incremental progress has been made, and
    it has been helping some people a lot, yada, yada, the unvarnished truth is
    that it hasn’t been working for the majority of patients or
    practitioners nearly as well as it could.

    This is what we hear behind your politeness: “We think what you’re
    doing is lovely but don’t ask to include it in our version of what the
    acupuncture profession should be, the one we say represents all acupuncturists.
    We’ve got our course and we’re sticking with it (even though it isn’t working
    and wasting precious resources and letting people suffer). We just want to keep
    taking the blue pill—acupuncture is great and complicated and nuanced, patients
    need privacy and will find a way to give up groceries to come see us, md’s will
    eventually let us take a huge piece of “their” pie, insurance companies will want
    to give us the money, acupuncture education has to be expensive, legislators
    will give a damn about this little thing that almost 90 % of their constituents
    have never heard of, etc etc” So just stay out back and keep quiet, will ya?
    Shhh, stop being so angry. And if we let you in to say anything, we’re going to
    insist on editing it for politeness first.”

    I’m a scrappy, working class, over-educated, uninsured feminist woman
    acupuncturist clinic owner serving hundreds of patients a month, who’s busted
    my ass to get here and been shaped by my experiences and my devotion to my
    patients to have a vision of social justice and healthcare as a human right.
    You don’t think being spoken to like that is going to lead to a little anger?

    There is a power structure that benefits, mostly financially
    and in professional status, from the status quo and will fight tooth and nail
    and with all the politeness they can wield like a club to avoid any change that
    threatens their system. It is the same with every group that has been up-ended
    by revolution. Suffering –> anger at injustice–>moral imperative–>
    quo resistance (i’m so glad i figured out how to do those little arrows so i
    could further simplify the argument–ha!)


    Is the polite professional organization looking out for
    patients? Are they looking out for you? Ask them to prove it. In whatever polite
    way you see fit. And if you get the same lack of straight answers, you might be
    back around to drink with us—not the Kool-Aid, but the light refreshing taste
    of truth in action.


    Honestly, it would be so much easier to take the blue pill.
    But taking the red one has opened my eyes and I’d rather live with the truth.
    Are we perfect at doing all this? Not a chance. Are we willing to hang out
    there and work towards something better?. Over 100 clinics around the US,
    Canada, Israel, UK, etc over 500 diverse, thoughtful CAN members say yes!




    Good health is not a measure of adapting to a sick society.

    When the power of love outshines the love of power,
    the world will know peace.

  55. melissa, this thread has

    melissa, this thread has kept me up nights, and i have been examining my thoughts as deeply as i know how, and questioning my views carefully… and then, you captured it all. every single thing.

    it is a TRUE THRILL to be mentored here; thank you so much. our clinic and patients benefit from the discourse on CAN, filtered through our systems (CAN ones), our approach (CAN-based), and our compassion (CAN-supported).

    through the soul-searching,  i realized that i am a pretty simple person, and that i feel great about restricting my work to one philosophy and methodology. it’s my best chance to do the most good.

    thanks again, so much.

  56. Some nice words

    Yo! CAN folks!

    I am Tatyana and Pam’s new punk and just started a month ago with them. My journey feels delightlfully brave having a support as your blog. School never gave me this, and when I first heard of CAN over a year ago that was when I knew something was being done right in this here and now world of feeling alienated and very much in school debt.

    Lisa’s blogs are brave to me and I think many of you are to stand up and look deeper in ourselves and of our work. Community is a beautiful power to folks coming for acupuncture at our clinics. Our lives and their lives are healing together no matter what we bring to the table or recliner.

    More later, Ellie



  57. Is anyone else having

    Is anyone else having problems with this thread, I only see about 10 responses, and there is nothing indicting where the rest are.  I have a mac so that may be a factor.

  58. Computer issue

    This is strange, when I log out all the posts show up again, but if I log back in they disappear.


  59. OMG….Paul is not a white male at all!

    I happen to know “he” is a gay african american communist female in a wheelchair.

    This totally changes the conversation and I’d like to see it re written in a format conducive to non-white-liberaltrash nazi males. Thank you.

    Frankly I’m embarrassed for you jumping to these assumptions but hey, it happens. Now please re write the post that is more fitting. After all, it matters.