Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Hi There- I just caught up on the recent flurry of opinions and concerns about Community Acupuncture and, being an owner/practitioner at a CA style clinic, I wanted to throw my two cents into the discussion. First some details about how we run our practice: Our clinic is open 6 days/week, we have 5 acupuncturists who work there (two of us are the owners). We see 4 existing patients each hour, or two new patients each hour. All of our intakes are done in a private room with a table in case we need to perform an exam. Shifts are approximately 4.5 hours long and contain approx 15 patients. That seems to be the most number of patients we can see in a day without feeling burnt out. We charge $20-$40 for existing pts, $40-$60 for new patients. We also offer private treatments out of the same office at $80 each. All patients fill out health history forms, informed consent forms and we keep SOAP notes on them all in individual files in a locked cabinet, just like any other acupuncturist. We are clear with our CA patients about what we can realistically treat given the CA model and its limitations. If we feel the patient would best be served with private acupuncture treatments (we cant do moxa, cupping, gua sha, e-stim in the community room) , need a more in-depth intake or herbal consult, or a DC, PT, ND, MD, what have you, we refer them out. We have many patients who come in monthly for private treatments and then weekly for Community treatments. So why am I telling you all this? I guess to say: that it is working for us. My partner and I love being able to treat first timers (about 40% of our new patients have never had acupuncture), or people who cant afford the more expensive treatments and watch them get better. Because of our rates, many people can afford to come weekly or bi-weekly and that frequency of treatment can make a big difference in their healing, To Lee I would say: just as you may have had patients tell you they haven't gotten better by going to a CA clinic (or a MD or DC) , we hear similar stories! I think every acupuncturist does. In our case, often the pt has been getting private treatments but only going once a month because they can't afford to go more often. And in our private treatments, we see patients who didn't get better with one practitioner, but do well with another. Just as we woudn't infer that this meant all private treatments are ineffective, I don't think it is fair to assume that CA treatments don't work, either. As far as CA being a disservice to the practitioner because it is more work for the same amount of money- well, that is up to the practitioner. If I gross an average of $95 seeing 4 pts in an hour, am I doing myself more or less of a disservice than the practitioner who charges $60 per visit and sees one person per hour? Because practitioners with those rates exist, too. I am okay with that. I know of practitioners who don't call themselves community acupuncture practitioners, yet they see similar numbers of people, often in rooms with curtains separating the tables from each other. I dont think this is much different from what we do, except for the name or 'classification' of type of clinic. Do people who object to the CA model also object to practitioners who see 4 or more pts/hour? Because 'private' practitioners have been doing that for a long, long time. Perhaps the distinction in a case like this is in name only? I really think the CA model is not a new style of practicing. It may have a new name, but it is still acupuncture to me. Sorry for the long post. Looking forward to your comments! -Rebekah ------------ Rebekah Sitty, MS, L.Ac. San Francisco Community Acupuncture 220 Valencia St. San Francisco, CA 94103 415.675.8973 rsitty ------------- The information contained in this electronic message may contain protected health information confidential under applicable law, and is intended only for the use of the individual or entity named above. If the recipient of this copy is not the intended recipient, you are hereby notified that any dissemination, copy or disclosure of this communication is strictly prohibited. If you have received this communication in error, please notify the sender and purge the communication immediately without making any copy or distribution. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 15 years ago, I went to a well known acupuncturist in Denver who treated me and my mom in about 5 minutes each. He had a doctorate degree from China and was licensed in the US. He took the pulse in about 1 minute, asked 2 questions and put needles in as fast as I've ever seen. That was it, didn't see him after those 5 minutes. His assistant took out the needles. His wife took the money and gave the herbs in home-made pills. That was it. Less time than a community acupuncture clinic, but cost $80 for the needles and another $40 for the pills for the week. Still, he had this huge reputation and no one would even think that he was dangerous to the profession. Maybe it's more about the individual practitioner's skills and attentiveness, even if it's focused for 5 minutes? K On Tue, Mar 2, 2010 at 7:51 PM, Rebekah Sitty L.Ac. <rsittywrote: > > > Hi There- > I just caught up on the recent flurry of opinions and concerns about > Community Acupuncture and, being an owner/practitioner at a CA style clinic, > I wanted to throw my two cents into the discussion. > > First some details about how we run our practice: Our clinic is open 6 > days/week, we have 5 acupuncturists who work there (two of us are the > owners). We see 4 existing patients each hour, or two new patients each > hour. All of our intakes are done in a private room with a table in case we > need to perform an exam. Shifts are approximately 4.5 hours long and contain > approx 15 patients. That seems to be the most number of patients we can see > in a day without feeling burnt out. We charge $20-$40 for existing pts, > $40-$60 for new patients. We also offer private treatments out of the same > office at $80 each. > > All patients fill out health history forms, informed consent forms and we > keep SOAP notes on them all in individual files in a locked cabinet, just > like any other acupuncturist. > > We are clear with our CA patients about what we can realistically treat > given the CA model and its limitations. If we feel the patient would best be > served with private acupuncture treatments (we cant do moxa, cupping, gua > sha, e-stim in the community room) , need a more in-depth intake or herbal > consult, or a DC, PT, ND, MD, what have you, we refer them out. > > We have many patients who come in monthly for private treatments and then > weekly for Community treatments. > > So why am I telling you all this? I guess to say: that it is working for > us. My partner and I love being able to treat first timers (about 40% of our > new patients have never had acupuncture), or people who cant afford the more > expensive treatments and watch them get better. Because of our rates, many > people can afford to come weekly or bi-weekly and that frequency of > treatment can make a big difference in their healing, > > To Lee I would say: just as you may have had patients tell you they haven't > gotten better by going to a CA clinic (or a MD or DC) , we hear similar > stories! I think every acupuncturist does. In our case, often the pt has > been getting private treatments but only going once a month because they > can't afford to go more often. And in our private treatments, we see > patients who didn't get better with one practitioner, but do well with > another. Just as we woudn't infer that this meant all private treatments are > ineffective, I don't think it is fair to assume that CA treatments don't > work, either. > > As far as CA being a disservice to the practitioner because it is more work > for the same amount of money- well, that is up to the practitioner. If I > gross an average of $95 seeing 4 pts in an hour, am I doing myself more or > less of a disservice than the practitioner who charges $60 per visit and > sees one person per hour? Because practitioners with those rates exist, too. > I am okay with that. > > I know of practitioners who don't call themselves community acupuncture > practitioners, yet they see similar numbers of people, often in rooms with > curtains separating the tables from each other. I dont think this is much > different from what we do, except for the name or 'classification' of type > of clinic. Do people who object to the CA model also object to practitioners > who see 4 or more pts/hour? Because 'private' practitioners have been doing > that for a long, long time. Perhaps the distinction in a case like this is > in name only? I really think the CA model is not a new style of practicing. > It may have a new name, but it is still acupuncture to me. > > Sorry for the long post. Looking forward to your comments! > -Rebekah > > ------------ > Rebekah Sitty, MS, L.Ac. > San Francisco Community Acupuncture > 220 Valencia St. > San Francisco, CA 94103 > 415.675.8973 rsitty <rsitty%40earthlink.net> > ------------- > > The information contained in this electronic message may contain protected > health information confidential under applicable law, and is intended only > for the use of the individual or entity named above. If the recipient of > this copy is not the intended recipient, you are hereby notified that any > dissemination, copy or disclosure of this communication is strictly > prohibited. If you have received this communication in error, please notify > the sender and purge the communication immediately without making any copy > or distribution. > > > -- "" www.tcmreview.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 I agree with Rebekah, private practitioners have been doing this for a long time (so do I, I also see three patients per hour, in two to three shifts of three to four hours). Besides, it is also the way (senior) acupuncturists practice in China. I can see how other private practitioners feel threatened by CA clinics that set their fees below the average. It is kind of undermining their market value. In Belgium the professional organization that I belong to (www.eufom.com) has set a minimum price for a consultation fee, to avoid people undercharging and perhaps undermining the profession. Maybe the American acupuncture professional organizations need to think about what they want to do with this? We have had the same discussions here with physiotherapists, some MDS,... For sure we have all treated some patients for free or for a discounted price, and I think we should continue to do so if there is a need for that. I think America's problem has to do with the fact that they have charged too much (like 60-80$, right?) from the beginning - 30€ is the going rate in Belgium. In countries like the Netherlands, where insurance paybacks are better, people charge closer to 45-50€. A side-effect of insurance reimbursement, I guess...since income levels are similar in between those two countries. This is something that American list members should also bring to the attention of their chosen representatives. Tom Verhaeghe Stationsplein 59 8770 Ingelmunster www.chinese-geneeskunde.be Chinese Medicine Chinese Medicine On Behalf Of woensdag 3 maart 2010 9:12 Chinese Medicine Re: Re: Community Acupuncture 15 years ago, I went to a well known acupuncturist in Denver who treated me and my mom in about 5 minutes each. He had a doctorate degree from China and was licensed in the US. He took the pulse in about 1 minute, asked 2 questions and put needles in as fast as I've ever seen. That was it, didn't see him after those 5 minutes. His assistant took out the needles. His wife took the money and gave the herbs in home-made pills. That was it. Less time than a community acupuncture clinic, but cost $80 for the needles and another $40 for the pills for the week. Still, he had this huge reputation and no one would even think that he was dangerous to the profession. Maybe it's more about the individual practitioner's skills and attentiveness, even if it's focused for 5 minutes? K On Tue, Mar 2, 2010 at 7:51 PM, Rebekah Sitty L.Ac. <rsittywrote: > > > Hi There- > I just caught up on the recent flurry of opinions and concerns about > Community Acupuncture and, being an owner/practitioner at a CA style clinic, > I wanted to throw my two cents into the discussion. > > First some details about how we run our practice: Our clinic is open 6 > days/week, we have 5 acupuncturists who work there (two of us are the > owners). We see 4 existing patients each hour, or two new patients each > hour. All of our intakes are done in a private room with a table in case we > need to perform an exam. Shifts are approximately 4.5 hours long and contain > approx 15 patients. That seems to be the most number of patients we can see > in a day without feeling burnt out. We charge $20-$40 for existing pts, > $40-$60 for new patients. We also offer private treatments out of the same > office at $80 each. > > All patients fill out health history forms, informed consent forms and we > keep SOAP notes on them all in individual files in a locked cabinet, just > like any other acupuncturist. > > We are clear with our CA patients about what we can realistically treat > given the CA model and its limitations. If we feel the patient would best be > served with private acupuncture treatments (we cant do moxa, cupping, gua > sha, e-stim in the community room) , need a more in-depth intake or herbal > consult, or a DC, PT, ND, MD, what have you, we refer them out. > > We have many patients who come in monthly for private treatments and then > weekly for Community treatments. > > So why am I telling you all this? I guess to say: that it is working for > us. My partner and I love being able to treat first timers (about 40% of our > new patients have never had acupuncture), or people who cant afford the more > expensive treatments and watch them get better. Because of our rates, many > people can afford to come weekly or bi-weekly and that frequency of > treatment can make a big difference in their healing, > > To Lee I would say: just as you may have had patients tell you they haven't > gotten better by going to a CA clinic (or a MD or DC) , we hear similar > stories! I think every acupuncturist does. In our case, often the pt has > been getting private treatments but only going once a month because they > can't afford to go more often. And in our private treatments, we see > patients who didn't get better with one practitioner, but do well with > another. Just as we woudn't infer that this meant all private treatments are > ineffective, I don't think it is fair to assume that CA treatments don't > work, either. > > As far as CA being a disservice to the practitioner because it is more work > for the same amount of money- well, that is up to the practitioner. If I > gross an average of $95 seeing 4 pts in an hour, am I doing myself more or > less of a disservice than the practitioner who charges $60 per visit and > sees one person per hour? Because practitioners with those rates exist, too. > I am okay with that. > > I know of practitioners who don't call themselves community acupuncture > practitioners, yet they see similar numbers of people, often in rooms with > curtains separating the tables from each other. I dont think this is much > different from what we do, except for the name or 'classification' of type > of clinic. Do people who object to the CA model also object to practitioners > who see 4 or more pts/hour? Because 'private' practitioners have been doing > that for a long, long time. Perhaps the distinction in a case like this is > in name only? I really think the CA model is not a new style of practicing. > It may have a new name, but it is still acupuncture to me. > > Sorry for the long post. Looking forward to your comments! > -Rebekah > > ------------ > Rebekah Sitty, MS, L.Ac. > San Francisco Community Acupuncture > 220 Valencia St. > San Francisco, CA 94103 > 415.675.8973 rsitty <rsitty%40earthlink.net> > ------------- > > The information contained in this electronic message may contain protected > health information confidential under applicable law, and is intended only > for the use of the individual or entity named above. If the recipient of > this copy is not the intended recipient, you are hereby notified that any > dissemination, copy or disclosure of this communication is strictly > prohibited. If you have received this communication in error, please notify > the sender and purge the communication immediately without making any copy > or distribution. > > > -- "" www.tcmreview.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Let us not forget that many high level practitioners in China and elsewhere use ONLY acupuncture needles and treat 100 plus patients in a morning or at least during the whole day. They apparently are streamlined enough in their documentation and their skills. When one is exposed to that many patients per day......you get experienced if you weren't before......and more importantly you get fast, effective........ and to the point. (Pun intended). Richard In a message dated 3/3/2010 11:18:21 A.M. Eastern Standard Time, naturaldoc1 writes: My concern is with reduction of treatment options and limitations of diagnostics due to patient positioning. If a CAN clinic has a separate exam room, that they use for this on each patient, as needed, then I see no problem with creating an adequate diagnosis. One important question here is if reduced fees equal better patient outcomes because patients are then assumed to come more often. I do not have this answer but feel it is really at the crux of this thread. Each of us needs to find what this means in our own practices. Michael W. Bowser, DC, LAc Chinese Medicine tom.verhaeghe Wed, 3 Mar 2010 11:44:53 +0100 RE: Re: Community Acupuncture I agree with Rebekah, private practitioners have been doing this for a long time (so do I, I also see three patients per hour, in two to three shifts of three to four hours). Besides, it is also the way (senior) acupuncturists practice in China. I can see how other private practitioners feel threatened by CA clinics that set their fees below the average. It is kind of undermining their market value. In Belgium the professional organization that I belong to (www.eufom.com) has set a minimum price for a consultation fee, to avoid people undercharging and perhaps undermining the profession. Maybe the American acupuncture professional organizations need to think about what they want to do with this? We have had the same discussions here with physiotherapists, some MDS,... For sure we have all treated some patients for free or for a discounted price, and I think we should continue to do so if there is a need for that. I think America's problem has to do with the fact that they have charged too much (like 60-80$, right?) from the beginning - 30€ is the going rate in Belgium. In countries like the Netherlands, where insurance paybacks are better, people charge closer to 45-50€. A side-effect of insurance reimbursement, I guess...since income levels are similar in between those two countries. This is something that American list members should also bring to the attention of their chosen representatives. Tom Verhaeghe Stationsplein 59 8770 Ingelmunster www.chinese-geneeskunde.be -----Original Message----- Chinese Medicine Chinese Medicine On Behalf Of john kokko woensdag 3 maart 2010 9:12 Chinese Medicine Re: Re: Community Acupuncture 15 years ago, I went to a well known acupuncturist in Denver who treated me and my mom in about 5 minutes each. He had a doctorate degree from China and was licensed in the US. He took the pulse in about 1 minute, asked 2 questions and put needles in as fast as I've ever seen. That was it, didn't see him after those 5 minutes. His assistant took out the needles. His wife took the money and gave the herbs in home-made pills. That was it. Less time than a community acupuncture clinic, but cost $80 for the needles and another $40 for the pills for the week. Still, he had this huge reputation and no one would even think that he was dangerous to the profession. Maybe it's more about the individual practitioner's skills and attentiveness, even if it's focused for 5 minutes? K On Tue, Mar 2, 2010 at 7:51 PM, Rebekah Sitty L.Ac. <rsittywrote: > > > Hi There- > I just caught up on the recent flurry of opinions and concerns about > Community Acupuncture and, being an owner/practitioner at a CA style clinic, > I wanted to throw my two cents into the discussion. > > First some details about how we run our practice: Our clinic is open 6 > days/week, we have 5 acupuncturists who work there (two of us are the > owners). We see 4 existing patients each hour, or two new patients each > hour. All of our intakes are done in a private room with a table in case we > need to perform an exam. Shifts are approximately 4.5 hours long and contain > approx 15 patients. That seems to be the most number of patients we can see > in a day without feeling burnt out. We charge $20-$40 for existing pts, > $40-$60 for new patients. We also offer private treatments out of the same > office at $80 each. > > All patients fill out health history forms, informed consent forms and we > keep SOAP notes on them all in individual files in a locked cabinet, just > like any other acupuncturist. > > We are clear with our CA patients about what we can realistically treat > given the CA model and its limitations. If we feel the patient would best be > served with private acupuncture treatments (we cant do moxa, cupping, gua > sha, e-stim in the community room) , need a more in-depth intake or herbal > consult, or a DC, PT, ND, MD, what have you, we refer them out. > > We have many patients who come in monthly for private treatments and then > weekly for Community treatments. > > So why am I telling you all this? I guess to say: that it is working for > us. My partner and I love being able to treat first timers (about 40% of our > new patients have never had acupuncture), or people who cant afford the more > expensive treatments and watch them get better. Because of our rates, many > people can afford to come weekly or bi-weekly and that frequency of > treatment can make a big difference in their healing, > > To Lee I would say: just as you may have had patients tell you they haven't > gotten better by going to a CA clinic (or a MD or DC) , we hear similar > stories! I think every acupuncturist does. In our case, often the pt has > been getting private treatments but only going once a month because they > can't afford to go more often. And in our private treatments, we see > patients who didn't get better with one practitioner, but do well with > another. Just as we woudn't infer that this meant all private treatments are > ineffective, I don't think it is fair to assume that CA treatments don't > work, either. > > As far as CA being a disservice to the practitioner because it is more work > for the same amount of money- well, that is up to the practitioner. If I > gross an average of $95 seeing 4 pts in an hour, am I doing myself more or > less of a disservice than the practitioner who charges $60 per visit and > sees one person per hour? Because practitioners with those rates exist, too. > I am okay with that. > > I know of practitioners who don't call themselves community acupuncture > practitioners, yet they see similar numbers of people, often in rooms with > curtains separating the tables from each other. I dont think this is much > different from what we do, except for the name or 'classification' of type > of clinic. Do people who object to the CA model also object to practitioners > who see 4 or more pts/hour? Because 'private' practitioners have been doing > that for a long, long time. Perhaps the distinction in a case like this is > in name only? I really think the CA model is not a new style of practicing. > It may have a new name, but it is still acupuncture to me. > > Sorry for the long post. Looking forward to your comments! > -Rebekah > > ------------ > Rebekah Sitty, MS, L.Ac. > San Francisco Community Acupuncture > 220 Valencia St. > San Francisco, CA 94103 > 415.675.8973 rsitty <rsitty%40earthlink.net> > ------------- > > The information contained in this electronic message may contain protected > health information confidential under applicable law, and is intended only > for the use of the individual or entity named above. If the recipient of > this copy is not the intended recipient, you are hereby notified that any > dissemination, copy or disclosure of this communication is strictly > prohibited. If you have received this communication in error, please notify > the sender and purge the communication immediately without making any copy > or distribution. > > > -- " when you smile, you defy gravity " www.tcmreview.com [Non-text portions of this message have been removed] --- Subscribe to the free online journal for TCM at Times http://www.chinesemedicinetimes.com Help build the world's largest online encyclopedia for Chinese medicine and acupuncture, click, http://www.chinesemedicinetimes.com/wiki/CMTpedia To change your email delivery settings, click, and adjust accordingly. Messages are the property of the author. Any duplication outside the group requires prior permission from the author. Please consider the environment and only print this message if absolutely necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 I can't imagine what kind of limitations some might be referring to. I just finished a many year process with Dr Wu, Boping OMD MD PhD of transcribing a discussion-translation of BIAO YOU FU. This is a high level book for acupuncturists who have read such basic works as YU LONG GE etc. and are now ready for a more advanced level. It is not the usual word-for-word Chinese to English translation but a sentence by sentence discussion of high level use of acupuncture. It is not meant for publication in book form (at this moment if at all) - more for a lengthy magazine article. I'll advise when it's available in English with the Chinese. Richard In a message dated 3/3/2010 11:40:21 A.M. Eastern Standard Time, joe.messey writes: As long as HIPAA requirements are met and patients are informed when the limitations of this style make it insufficient for their particular needs, cant' see anything wrong with this. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Michael There are ways to build proper SOAP note categories into a single form and simply and quickly write the data fill-in in less than a few minutes. You don't have to write an essay on each situation or category. This can and is already being done. It goes back to beating the proverbial " dead horse " . This can be debated ad infinitum. Practitioners might seek to improve where their time and energies are unnecessarily expended....but only if they so choose. Richard In a message dated 3/3/2010 1:58:24 P.M. Eastern Standard Time, naturaldoc1 writes: Richard, Good points but rules regarding documentation are much more stringent in the US then in China. Not a fair comparison. Michael W. Bowser, DC, LAc Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 The biggest threat to acupuncturists is acupuncture performed by those with little, ineffective, or no training. Physical therapists who have been shown " dry needling " , MDs/DOs/DCs who trained one weekend in Florida and learned three strategies for pain, medical doctors who read an interesting article and bought some neeedles. How about the MD who performs his best estimation of acupuncture (tho hes had absolutely no formal training in chinese medicine foundations) and bills insurance for " surgery " taking only co-pay from the patient. The threat comes when the treatments have limited success and the Px is told (by someone they have been brainwashed from birth to trust and revere) that is all they can expect from acupuncture! How about acu-hacks who graduated from accredited schools happy to take their money and advance them even tho they had no real skills, yet somehow passed their boards. Can't distinguish pulses, poor point location skills, treats by trying to match symptoms to a suggested needling Rx from CAM, or simply follows the pictures that accompany the needling RX their " acugraph III " suggests based on " meridian flow analysis " ? It is clear that even " sham " acupuncture is effective to some extent, according to most studies more effective than many " traditional " treatments (drug therapy) for some conditions. Botox parties are popular in some portions of the country: amature enthusiatic narcissists injecting ethanol-emboldened acquaintances with dangerous toxins in hopes of recreational wrinkle-removal. Can trigger-point dry-needling parties for desperate-but-frugal chronic pain suffers be next? Maybe Prolo-Parties?? Even if we legislate that ACUPUNCTURE can only be performed by one fully trained in TCM in approved programs at credentialed institutions, there are plenty of other names for treatments that will not violate such laws. What about someone who uses no needles, say only laser, or tuning fork, or only uses " acupressure " ? They can say " its just like acupuncture, only it doesn't hurt! " CM students learn that many previous graduates a)never ended-up practicing or b)many failed in practice from not making enough money to sustain or c) were unable to attract enough patients (perhaps due to the high price of treatments or general lack of understanding of the value of TCM in their community, or because insurance does not cover acu in their State) and thus succombed to b) above. Community acupuncture is a relatively new model with fervent backing by some who are practicing it that would like to see others follow their footsteps. Many schools are exposing current students to the model, and students tend to be an impressionable bunch. We will see CA clinics start-up and fail at the same rate we see other model (and even model-less) non CA clinics start-up and fail. No different from any other business. 80% of all new restaurants (1st timers) fail within 6 months. Study continually. Cultivate your Qi. Develop your skills. Educate your patients. Learn from others who are successfully changing their patients lives by truly restoring proper health function. Honor the tradition by following the advice in the Classics. Strive to be an exceptional practitioner. Be honest with your patients and yourself. Help them understand the power and value of your medicine thru education and results. Explain how they can get the best results and do not be afraid to alter their lifestyle (thats what got them into trouble in the forst place!). My words are not intended to offend. Your mileage may vary. Mark Zaranski Chinese Medicine , " Mercurius Trismegistus " <magisterium_magnum wrote: > > Were the treatments effective? > > > > > - > " " <johnkokko > <Chinese Medicine > > Wednesday, March 03, 2010 12:11 AM > Re: Re: Community Acupuncture > > > > 15 years ago, I went to a well known acupuncturist in Denver who treated > > me > > and my mom in about 5 minutes each. He had a doctorate degree from China > > and was licensed in the US. He took the pulse in about 1 minute, asked 2 > > questions and put needles in as fast as I've ever seen. That was it, > > didn't > > see him after those 5 minutes. His assistant took out the needles. His > > wife took the money and gave the herbs in home-made pills. That was it. > > Less time than a community acupuncture clinic, but cost $80 for the > > needles > > and another $40 for the pills for the week. Still, he had this huge > > reputation and no one would even think that he was dangerous to the > > profession. > > Maybe it's more about the individual practitioner's skills and > > attentiveness, even if it's focused for 5 minutes? > > > > K > > > > > > > > On Tue, Mar 2, 2010 at 7:51 PM, Rebekah Sitty L.Ac. > > <rsittywrote: > > > >> > >> > >> Hi There- > >> I just caught up on the recent flurry of opinions and concerns about > >> Community Acupuncture and, being an owner/practitioner at a CA style > >> clinic, > >> I wanted to throw my two cents into the discussion. > >> > >> First some details about how we run our practice: Our clinic is open 6 > >> days/week, we have 5 acupuncturists who work there (two of us are the > >> owners). We see 4 existing patients each hour, or two new patients each > >> hour. All of our intakes are done in a private room with a table in case > >> we > >> need to perform an exam. Shifts are approximately 4.5 hours long and > >> contain > >> approx 15 patients. That seems to be the most number of patients we can > >> see > >> in a day without feeling burnt out. We charge $20-$40 for existing pts, > >> $40-$60 for new patients. We also offer private treatments out of the > >> same > >> office at $80 each. > >> > >> All patients fill out health history forms, informed consent forms and we > >> keep SOAP notes on them all in individual files in a locked cabinet, just > >> like any other acupuncturist. > >> > >> We are clear with our CA patients about what we can realistically treat > >> given the CA model and its limitations. If we feel the patient would best > >> be > >> served with private acupuncture treatments (we cant do moxa, cupping, gua > >> sha, e-stim in the community room) , need a more in-depth intake or > >> herbal > >> consult, or a DC, PT, ND, MD, what have you, we refer them out. > >> > >> We have many patients who come in monthly for private treatments and then > >> weekly for Community treatments. > >> > >> So why am I telling you all this? I guess to say: that it is working for > >> us. My partner and I love being able to treat first timers (about 40% of > >> our > >> new patients have never had acupuncture), or people who cant afford the > >> more > >> expensive treatments and watch them get better. Because of our rates, > >> many > >> people can afford to come weekly or bi-weekly and that frequency of > >> treatment can make a big difference in their healing, > >> > >> To Lee I would say: just as you may have had patients tell you they > >> haven't > >> gotten better by going to a CA clinic (or a MD or DC) , we hear similar > >> stories! I think every acupuncturist does. In our case, often the pt has > >> been getting private treatments but only going once a month because they > >> can't afford to go more often. And in our private treatments, we see > >> patients who didn't get better with one practitioner, but do well with > >> another. Just as we woudn't infer that this meant all private treatments > >> are > >> ineffective, I don't think it is fair to assume that CA treatments don't > >> work, either. > >> > >> As far as CA being a disservice to the practitioner because it is more > >> work > >> for the same amount of money- well, that is up to the practitioner. If I > >> gross an average of $95 seeing 4 pts in an hour, am I doing myself more > >> or > >> less of a disservice than the practitioner who charges $60 per visit and > >> sees one person per hour? Because practitioners with those rates exist, > >> too. > >> I am okay with that. > >> > >> I know of practitioners who don't call themselves community acupuncture > >> practitioners, yet they see similar numbers of people, often in rooms > >> with > >> curtains separating the tables from each other. I dont think this is much > >> different from what we do, except for the name or 'classification' of > >> type > >> of clinic. Do people who object to the CA model also object to > >> practitioners > >> who see 4 or more pts/hour? Because 'private' practitioners have been > >> doing > >> that for a long, long time. Perhaps the distinction in a case like this > >> is > >> in name only? I really think the CA model is not a new style of > >> practicing. > >> It may have a new name, but it is still acupuncture to me. > >> > >> Sorry for the long post. Looking forward to your comments! > >> -Rebekah > >> > >> ------------ > >> Rebekah Sitty, MS, L.Ac. > >> San Francisco Community Acupuncture > >> 220 Valencia St. > >> San Francisco, CA 94103 > >> 415.675.8973 rsitty <rsitty%40earthlink.net> > >> ------------- > >> > >> The information contained in this electronic message may contain > >> protected > >> health information confidential under applicable law, and is intended > >> only > >> for the use of the individual or entity named above. If the recipient of > >> this copy is not the intended recipient, you are hereby notified that any > >> dissemination, copy or disclosure of this communication is strictly > >> prohibited. If you have received this communication in error, please > >> notify > >> the sender and purge the communication immediately without making any > >> copy > >> or distribution. > >> > >> > >> > > > > > > > > -- > > > > > > "" > > > > > > www.tcmreview.com > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Rebekah: All patients fill out health history forms, informed consent forms and we keep SOAP notes on them all in individual files in a locked cabinet, just like any other acupuncturist. Joe sez: don't think anyone can criticize here... As long as HIPAA requirements are met and patients are informed when the limitations of this style make it insufficient for their particular needs, cant' see anything wrong with this. Rebekah: We are clear with our CA patients about what we can realistically treat given the CA model and its limitations. If we feel the patient would best be served with private acupuncture treatments (we cant do moxa, cupping, gua sha, e-stim in the community room) , need a more in-depth intake or herbal consult, or a DC, PT, ND, MD, what have you, we refer them out. Joe sez: Got that part covered K: He took the pulse in about 1 minute, asked 2 questions and put needles in as fast as I've ever seen. Maybe it's more about the individual practitioner's skills and attentiveness, even if it's focused for 5 minutes? Joe sez: a hallmark of a skilled and experienced practitioner is " getting to the point " (sorry, I just couldn't hold it back). K - you didn't say if the treatments worked. Did they? Tom: Besides, it is also the way (senior) acupuncturists practice in China. Zedbowls: The biggest threat to acupuncturists is acupuncture performed by those with little, ineffective, or no training. Joe sez: valid points, guys Rebekah - you have less than 4 years experience, your partner just 3 and your 2 assistants only have 2 years experience each. How do you (plural) diagnose at the pace you describe without the benefit of decades of experience? Are you able to triage your patients? Do you have certain conditions each of you focus and refer the others? How does that work? Joe wants to know Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 On Mar 2, 2010, at 3:28 PM, wrote: > first what cost? needles are pennies on the dollar. I have seen this argument a number of times and am always surprised by it. Are we charging like plumbers and carpenters? Our fee being equal to the cost of materials (if you are lucky)? Obviously, needles are only a very small fraction of the cost of running a practice. Paper is cheap, too, and that is all lawyers push around. Sean Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Mark: I always appreciate your posts. You have good business sense, and if we can't stay in business, we can't help people. You tell it like it is. The model doesn't make a difference. It is how we view ourselves as professionals. Anne Sent from my Verizon Wireless BlackBerry " zedbowls " <zaranski Wed, 03 Mar 2010 14:14:29 <Chinese Medicine > Re: Community Acupuncture The biggest threat to acupuncturists is acupuncture performed by those with little, ineffective, or no training. Physical therapists who have been shown " dry needling " , MDs/DOs/DCs who trained one weekend in Florida and learned three strategies for pain, medical doctors who read an interesting article and bought some neeedles. How about the MD who performs his best estimation of acupuncture (tho hes had absolutely no formal training in chinese medicine foundations) and bills insurance for " surgery " taking only co-pay from the patient. The threat comes when the treatments have limited success and the Px is told (by someone they have been brainwashed from birth to trust and revere) that is all they can expect from acupuncture! How about acu-hacks who graduated from accredited schools happy to take their money and advance them even tho they had no real skills, yet somehow passed their boards. Can't distinguish pulses, poor point location skills, treats by trying to match symptoms to a suggested needling Rx from CAM, or simply follows the pictures that accompany the needling RX their " acugraph III " suggests based on " meridian flow analysis " ? It is clear that even " sham " acupuncture is effective to some extent, according to most studies more effective than many " traditional " treatments (drug therapy) for some conditions. Botox parties are popular in some portions of the country: amature enthusiatic narcissists injecting ethanol-emboldened acquaintances with dangerous toxins in hopes of recreational wrinkle-removal. Can trigger-point dry-needling parties for desperate-but-frugal chronic pain suffers be next? Maybe Prolo-Parties?? Even if we legislate that ACUPUNCTURE can only be performed by one fully trained in TCM in approved programs at credentialed institutions, there are plenty of other names for treatments that will not violate such laws. What about someone who uses no needles, say only laser, or tuning fork, or only uses " acupressure " ? They can say " its just like acupuncture, only it doesn't hurt! " CM students learn that many previous graduates a)never ended-up practicing or b)many failed in practice from not making enough money to sustain or c) were unable to attract enough patients (perhaps due to the high price of treatments or general lack of understanding of the value of TCM in their community, or because insurance does not cover acu in their State) and thus succombed to b) above. Community acupuncture is a relatively new model with fervent backing by some who are practicing it that would like to see others follow their footsteps. Many schools are exposing current students to the model, and students tend to be an impressionable bunch. We will see CA clinics start-up and fail at the same rate we see other model (and even model-less) non CA clinics start-up and fail. No different from any other business. 80% of all new restaurants (1st timers) fail within 6 months. Study continually. Cultivate your Qi. Develop your skills. Educate your patients. Learn from others who are successfully changing their patients lives by truly restoring proper health function. Honor the tradition by following the advice in the Classics. Strive to be an exceptional practitioner. Be honest with your patients and yourself. Help them understand the power and value of your medicine thru education and results. Explain how they can get the best results and do not be afraid to alter their lifestyle (thats what got them into trouble in the forst place!). My words are not intended to offend. Your mileage may vary. Mark Zaranski Chinese Medicine , " Mercurius Trismegistus " <magisterium_magnum wrote: > > Were the treatments effective? > > > > > - > " " <johnkokko > <Chinese Medicine > > Wednesday, March 03, 2010 12:11 AM > Re: Re: Community Acupuncture > > > > 15 years ago, I went to a well known acupuncturist in Denver who treated > > me > > and my mom in about 5 minutes each. He had a doctorate degree from China > > and was licensed in the US. He took the pulse in about 1 minute, asked 2 > > questions and put needles in as fast as I've ever seen. That was it, > > didn't > > see him after those 5 minutes. His assistant took out the needles. His > > wife took the money and gave the herbs in home-made pills. That was it. > > Less time than a community acupuncture clinic, but cost $80 for the > > needles > > and another $40 for the pills for the week. Still, he had this huge > > reputation and no one would even think that he was dangerous to the > > profession. > > Maybe it's more about the individual practitioner's skills and > > attentiveness, even if it's focused for 5 minutes? > > > > K > > > > > > > > On Tue, Mar 2, 2010 at 7:51 PM, Rebekah Sitty L.Ac. > > <rsittywrote: > > > >> > >> > >> Hi There- > >> I just caught up on the recent flurry of opinions and concerns about > >> Community Acupuncture and, being an owner/practitioner at a CA style > >> clinic, > >> I wanted to throw my two cents into the discussion. > >> > >> First some details about how we run our practice: Our clinic is open 6 > >> days/week, we have 5 acupuncturists who work there (two of us are the > >> owners). We see 4 existing patients each hour, or two new patients each > >> hour. All of our intakes are done in a private room with a table in case > >> we > >> need to perform an exam. Shifts are approximately 4.5 hours long and > >> contain > >> approx 15 patients. That seems to be the most number of patients we can > >> see > >> in a day without feeling burnt out. We charge $20-$40 for existing pts, > >> $40-$60 for new patients. We also offer private treatments out of the > >> same > >> office at $80 each. > >> > >> All patients fill out health history forms, informed consent forms and we > >> keep SOAP notes on them all in individual files in a locked cabinet, just > >> like any other acupuncturist. > >> > >> We are clear with our CA patients about what we can realistically treat > >> given the CA model and its limitations. If we feel the patient would best > >> be > >> served with private acupuncture treatments (we cant do moxa, cupping, gua > >> sha, e-stim in the community room) , need a more in-depth intake or > >> herbal > >> consult, or a DC, PT, ND, MD, what have you, we refer them out. > >> > >> We have many patients who come in monthly for private treatments and then > >> weekly for Community treatments. > >> > >> So why am I telling you all this? I guess to say: that it is working for > >> us. My partner and I love being able to treat first timers (about 40% of > >> our > >> new patients have never had acupuncture), or people who cant afford the > >> more > >> expensive treatments and watch them get better. Because of our rates, > >> many > >> people can afford to come weekly or bi-weekly and that frequency of > >> treatment can make a big difference in their healing, > >> > >> To Lee I would say: just as you may have had patients tell you they > >> haven't > >> gotten better by going to a CA clinic (or a MD or DC) , we hear similar > >> stories! I think every acupuncturist does. In our case, often the pt has > >> been getting private treatments but only going once a month because they > >> can't afford to go more often. And in our private treatments, we see > >> patients who didn't get better with one practitioner, but do well with > >> another. Just as we woudn't infer that this meant all private treatments > >> are > >> ineffective, I don't think it is fair to assume that CA treatments don't > >> work, either. > >> > >> As far as CA being a disservice to the practitioner because it is more > >> work > >> for the same amount of money- well, that is up to the practitioner. If I > >> gross an average of $95 seeing 4 pts in an hour, am I doing myself more > >> or > >> less of a disservice than the practitioner who charges $60 per visit and > >> sees one person per hour? Because practitioners with those rates exist, > >> too. > >> I am okay with that. > >> > >> I know of practitioners who don't call themselves community acupuncture > >> practitioners, yet they see similar numbers of people, often in rooms > >> with > >> curtains separating the tables from each other. I dont think this is much > >> different from what we do, except for the name or 'classification' of > >> type > >> of clinic. Do people who object to the CA model also object to > >> practitioners > >> who see 4 or more pts/hour? Because 'private' practitioners have been > >> doing > >> that for a long, long time. Perhaps the distinction in a case like this > >> is > >> in name only? I really think the CA model is not a new style of > >> practicing. > >> It may have a new name, but it is still acupuncture to me. > >> > >> Sorry for the long post. Looking forward to your comments! > >> -Rebekah > >> > >> ------------ > >> Rebekah Sitty, MS, L.Ac. > >> San Francisco Community Acupuncture > >> 220 Valencia St. > >> San Francisco, CA 94103 > >> 415.675.8973 rsitty <rsitty%40earthlink.net> > >> ------------- > >> > >> The information contained in this electronic message may contain > >> protected > >> health information confidential under applicable law, and is intended > >> only > >> for the use of the individual or entity named above. If the recipient of > >> this copy is not the intended recipient, you are hereby notified that any > >> dissemination, copy or disclosure of this communication is strictly > >> prohibited. If you have received this communication in error, please > >> notify > >> the sender and purge the communication immediately without making any > >> copy > >> or distribution. > >> > >> > >> > > > > > > > > -- > > > > > > "" > > > > > > www.tcmreview.com > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 I am deeply concerned about the CAN political agenda that really seeks more to divide us, as well as get us to take our eyes off the ball, as others are then more easily able to take acupuncture as their own. Practice is one thing but the CAN politics is quite another. Michael W. Bowser, DC, LAc Chinese Medicine anne.crowley Wed, 3 Mar 2010 15:12:04 +0000 Re: Re: Community Acupuncture Mark: I always appreciate your posts. You have good business sense, and if we can't stay in business, we can't help people. You tell it like it is. The model doesn't make a difference. It is how we view ourselves as professionals. Anne Sent from my Verizon Wireless BlackBerry " zedbowls " <zaranski Wed, 03 Mar 2010 14:14:29 <Chinese Medicine > Re: Community Acupuncture The biggest threat to acupuncturists is acupuncture performed by those with little, ineffective, or no training. Physical therapists who have been shown " dry needling " , MDs/DOs/DCs who trained one weekend in Florida and learned three strategies for pain, medical doctors who read an interesting article and bought some neeedles. How about the MD who performs his best estimation of acupuncture (tho hes had absolutely no formal training in chinese medicine foundations) and bills insurance for " surgery " taking only co-pay from the patient. The threat comes when the treatments have limited success and the Px is told (by someone they have been brainwashed from birth to trust and revere) that is all they can expect from acupuncture! How about acu-hacks who graduated from accredited schools happy to take their money and advance them even tho they had no real skills, yet somehow passed their boards. Can't distinguish pulses, poor point location skills, treats by trying to match symptoms to a suggested needling Rx from CAM, or simply follows the pictures that accompany the needling RX their " acugraph III " suggests based on " meridian flow analysis " ? It is clear that even " sham " acupuncture is effective to some extent, according to most studies more effective than many " traditional " treatments (drug therapy) for some conditions. Botox parties are popular in some portions of the country: amature enthusiatic narcissists injecting ethanol-emboldened acquaintances with dangerous toxins in hopes of recreational wrinkle-removal. Can trigger-point dry-needling parties for desperate-but-frugal chronic pain suffers be next? Maybe Prolo-Parties?? Even if we legislate that ACUPUNCTURE can only be performed by one fully trained in TCM in approved programs at credentialed institutions, there are plenty of other names for treatments that will not violate such laws. What about someone who uses no needles, say only laser, or tuning fork, or only uses " acupressure " ? They can say " its just like acupuncture, only it doesn't hurt! " CM students learn that many previous graduates a)never ended-up practicing or b)many failed in practice from not making enough money to sustain or c) were unable to attract enough patients (perhaps due to the high price of treatments or general lack of understanding of the value of TCM in their community, or because insurance does not cover acu in their State) and thus succombed to b) above. Community acupuncture is a relatively new model with fervent backing by some who are practicing it that would like to see others follow their footsteps. Many schools are exposing current students to the model, and students tend to be an impressionable bunch. We will see CA clinics start-up and fail at the same rate we see other model (and even model-less) non CA clinics start-up and fail. No different from any other business. 80% of all new restaurants (1st timers) fail within 6 months. Study continually. Cultivate your Qi. Develop your skills. Educate your patients. Learn from others who are successfully changing their patients lives by truly restoring proper health function. Honor the tradition by following the advice in the Classics. Strive to be an exceptional practitioner. Be honest with your patients and yourself. Help them understand the power and value of your medicine thru education and results. Explain how they can get the best results and do not be afraid to alter their lifestyle (thats what got them into trouble in the forst place!). My words are not intended to offend. Your mileage may vary. Mark Zaranski Chinese Medicine , " Mercurius Trismegistus " <magisterium_magnum wrote: > > Were the treatments effective? > > > > > - > " " <johnkokko > <Chinese Medicine > > Wednesday, March 03, 2010 12:11 AM > Re: Re: Community Acupuncture > > > > 15 years ago, I went to a well known acupuncturist in Denver who treated > > me > > and my mom in about 5 minutes each. He had a doctorate degree from China > > and was licensed in the US. He took the pulse in about 1 minute, asked 2 > > questions and put needles in as fast as I've ever seen. That was it, > > didn't > > see him after those 5 minutes. His assistant took out the needles. His > > wife took the money and gave the herbs in home-made pills. That was it. > > Less time than a community acupuncture clinic, but cost $80 for the > > needles > > and another $40 for the pills for the week. Still, he had this huge > > reputation and no one would even think that he was dangerous to the > > profession. > > Maybe it's more about the individual practitioner's skills and > > attentiveness, even if it's focused for 5 minutes? > > > > K > > > > > > > > On Tue, Mar 2, 2010 at 7:51 PM, Rebekah Sitty L.Ac. > > <rsittywrote: > > > >> > >> > >> Hi There- > >> I just caught up on the recent flurry of opinions and concerns about > >> Community Acupuncture and, being an owner/practitioner at a CA style > >> clinic, > >> I wanted to throw my two cents into the discussion. > >> > >> First some details about how we run our practice: Our clinic is open 6 > >> days/week, we have 5 acupuncturists who work there (two of us are the > >> owners). We see 4 existing patients each hour, or two new patients each > >> hour. All of our intakes are done in a private room with a table in case > >> we > >> need to perform an exam. Shifts are approximately 4.5 hours long and > >> contain > >> approx 15 patients. That seems to be the most number of patients we can > >> see > >> in a day without feeling burnt out. We charge $20-$40 for existing pts, > >> $40-$60 for new patients. We also offer private treatments out of the > >> same > >> office at $80 each. > >> > >> All patients fill out health history forms, informed consent forms and we > >> keep SOAP notes on them all in individual files in a locked cabinet, just > >> like any other acupuncturist. > >> > >> We are clear with our CA patients about what we can realistically treat > >> given the CA model and its limitations. If we feel the patient would best > >> be > >> served with private acupuncture treatments (we cant do moxa, cupping, gua > >> sha, e-stim in the community room) , need a more in-depth intake or > >> herbal > >> consult, or a DC, PT, ND, MD, what have you, we refer them out. > >> > >> We have many patients who come in monthly for private treatments and then > >> weekly for Community treatments. > >> > >> So why am I telling you all this? I guess to say: that it is working for > >> us. My partner and I love being able to treat first timers (about 40% of > >> our > >> new patients have never had acupuncture), or people who cant afford the > >> more > >> expensive treatments and watch them get better. Because of our rates, > >> many > >> people can afford to come weekly or bi-weekly and that frequency of > >> treatment can make a big difference in their healing, > >> > >> To Lee I would say: just as you may have had patients tell you they > >> haven't > >> gotten better by going to a CA clinic (or a MD or DC) , we hear similar > >> stories! I think every acupuncturist does. In our case, often the pt has > >> been getting private treatments but only going once a month because they > >> can't afford to go more often. And in our private treatments, we see > >> patients who didn't get better with one practitioner, but do well with > >> another. Just as we woudn't infer that this meant all private treatments > >> are > >> ineffective, I don't think it is fair to assume that CA treatments don't > >> work, either. > >> > >> As far as CA being a disservice to the practitioner because it is more > >> work > >> for the same amount of money- well, that is up to the practitioner. If I > >> gross an average of $95 seeing 4 pts in an hour, am I doing myself more > >> or > >> less of a disservice than the practitioner who charges $60 per visit and > >> sees one person per hour? Because practitioners with those rates exist, > >> too. > >> I am okay with that. > >> > >> I know of practitioners who don't call themselves community acupuncture > >> practitioners, yet they see similar numbers of people, often in rooms > >> with > >> curtains separating the tables from each other. I dont think this is much > >> different from what we do, except for the name or 'classification' of > >> type > >> of clinic. Do people who object to the CA model also object to > >> practitioners > >> who see 4 or more pts/hour? Because 'private' practitioners have been > >> doing > >> that for a long, long time. Perhaps the distinction in a case like this > >> is > >> in name only? I really think the CA model is not a new style of > >> practicing. > >> It may have a new name, but it is still acupuncture to me. > >> > >> Sorry for the long post. Looking forward to your comments! > >> -Rebekah > >> > >> ------------ > >> Rebekah Sitty, MS, L.Ac. > >> San Francisco Community Acupuncture > >> 220 Valencia St. > >> San Francisco, CA 94103 > >> 415.675.8973 rsitty <rsitty%40earthlink.net> > >> ------------- > >> > >> The information contained in this electronic message may contain > >> protected > >> health information confidential under applicable law, and is intended > >> only > >> for the use of the individual or entity named above. If the recipient of > >> this copy is not the intended recipient, you are hereby notified that any > >> dissemination, copy or disclosure of this communication is strictly > >> prohibited. If you have received this communication in error, please > >> notify > >> the sender and purge the communication immediately without making any > >> copy > >> or distribution. > >> > >> > >> > > > > > > > > -- > > > > > > "" > > > > > > www.tcmreview.com > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Mercurius, For myself, that was the one time I saw him... for my mom, she continued to see him once/ week for months for back aches. Was it effective? That's hard to say, because pain is something that can come back very easily depending on your job, lifestyle and stress. I can say that he wasn't as effective as someone she went to after that. This later doctor spent a lot more time with her and also did moxa therapy. He also didn't have the same academic credentials, but had a fine reputation in the Korean community of Denver. Since then, he has retired. How do I know that he was better? .... because he treated the root. Did she feel better?.... definitely. K Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 My concern is with reduction of treatment options and limitations of diagnostics due to patient positioning. If a CAN clinic has a separate exam room, that they use for this on each patient, as needed, then I see no problem with creating an adequate diagnosis. One important question here is if reduced fees equal better patient outcomes because patients are then assumed to come more often. I do not have this answer but feel it is really at the crux of this thread. Each of us needs to find what this means in our own practices. Michael W. Bowser, DC, LAc Chinese Medicine tom.verhaeghe Wed, 3 Mar 2010 11:44:53 +0100 RE: Re: Community Acupuncture I agree with Rebekah, private practitioners have been doing this for a long time (so do I, I also see three patients per hour, in two to three shifts of three to four hours). Besides, it is also the way (senior) acupuncturists practice in China. I can see how other private practitioners feel threatened by CA clinics that set their fees below the average. It is kind of undermining their market value. In Belgium the professional organization that I belong to (www.eufom.com) has set a minimum price for a consultation fee, to avoid people undercharging and perhaps undermining the profession. Maybe the American acupuncture professional organizations need to think about what they want to do with this? We have had the same discussions here with physiotherapists, some MDS,... For sure we have all treated some patients for free or for a discounted price, and I think we should continue to do so if there is a need for that. I think America's problem has to do with the fact that they have charged too much (like 60-80$, right?) from the beginning - 30€ is the going rate in Belgium. In countries like the Netherlands, where insurance paybacks are better, people charge closer to 45-50€. A side-effect of insurance reimbursement, I guess...since income levels are similar in between those two countries. This is something that American list members should also bring to the attention of their chosen representatives. Tom Verhaeghe Stationsplein 59 8770 Ingelmunster www.chinese-geneeskunde.be Chinese Medicine Chinese Medicine On Behalf Of woensdag 3 maart 2010 9:12 Chinese Medicine Re: Re: Community Acupuncture 15 years ago, I went to a well known acupuncturist in Denver who treated me and my mom in about 5 minutes each. He had a doctorate degree from China and was licensed in the US. He took the pulse in about 1 minute, asked 2 questions and put needles in as fast as I've ever seen. That was it, didn't see him after those 5 minutes. His assistant took out the needles. His wife took the money and gave the herbs in home-made pills. That was it. Less time than a community acupuncture clinic, but cost $80 for the needles and another $40 for the pills for the week. Still, he had this huge reputation and no one would even think that he was dangerous to the profession. Maybe it's more about the individual practitioner's skills and attentiveness, even if it's focused for 5 minutes? K On Tue, Mar 2, 2010 at 7:51 PM, Rebekah Sitty L.Ac. <rsittywrote: > > > Hi There- > I just caught up on the recent flurry of opinions and concerns about > Community Acupuncture and, being an owner/practitioner at a CA style clinic, > I wanted to throw my two cents into the discussion. > > First some details about how we run our practice: Our clinic is open 6 > days/week, we have 5 acupuncturists who work there (two of us are the > owners). We see 4 existing patients each hour, or two new patients each > hour. All of our intakes are done in a private room with a table in case we > need to perform an exam. Shifts are approximately 4.5 hours long and contain > approx 15 patients. That seems to be the most number of patients we can see > in a day without feeling burnt out. We charge $20-$40 for existing pts, > $40-$60 for new patients. We also offer private treatments out of the same > office at $80 each. > > All patients fill out health history forms, informed consent forms and we > keep SOAP notes on them all in individual files in a locked cabinet, just > like any other acupuncturist. > > We are clear with our CA patients about what we can realistically treat > given the CA model and its limitations. If we feel the patient would best be > served with private acupuncture treatments (we cant do moxa, cupping, gua > sha, e-stim in the community room) , need a more in-depth intake or herbal > consult, or a DC, PT, ND, MD, what have you, we refer them out. > > We have many patients who come in monthly for private treatments and then > weekly for Community treatments. > > So why am I telling you all this? I guess to say: that it is working for > us. My partner and I love being able to treat first timers (about 40% of our > new patients have never had acupuncture), or people who cant afford the more > expensive treatments and watch them get better. Because of our rates, many > people can afford to come weekly or bi-weekly and that frequency of > treatment can make a big difference in their healing, > > To Lee I would say: just as you may have had patients tell you they haven't > gotten better by going to a CA clinic (or a MD or DC) , we hear similar > stories! I think every acupuncturist does. In our case, often the pt has > been getting private treatments but only going once a month because they > can't afford to go more often. And in our private treatments, we see > patients who didn't get better with one practitioner, but do well with > another. Just as we woudn't infer that this meant all private treatments are > ineffective, I don't think it is fair to assume that CA treatments don't > work, either. > > As far as CA being a disservice to the practitioner because it is more work > for the same amount of money- well, that is up to the practitioner. If I > gross an average of $95 seeing 4 pts in an hour, am I doing myself more or > less of a disservice than the practitioner who charges $60 per visit and > sees one person per hour? Because practitioners with those rates exist, too. > I am okay with that. > > I know of practitioners who don't call themselves community acupuncture > practitioners, yet they see similar numbers of people, often in rooms with > curtains separating the tables from each other. I dont think this is much > different from what we do, except for the name or 'classification' of type > of clinic. Do people who object to the CA model also object to practitioners > who see 4 or more pts/hour? Because 'private' practitioners have been doing > that for a long, long time. Perhaps the distinction in a case like this is > in name only? I really think the CA model is not a new style of practicing. > It may have a new name, but it is still acupuncture to me. > > Sorry for the long post. Looking forward to your comments! > -Rebekah > > ------------ > Rebekah Sitty, MS, L.Ac. > San Francisco Community Acupuncture > 220 Valencia St. > San Francisco, CA 94103 > 415.675.8973 rsitty <rsitty%40earthlink.net> > ------------- > > The information contained in this electronic message may contain protected > health information confidential under applicable law, and is intended only > for the use of the individual or entity named above. If the recipient of > this copy is not the intended recipient, you are hereby notified that any > dissemination, copy or disclosure of this communication is strictly > prohibited. If you have received this communication in error, please notify > the sender and purge the communication immediately without making any copy > or distribution. > > > -- "" www.tcmreview.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Our market value depends on a few things... 1. how much it cost (money, time and energy) to learn what we learned (in school, outside of school, in clinical practice etc) 2. how much it costs to maintain a practice in the location we have our clinic situated (high end rent/ parking versus) 3. how saturated the area we practice is with competitive forces 4. the specific modality we practice (facial acupuncture vs pain management vs fertility etc) 5. the model we practice (community style vs 1 patient/ hour vs 2/ hour etc.) A 10 cents/ needle Seirin vs 2.25 cents / needle DBC is not so important from a money point of view (about 80 cents/ treatment difference), but I guess that could add up.... 40 treatments/ week = $32 or $300/ year. The worst part of the Seirins is all of the wasted paper and plastic (one needle/ guide tube/ package). This is just a generalization, but I've found that women like to pay more for treatments than men. Students of all types usually can't afford more than $50/ treatment (once/ week) Middle aged patients generally will pay more than elderly patients (who have a high insurance cost / month as well) and finally... lawyers don't like to pay very much for their treatments, even though they need the care more than most. K On Wed, Mar 3, 2010 at 7:02 AM, Sean Doherty <sean wrote: > > > > On Mar 2, 2010, at 3:28 PM, wrote: > > > first what cost? needles are pennies on the dollar. > > I have seen this argument a number of times and am always surprised by it. > Are we charging like plumbers and carpenters? Our fee being equal to the > cost of materials (if you are lucky)? Obviously, needles are only a very > small fraction of the cost of running a practice. Paper is cheap, too, and > that is all lawyers push around. > > Sean > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Rebekah and other CA practitioners, on average, how often do your CA patients come in to the office? If that's twice / week at $30/ tx = $60/ week. K On Wed, Mar 3, 2010 at 8:06 AM, mike Bowser <naturaldoc1 wrote: > > My concern is with reduction of treatment options and limitations of > diagnostics due to patient positioning. If a CAN clinic has a separate exam > room, that they use for this on each patient, as needed, then I see no > problem with creating an adequate diagnosis. > > > > One important question here is if reduced fees equal better patient > outcomes because patients are then assumed to come more often. I do not > have this answer but feel it is really at the crux of this thread. Each of > us needs to find what this means in our own practices. > > > > Michael W. Bowser, DC, LAc Chinese Medicine > tom.verhaeghe > Wed, 3 Mar 2010 11:44:53 +0100 > RE: Re: Community Acupuncture > > > > > > I agree with Rebekah, private practitioners have been doing this for a long > time (so do I, I also see three patients per hour, in two to three shifts of > three to four hours). Besides, it is also the way (senior) acupuncturists > practice in China. > > I can see how other private practitioners feel threatened by CA clinics > that set their fees below the average. It is kind of undermining their > market value. In Belgium the professional organization that I belong to ( > www.eufom.com) has set a minimum price for a consultation fee, to avoid > people undercharging and perhaps undermining the profession. Maybe the > American acupuncture professional organizations need to think about what > they want to do with this? We have had the same discussions here with > physiotherapists, some MDS,... > > For sure we have all treated some patients for free or for a discounted > price, and I think we should continue to do so if there is a need for that. > > I think America's problem has to do with the fact that they have charged > too much (like 60-80$, right?) from the beginning - 30€ is the going rate in > Belgium. In countries like the Netherlands, where insurance paybacks are > better, people charge closer to 45-50€. A side-effect of insurance > reimbursement, I guess...since income levels are similar in between those > two countries. > > This is something that American list members should also bring to the > attention of their chosen representatives. > > Tom Verhaeghe > Stationsplein 59 > 8770 Ingelmunster > www.chinese-geneeskunde.be > > Chinese Medicine [ > Chinese Medicine ] On Behalf Of > woensdag 3 maart 2010 9:12 > Chinese Medicine > Re: Re: Community Acupuncture > > 15 years ago, I went to a well known acupuncturist in Denver who treated me > and my mom in about 5 minutes each. He had a doctorate degree from China > and was licensed in the US. He took the pulse in about 1 minute, asked 2 > questions and put needles in as fast as I've ever seen. That was it, didn't > see him after those 5 minutes. His assistant took out the needles. His > wife took the money and gave the herbs in home-made pills. That was it. > Less time than a community acupuncture clinic, but cost $80 for the needles > and another $40 for the pills for the week. Still, he had this huge > reputation and no one would even think that he was dangerous to the > profession. > Maybe it's more about the individual practitioner's skills and > attentiveness, even if it's focused for 5 minutes? > > K > > On Tue, Mar 2, 2010 at 7:51 PM, Rebekah Sitty L.Ac. <rsitty > >wrote: > > > > > > > Hi There- > > I just caught up on the recent flurry of opinions and concerns about > > Community Acupuncture and, being an owner/practitioner at a CA style > clinic, > > I wanted to throw my two cents into the discussion. > > > > First some details about how we run our practice: Our clinic is open 6 > > days/week, we have 5 acupuncturists who work there (two of us are the > > owners). We see 4 existing patients each hour, or two new patients each > > hour. All of our intakes are done in a private room with a table in case > we > > need to perform an exam. Shifts are approximately 4.5 hours long and > contain > > approx 15 patients. That seems to be the most number of patients we can > see > > in a day without feeling burnt out. We charge $20-$40 for existing pts, > > $40-$60 for new patients. We also offer private treatments out of the > same > > office at $80 each. > > > > All patients fill out health history forms, informed consent forms and we > > keep SOAP notes on them all in individual files in a locked cabinet, just > > like any other acupuncturist. > > > > We are clear with our CA patients about what we can realistically treat > > given the CA model and its limitations. If we feel the patient would best > be > > served with private acupuncture treatments (we cant do moxa, cupping, gua > > sha, e-stim in the community room) , need a more in-depth intake or > herbal > > consult, or a DC, PT, ND, MD, what have you, we refer them out. > > > > We have many patients who come in monthly for private treatments and then > > weekly for Community treatments. > > > > So why am I telling you all this? I guess to say: that it is working for > > us. My partner and I love being able to treat first timers (about 40% of > our > > new patients have never had acupuncture), or people who cant afford the > more > > expensive treatments and watch them get better. Because of our rates, > many > > people can afford to come weekly or bi-weekly and that frequency of > > treatment can make a big difference in their healing, > > > > To Lee I would say: just as you may have had patients tell you they > haven't > > gotten better by going to a CA clinic (or a MD or DC) , we hear similar > > stories! I think every acupuncturist does. In our case, often the pt has > > been getting private treatments but only going once a month because they > > can't afford to go more often. And in our private treatments, we see > > patients who didn't get better with one practitioner, but do well with > > another. Just as we woudn't infer that this meant all private treatments > are > > ineffective, I don't think it is fair to assume that CA treatments don't > > work, either. > > > > As far as CA being a disservice to the practitioner because it is more > work > > for the same amount of money- well, that is up to the practitioner. If I > > gross an average of $95 seeing 4 pts in an hour, am I doing myself more > or > > less of a disservice than the practitioner who charges $60 per visit and > > sees one person per hour? Because practitioners with those rates exist, > too. > > I am okay with that. > > > > I know of practitioners who don't call themselves community acupuncture > > practitioners, yet they see similar numbers of people, often in rooms > with > > curtains separating the tables from each other. I dont think this is much > > different from what we do, except for the name or 'classification' of > type > > of clinic. Do people who object to the CA model also object to > practitioners > > who see 4 or more pts/hour? Because 'private' practitioners have been > doing > > that for a long, long time. Perhaps the distinction in a case like this > is > > in name only? I really think the CA model is not a new style of > practicing. > > It may have a new name, but it is still acupuncture to me. > > > > Sorry for the long post. Looking forward to your comments! > > -Rebekah > > > > ------------ > > Rebekah Sitty, MS, L.Ac. > > San Francisco Community Acupuncture > > 220 Valencia St. > > San Francisco, CA 94103 > > 415.675.8973 rsitty <rsitty%40earthlink.net> > > ------------- > > > > The information contained in this electronic message may contain > protected > > health information confidential under applicable law, and is intended > only > > for the use of the individual or entity named above. If the recipient of > > this copy is not the intended recipient, you are hereby notified that any > > dissemination, copy or disclosure of this communication is strictly > > prohibited. If you have received this communication in error, please > notify > > the sender and purge the communication immediately without making any > copy > > or distribution. > > > > > > > > -- > > > "" > > > www.tcmreview.com > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 This seems a bit disingenuous to pay a fee to join CAN but then be denied posting ops to the LOC. I am curious as to why do they allow for this discrepancy. Michael W. Bowser, DC, LAc > Chinese Medicine > johnkokko > Tue, 2 Mar 2010 18:13:13 -0800 > Re: Re: Community Acupuncture > > David, > thanks for the clarification. So, anyone can use the community acupuncture > model and call it a " community acupuncture clinic " .. right? even without > being part of CAN... > The CAN network helps people locate a community acupuncture clinic in their > neighborhood and serves the practitioners on the forum and other political > action... right? > no worries. > > K > > > > On Tue, Mar 2, 2010 at 12:26 PM, davel30 <davel30 wrote: > > > > > > > Hello Kokko > > > > That is a misinterpretation. Anyone can be a member of CAN. You pay your > > dues and you are a member. What you are reading is a definition of what CAN > > considers a Community Acupuncture Clinic. CAN members are welcome to run > > their clinical practices however they wish, and use any business model they > > choose. One can see two patients a week in padlocked vaults and charge $600 > > a treatment and still be a member of CAN. Yes, I'm being facetious -- yet > > factual. > > > > What you quote is a definition of a Community Clinic. Where it is put into > > affect is on the Locate a Clinic (LOC) page on the website ( > > http://www.communityacupuncturenetwork.org/clinics). This page serves as a > > referral listing of Community Acupuncture clinics for patients. It has > > strict guidelines in order to make sure that when patients go to another LOC > > listed clinic (or refer friends and family) that they will not be surprised > > by business practices that vary from what they are used to. CAN does > > maintain a second list of clinics ( > > http://www.communityacupuncturenetwork.org/clinics/other) that lists > > clinics of all business varieties. > > > > Yes, some clinics have been denied inclusion to the LOC list, yet this does > > not mean that they are denied membership to CAN. > > > > I hope this clears up any confusion. > > > > David Lesseps > > board member of CAN, and LOC Administrator > > > > ~~~~~~~~~~~~~~~~~~~~~~~~ > > Circle Community Acupuncture > > 1351 Harrison St > > San Francisco, CA 94103 > > (415) 864-1070 > > www.circleca.com > > > > > > --- In Chinese Medicine <Chinese Medicine%40yaho\ ogroups.com>, > > <johnkokko wrote: > > > > > > Here are the membership requirements from the CAN bylaws: > > > > > > 2. Community Acupuncture shall be defined as including clinics that meet > > the > > > following criteria: > > > > > > a. Group treatment spaces (no private acupuncture treatments) > > > > > > b. If a sliding scale is used, it is somewhere between $15 and $40 with > > no > > > greater than a $15 > > > > > > surcharge for the initial treatment. > > > > > > c. If a flat rate is charged, it's $30 or less. > > > > > > d. No proof of income is required or requested. > > > > > > e. Herbal consults are charged at the same rates as the community > > > acupuncture rates above. > > > > > > f. The clinic must be open at least three days a week. > > > > > > http://www.communityacupuncturenetwork.org/sites/allBy-Laws.pdf > > > > > > > > > If you don't follow all of these requirements, you can't be a CAN member. > > > > > > A. is the kicker... no private acupuncture treatments. I have friends who > > > aren't part of CAN because they still want to see private patients and > > they > > > don't want to do CA at least 3 days/ week. Anyway, CAN can make up their > > > own rules and people can choose to join or not. > > > > > > > > > K > > > > > > > > > > > > > > > > > > > -- > > > "" > > > www.tcmreview.com > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Here's a correction on my needle $ comparison: Seirins = $10 / pack of 100 = 10 cents / each DBC = $22.50 for pack of 1000 = 2.25 cents/ each 40 treatments / week = Seirins $40/ week $160/ month about $1760/ year (4 weeks off for vacation) = DBC $9/ week $36 / month about $396 / year (4 weeks off for vacation) The difference is $1760 - 396 = *$1364 / year* if you see 40 patients/ week. So cost of needles do make a difference. K On Wed, Mar 3, 2010 at 8:08 AM, <johnkokko wrote: > Our market value depends on a few things... > 1. how much it cost (money, time and energy) to learn what we learned (in > school, outside of school, in clinical practice etc) > 2. how much it costs to maintain a practice in the location we have our > clinic situated (high end rent/ parking versus) > 3. how saturated the area we practice is with competitive forces > 4. the specific modality we practice (facial acupuncture vs pain management > vs fertility etc) > 5. the model we practice (community style vs 1 patient/ hour vs 2/ hour > etc.) > > A 10 cents/ needle Seirin vs 2.25 cents / needle DBC is not so important > from a money point of view (about 80 cents/ treatment difference), but I > guess that could add up.... 40 treatments/ week = $32 or $300/ year. > The worst part of the Seirins is all of the wasted paper and plastic (one > needle/ guide tube/ package). > > This is just a generalization, but I've found that women like to pay more > for treatments than men. > Students of all types usually can't afford more than $50/ treatment (once/ > week) > Middle aged patients generally will pay more than elderly patients (who > have a high insurance cost / month as well) > and finally... lawyers don't like to pay very much for their treatments, > even though they need the care more than most. > > > K > > > > On Wed, Mar 3, 2010 at 7:02 AM, Sean Doherty <seanwrote: > >> >> >> >> On Mar 2, 2010, at 3:28 PM, wrote: >> >> > first what cost? needles are pennies on the dollar. >> >> I have seen this argument a number of times and am always surprised by it. >> Are we charging like plumbers and carpenters? Our fee being equal to the >> cost of materials (if you are lucky)? Obviously, needles are only a very >> small fraction of the cost of running a practice. Paper is cheap, too, and >> that is all lawyers push around. >> >> Sean >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 John, Would remind us that our personal living expenses (ie, mortgage, car) also need to be added to our budget as well. Good reminder. Michael W. Bowser, DC, LAc > Chinese Medicine > johnkokko > Wed, 3 Mar 2010 08:08:23 -0800 > Re: Re: Community Acupuncture > > Our market value depends on a few things... > 1. how much it cost (money, time and energy) to learn what we learned (in > school, outside of school, in clinical practice etc) > 2. how much it costs to maintain a practice in the location we have our > clinic situated (high end rent/ parking versus) > 3. how saturated the area we practice is with competitive forces > 4. the specific modality we practice (facial acupuncture vs pain management > vs fertility etc) > 5. the model we practice (community style vs 1 patient/ hour vs 2/ hour > etc.) > > A 10 cents/ needle Seirin vs 2.25 cents / needle DBC is not so important > from a money point of view (about 80 cents/ treatment difference), but I > guess that could add up.... 40 treatments/ week = $32 or $300/ year. > The worst part of the Seirins is all of the wasted paper and plastic (one > needle/ guide tube/ package). > > This is just a generalization, but I've found that women like to pay more > for treatments than men. > Students of all types usually can't afford more than $50/ treatment (once/ > week) > Middle aged patients generally will pay more than elderly patients (who have > a high insurance cost / month as well) > and finally... lawyers don't like to pay very much for their treatments, > even though they need the care more than most. > > > K > > > > On Wed, Mar 3, 2010 at 7:02 AM, Sean Doherty <sean wrote: > > > > > > > > > On Mar 2, 2010, at 3:28 PM, wrote: > > > > > first what cost? needles are pennies on the dollar. > > > > I have seen this argument a number of times and am always surprised by it. > > Are we charging like plumbers and carpenters? Our fee being equal to the > > cost of materials (if you are lucky)? Obviously, needles are only a very > > small fraction of the cost of running a practice. Paper is cheap, too, and > > that is all lawyers push around. > > > > Sean > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Sent from my Verizon Wireless BlackBerry <johnkokko Wed, 3 Mar 2010 08:30:34 <Chinese Medicine > Re: Re: Community Acupuncture Here's a correction on my needle $ comparison: Seirins = $10 / pack of 100 = 10 cents / each DBC = $22.50 for pack of 1000 = 2.25 cents/ each 40 treatments / week = Seirins $40/ week $160/ month about $1760/ year (4 weeks off for vacation) = DBC $9/ week $36 / month about $396 / year (4 weeks off for vacation) The difference is $1760 - 396 = *$1364 / year* if you see 40 patients/ week. So cost of needles do make a difference. K On Wed, Mar 3, 2010 at 8:08 AM, <johnkokko wrote: > Our market value depends on a few things... > 1. how much it cost (money, time and energy) to learn what we learned (in > school, outside of school, in clinical practice etc) > 2. how much it costs to maintain a practice in the location we have our > clinic situated (high end rent/ parking versus) > 3. how saturated the area we practice is with competitive forces > 4. the specific modality we practice (facial acupuncture vs pain management > vs fertility etc) > 5. the model we practice (community style vs 1 patient/ hour vs 2/ hour > etc.) > > A 10 cents/ needle Seirin vs 2.25 cents / needle DBC is not so important > from a money point of view (about 80 cents/ treatment difference), but I > guess that could add up.... 40 treatments/ week = $32 or $300/ year. > The worst part of the Seirins is all of the wasted paper and plastic (one > needle/ guide tube/ package). > > This is just a generalization, but I've found that women like to pay more > for treatments than men. > Students of all types usually can't afford more than $50/ treatment (once/ > week) > Middle aged patients generally will pay more than elderly patients (who > have a high insurance cost / month as well) > and finally... lawyers don't like to pay very much for their treatments, > even though they need the care more than most. > > > K > > > > On Wed, Mar 3, 2010 at 7:02 AM, Sean Doherty <seanwrote: > >> >> >> >> On Mar 2, 2010, at 3:28 PM, wrote: >> >> > first what cost? needles are pennies on the dollar. >> >> I have seen this argument a number of times and am always surprised by it. >> Are we charging like plumbers and carpenters? Our fee being equal to the >> cost of materials (if you are lucky)? Obviously, needles are only a very >> small fraction of the cost of running a practice. Paper is cheap, too, and >> that is all lawyers push around. >> >> Sean >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Wow, I could go on vacation with the difference. I am pretty hooked on serins. Anne Sent from my Verizon Wireless BlackBerry <johnkokko Wed, 3 Mar 2010 08:30:34 <Chinese Medicine > Re: Re: Community Acupuncture Here's a correction on my needle $ comparison: Seirins = $10 / pack of 100 = 10 cents / each DBC = $22.50 for pack of 1000 = 2.25 cents/ each 40 treatments / week = Seirins $40/ week $160/ month about $1760/ year (4 weeks off for vacation) = DBC $9/ week $36 / month about $396 / year (4 weeks off for vacation) The difference is $1760 - 396 = *$1364 / year* if you see 40 patients/ week. So cost of needles do make a difference. K On Wed, Mar 3, 2010 at 8:08 AM, <johnkokko wrote: > Our market value depends on a few things... > 1. how much it cost (money, time and energy) to learn what we learned (in > school, outside of school, in clinical practice etc) > 2. how much it costs to maintain a practice in the location we have our > clinic situated (high end rent/ parking versus) > 3. how saturated the area we practice is with competitive forces > 4. the specific modality we practice (facial acupuncture vs pain management > vs fertility etc) > 5. the model we practice (community style vs 1 patient/ hour vs 2/ hour > etc.) > > A 10 cents/ needle Seirin vs 2.25 cents / needle DBC is not so important > from a money point of view (about 80 cents/ treatment difference), but I > guess that could add up.... 40 treatments/ week = $32 or $300/ year. > The worst part of the Seirins is all of the wasted paper and plastic (one > needle/ guide tube/ package). > > This is just a generalization, but I've found that women like to pay more > for treatments than men. > Students of all types usually can't afford more than $50/ treatment (once/ > week) > Middle aged patients generally will pay more than elderly patients (who > have a high insurance cost / month as well) > and finally... lawyers don't like to pay very much for their treatments, > even though they need the care more than most. > > > K > > > > On Wed, Mar 3, 2010 at 7:02 AM, Sean Doherty <seanwrote: > >> >> >> >> On Mar 2, 2010, at 3:28 PM, wrote: >> >> > first what cost? needles are pennies on the dollar. >> >> I have seen this argument a number of times and am always surprised by it. >> Are we charging like plumbers and carpenters? Our fee being equal to the >> cost of materials (if you are lucky)? Obviously, needles are only a very >> small fraction of the cost of running a practice. Paper is cheap, too, and >> that is all lawyers push around. >> >> Sean >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Michael OK. What do you mean by more services? Richard In a message dated 3/3/2010 4:09:08 P.M. Eastern Standard Time, naturaldoc1 writes: Richard, I know that. My point was with less stringest reqs for note taking equals more time to treat patients. Doing this for many years also allows them to be more focused and still provide more services to the patient. Michael W. Bowser, DC, LAc Chinese Medicine acudoc11 Wed, 3 Mar 2010 14:06:50 -0500 Re: Re: Community Acupuncture Michael There are ways to build proper SOAP note categories into a single form and simply and quickly write the data fill-in in less than a few minutes. You don't have to write an essay on each situation or category. This can and is already being done. It goes back to beating the proverbial " dead horse " . This can be debated ad infinitum. Practitioners might seek to improve where their time and energies are unnecessarily expended....but only if they so choose. Richard In a message dated 3/3/2010 1:58:24 P.M. Eastern Standard Time, naturaldoc1 writes: Richard, Good points but rules regarding documentation are much more stringent in the US then in China. Not a fair comparison. Michael W. Bowser, DC, LAc [Non-text portions of this message have been removed] _______________ Your E-mail and More On-the-Go. Get Windows Live Hotmail Free. http://clk.atdmt.com/GBL/go/201469229/direct/01/ [Non-text portions of this message have been removed] --- Subscribe to the free online journal for TCM at Times http://www.chinesemedicinetimes.com Help build the world's largest online encyclopedia for Chinese medicine and acupuncture, click, http://www.chinesemedicinetimes.com/wiki/CMTpedia To change your email delivery settings, click, and adjust accordingly. Messages are the property of the author. Any duplication outside the group requires prior permission from the author. Please consider the environment and only print this message if absolutely necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 This comment saddens and disturbs me. CAN's " political agenda " is to promote the accessibility of acupuncture. What " seeks more to divide us " are the comments from people who continually disparage the competence and integrity of CAN practitioners. Emily KonstanProud CAN Practitioner > Chinese Traditional Medicine > naturaldoc1 > Wed, 3 Mar 2010 15:30:30 +0000 > RE: Re: Community Acupuncture > > > I am deeply concerned about the CAN political agenda that really seeks more to divide us, as well as get us to take our eyes off the ball, as others are then more easily able to take acupuncture as their own. > > > > Practice is one thing but the CAN politics is quite another. > > Michael W. Bowser, DC, LAc > Chinese Medicine > anne.crowley > Wed, 3 Mar 2010 15:12:04 +0000 > Re: Re: Community Acupuncture > > > > > > Mark: > I always appreciate your posts. You have good business sense, and if we can't stay in business, we can't help people. You tell it like it is. The model doesn't make a difference. It is how we view ourselves as professionals. > Anne > Sent from my Verizon Wireless BlackBerry > > > " zedbowls " <zaranski > Wed, 03 Mar 2010 14:14:29 > <Chinese Medicine > > Re: Community Acupuncture > > The biggest threat to acupuncturists is acupuncture performed by those with little, ineffective, or no training. > > Physical therapists who have been shown " dry needling " , MDs/DOs/DCs who trained one weekend in Florida and learned three strategies for pain, medical doctors who read an interesting article and bought some neeedles. > > How about the MD who performs his best estimation of acupuncture (tho hes had absolutely no formal training in chinese medicine foundations) and bills insurance for " surgery " taking only co-pay from the patient. > > The threat comes when the treatments have limited success and the Px is told (by someone they have been brainwashed from birth to trust and revere) that is all they can expect from acupuncture! > > How about acu-hacks who graduated from accredited schools happy to take their money and advance them even tho they had no real skills, yet somehow passed their boards. Can't distinguish pulses, poor point location skills, treats by trying to match symptoms to a suggested needling Rx from CAM, or simply follows the pictures that accompany the needling RX their " acugraph III " suggests based on " meridian flow analysis " ? > > It is clear that even " sham " acupuncture is effective to some extent, according to most studies more effective than many " traditional " treatments (drug therapy) for some conditions. > > Botox parties are popular in some portions of the country: amature enthusiatic narcissists injecting ethanol-emboldened acquaintances with dangerous toxins in hopes of recreational wrinkle-removal. Can trigger-point dry-needling parties for desperate-but-frugal chronic pain suffers be next? Maybe Prolo-Parties?? > > Even if we legislate that ACUPUNCTURE can only be performed by one fully trained in TCM in approved programs at credentialed institutions, there are plenty of other names for treatments that will not violate such laws. What about someone who uses no needles, say only laser, or tuning fork, or only uses " acupressure " ? They can say " its just like acupuncture, only it doesn't hurt! " > > CM students learn that many previous graduates a)never ended-up practicing or b)many failed in practice from not making enough money to sustain or c) were unable to attract enough patients (perhaps due to the high price of treatments or general lack of understanding of the value of TCM in their community, or because insurance does not cover acu in their State) and thus succombed to b) above. > > Community acupuncture is a relatively new model with fervent backing by some who are practicing it that would like to see others follow their footsteps. Many schools are exposing current students to the model, and students tend to be an impressionable bunch. > > We will see CA clinics start-up and fail at the same rate we see other model (and even model-less) non CA clinics start-up and fail. No different from any other business. 80% of all new restaurants (1st timers) fail within 6 months. > > Study continually. Cultivate your Qi. Develop your skills. Educate your patients. Learn from others who are successfully changing their patients lives by truly restoring proper health function. Honor the tradition by following the advice in the Classics. Strive to be an exceptional practitioner. Be honest with your patients and yourself. Help them understand the power and value of your medicine thru education and results. Explain how they can get the best results and do not be afraid to alter their lifestyle (thats what got them into trouble in the forst place!). > > My words are not intended to offend. Your mileage may vary. > > Mark Zaranski > > Chinese Medicine , " Mercurius Trismegistus " <magisterium_magnum wrote: > > > > Were the treatments effective? > > > > > > > > > > - > > " " <johnkokko > > <Chinese Medicine > > > Wednesday, March 03, 2010 12:11 AM > > Re: Re: Community Acupuncture > > > > > > > 15 years ago, I went to a well known acupuncturist in Denver who treated > > > me > > > and my mom in about 5 minutes each. He had a doctorate degree from China > > > and was licensed in the US. He took the pulse in about 1 minute, asked 2 > > > questions and put needles in as fast as I've ever seen. That was it, > > > didn't > > > see him after those 5 minutes. His assistant took out the needles. His > > > wife took the money and gave the herbs in home-made pills. That was it. > > > Less time than a community acupuncture clinic, but cost $80 for the > > > needles > > > and another $40 for the pills for the week. Still, he had this huge > > > reputation and no one would even think that he was dangerous to the > > > profession. > > > Maybe it's more about the individual practitioner's skills and > > > attentiveness, even if it's focused for 5 minutes? > > > > > > K > > > > > > > > > > > > On Tue, Mar 2, 2010 at 7:51 PM, Rebekah Sitty L.Ac. > > > <rsittywrote: > > > > > >> > > >> > > >> Hi There- > > >> I just caught up on the recent flurry of opinions and concerns about > > >> Community Acupuncture and, being an owner/practitioner at a CA style > > >> clinic, > > >> I wanted to throw my two cents into the discussion. > > >> > > >> First some details about how we run our practice: Our clinic is open 6 > > >> days/week, we have 5 acupuncturists who work there (two of us are the > > >> owners). We see 4 existing patients each hour, or two new patients each > > >> hour. All of our intakes are done in a private room with a table in case > > >> we > > >> need to perform an exam. Shifts are approximately 4.5 hours long and > > >> contain > > >> approx 15 patients. That seems to be the most number of patients we can > > >> see > > >> in a day without feeling burnt out. We charge $20-$40 for existing pts, > > >> $40-$60 for new patients. We also offer private treatments out of the > > >> same > > >> office at $80 each. > > >> > > >> All patients fill out health history forms, informed consent forms and we > > >> keep SOAP notes on them all in individual files in a locked cabinet, just > > >> like any other acupuncturist. > > >> > > >> We are clear with our CA patients about what we can realistically treat > > >> given the CA model and its limitations. If we feel the patient would best > > >> be > > >> served with private acupuncture treatments (we cant do moxa, cupping, gua > > >> sha, e-stim in the community room) , need a more in-depth intake or > > >> herbal > > >> consult, or a DC, PT, ND, MD, what have you, we refer them out. > > >> > > >> We have many patients who come in monthly for private treatments and then > > >> weekly for Community treatments. > > >> > > >> So why am I telling you all this? I guess to say: that it is working for > > >> us. My partner and I love being able to treat first timers (about 40% of > > >> our > > >> new patients have never had acupuncture), or people who cant afford the > > >> more > > >> expensive treatments and watch them get better. Because of our rates, > > >> many > > >> people can afford to come weekly or bi-weekly and that frequency of > > >> treatment can make a big difference in their healing, > > >> > > >> To Lee I would say: just as you may have had patients tell you they > > >> haven't > > >> gotten better by going to a CA clinic (or a MD or DC) , we hear similar > > >> stories! I think every acupuncturist does. In our case, often the pt has > > >> been getting private treatments but only going once a month because they > > >> can't afford to go more often. And in our private treatments, we see > > >> patients who didn't get better with one practitioner, but do well with > > >> another. Just as we woudn't infer that this meant all private treatments > > >> are > > >> ineffective, I don't think it is fair to assume that CA treatments don't > > >> work, either. > > >> > > >> As far as CA being a disservice to the practitioner because it is more > > >> work > > >> for the same amount of money- well, that is up to the practitioner. If I > > >> gross an average of $95 seeing 4 pts in an hour, am I doing myself more > > >> or > > >> less of a disservice than the practitioner who charges $60 per visit and > > >> sees one person per hour? Because practitioners with those rates exist, > > >> too. > > >> I am okay with that. > > >> > > >> I know of practitioners who don't call themselves community acupuncture > > >> practitioners, yet they see similar numbers of people, often in rooms > > >> with > > >> curtains separating the tables from each other. I dont think this is much > > >> different from what we do, except for the name or 'classification' of > > >> type > > >> of clinic. Do people who object to the CA model also object to > > >> practitioners > > >> who see 4 or more pts/hour? Because 'private' practitioners have been > > >> doing > > >> that for a long, long time. Perhaps the distinction in a case like this > > >> is > > >> in name only? I really think the CA model is not a new style of > > >> practicing. > > >> It may have a new name, but it is still acupuncture to me. > > >> > > >> Sorry for the long post. Looking forward to your comments! > > >> -Rebekah > > >> > > >> ------------ > > >> Rebekah Sitty, MS, L.Ac. > > >> San Francisco Community Acupuncture > > >> 220 Valencia St. > > >> San Francisco, CA 94103 > > >> 415.675.8973 rsitty <rsitty%40earthlink.net> > > >> ------------- > > >> > > >> The information contained in this electronic message may contain > > >> protected > > >> health information confidential under applicable law, and is intended > > >> only > > >> for the use of the individual or entity named above. If the recipient of > > >> this copy is not the intended recipient, you are hereby notified that any > > >> dissemination, copy or disclosure of this communication is strictly > > >> prohibited. If you have received this communication in error, please > > >> notify > > >> the sender and purge the communication immediately without making any > > >> copy > > >> or distribution. > > >> > > >> > > >> > > > > > > > > > > > > -- > > > > > > > > > "" > > > > > > > > > www.tcmreview.com > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Michael And what about the those at-large trying on the other side moving to jam through their agenda on FPD? It appears that politics exist in many places on all sides. Richard In a message dated 3/3/2010 5:30:48 P.M. Eastern Standard Time, naturaldoc1 writes: I do think it is disingenuous to think that we should give it all away as providers, we also need to make a living. CAN has been very outspoken politically and tried to push an agenda through various media. I have no problems with them staying focused upon sliding scale clinical training for clinicians, just refrain from the politics. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 Richard, Good points but rules regarding documentation are much more stringent in the US then in China. Not a fair comparison. Michael W. Bowser, DC, LAc Chinese Medicine acudoc11 Wed, 3 Mar 2010 11:51:40 -0500 Re: Re: Community Acupuncture Let us not forget that many high level practitioners in China and elsewhere use ONLY acupuncture needles and treat 100 plus patients in a morning or at least during the whole day. They apparently are streamlined enough in their documentation and their skills. When one is exposed to that many patients per day......you get experienced if you weren't before......and more importantly you get fast, effective........ and to the point. (Pun intended). Richard In a message dated 3/3/2010 11:18:21 A.M. Eastern Standard Time, naturaldoc1 writes: My concern is with reduction of treatment options and limitations of diagnostics due to patient positioning. If a CAN clinic has a separate exam room, that they use for this on each patient, as needed, then I see no problem with creating an adequate diagnosis. One important question here is if reduced fees equal better patient outcomes because patients are then assumed to come more often. I do not have this answer but feel it is really at the crux of this thread. Each of us needs to find what this means in our own practices. Michael W. Bowser, DC, LAc Chinese Medicine tom.verhaeghe Wed, 3 Mar 2010 11:44:53 +0100 RE: Re: Community Acupuncture I agree with Rebekah, private practitioners have been doing this for a long time (so do I, I also see three patients per hour, in two to three shifts of three to four hours). Besides, it is also the way (senior) acupuncturists practice in China. I can see how other private practitioners feel threatened by CA clinics that set their fees below the average. It is kind of undermining their market value. In Belgium the professional organization that I belong to (www.eufom.com) has set a minimum price for a consultation fee, to avoid people undercharging and perhaps undermining the profession. Maybe the American acupuncture professional organizations need to think about what they want to do with this? We have had the same discussions here with physiotherapists, some MDS,... For sure we have all treated some patients for free or for a discounted price, and I think we should continue to do so if there is a need for that. I think America's problem has to do with the fact that they have charged too much (like 60-80$, right?) from the beginning - 30€ is the going rate in Belgium. In countries like the Netherlands, where insurance paybacks are better, people charge closer to 45-50€. A side-effect of insurance reimbursement, I guess...since income levels are similar in between those two countries. This is something that American list members should also bring to the attention of their chosen representatives. Tom Verhaeghe Stationsplein 59 8770 Ingelmunster www.chinese-geneeskunde.be Chinese Medicine Chinese Medicine On Behalf Of woensdag 3 maart 2010 9:12 Chinese Medicine Re: Re: Community Acupuncture 15 years ago, I went to a well known acupuncturist in Denver who treated me and my mom in about 5 minutes each. He had a doctorate degree from China and was licensed in the US. He took the pulse in about 1 minute, asked 2 questions and put needles in as fast as I've ever seen. That was it, didn't see him after those 5 minutes. His assistant took out the needles. His wife took the money and gave the herbs in home-made pills. That was it. Less time than a community acupuncture clinic, but cost $80 for the needles and another $40 for the pills for the week. Still, he had this huge reputation and no one would even think that he was dangerous to the profession. Maybe it's more about the individual practitioner's skills and attentiveness, even if it's focused for 5 minutes? K On Tue, Mar 2, 2010 at 7:51 PM, Rebekah Sitty L.Ac. <rsittywrote: > > > Hi There- > I just caught up on the recent flurry of opinions and concerns about > Community Acupuncture and, being an owner/practitioner at a CA style clinic, > I wanted to throw my two cents into the discussion. > > First some details about how we run our practice: Our clinic is open 6 > days/week, we have 5 acupuncturists who work there (two of us are the > owners). We see 4 existing patients each hour, or two new patients each > hour. All of our intakes are done in a private room with a table in case we > need to perform an exam. Shifts are approximately 4.5 hours long and contain > approx 15 patients. That seems to be the most number of patients we can see > in a day without feeling burnt out. We charge $20-$40 for existing pts, > $40-$60 for new patients. We also offer private treatments out of the same > office at $80 each. > > All patients fill out health history forms, informed consent forms and we > keep SOAP notes on them all in individual files in a locked cabinet, just > like any other acupuncturist. > > We are clear with our CA patients about what we can realistically treat > given the CA model and its limitations. If we feel the patient would best be > served with private acupuncture treatments (we cant do moxa, cupping, gua > sha, e-stim in the community room) , need a more in-depth intake or herbal > consult, or a DC, PT, ND, MD, what have you, we refer them out. > > We have many patients who come in monthly for private treatments and then > weekly for Community treatments. > > So why am I telling you all this? I guess to say: that it is working for > us. My partner and I love being able to treat first timers (about 40% of our > new patients have never had acupuncture), or people who cant afford the more > expensive treatments and watch them get better. Because of our rates, many > people can afford to come weekly or bi-weekly and that frequency of > treatment can make a big difference in their healing, > > To Lee I would say: just as you may have had patients tell you they haven't > gotten better by going to a CA clinic (or a MD or DC) , we hear similar > stories! I think every acupuncturist does. In our case, often the pt has > been getting private treatments but only going once a month because they > can't afford to go more often. And in our private treatments, we see > patients who didn't get better with one practitioner, but do well with > another. Just as we woudn't infer that this meant all private treatments are > ineffective, I don't think it is fair to assume that CA treatments don't > work, either. > > As far as CA being a disservice to the practitioner because it is more work > for the same amount of money- well, that is up to the practitioner. If I > gross an average of $95 seeing 4 pts in an hour, am I doing myself more or > less of a disservice than the practitioner who charges $60 per visit and > sees one person per hour? Because practitioners with those rates exist, too. > I am okay with that. > > I know of practitioners who don't call themselves community acupuncture > practitioners, yet they see similar numbers of people, often in rooms with > curtains separating the tables from each other. I dont think this is much > different from what we do, except for the name or 'classification' of type > of clinic. Do people who object to the CA model also object to practitioners > who see 4 or more pts/hour? Because 'private' practitioners have been doing > that for a long, long time. Perhaps the distinction in a case like this is > in name only? I really think the CA model is not a new style of practicing. > It may have a new name, but it is still acupuncture to me. > > Sorry for the long post. Looking forward to your comments! > -Rebekah > > ------------ > Rebekah Sitty, MS, L.Ac. > San Francisco Community Acupuncture > 220 Valencia St. > San Francisco, CA 94103 > 415.675.8973 rsitty <rsitty%40earthlink.net> > ------------- > > The information contained in this electronic message may contain protected > health information confidential under applicable law, and is intended only > for the use of the individual or entity named above. If the recipient of > this copy is not the intended recipient, you are hereby notified that any > dissemination, copy or disclosure of this communication is strictly > prohibited. If you have received this communication in error, please notify > the sender and purge the communication immediately without making any copy > or distribution. > > > -- "" www.tcmreview.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 3, 2010 Report Share Posted March 3, 2010 First, my reply isn't so much about CAN...I think each practitioner has a right to choose their business model and preferred method of treatment. I do wish, however, that practitioners who chose the CA model wouldn't discuss in a negative way the private practice model with the undercurrent that we are all money-grubbers and overcharging (and vice versa, of course). Which brings me to my main point of this reply. [begin quote] said: > first what cost? needles are pennies on the dollar. So invariably you may > be saying that the cost of your time is increasing? OK, that's up to you > to decide. Other costs increasing as far as schools go, well that's up to > them because they will keep adding hours and adding hours until it takes six > years to get thru TCM school, let alone three. > > [end quote] Are you kidding? If you think that needles are the only overhead costs of a practice and because they are " pennies on the dollar " that somehow means our fees should reflect that...I really don't mean to be pejorative so I hope you don't take offense, but I do need to ask if you have ever run your own clinic? Good Lord, my overhead is so much more than just needles and my time and cost of education. If anyone thinks that I, as a private practitioner, get to " keep " the whole or even a large portion of the $75 I charge for a return visit...trust me, that is so not the case. Monthly expenses NOT including salaries: Rent: $1809.69 Electricity: $50 Telecom: $182 (includes DSL, phone, fax, cell) Marketing: $500 Merchant Fees: $70 Administrative Services: $350 (call services) Maintaining Inventory: $700 (note: I maintain at least $8,000 in inventory at a time) Office Supplies: $45 Medical Supplies: $300 Annual expenses NOT including salaries: Accountant Fees: $950 Gen insurance: $650 Malpractice insurance: $1000 Website/hosting: $300 Property Taxes: $100 Medical Waste Generator Permit: $165 Professional Development (CMEs): $1500 Travel (for CMEs): $1000 Meals: $400 CA Acu License Renewal: $162 ($325 q 2 years) NCCAOM Diplomate renewal: $55 ($220 q 4 years) That's roughly $54,000.00/year in overhead, NOT including salaries, just to keep the doors open - and I could be leaving some costs out. If I want to actually pay anybody, myself included, then I have to pull in even more than that... This conversation should be about the realities of practice, whatever your model, and not reduce it to a discussion of how one method is undercutting the other or how the other side is overcharging money-grubbers... The real bottom line is this, imho: the business of medicine is a difficult road to navigate regardless of your business model. I know some colleagues who now practice in the CA-model (used to be PP) and they told me their primary motivation was because it was too difficult to make any money as a private practitioner and they decided to go to a business model that enabled volume. And, from a fiscal perspective, it does work for them. We should all be asking what we can learn from each other because it's not easy out there. There is a part of me that feels if I let the PP-model go for the CA-model that I would miss certain elements of practice. On the other hand, there is something to be said for " getting to the point " quickly, and hopefully, efficiently, and moving on to the next patient. As for the population served by acupuncture, I will say that personally I never only wanted to cater to the the population of people who have discretionary money to spend on Chinese medicine. And yes, it doesn't sit well with me that only a small percentage of people can afford Chinese medicine and for this reason I support efforts for increasing insurance coverage to include acupuncture (which I realize is another hot-polarizing-topic for us). As many of you, I rarely turn anyone away for failure to afford treatment (I can't say " ever " because there have been a few instances where red-flags went off in my head and I didn't feel comfortable accepting the person as a patient, regardless of monetary issues). I also refer out to CA clinics and will continue to do so. I think that having CA clinics nearby are a great thing because they do help to increase the accessibility of acupuncture. I think someone on this discussion mentioned that, as a CA-practitioner, she also referred to private practice for issues that would better be addressed in that model... Shouldn't that be the way it is - both models of practice referring to the other in the best interest of the patient? Supporting each other from a place of camaraderie and not being so fear-based that we think one model is denigrating the other or worrying so much that one model of practice is causing the other model market-harm or that one side is more healing than another, etc., etc. There will always be patients who prefer one model over the other, and that really should be their choice. There will also be conditions better treated in one model over the other. I also think that a combination of models is sometimes in the patient's best interest. We, as practitioners, should present their options in a way that does not aggrandize one and malign the other. Medical ethics state that we have a fiduciary responsibility to our patients which means that we can not put our personal gain above the best interest of the patient. It saddens me when I think of how steep a hill the general-we are still climbing professionally from a laws/regs/public-perception perspective and to know that from within the profession the general-we are so polarized and defensive that the general-we can't seem to get together and make real change that could affect our profession as a whole for the better. Too much in-fighting. J Quote Link to comment Share on other sites More sharing options...
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