March, 2008

http://health.msn.com/health-topics/articlepage.aspx?cp-documentid=100199524&GT1=31036

New guidelines re resuscitation. No more need for mouth-to-mouth, for adults.

It occurred to me that the last month or so of preparation for opening my clinic has been filled with a lot of really mundane details. It feels great to get all that preparatory stuff out of the way—accumulating the furniture, setting up the reception area, getting the logo designed, making new intake forms, consent forms, and all the rest. I feel like a benchmark has been reached, and I feel like celebrating, but I think an open house is premature. For one thing, I only have one patient so far! Community Health Acupuncture Center in Royal Oak, MI, is finally ready for patients, but are the patients ready for CHAC?

Last week I got an email from the organization that gave me and Korben a loan when we were starting out 7 months ago.  The subject line announced a women-owned business award of $2000.  I almost ignored it completely but it was nagging at me.  I read it.  All you needed to compete, it said, was a completed business plan and a compelling reason that your business could use the money.  I called and it turned out that last year, only one person had applied for it.  I had hope.  

To make a not-so-long story even shorter, I am blogging to say that I filled out the application, sent in the business plan and required legal pieces of paper, and a few days later received a phone call saying that I had won the $2K.  That night they came to interview and photograph me.  Next week I am going to pick up the check.

I’ve been working lately with a very talented rolfer/cranio-sacral therapist who has taken her work to the level of art.  She disappears into her work when the client is on the table, and loses all track of time when working.  She is gentle, yet persistent, and rejoices and celebrates whenever her fingers feel an engagement during the movement.  I find her work quite amazing, and yet here she is, after 20 years of honing her craft and studying with the giants in her profession, still struggling to pay basic bills and sharing a room with other practitioners.

About a year ago, I came across a book by clinical psychologist Elaine Aron, Ph.D., "The Highly Sensitive Person: How to Thrive When the World Overwhelms You", 1996.  Aron writes HSPs (highly sensitive persons) are found in approximately 15-20% of any population (including animals). HSPs have more finely tuned central nervous systems which makes them more susceptible to environmental stimuli.

The stimuli can be noise, fragrance, certain foods, beauty, pain, etc.  HSPs process this sensory stimuli more deeply than the other 80% of people.

 The discussion around Ann’s post below, “To the Acupuncture Community”,  got me thinking about a discussion I’ve been wanting to have with you all for a while now. 

At the heart of the CAN movement is anger at the failure of medicine to serve community. 

I am writing from the United States, the land of the myth of the rugged individualist.  I say myth because the history of any country including this one is that of interdependence of its peoples.   In 2008 the entire world is interdependent.  The sub-primehousing loan fallout in this country is having global repercussions, for instance.  We rise and fall together.  With this backdrop, what is the responsibility of medicine?

I am posting below a guest blog from my sweetie, Paul, describing our new clinic.

I will just preface it with a couple of comments:

We are in Albany, CA, just north of Berkeley.

We had a lovely "soft opening" last Wednesday. We treated 20 people in the first two days of business.

We are currently open 3 days a week and have 30 appointments booked for the upcoming week!

Later this week we are having a space-clearing and blessing ceremony and we plan to have an opening reception sometime in the next month or two.

Our website is here: http://www.saranacommunityacupuncture.com

Photos are here: http://picasaweb.google.com/sarana.acu/SaranaCommunityAcupuncture

-tatyana

Paul's blog:

It is my week to blog, and it’s taken me some time to think about what I’d like to say. At first I thought it would be best to keep private the most recent events in my life and business, but then I realized that sweeping everything under the rug never does any good because it just resurfaces. I could have hidden away and hoped nobody noticed, but eventually anyone on CAN would figure it out. I am no longer an owner of Back to Balance Acupuncture Center – I’m starting over.

On good days at work, which really are most days, I feel
like my grandson Zach’s favorite storybook train, Thomas.  Thomas is happiest when he feels really
useful, and being a Community Acti-punctur-ist * definitely gives me that
feeling.  I feel way more useful than I
did for 10 years of conventional practice. 
Beyond that, I feel useful to folks who, due to class status, income or
age, have fewer options. 

Usually when I need acupuncture I treat myself. So much for relaxation….Typically I’ll lie on the floor as I needle the usual suspects. This past week, out of the blue, a wind invasion hit me like a ton of bricks. I still hadn’t even considered coming to our clinic until I remembered that my business partner had come in the day before. Hmmm….What a great idea!

What better nurturing experience then having somebody ask what’s about you and treat you with acupuncture? It’s so easy to forget how great acupuncture can be when you give it yet don’t receive it. Doing it to oneself just doesn’t cut it. After the placement of Yin Tang I felt as if a collidascope of worlds were swirling inwards as I slowly lost consciousness. It was a great experience. I can see why these people come back every week!

This is inspired by Andy's post below. He refers to an article by Kevin Kelly.
Look it over if you haven't. As I was reading it, my wife walked by the computer and said "oh yeah, that's an awesome article." What I'd like to write about here is why she, an artist, and I, and acupunk, had both come across it, and why it's meaningful to both of us.

My wife, Amy Walsh, has totally changed her relationship to earning a living as an artist over the last year or so. These very conscious shifts have in no small way been informed by Lisa Rohleder's book about changing the business of acupuncture, and by helping me

A week or so ago, the thought suddenly occured to me that my patient profile had radically shifted from my days as a boutique acupuncturist. On this particular morning, we had three patients - one was a middle aged woman who had been sleeping in her car for years. Another was a black man living in a Tent City. A third was a single mother working at a job she hated and generally struggling to get by. The two women have since become regulars and the one who sleeps in her car seems to catch up on her sleep in our recliner.

Well, what do I say? It's been a while since I've been up here blogging, and a lot has passed.

First, let me explain my absence. In December I graduated from that great loan-driven institution known as ACTCM. At that point I buried myself in a pile of books and tried to digest everthing I learned in 4 years of TCM school. February 13, I went through the institutionalized hazing known as the Califonia Acupuncture License Exam, and spent 3.5 tortuous weeks waiting for the results. Last Friday they arrived -- I passed! Woo Hoo. Now I have the right to pay for a license and become an official acupunk!

Today, I renewed my CAN membership and updated from the Student level to the Practitioner level. Yep, I now have a title.

I promised Skip that once I finished the exam I would start posting on the front page again. So here I am, a few months absent, a week past my official turn, and I'm not sure what I have to say. Except thanks.

Hello all, my name is Chad and this is my first blog for CAN, in fact this is my first blog ever. I always enjoy reading the contributions here so I feel a little intimidated to be among such creative folk.

Patients have started asking this question again:  "How long have you been in practice?" I always hate to admit I've only been out of school for a couple of years, but really, it's just a horribly flawed question if the person is trying to figure out how much experience you have or don't have, let alone trying to figure out if you are reliable or able to help them at all.  I don't believe that more experience = better at acupuncture, but just in case it does, community acupuncture is the fastest track around.  

One of the great things about using an online scheduling service like Appointment Quest is that it counts things for you, like how many patients you've seen in any given length of time.  A search just revealed that I have had 1576 appointments in the past 7 months since Philadelphia Community Acupuncture opened.  That averages out to 53 patients a week, including the early and slower months.  I am probably seeing about 65 patients a week right now.

I’m usually ready for blog week but I’m gearing up to movemy clinic in July so time got away from me.  So, I’ll tell you about my wonderful week at CA lastweek. 

I used to have a day job teaching clinical nursing.  I quit the job in December and got aroundto taking the textbooks back on Feb. 29. My top week before last week was seeing 51 visits last September. 

A former classmate called me the other day raving about a clinic she had visited.  This clinic belongs to one of our former teachers.  Anyway, she went on telling me how busy he was and that while she was there, one of his patients left the office after paying a $280.00 bill for one visit.  (Now, keep in mind that she always refers to what I do as "that community thing".)  She thought it was so great that he was making so much money, charging for injection therapy (a big thing here in Florida), herbs and a visit.  "Well, isn't that awesome?" she asked me. Hmmm... 

In his excellent "The Technium" blog, Kevin Kelly posits a hypothetical threshold of "1,000 true fans" an artist would need to make a living while working their chosen craft (http://www.kk.org/thetechnium/archives/2008/03/1000_true_fans.php).

The biz model Kelly suggests strikes me as fundamentally similar to the manner Community Acupuncturists approach their clinics; that is maintaining financial partnerships with many 'modest-paying', appreciative 'fans' rather than a scant number of higher-paying ones.

All-  One of the questions we got from the New York workshops was how can one set up a CA practice where the rent is so high?  Lisa and I answered this too ways:  First that's a problem that all acupuncturists face, not just CA acupuncturists.  Second we have Lumiel's clinic in San Rafael to use as a model.  Her clinic is in a very high rent district and if she can do it solo practitioners anywhere can do it.  I wrote about her clinic last September and below I have rescued that post for all to read and ponder.

First, I want to second what Lisa says below about our great NYC weekend.  Its always great to get out of your comfort zone to get some perspective and this happened for us.  

This past weekend Skip and I went to New York to do two workshops back to back:  a big workshop at PCOM on Sunday and a smaller one on Saturday for some students from the Swedish Institute who couldn't go to the one on Sunday. We took the redeye flight from Portland to New York on Thursday night and arrived bleary and mostly sleepless on Friday morning to find New York in the grip of what seemed to us (wimps from Portland) seriously nasty weather:  20 degrees, snow showers,  piercing wind. 

But it was a beautiful weekend.

After reading Skip's 55-85% blog, I thought "That's the kind of thing you could only learn the hard way". After I thought about it I realized that there are a lot of things that Justine and I have learned by trial and error while we were setting up our clinic. I hope folks find some of these ideas useful; here they are in no particular order:

I found Score to be helpful especially for legal and financial questions and I loved their one day seminar in which they made it very clear how much work being a small business owner is. It also had great ideas on how to manage the finances during the first few years while the business is paying back the start up loans.

We clearly laid out all of our business agreements in a document that included a detailed section on how we would end our business relationship if we chose to do so.

This is one that is about 3 weeks overdue.

As those of you who are following know, February 5th was Super Tuesday in many states, including mine (Colorado).  The next day was free day at the Colorado CA clinics.  For me, given that I am the Democratic precinct committee person for my precinct in a state that was a caucus state, it was one of the most hectic 48 hours of my life, and one of the most inclusive.