When the Trickster Starts A-Pokin’

Alert reader Nancy Sutton sent me a fascinating article published by none other than our friends at MPA Media, who are of course the very same — just in case anyone has forgotten — publishers who fired me from Acupuncture Today.  Yes, I can hold a grudge for years, thank you for noticing, but really, that's not the point. The irony here can only be fully appreciated after you have read the article in question.

But before I link you to it, I have a warning or two. The article is relatively long and detailed, so you'll want to read it when you have a little time. It's about chiropractic business models, so you'll want to read it when you have some readily available brainpower (perhaps not at the end of a busy clinic shift). Most importantly, however, you'll want to be careful about reading it on a full stomach. Certain paragraphs made me want to throw up. And if you make it through the nausea and go back to re-read it, as I did, you might feel the need for an antidote to that particular kind of crushing depression that vexes those of us who think that health care and social justice should not be mutually exclusive.

Might I recommend Gogol Bordello as a soundtrack to this post. I had to listen to them for an hour or so before I could tackle it. Here, let me help you: When the Trickster Starts a-Pokin'.

Optzay! Now here's the article: The Sustainability of Chiropractic, by Greg Stanley.

The success of chiropractors in securing insurance reimbursement and subsequently making oodles of money has been used by people in the acupuncture profession to justify all sorts of nefarious shenanigans, classified under “following in the chiros' footsteps” or “learning from the chiros' example”. These shenanigans include, but are not limited to, advancing an ill-conceived first professional doctorate and cancelling my column in Acupuncture Today. So now we hear, from someone who sounds like he really knows what he's talking about even if his approval of healthcare profiteering seriously squicks me out, that actually, the chiros are now headed back to the place we acupuncturists already are — where the practice that you spent $100K to learn is, if you're lucky, a second job.

Perhaps some of you read the article and wondered, what did he mean by “the box on the wall era”? Let a chiropractor who is still doing it explain it to you here.

And for another, significantly less repulsive, discussion of the evolution of chiropractic business models, read this.

Here's the take-home message as far as I can tell: there is no way to really provide complementary/alternative preventative care without making your services very inexpensive, very convenient, and independent of insurance reimbursement. Chiropractors have taken a long, roundabout, morally dubious detour from reality in an effort to get away from the box on the wall, and it didn't work out. The choice seems to be between being “an underpaid and under-respected industry” (Stanley) and “using a patient's financial resources as a guideline for clinical recommendations/stealing” (Esteb).

Mama, of course the hopes are so fragile/ Papa, I can't believe what it costs!/ …so I did, what I did, and it's worth, what it's worth, what it's worth!  Hey!

I don't know about you, but aside from the disgusting parts, I found it pretty cool to read about the old box on the wall practices and see how similar they are to our community clinics. Whole families coming in for care.  The practitioners embraced by their communities and “highly committed to the concept of natural healing and serving for the sake of serving” (Stanley).  An entire industry gave all that up, for a source of money that is now withering away and a huge public image problem; yet for many acupuncturists, that's the industry we should all work harder to emulate.

Hey! I'd like to see you try it! What you gonna do about it…

And then along comes community acupuncture, cheerfully devaluing the profession. The trickster starts a-pokin'.

When the trickster starts a-walking/ He sends the whole world askew/ just when you think that it's all through/ it's just the birth of something new…

Comrades, I certainly hope we are the birth of something new. And if things keep going the way they look like they're going, in the wide world outside of health care business models, I might get to use Underdog World Strike as a soundtrack for a future post.

Let's go.

(Cross-posted in Prick, Prod and Provoke, where you may leave all your profanity-laden diatribes in the comment section.)



Author: lisafer

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