American Acupuncturist: Please describe your past involvement with community acupuncture for our readers.
JVV: During acupuncture school, I was fortunate to have many opportunities to practice in public health clinics. For the most part, though, these clinics bore little resemblance to the business model that has recently emerged via Working Class Acupuncture in Portland, and the nationwide Community Acupuncture Network. What these external school clinics instilled in me was a deep satisfaction for treating ordinary people, usually of low income and mixed race. And, of course, I saw that acupuncture worked, that it helped improve their quality of life, minimize pain, and reduce disease symptoms.
In October, 2005, I went to New Orleans to participate in Acupuncturists Without Borders’ efforts to bring trauma relief to hurricane evacuees, first responders, residents,
etc. There were some unusual clinic locations (freeway off-ramps, gutted buildings, a musty army tent, etc.) but in some ways these venues resembled the community clinics
I’d worked in previously…except for one overriding truth this was the middle of a disaster zone. The entire city, myself included, was palpably affected at some level by PTSD (post-traumatic stress disorder). The islands of calm and peace created by setting out a few chairs in a circle and treating anyone and everyone made it clear to me that group treatment settings are powerfully effective for individual (and group) healing.
Around this time, someone mentioned Working Class Acupuncture (WCA), a community acupuncture clinic in Portland. I checked out their website and an online guest column in Acupuncture Today by Lisa Rohleder, one of the founders of WCA. The ideas I read about found a resonance with my original motivation for becoming an
acupuncturist: service and healing that transcends individuals but extends to the larger world we all share. I decided to attend WCA’s first conference in October, 2006. Attending that conference caused me to realize two significant limitations to community medicine .
First, government sponsored clinics and non-profit clinics generally fill only a small niche for people in our country who could benefit from acupuncture but can’t afford it.
Their institutional charity model excludes the vast majority of people, either explicitly by their eligibility requirements, or more generally as a result of the class barriers
they inadvertently create. Working class people do not generally feel comfortable accepting charity and thereby risking being mistaken for someone of the indigent class.
Second, while these niche clinics may provide a small side income for a few acupuncturists, for the most part, they do not provide a sustainable living for acupuncturists.
Encouraged by a successful model in WCA, and the Community Acupuncture Network (CAN), a newly launched network of supportive practitioners sharing information and endeavoring to follow a similar vision, I connected with another local acupuncturist, Serena Sundaram, who shared the vision of affordable acupuncture care for everyone and a sustainable living for the practice of acupuncture. Together we started CommuniChi, a clinic on Beacon Hill (south side of Seattle) located inside a Latino community center.
In the nearly one year since we’ve been open, we’ve seen a growing community of patients who largely find us via word of mouth. The financial side of our business is
very positive for a startup. In each of the last 3 months we’ve seen over 250 patients. Best of all, we have the opportunity to serve our community well, without needing to
turn people away based on inability to pay for care.
American Acupuncturist: Do you find that seeing patients more frequently in a community health venue allows them to progress at a different rate than patients in private practice? If so, how?
JVV: Yes. The vast majority of Americans simply can’t afford to have frequent, out of pocket acupuncture at $75 per treatment and up. Even if they have insurance, often
they don’t want to use all 8 or 12 of their annually allotted visits too quickly. So if they can pay $15 a visit, and I tell them they would benefit from coming twice a week for 6 weeks and then have a re-evaluation, that’s more likely to be possible due to our sliding scale prices. Frequent acupuncture (once a week minimum) helps people feel better. Why? I don’t know honestly…there are many theories, but more important to the theories for me are the results I see this all the time. This was less evident in my previous acupuncture practice based on the conventional model of managed care and high out of pocket expenses.
American Acupuncturist: Do you believe that community health work provides the opportunity to see the efficacy of acupuncture as a stand alone treatment? Why or why not?
JVV: In many cases, yes. Being able to use acupuncture as frequently as needed, allowing patients to remain in the treatment as long as they want brings excellent results.
However, we also believe in responsible medical referral. If there is another practitioner in the larger health community we believe that a patient could benefit from, we will make such suggestions. Whether or not the patient can afford alternate (mainstream) care is another issue.
One of the beauties of the community acupuncture model is that it empowers the individual and de-emphasizes the role of the practitioner. It provides a space for people to
resolve medical issues by accessing their own healthy qi. Again, this is less possible if the price of care is out of reach or inaccessible due to other cultural barriers such as
having to endure a long clinical intake in an environment that is out of the norm for their lifestyle.
American Acupuncturist: Could you elaborate on a case that illustrates a patient success story from your community health work? We had a patient who suffered from
fibromyalgia and chronic insomnia. She was in constant pain, too tired to be very productive in her daily life, and she was in despair. Though unemployed, she managed
to come once a week for months and her health gradually improved. She became seriously engaged in looking for work again and now has a full-time job. She comes to
our clinic on her day off for her weekly treatment. She is very clear that without access to regular acupuncture she would not be able to hold a job for very long. To see her transformation from exhausted and defeated to proud, self-sufficient, and vibrant has been a great gift and one of many we experience in community acupuncture.
American Acupuncturist: Do you think there were aspects of the community health experience that directly contributed to this patient’s improvement that might have been more difficult for this patient to experience if treated in a private care setting?
JVV: Beside the fact that this is the only way she could afford acupuncture at all, coming to the clinic was a big part of her week; she came as much for the warmth and community feeling as for the treatments. Being out of work left a highly social person isolated, and her involvement in our clinic helped counteract this. People in private practice waiting rooms rarely interact, often invoking elevator etiquette (no eye contact, etc…) whereas people in our clinic often come as a group or enter into friendly conversation in the waiting room.
American Acupuncturist: How has your work in both private practice and in community health impacted your abilities as a practitioner to account for a patient’s resources when recommending treatment options?
JVV: In private practice, I always felt that I was walking on eggshells when discussing a treatment plan. On the one hand, my training and experience suggested that long
treatment courses are often necessary (but effective) for addressing health imbalances via acupuncture. On the other hand, the reality of the current health care system
made it unlikely in most cases that people would follow the recommended plan.
When I found myself deferring to their financial concerns, inevitably the efficacy of long term results suffered. This negatively affected my business as well because patients who have an incomplete experience of acupuncture’s full potential are less likely to come back or refer others. In the community acupuncture model, I am better able to meet a patient where they are at and look at a few key suggestions that are within the realm of possibility for them. The fact that they can come in once a week for $60 a month means not only receiving acupuncture 4 times a month but also having frequent access to our bookshelves so they can research things for themselves. Also, we can gradually educate them on possible improvements to their diet or lifestyle to the extent that they are open to our suggestions.
American Acupuncturist: Can you illustrate a case where you had to adjust your treatment planning in a community health patient case due to resource availability? Was this adjustment successful or not?
JVV: Community acupuncture alone cannot create economic justice in our culture. There are plenty of people in America for whom $60 a month for health care means a choice between food and health care. One tradition we have initiated at CommuniChi is to host a free day once every other month. We advertise this widely in the community and usually see 25 to 30 new patients on this day. Many of these folks go on to become regular patients, and/or refer others. We also started a “Circle of Kindness Fund.” More affluent patients contribute, making it possible for people with less income to get free acupuncture on a continuing basis.
Jordan Van Voast, LAc, graduated from Bowdoin College in 1981 with a BA in psychology. In 1997 he completed his masters in acupuncture from the Northwest Institute of Acupuncture & Oriental Medicine. He is board certified by the NCCAOM. In 2005 Jordan joined Acupuncturists Without Borders as a volunteer acupuncturist doing
trauma relief work in New Orleans after Hurricane Katrina, becoming a team leader on later trips as well as a founding member of the board of directors. He has worked in
several community health clinics including a Tibetan refugee clinic in Northern India. In Seattle he has worked at the Asian Refugee clinic at Harborview Public Hospital, Mount St. Vincent’s Nursing Home, SeaMar Clinic, North End Rehabilitation Facility (a low security jail), Kang Wen clinic (serving people living with HIV/AIDS), and Evergreen Clinic (chemical dependency recovery). Jordan also serves on the board of the Dharma Friendship Foundation, a Buddhist center in Seattle.
Tags: acupuncture, affordable acupuncture, beacon hill, communichi, Community Acupuncture, El Centro de la Raza, healthcare, seattle