So You Just Graduated From Acu-School….

All of us have been in this position or are in it now: brand new in the
field, no experience, trying to start a practice. How do you get people
to see you? Why would anyone see you and not some more experienced
practitioner a half mile away? How do you get traction in your

Stop right there.

At this point there’s two directions a practitioner can build their
practice and you can see both of those ways in the questions I just
write above. 

1) One way is to concentrate on your practice.

2) The other way is to concentrate on you.

Do you see both of those points of emphasis in the first paragraph?
“You” and “practice” are the two independent variables in the first
paragraph. Let’s see how they are actually almost completely mutually
exclusive in real life.

1) Concentrating on your practice

If you do this you focus on what patients need. Not what they think
they need but actually what helps them.  The success of your clinic is
dependent on helping the patients feel better. As a result, you treat
in a style that fits you, that matches your personality. You are
authentic and being authentic with your patients is what drives your
clinic’s success and your happiness. How you treat your patients,
technique-wise, is very specific to you. In other words you will lose
most of what you were taught in school and keep and augment only those
techniques that you feel best at in working with your patients. 

Because you are concentrating on your patients in this way your
technique becomes quite simple. You sift through what you learned in
school, discarding most of it, then add knowledge along the lines that
you have set out for yourself. Since your technique is simple it is
easily and quickly replicated with most of your patients with success.
You have a CA clinic and your numbers are driven by word of mouth.
(Yes, you need to do some marketing at first. That is covered on other

2) Concentrating on yourself

There’s that video going around that illustrates this perfectly:

You go down this route and your practice becomes an extension of
your self-image.  You concentrate on techniques and on building your
authority vis a vis your patients. You become an expert. The success of
your practice is dependent on how good your patients think you are. In
other words you become, “a small, exclusive business offering a
customized service.” That quote is the second definition of the word “boutique” on
Your clinic should go down the route of a boutique clinic because your
emphasis on yourself makes it that you have to spend more time with
your patients so you have to charge more. One just follows the other.
Your patients need to know you more and that takes time. Time is money.
A BA clinic. 


Okay that’s a quick primer on how a CA clinic vs. how a BA clinic
develops. But can’t a person develop both aspects or both of the
variables that I identified above: “you” and “practice”. Are they
really exclusive from each other?  In other words, can’t one have a
successful “hybrid” clinic? Can’t a practitioner have a table off in a
private room where they work on the “really hard cases?”

The answer in the real word is: no. That only very rarely works.  Why? A couple of reasons: 

– From the point of view of a CA practitioner there are no “really
hard cases” or cases where you have to spend more time with the
patient. People are people are people. Oh yeah-there will be a bunch of
patients who you won’t cure. But that’s true with any type of medical
practice the world over. That’s an important lesson that schools teach
that you have to drop when you step into the real world: you aren’t
gonna cure all that many people. A bunch of patients you can help just
by managing their pain. Some patients you won’t make a dent in. Being a
BA practitioner and spending more time with them won’t help. That’s

– From the point of view of the BA practitioner, your practice is
dependent on your patients being wowed by you. So in theory you can put
some of your patients sometime in a chair and do a simple treatment but
then you’ll have to make a decision: either that works for most of your
patients and you wind up going CA or you realize that giving patients
cheaper simpler treatments drives=down patient loyalty and you aren’t
getting enough cash flow to stay open.  

So it is hard to combine BA and CA into a hybrid.  Not impossible
but very hard. In my experience I find those practitioners who try
hybrids do so more out of fear than anything. They tend to be confused
about their priorities, their goals and that makes it likely that that
clinic remains anemic, barely able to stay open. Yes, there are
exceptions, hybrids that are making a profit. But since you can count
them on one hand, they are exceptions that prove the rules that I state


Both types of clinics can be effective and by effective I mean
successful financially. However most graduating Punks eventually fail
financially and a lot of them go out of practice. We started CAN
because we knew the BA model was just not working for a whole lot of
Punks and we figured that was because at least some of them didn’t have
an interest in building a practice around their ego* and so miserably
failed. Like Lisa and I did. Laughing Eventually
we figured out how to practice using a different starting point:
concentrating on your practice. It led to us to a different set of
conclusions on how to set up a practice. And it worked for us. So now
we have an alternative, a quickly growing alternative, and that is what
CAN is about. 

However everyone is a little bit different from Lisa and me, and so
that is why we have the forums: to discuss how we deal with our
differences so more of us can be successful. But right now ask
yourself: how much of your practice is about you and how much is about
your practice? If you have a little in both camps, talk about it below
because it is really important to get clear on this. 

* Realize that when I use the word ego I am not being pejorative.
All of us here have an ego. Yeah, we are told by some that perhaps it
would be a good thing to lose. But you can’t just lose it. There are
reasons that we have our ego.  In fact I would say that one should
learn to see it for what it really is and that you have to do that
before you try to lose it. So for some of us, by my way of thinking, it
is better that we own our ego so the whole world sees it so we see what
it really is. If that means running a BA practice, that’s fine.  

Skip Van Meter
Author: Skip Van Meter

Skip is Lead Acupuncturist and Co-Founder of <a href="" target="_blank">Working Class Acupuncture</a> in Portland, Oregon. With the earlier part of his life spent acquiring knowledge about geology, urban planning and teaching high school, he has now been an acupuncturist for 19 years, using about a 1,750,000 needles poking his patients. He likes all things soccer, has three fabulous sons, the best wife in the world, and a great dog and two cool cats.

Related Articles

Survey of CAN clinics

Skeptics in the acupuncture community say that CA clinics can’t be successful.  A variety of reasons are cited – prices too low, patients want one-on-one attention and wouldn’t like treatments in a room with other people, Dr.


  1. Thank you

    for making this a blog post.  It’s just a nice clear explanation of why you have to totally commit to CA to make it work, and I think this is good information to have available to non-CAN acupunks.  Now when someone tells me they want to try CA but they’re going to keep their private rooms or only have CA available once a month or some other form of a hybrid, I’ll give them this little bit of homework to read…

  2. wow. reading this at 7am.

    wow. reading this at 7am. completely inspiring.
    every time i read something that really breaks down the heart of CA (like when I read the first few pages of Noodles) i find my self dumbfounded by the obvious, practical, loving, magical space that has been created through CA for TCM. Forget A-HA! moments. I love a good DUH! moment.
    -TCM student, CA fan