More Stories from The Integrator
Posted September 12th, 2007 by Skip
Alert readers will remember our comrade in blog-land, John Weeks:
http://theintegratorblog.com/site/index.php?option=com_frontpage&Itemid=...
Recently John posted 2 stories which included discussions of CAN, and which make fascinating reading for anyone interested in community acupuncture. He asked Lisa for her comments, which I thought should be posted here too. Happy reading!
Dear John,
Thank you for posting the two recent pieces that addressed low-cost, high volume business models for massage http://theintegratorblog.com/site/index.php?option=com_content&task=view... and the resonance of group visits with holistic healthcare http://theintegratorblog.com/site/index.php?option=com_content&task=view.... I’m most interested, as you know, in combining those two concepts to create greater access to acupuncture for as many people as possible. It’s very exciting to receive news that these approaches are gaining traction in other areas of medicine.
You commented that it’s “interesting how the venture capitalism of Massage Envy and the collective consciousness/socialism of WCA find their way to similar models”. Paul Hawken in his new book suggests that humanity is creating new forms of organization as a biological response to our ecological crisis:http://www.evidenceofhumanity.org/story.php?id=226
The hope is that we are evolving toward creating structures that better serve humanity as a whole, and whether we call them venture capitalism or communism is less important that what those structures can actually accomplish.
In terms of complementary/alternative medicine, I believe that we are experiencing our own form of evolution as well. We are past the infancy of CAM in this country and unmistakably into its adolescence. Our current struggles are adolescent struggles that will be resolved, I hope, by maturation. “The struggle to create successful business models in complementary healthcare” is a function of two classic attributes of adolescence: an unstable identity and extreme self-centeredness. I feel I can state this with confidence with regards to my own discipline, acupuncture, but I think it applies to a number of other CAM disciplines as well. We don’t really know who we are, so we try to be what we’re not -- usually MDs, though we’ll settle for being spa therapists as well, if that niche appears to be open. We worry a lot about titles, turf, and what other people think about us.
We don’t, honestly, have very much interest in patients, not the selfless kind of interest which is supposed to characterize medicine. What Massage Envy and Working Class Acupuncture have in common is a willingness to adapt the delivery of care to what the patient actually needs and can actually use in real life, which is why both businesses are successful, even though they come from different ideologies. It’s also what distinguishes them from other CAM business models. A lot of CAM disciplines can’t get past the issue of whether insurance will pay for our services ( a subset of “what other people think of us”) even though it ought to be clear that insurance is not responsive to us or to an increasing number of patients who are uninsured or underinsured. CAM in general sees no problem with abdicating our responsibility to be financially accessible to patients to a lot of huge, third-party, for profit corporations -- and then we wonder why things are going so badly. Adolescents tend to be naive, too.
Dr. Gmeiner comments that, “If you have an educational or patient empowerment focus, group visits are it.” The problem is that CAM does not have a patient empowerment focus, not yet -- we are far too insecure for that. Group visits do have better outcomes, in part because there is less room for practitioner egos. CAM in general will not be interested in the benefits of group visits until we outgrow our current self-centeredness and get interested in real service to real patients -- the vast majority of whom cannot afford boutique medicine.
Lisa
Re: More Stories from The Integrator
Rereading through this entire thread, I see my comments above may have been a bit off the cuff. To be painfully honest, I probably still have a little of the turf war mentality working its way out of my subconscious like a poison being released slowly from my Liver.
As if a hypothetical corporate Acupuncture Envy could come in and co-opt the CA movement with a groovy-chi nation-wide chain of acupuncture salons? I don't think so.
Okay, there's my small mindedness out in the open. But fortunately, it doesn't rule my thinking all the time. When I look at CommuniChi, our patient volume is growing every month, and why not? - We had Skip, Lisa, and Lupine and too many others to mention, helping us get started on the right foot, we love what we do, and we are more concerned about our patient's well being than the amount they are dropping in our payment box.
The Chi is flowing, and it's a delight to hear about other clinics and their successes. Acupuncture can change the world!
Perhaps there is a place for the type of clinic you envision John. And perhaps it could even be a bridge helping new acupuncture graduates gain a footing in CA style acupuncture while assisting them in starting to pay off their school loans. It wouldn't really be CA as defined by CAN unless they adhered to the $15 to $40 scale, but I'll try to be more optimistic and open minded, and consider the possibility that if such a venture were ever to be initiated, that it could be an important stepping stone for our profession.
I don't know of any CA clinics located within the downtown core of any major city (i.e. the high high rent district), and one would expect the prices to be a little higher just to meet expenses.
All idle speculation for me at this point because its obviously not my path to break ground in that direction, but thank you (John) for giving me cause to temper my remarks. And thank you for the support you offer CAN and CommuniChi.
Re: More Stories from The Integrator
I first began thinking of CA as potentially a more commercial model in 1997-1998 or so. Liza Goldblatt, then with OCOM, and I and others were part of a group working with the possibility of developing a not-for-profit health/wellness center inside a large for-profit natural foods superstore. (Natures, which had recently been purchased by General Nutrition Centers.) An interesting element to this hybrid was that a partner was the school of public health at Oregon State Health and Sciences University. The planning was never realized.
Then, as dot-com and magical thinking venture capital money began flowing toward "CAM" in the late 1990s - and thinking about business models began to percolate - I recall thinking with some of the potential of a kind of high-end CA. CA salons, downtown, accessible to professionals to drop in, nicely but sparsely appointed, "cool" and perhaps hip and appealing to those who, like the Massage Envy clientele, might like to be able to drop in. (I don't see why an acupuncturist, hired to work in such a place, in such a "franchise" would need to be paid poorly, BTW.)
That said, I never heard of anyone ever developing an actual business plan around this. Never more than talk. Reflecting on the apparent success of Massage Envy, I wonder if acupuncture has, for enough people, reached status as a good routine part of life. (The way my spouse and daughter uses your clinic, Jordan!) The perception that massage had crossed that threshold was apparently the seed that stimulated the development of the massage Envy model.
Re: More Stories from The Integrator
Personally, I have my doubts as to whether a franchised CA would work. It would take incredible sensitivity to retain the social justice element and class/diversity sensitivity inherent in a true CA clinic. It would probably only be a CA clinic in name.
Further, part of the founding principles of CAN is to create a sustainable lifestyle for acupuncturists. Given the comments about the low wages for Massage Envy therapists, a sustainable wage for acupuncturists within corporate CA would be highly unlikely.
Would people flock to it anyways and pay their $30 flat fees or whatever? (Can't imagine them going much lower than that). Maybe.
Would it hurt business for existing CA practices? I can't see how. It might even result in sending more patients our way.
Re: More Stories from The Integrator
One of the Integrator's final comments caught my eye: "Second, I wonder how long it will be until some entrepreneur takes the community room acupuncture model and franchises it nationally as a major, corporate, for-profit roll-out. It will happen. "
He's probably right but, like, yuck. I wouldn't want to work at a place like that. But interesting to think that maybe enough acupunks (new grads?) would.