Widening the Door: Privilege and Access

December 31, 2006

http://acupuncturetoday.com/mpacms/at/article.php?id=31448

I think Lisa Rohleder makes alot of assumptions in the article that

are just not true.

1. working class people prefer their practitioners to dress and

behave like they do; research shows most people of all types prefer

their doctors to dress and act like the elitest professionals they are.

2. there is a huge market of working class folks out there just

itching to get acupuncture. she has probably tapped a market in a

notoriously liberal and progressive town that happens to be home to a

rare breed (a sizable number of highly educated left-wing working

class folks). it is not generally true that such a population exists

in all major cities. I lived in portland for 13 years. I also lived

in san diego for 5. like two different worlds. its great to serve

poor people, but the fact remains that the vast majority of americans

are middle-class and DO have health insurance. Her argument does not

explain why so many of these folks choose not to use acupuncture

services. A dirty little fact is that most chinese themselves also

choose not to use acupuncture, even though is basically free in China.

3. that this model is the solution to the lack of success so many

experience in the field. Lisa is clearly hardworking, enterprising

and dedicated to her ideals. She has tapped a niche market. good for

her. but having worked and been treated in a number of group settings

(ITM's old IEP, Portland's PAAC, and a PCOM clinic that has just

started up when I left town), I am pretty sure of a couple of things.

I don't like either treating or being treated in such an environment.

this is not an elitest position. it is a practical one. first of all,

it is basically a perversion of HIPAA rules to put people in such a

position that because they are poor, they will have to waive their

privacy rights. I am sure everyone does this willingly, but they

shouldn't have to. People should not kid themselves. Patients get

treated in this way because they have no choice, not because most of

them would prefer this to a private consultation. I am sure those who

have figured out how to tap an untapped market are happy that they

are actually able to earn a decent living. But the fact is that there

are not an unlimited amount of potential acupuncture patients in any

socioeconomic class. If there were, then usage rates amongst those

can afford to pay would have increased between 1990 and 2005, rather

than stayed flat about 15 of the population. the only way Lisa's

argument can be seen as a panacea is if the largest segment of the

population were working poor and this group was only not going for

services cause they couldn't afford to pay.

Chinese Herbs

December 31, 2006

I've always felt uncomfortable with her model. Perhaps if she had named it

Affordable

Acupuncture or Everyday Acupuncture I would feel better. Of course, people often

balk at

the $65 to 150 that colleagues charge. I've started charging probably the lowest

rates in

my area. It's my thought that people can more easily afford a lower rate several

times a

month than a slightly higher rate once a month. Perhaps I should start a

movement of

Artists Class Acupuncture. Although she has a lot of political reasoning, this

is a brilliant

marketing and branding device. And I'm not sure, like that this is the

answer for a

number of acupuncturists.

In LA we have the very low-cost schools and through the schools, several public

health

facilities that are basically free. Yes, they are filled up with patients but I

agree that the

patients in many cases would prefer to have more private care. This is fine if

you have

neck pain or whatever that could benefit from 5 treatments a week but like it or

not we fill

a gatekeeper role to more serious conditions and large amounts of unhappiness

and

frustrations.

I saw last year in China a lot of people still getting acupuncture in this kind

of public

setting. But as people now pay a little for treatments I see more and more

privacy creeping

in. In the internal medicine wards, there was almost as much privacy as here.

Instead of a

large room with people crowding around, there are cubicles where assessments are

made.

I've never used a flat relatively low-price as a marketing device. It's not

something I feel

proud about. I just got tired of trying to scope out what a person could really

pay. And

then feeling uncomfortable whith so many different rates, shaving money off here

and

there and charging more for the person who comes in next with what should be the

same

care.

In Los Angeles my friend said the way to success would be to spruce up my

Spanish and

change my street sign to Acupunctura. So there are other solutions than the

Working Class

label.

doug

, < wrote:

>

> http://acupuncturetoday.com/mpacms/at/article.php?id=31448

>

> I think Lisa Rohleder makes alot of assumptions in the article that

> are just not true.

>

> 1. working class people prefer their practitioners to dress and

> behave like they do; research shows most people of all types prefer

> their doctors to dress and act like the elitest professionals they are.

>

> 2. there is a huge market of working class folks out there just

> itching to get acupuncture. she has probably tapped a market in a

> notoriously liberal and progressive town that happens to be home to a

> rare breed (a sizable number of highly educated left-wing working

> class folks). it is not generally true that such a population exists

> in all major cities. I lived in portland for 13 years. I also lived

> in san diego for 5. like two different worlds. its great to serve

> poor people, but the fact remains that the vast majority of americans

> are middle-class and DO have health insurance. Her argument does not

> explain why so many of these folks choose not to use acupuncture

> services. A dirty little fact is that most chinese themselves also

> choose not to use acupuncture, even though is basically free in China.

>

> 3. that this model is the solution to the lack of success so many

> experience in the field. Lisa is clearly hardworking, enterprising

> and dedicated to her ideals. She has tapped a niche market. good for

> her. but having worked and been treated in a number of group settings

> (ITM's old IEP, Portland's PAAC, and a PCOM clinic that has just

> started up when I left town), I am pretty sure of a couple of things.

> I don't like either treating or being treated in such an environment.

> this is not an elitest position. it is a practical one. first of all,

> it is basically a perversion of HIPAA rules to put people in such a

> position that because they are poor, they will have to waive their

> privacy rights. I am sure everyone does this willingly, but they

> shouldn't have to. People should not kid themselves. Patients get

> treated in this way because they have no choice, not because most of

> them would prefer this to a private consultation. I am sure those who

> have figured out how to tap an untapped market are happy that they

> are actually able to earn a decent living. But the fact is that there

> are not an unlimited amount of potential acupuncture patients in any

> socioeconomic class. If there were, then usage rates amongst those

> can afford to pay would have increased between 1990 and 2005, rather

> than stayed flat about 15 of the population. the only way Lisa's

> argument can be seen as a panacea is if the largest segment of the

> population were working poor and this group was only not going for

> services cause they couldn't afford to pay.

>

> Chinese Herbs

>

December 31, 2006

And it seems Portland has it's own public facility for acupuncture. Perhaps you

worked

here in Portland, Todd

http://www.outsidein.org/acupuncture.htm

The Chinese Medical Clinic is staffed by volunteer licensed acupuncturists as

well as

interns supervised by experienced doctors from the Oregon College of Oriental

Medicine

and the National College of Naturopathic Medicine's Chinese Medical Department.

We offer

excellent professional medical care for a wide variety of complaints. The

atmosphere is

friendly and soothing. Services are offered by appointment only, and an effort

is made to

allow patients to see the same practitioner repeatedly, though this is not

always possible.

The cost is based on a sliding scale, and the herbs and medications are always

free of

charge.

A wide variety of modalities are offered at the Chinese medicine clinic

including:

Acupuncture (using one-time-use sterile disposable needles)

Acupressure

Moxabustion

Tui na

Gua sha

Cupping

Liniments

Herbal Pills

Herbal Powders

Bulk Herbs for Teas

Limited Massage

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