The Yin and Yang of being a CAN practitioner.

Lately I have been discovering the dance of yin and yang in my own practice, as I attempt to teach this concept to my students in my introductory class at the local community college.Each quarter thatI taught this, I would give them a list of yin words with a match list of the polar opposites, the yang words.At the end of the quarter, their understanding of this was improved but not profoundly.I tried demonstrating the contrasts by playing games and using physical examples and demonstrations, but time and again found all of us sucked into the delusion of one or the other.As soon as we got comfortable with one, we’d lose our vigilance, and the yin would become yang without our noticing, and confuse us.Or yang would become yin.

When I first embraced the CA concept in 2006, the entire concept seemed so elegant in its simplicity and power: lower costs and fees, simplify treatments, treat more people in an hour.In the following two years I discovered that these principles work! And I also found that by espousing this new model of acupuncture delivery to the public, I differentiated myself from the rest of the rank-and-file acupuncturists.I became a “nice” and “kind” person in the eyes of whomever was given this manifesto: empower the people by offering an affordable treatment!By continuing to see myself in this new role, I found myself offering succor to not only the ordinary grateful local citizens, but also the down-trodden poor and depressed, the whiners and the blamers.Here I had continued to expand outward without caution, in my careless compassion, and these elements just came right in and sucked me up into their dramas.Ouch.It didn’t take long to realize that I needed to balance my attitude in seeking new patients.

I still believe in CAN’s mission is bringing affordable acupuncture to the masses, even more ardently today.But I now realize that running a clinic like this is lots harder than running a business simply because you want to make money.It takes constant vigilance to keep a balance between yin and yang, between offering and accepting, welcoming and setting boundaries, spending and earning, opening and closing, moving swiftly through the treatment and making the patient at the same time feel as if you are completely focused on them, letting your intuition guide your choice of treatment while remembering the advice of your teachers, making your clinic beautiful but comfortable, the list is endless.

I decided to write this because I realize that new CAN practitioners could be struggling with this.They may be asking themselves if the CA idea isn’t the remedy they thought it would be for them, because their expectations aren’t being fulfilled.This certainly happened with me in the beginning when I operated out of a three-chair clinic, and found that although I had more patients than ever before, I wasn’t earning enough money to more than meet expenses.Like me, many of the smaller clinics were hesitant to take such financial risks by expanding into a large clinic. I added another chair, and later moved to a larger place that gives me 6 chairs (actually 4 chairs and 2 tables).Around this time Ann Mongeau conducted her survey of the CAN clinics, and showed statistically that the clinics with a minimum of 7 chairs were financially successful.This also confirmed the original premise that high volume coupled with low fees could create a sustainable practice.High.Not medium. The yang expansion created a large enough space to welcome in (yin) more patients which brought more income and a more complete community.

Another common example is the startup panic when some patients seem to be dissatisfied, and they leave or they complain about things.Or they leave because of financial constraints.And you think: this isn’t supposed to happen when my fees are so low!Then you start doubting your own knowledge base or your competence, and you make mistakes because you’re no longer comfortable in your personal space.Your diminishing patient load pulls you into a yin-spin, and you think about the rent that’s due at the end of the month, and you have a harder and harder time feeling positive about your business.Maybe you lower your standards a bit and accept a patient you know is going to be difficult, emotionally.You find yourself willing to work at inconvenient hours for just one patient.You may be telling yourself that you need to do this to bring in enough money.Before you know it, you’re at the bottom of the barrel, focusing on — guess what–money.From starting out with a starry-eyed vision of taking care of a large community of patients who need your expertise, you’ve arrived as this struggling acupuncturist wondering if you made the right choice, because you’re no longer having fun.

You can change this in an instant.

I look at the successful practitioners and interpret their main attitude as yang: expanding outward to look for all the people who need their services.They think in terms of reaching the largest number of people possible to help, in contrast to pulling in the largest number of paying patients to keep their clinic and their lives afloat financially.These practitioners have managed to step over that delusion of money being the foundation of their business; they intuitively live in a constantly rejuvenating energetic spiral outward, this spiral bringing their services to more people, who in yin turn bring in more business but more importantly their pure qi, which circulates in the clinic and in the clinic’s community to give it solidity and life.This dance of yin and yang, in my opinion, is what is making some clinics really successful.

Most of these practitioners never did this intentionally.They are, as Larry G. has said, Expressing Themselves.They are expressing their belief in the perfection of humanity and themselves by aiming their life’s work at the high ideal of social justice for all.They are so fired up by this bright vision that momentary setbacks and patient difficulties or challenges are minor problems, because the goal is bigger than they are.Patients seem to sense this, as they connect with these practitioners.They trust them because they know their acupuncturist is genuinely concerned about them as humans, not just as customers.They relate to them on an impersonal level, as a human, not as a named identity.I suspect this is why they have no qualms about discussing their complaints during intake in a crowded reception room. You would think that people would want to be recognized for their individual, personal selves first (as often happens with a private practice).But now I’m beginning to think that if we are treated as the sacred humans we all are, we get more satisfaction out of that kind of rapport because we are treated with more kindness and respect.

Here’s a Thanksgiving blessing I pulled out of a Real Simple magazine:

“Bless this food we are about to receive.

To those who hunger give bread;

And to those who have bread give the hunger for justice.”

(traditional Latin American grace)

Author: lumiel

I earned a B.A. in Hotel/Restaurant Admin, but soon realized that I wanted to do something more meaningful.  Became interested in nutrition and education when pregnant with my first child. Interest in health led me to becoming a foot reflexologist, which led to a massage practice and suddenly discovering the love of my life: Chinese medicine! Practicing for 18 years, Hawaiian/Californian, acu-educated PCOM San Diego/OCOM Portland. Started my CAP in <a href="" target="_blank">San Rafael</a>, Marin County, July 4, 2006, even while earning my doctorate at OCOM.  This didn't seem to make sense, but it was my way of comparing the old way of practicing acupuncture to a simpler, truer expression of what I had learned in school.  I love it. And I love being a part of this grand movement to change the world by being true to our conscience. Reopened all over again when I moved to a place where no one had ever heard of me. 3 months open so far, and just beginning to meet expenses. I have no doubt this will succeed and I will be hiring by next year.

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  1. lumiel, this is so interesting – we are just re-visiting and re-organizing around the idea of giving lots of free acupuncture to as many people as possible and planning to do as much of it as possible and focus more on the number of treatments we give rather than the amount money we bring in. good timing for this beautiful post. thanks! -tatyana

  2. Tatyana, can you please

    Tatyana, can you please explain this further?  How are you giving as much free acupuncture as possible?

    Lumiel, thank you for writing this.  It is amazingly timely.  As an owner of a new CAP, I have spent plenty of time fighting the internal battle between worrying about patients and worrying about money.  Your words struck a chord with me tonight.


    – David 

    Circle Community Acupuncture

    San Francisco

  3. david, i did not say that we wanted to give as much free acupuncture as possible, but that we wanted to give free acupuncture (as in one free treatment) to AS MANY PEOPLE AS POSSIBLE. many ways to accomplish that – you are doing some of it very successfully already, as far as i could see from visiting your clinic (and you gave me some good ideas too!) i can tell you the stuff we are trying / planning when i see you, but i think i will write about it on CAN separetely at some point when we get going more.


  4. goodness

    Lumiel. This is so beautiful and so important – both for new CAPS to kow and for all of us to remember.

     Yes, there’s this kind of faith-filled opening up and offering of ourselves which is not the same thing as business smarts  but its what creates the energy towards which our patients come. They arrive, expecting basic goodness and basic competence from us, and contributing their own basic goodness and upward trending energy back into the pot. From the moment of understanding what we’re offering, patients mostly decide to show up acting IN (yin) instead of acting out, ready to receive and to make room for and invite others.

    But, thank you for reminding me to look at it in yin and yang terms. That really helps me understand what’s happening, and that yes, I get to go keep being expansive and yang, that we jut get to keep going and getting to know everyone in our communities.

  5. Yin-Spin

    is my new favorite term to describe how I feel when I am worried about my clinic, worried about my acupuncturists, worried about money.

     You are so right that balancing with some yang energy, promoting the clinic, talking with folks about what we’re all doing, or even just projecting myself into my body (yang) and out of my mind (yin) balances out the yin-spin.

    Got that yang-thang for my yin-spin. 

    Great post Lumiel.  Thanks.