From Lisa's Inbox: Part One

For my blog entry this week, I wanted to share two letters that I’ve received recently, because both of them have to do with the public aspects of CAN, and I figure that’s your business, all of you, as much as it is mine, and that they belong here, because this is CAN’s public blog.

Part One is the following letter, which was not anonymous. I responded, and asked the sender for permission to also respond publicly here. I never heard back, so I’m not going to share the sender’s name, but I am going to share the letter itself, because I think it raises some important issues:

[i]Hello:

I am a huge advocate of what has been labeled "Community Acupuncture" but feel that there is a need to honestly acknowledge its origins. Those of us
associated with The National Acupuncture Detoxification Association (NADA) have been providing treatments in a group, supportive, and barrier-free environment for over 30 years. I believe this is truly what set the stage for the emergence of "community acupuncture."[/i]

My first take on this letter was that the sender felt that CAN was not sufficiently acknowledging the influence that NADA has had on CAN’s formation and activities. This was one reason I wanted to post this letter here, since the purpose of this blog is public discussion -- and public acknowledgement. I replied to the sender that I, personally, have been hugely influenced by NADA, and have been very open about that. I think I made my debt to NADA fairly clear in [u]The Remedy[/u]. Without employment in a NADA program, I would have almost certainly joined the ranks of the 50-80% of acupuncturists who give up on acupuncture less than five years after graduation. NADA taught me about group chi; NADA established my faith in simple treatments; and NADA was for years the only place where I felt like acupuncture and social justice were on speaking terms. NADA was pivotal, irreplaceable, enormous in my professional development.

But that’s just me, and I’m not CAN.

Everybody better be nodding right now.

Seriously, though, that’s the issue. [u]The Remedy[/u] was about me and WCA, and anybody who read it would know how important NADA was to me and WCA. But CAN is about more than me, or WCA, or NADA, and probably there are folks in CAN who haven’t read [u]The Remedy[/u]. So just in case anybody who hasn’t, is thinking that I don’t owe a lot to NADA -- have we set the record straight on that?

Now about CAN, and NADA. I’m not sure if the person who sent the letter is suggesting that CAN should reference NADA more often when we describe what we do, but just in case, I want to clarify why we don’t.

First: one of the basic tenets of CAN is that acupuncture has been community-based for most of its long history, and is still community-based in much of Asia. No one that I know of is claiming that CAN invented community acupuncture. CAN members treating patients in community settings owes as much to the example of hospitals in China as to the example of Lincoln Hospital in New York (the birthplace of NADA). I can think of a number of CAN members who ended up here not because of acudetox training, but because of an internship experience in China. Community acupuncture is really the traditional standard, not something that any organization can take credit for creating.

Second: one of CAN’s goals is to promote a business model for community acupuncture. This differs significantly from NADA, which focuses on the clinical use of acupuncture as an adjunctive treatment for addictions and mental disorders. Much of NADA’s work occurs in public health settings, which are funded by grants, donations, and/or state and federal funding. CAN seeks to develop clinics which do not depend on any of these funding sources. Educating acupuncturists about creating a sustainable, community-based, fee-for-service business often requires persuading them to relinquish once and for all the hope that some other entity, like the government, will underwrite their acupuncture practice.

Third: an unfortunate byproduct of classism is the assumption that patients who can’t pay market rates for acupuncture are more likely to be addicted or mentally ill. The truth is that addiction and mental illness have no respect for socioeconomic status and afflict all classes of people. Patients in community acupuncture clinics are no more likely to require NADA treatment than patients in boutique practices. Nonetheless, many acupuncturists persist in assuming that a clinic that does not charge market rates must be doing public health addictions work, as if there were no other possibilities. The last thing CAN wants to do is to feed those prejudices.

I would be very sad to think that CAN’s success was in some way diminishing NADA’s -- and really I don’t think that’s possible. I remain somewhat puzzled by the letter, and I’d welcome your comments.