Where Devaluing The Profession Gets Personal and Emotional
Lisa's Journal of Chinese Medicine article seems to have struck a nerve in many Acupuncturists, both pro-and anti. I am here writing about what's up with the anti people. I'll get there by way of a detour…
Hey you! Have you seen the movie, Tinker, Tailor, Soldier, Spy yet? I loved it. It also got me to reread the book, written by John Le Carre. If you've never read anything by Le Carre I think you'll be in for a treat. He transcends the spy genre effortlessly cause he's a really good writer. (There's a lot of subtleties in the book that the movie can't do justice to, though the movie is also good.)
At any rate, there's a passage in the book that I want to quote here. It's at a crucial part of the book where the hero, Smiley, has figured things out, which is the Soviets have penetrated the English secret service with a double agent or mole, and is talking to one of the highest ranking spies in the English service, Toby Esterhase, who is totally clueless by what's been going on. Its Smiley's job at this point to tell Toby what's been happening: that a Soviet spy, code named Merlin, has infiltrated the English service by way of a double agent, called Gerald, and he starts off his explanation by way of telling a “theoretical” story. Smiley's been at it for a bit and we enter in at this point:
” …And that's why his (Merlin's) fellow conspirators look to him to deal with Gerald and agree to the terms, the financial terms. Because they do want money. Lots of money. I should have mentioned that. In that respect, secret services and their customers are like anyone else, I'm afraid. They value most what costs most, and Merlin costs a fortune. Ever bought a fake picture?”
“I sold a couple once,” said Toby with a flashy, nervous smile, but no one laughed.
“The more you pay for it, the less inclined you are to doubt it. Silly, but there we are. It's also comforting for everyone to know that Merlin is venal. That's a motive we all understand-right, Toby? Specially in the Treasury. Twenty thousand francs a month into a Swiss bank: well, there's no knowing who wouldn't bend a few egalitarian principles for money like that. So Whitehall pays him a fortune and calls his intelligence priceless. And some of it is good.”
The boldface is by me. You see what I'm doing here? The boldface wording is Smiley telling a universal truth about us humans. There is an underlying venality in all of us humans and we do our utmost to make it okay. In the passage the Soviet spy is using that universal truth to dupe, not just the English spy service but the English government (Whitehall) and the CIA (not mentioned here) as well. The bigger the lie they more they believe.
Again this venality and its defense is universal. So it applies not only to spies but to, oh, to take a random group of people, Acupuncturists. On a certain level what the Boutiquers have preached as a business model, charge a lot of money per treatment, takes perfect advantage of the venality truth: if the treatment costs a lot then it must be good. This it makes total sense that Boutiquers would be upset that we CA people charge so little. We are calling their lie. We are saying that Acupuncture is good AND its cheap.
But wait! There's more! Read the passage again and you realize that the Boutiquers are not just playing a scam, they are like Toby: dupes caught up in the game. They value most what costs most. Its not that they are some smart cynical players fooling their patients. They are just as caught up in the belief that if it is expense then it must be good and if we say that they are wrong then not only are they mad at us they are embarrassed as well. And more: they are scared that people would see them as venal in their core. And so they get all the more upset with us. They really believe in that Ming vase.
Venal is a bad word. In the US, and most likely everywhere on this planet, people do their utmost to pretend that they aren't venal. It gets silly. Just look at the Republican's in their nominating process. People will do almost anything to get away from being identified with that sin. But we all have it, including me and Lisa. That doesn't make it right. And suppressing our venal urges into our subconscious is really not the right thing to do. Yet that's what we routinely do.
Community Acupuncture tries to bring to the light our venal urges, our love of money and comfort. It automatically calls our acu-education into question as well as Boutiquer prices because it calls our love of security into question. It challenges the idea that high prices = right and valid treatment, even if a patient's pain goes away. Note that it doesn't answer the question for us. We each have to do that on our own. For those Acupuncturists who resist taking an honest look at their fees, they are often inclined to get real defensive and lash out in al directions at CA Punks. Their carefully agreed upon way of living is being called into question. Really, its a surprise that we Punks are surprised at all.
And, yes, I am a PK.
God, LeCarre is so good. I thought the new TTSS was really well done too – the mood was amazing, and the casting was really good (the weakest link perhaps was Esterhase); Oldman did a good job, and obviously Guiness was a tough act to follow. And it’s really unfair to compare a 3-hour film to a miniseries (or the novel.) I didn’t quite like the very last shot…but we can argue about that over beers in May.
Oh yeah, good post too, Skip! ;^)
I liked that movie as well. Interesting parallel and makes sense too. Reading your blog I thought of another example – the internet / email extortion scams. I have heard (and actually know of a person who this happened to) that once someone falls for the scam, the more money they lose / send to the scammer the harder it is for them to admit they are being scammed and do something about stopping it – They are stuck. They are embarrassed and they want so badly to believe that they won that special lottery or inherited the big jackpot form a long-lost relative. They know it is not true, but it is just so hard to face reality. In the same way the acupuncture profession cannot look directly at the truth of the situation because it is so damn awful – we have so much debt tied into such useless education and a system of practicing that failed most acupuncturists that try it…
The article has really fired up the infamous Lauren Buckley in Philly- who has sent out an email asking for all of the community acupuncturists and some non who she knows to respond. Here’s mine…
Hmm. So I’m writing my response, intentionally, without having read any others below yet- for the sake of speaking for myself..(other than yours Lauren, obviously). First of all- looking at the names of people on this list who I know, I have respect for lots of you on a personal basis for different reasons.. esp you Laura- because if you hadn’t gotten me a job with Philadelphia FIGHT, I don’t know if I’d be the same acupunk 🙂 I am today. I have a few thoughts on re-reading Lisa’s article. First of all, I think that we all bring ourselves into our interpretations of what we consume- whether it’s a book, tv, movie, or this article. And everyone reads something a little different because of that.. so if you have a strong reaction I’m sure it’s striking a chord for a reason that’s mostly personal. Lisa is obviously very confrontational, and she definitely means to be. The community acupuncture movement is her vision and she has put in a lot of sweat. Is she kind of scary to me.. yes. But in the way that standing on a rocky mountain-top in a thunderstorm is scary.. I would have an open conversation with her any day. She’s just intense, and more honest and real and to the point about things than about anyone I’ve ever met.
Nowhere in her article did she say that other people can’t call what they do “community acupuncture”.. But POCA and the “community acupuncture movement” that she is referring to goes beyond the fact that you treat people in recliners in a shared room (or tables in Laura’s place). Lisa refers to “building a structure” that allows lots of people to get lots of acupuncture. The structure is not just our individual clinics. The “structure” in my opinion of POCA is what makes it really inspiring and awesome. There are going to be lots and lots of people getting acupuncture in this country that would not get it otherwise. Her criticism, and that of other community acupunks of people practicing in “boutique” clinics (ok, I kind of hate hearing that over and over too) comes from a place of being fed up with a very narrow vision of the acupuncture profession on the whole and what we were taught that we should provide to people.. and to which people and comes mostly out of a place of anger about all of the (tons of) people that get left out of that equation.
The “acupunks” i know and have met are people that I deeply admire because of their dedication to patients, and to access.. and they rarely take the time to take anything personally. I am proud to be associated with them. Everyone is human and has their flaws as do I, but my gut feeling is that I trust these people a lot. And I get inspired by them.. which is far less than I have ever felt from the local, national, whatever community, regardless of having a fondness on a personal level. I feel moved to be a better acupuncturist, to address my own issues that may prevent people from feeling able to come to the clinic etc. by associating with other acupunks. I read Lisa’s article ultimately to have a lot of honesty and humility. In an aggressive way. But from where I stand, I read it as not a personal vendetta but as a passion and anger about something that she feels needs to change and happen.
If this article upset a bunch of people I think that’s a really awesome and productive thing. I have a friend, Jethro, who has been a community/grass-roots organizer. This reminds me of something that he said once when he was thinking about going back to school to get a masters in Conflict Resolution- “But I’m not interested in conflict resolution really- I’m more interested in conflict- it’s so much more interesting”. I like that a lot.
I think a lot of it, too, is about protecting their investment – which, thanks to a lot of the continuing ed offerings, is ongoing. So after acu-school, they’ll sink a few more grand into lengthy multi-year certification programs with various big-name teachers. Or they’ll invest in the DAOM. So now they’ve racked up even more debt and they’re not only looking to charge more but they’re very aggressive in protecting their turf – thus the current dry-needling issue, as well as the chiros before them, NADA, etc etc. All this makes for some serious hostility.
On the other hand, i do get frequent referrals from other acupuncturists who charge a lot of money; they’d rather see a potential patient get acupuncture even if they can’t afford the practitioner’s fees. Some of them even come to see me for treatment. So it’s not every private-tx acupuncturist that’s hostile. I think it’s mainly the ones who are insecure who see the situation as a zero-sum game. “If my patients get word that someone is charging a fraction of what i charge, they’ll desert me.” But if they can’t afford to pay you anymore, they’ll desert you anyway and not get any acupuncture at all. Who has the patient’s best interest at heart?
Where’s the beef?
As a person who avoids social media and internet forums beyond this one the article is news to me, as is the apparent backlash. I only saw this because I figured that it had been months since looking in the blogs. It’s not as convenient as the old ones and I’m greedy with my time lately.
Anyone have any links to some of the commentary? I’d love to see the criticism once I read the article. I still hope to find some well thought out criticism of community acupuncture one day since the only way to get stronger is to challenge ourselves and ideas. Nothing yet beyond knee jerk defensiveness though.