Does it Tingle?

Acupuncturists believe we’re the best-trained, most-qualified, most-effective providers of acupuncture. Many of us believe that our personal style of practice is superior to other styles and traditions.

And, we panic when faced with competition.

News of non-acupuncturists using filiform needles, a low-cost clinic opening in the area, or, a splashy franchise, are met with a combination of outrage and disdain, and fear that our practice, our clinic, the profession, won’t survive.

It’s an interesting juxtaposition. We’re the best, and, if the public has options we’re doomed.

There are reasons for concern. We’re burdened with debt. There’s consumer confusion. Reimbursement rates are falling, and, yes, competition is growing.

Efforts to increase educational hours, require additional training and certifications, add new titles and degrees, increase involvement of third party payers, and to “protect our turf,” have too often contributed to those problems rather than being the promised solutions.

We haven’t, with few exceptions, explored why clients would chose someone else’s services. Or considered how we might respond to client needs in mutually beneficial ways.

One notable exception — in 2002 Lisa Rohleder and Skip Van Meter founded a clinic to make it easier for more people to get more treatment, while also providing a stable income for practitioners. Lisa wrote a series of columns for Acupuncture Today to share her system with the profession as a whole. (These columns are excellent reading for all practitioners, whether or not sliding scale/community acupuncture is of any interest. Visit POCA for more information.)

After her sixth column, the Executive Editor of Acupuncture Today wrote to Lisa – “we are concerned about continuing your column under its current “theme”, for lack of a better word. While the concept of social entrepreneurship, particularly the “pay according to what you can afford” aspect, is admirable, it has dangerous potential from the perspective of professional advancement.”

Crazy, right?

Contrast that with AT’s love for Modern Acupuncture. Marilyn Allen, AT’s editor-in-chief has a new mantra – “Modern Acupuncture will save the profession.” She exhorts us to appreciate their “different” marketing, which, after all, has been designed by a top advertising firm to appeal to the “target demographic” (people with money). She even says we we should join the NCCAOM in promoting their advertising campaign.

I dislike MA’s marketing campaign, and I won’t promote their advertising. I’m sad that instead of, for example, exploring barriers to practice in underserved areas, we’ve got powerful voices touting acupuncture for hipsters. And I’m angry that Marilyn Allen and AT rave about MA but saw danger in “pay what you can afford.”

Meanwhile, rather than dwell on my judgements about how others practice, I choose to learn from my competition. Are they filling an unmet need? Is my pricing, location, schedule, office procedures, or technique keeping me from being more successful? How can I better serve my clients?

My patients don’t owe me anything. It’s their right to decide whether I serve their needs. If I don’t, I hope they will find someone who does. I wouldn’t be happy if there were serious competition down the street, but I’d try to learn from the experience.

We don’t have evidence that patient outcomes or satisfaction depends how long the practitioner went to school, the style of treatment, the treatment setting, or the practitioners titles or certifications. Different patients have different preferences and priorities.

There are many reasons to think the new acupuncture franchises won’t save the profession. Running the numbers raises doubts. Reports from early employees have been less than glowing.

So, I’m not counting on Modern Acupuncture to save us. Nor do I fear they’ll destroy the medicine. (It’s survived quite a lot over the millenia). My concerns for the future of the profession have nothing to do with competition, whether from LAcs or others.

My concern is that we don’t seem very interested in what our potential clients tell us they want. My concern is that we chase after the respect and acknowledgement of the establishment, even as the cracks in that establishment and the unhappiness of the participants grows. My concern is that some of the most powerful voices in the profession seem so clueless about what it’s really like to be a working LAc, and how their plans and policies so often hinder rather than help.

I don’t know whether that tingle I’ve been hearing about is the precursor to a pleasant thrill or shingles. I’ll focus my efforts on taking good care of my clients, supporting increased access to acupuncture for those who want it, and hoping that those with power use it for good. I hope you’ll do the same.

 

Copyright —

© Elaine Wolf Komarow and The Acupuncture Observer, 2013-2019. Unauthorized use and/or duplication of this material without express written permission from Elaine Wolf Komarow is prohibited. Excerpts and links are encouraged, provided that full and clear credit is given with specific direction to the original content.

10 thoughts on “Does it Tingle?

  1. Elaine, thanks for this information! Public info lists Marilyn Allen as “an adviser to the brand”, and I agree that this should be disclosed whenever “Modern Acupuncture” is mentioned in AT or any other public venue, regardless of whether or not she benefits financially from her relationship with them (just as the Washington Post always notes that the Post is owned by Jeff Bezos whenever they mention Amazon.) Here’s another article on their model: https://www.franchisetimes.com/August-2018/Into-the-Zen-Den-at-Modern-Acupuncture/

  2. Love this article. There are many barriers to becoming a successful practitioner, particularly when you’re not in a coastal area, which don’t seem to be on anyone’s radar.

    I came to acupuncture after a fairly lengthy corporate career and I’m continually running in to the same mind-set which drove me out of that environment – unwillingness to change/adapt when something is clearly not working or giving the return we thought it would, combined with unwillingness to think outside the box when considering potential solutions.

    I’m also not particularly enthused by many of the current advertising campaigns I’ve seen. Some of them are pushing the boundaries for what I’d consider ethical (e.g. guaranteeing results or giving the impression results are guaranteed). It saddens me to see our local and national organizations apparently getting behind such advertising.

    • I was just reminded that there are brochures out there which show Marilyn Allen as a “Strategic Partner” of Modern Acupuncture. I don’t have documentation of that, and I’m not sure what a “Strategic Partner” is, but it sure is unethical if she has a financial relationship with them and isn’t disclosing it every time she talks them up.

      It’s a huge shame that there is such a shortage of practitioners in so many areas of the country, and no one is taking that shortage seriously. All our efforts to get Medicare Coverage/be seen as a solution to the opioid crisis/help with Veterans are false promises if we don’t have LACs where they’re needed.

  3. Thank you, Elaine, for your thoughtful and informative post. I am late in my career and have not gotten involved in the fray, but have sniffed around the edges. I have a sense that the way some of us have developed our practices, i.e., authentically patient-centered, has less and less room in the marketplace. I find acupuncture, despite its increasing visibility, is misunderstood by many. Dry needling is an example of how acupuncture is misunderstood. I think the tingle is leaning toward shingles.

    • It might be good for the community to explore what makes an authentically patient-centered practice. For instance, I find most people respond to requests for discounts on services to be shock/taking offense/feeling it’s inappropriate. With the underlying belief “if you really valued my services you would find a way to pay.” Many of us were even taught that. I’m not suggesting we don’t take care of our own financial needs, but the “if you value my services” mindset isn’t patient centered. Likewise, when practitioners discuss whether it’s okay to rent that new office that’s at the top of a flight of stairs, an awful lot of the responses focus on whether it’s possible to have a successful practice that’s upstairs, not on ADA compliance or how that space might serve patients.

      If patients truly want a low-priced Saturday afternoon treatment that won’t take too much time, is a MA treatment patient-centered?

  4. Nice column and Happy New Year. I do not know anything about Modern Acupuncture. I do know Ms. Allen has a robust AOM insurance business. As the principal in AAC – which sounds like an acupuncture advocacy group – she is a frequent participant in professional meetings. I attended a recent California Acupuncture Board regulatory meeting. Someone who identified himself as a representative of AAC said they had 150,000 members. A CAB staffer responded there were quite a few less LAcs in the nation and followed up with “isn’t AAC an insurance business?”

    What I want to share is that the January 2019 issue of National Geographic features the “Future of Medicine: How New Technologies and Ancient Remedies are Changing Medicine.” The issue mostly focuses on AI and synthetic DNA etc. However (soft drum roll) the Secrets of Chinese Medicine piece is excellent. Out of place? Not at all. Very even handed in how “thousands of years” is managed. Info on using Chinese herbs and their emergence in synthesis forms is fresh. I did not realize a formula is very near FDA approval. Highly recommended.

    • I have no idea how they came up with 150,000 members. But I do know that by purchasing their insurance you become part of the AAC. Many people are part of the AAC because they needed insurance (and for a long while it was pretty much the only game in town), and have no idea that the group is playing such a major role in policy decisions in the profession.

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