Communion in Community
Introducing 'Acu-Hub' - a community acupuncture venture
What does the phrase Community Acupuncture bring to mind?
There are different viewpoints in the Australian Chinese medicine community surrounding community acupuncture. While some may consider a neutral or positive regard for it, others may feel it will water down or cheapen the industry or steal valuable clientele from their clinic room.
Of course, the former is a valid question that has begun to be explored through the qualitative experience of practitioners and patients in the US; the latter is a societal constructed competition-driven mindset and is not based in reality as outlined by the facts.
In South Australia, there are ten practitioners per 100,000 people, of which roughly a 3rd may be likely to try acupuncture – this is the fourth lowest practitioner-to-population ratio out of all Australian states. While the majority of registered acupuncturists work less than 35 hours per week, there is plenty of business for everyone; in fact, there is a dire need for more acupuncturists in both community settings and private clinics, especially within inner and outer rural areas (AHPRA 2020).
Though the acceptance of the work that we do appears to be increasing within circles of the general population and orthodox medical community, support and endorsement are still lacking; a large part of our potential customers are being referred to physios who often attend a weekend course and are practicing a curiously similar sounding version of what we do, entitled ‘western acupuncture’ or ‘dry needling.’ The similarities end in the name, the tools of the trade, and the ire of the Chinese medicine community would be better directed at regulators deciding who can legally practice acupuncture than community acupuncture clinics.
We must question our beliefs about how acupuncture best serves the wider community. This exploration will help break down the competitive mindset and false beliefs, often beneath our conscious notice. Suppose we, as highly skilled, registered practitioners of this fine art, do our best to accept and support our practitioner communities’ endeavours while promoting the benefits of traditional Chinese medicine and acupuncture widely and in as many ways as possible. In that case, the laggards of Orthodox medicine and the general community will be sure to follow.
Community vs private clinics, Acu-punks vs Acupuncturists
I believe that within a private clinic setting, the average cost of treatment is fair. Given the work that we do, our level of training, and the care we provide. After all, we must put bread and potatoes on the table and keep a roof over our heads. Yet this model can be inaccessible for clients with modest means and income, with no private health insurance or misconceptions about the nature of acupuncture. This creates an environment of exclusivity and luxury for health care which is essential to the quality of life and should stand alongside other primary healthcare modalities. For preventive health and chronic conditions, rather than occasional indulgence, acupuncture works best if received frequently and for an extended period.
Local community acupuncture clinics reach individuals of a broad socioeconomic spectrum and may allow for increased frequency of treatment. 1 (Maria 20
Another way of looking at the issue is given below
We also believe that there is a great need to create a different culture around the practice of acupuncture. Instead of acupuncture being esoteric and inaccessible, it should be widely embraced and appreciated... Instead of acupuncture being some kind of overpriced, exotic, New Age indulgence, it could be humble, universal, and infinitely useful (Rohleder 2009:5)
One qualitative analysis based in Oregon, U.S., concluded that patients described a relaxing atmosphere and rated the care as ‘high quality’; the individual is empowered by having control over when and how they are treated. Additionally, the group setting may reduce access barriers for those not considering acupuncture as a health care form. Higher frequency of treatments may increase the beneficial response to treatment; this suggests that the quality of care is not compromised, a broader client base is included, and the effective rate based on the frequency of treatments may be increased. 2 ()
Acu Punks (Community acupuncturists) interviewed referenced the unique ability of the CA practice model to break down various perceived barriers within American society. Some of the obstacles to acupuncture access (besides economic) include social and cultural beliefs as well as the lack of speaking the same language White 2015.
White (2015) further relates One female acu-punk experience in the following description,
The group healing is a “hum” that works specifically at breaking down: that kind of isolation that comes from individuality in this culture, in a very subtle way… You literally see other people who are here because they’re suffering, for whatever reason, and even if it’s not a conscious perception of that… People start to understand it: that they’re not alone, that other people have these problems too (Personal correspondence, August 2014)
White (2015) relates another Acu-punk experience
The calming nature of the room holds a “good feeling energy” that “helps everybody heal when multiple people focus on one goal” (Personal correspondence, August 2014)
There are, however, respected practitioner-scholars in the TCM field that hold differing opinions, an author of the widely used 'A Manual of Acupuncture,' Peter Deadman, says the following on the matter.
'[CA] is a pragmatic solution to a difficult problem. But that does not mean that it represents best possible practice, something that every patient - whatever their income or social status - deserves. Indeed, I would argue that in the form described in her article, this model risks - over time - impoverishing Chinese medicine.
Furthermore, he states that CA "limits access to many core body points and many treatment techniques," which "means that a swathe of acupuncture points [are] largely consigned to oblivion" Lastly, he states that "the shortened CA treatment blocks led to dispensing with the 'detailed question/answer/feedback process that is at the heart of differentiation of patterns," which Deadman identifies as a core principle of TCM (Deadman 2012)
These valid points need to be explored; only through practitioner and patient experience and feedback assisted by evidence-based research can we ascribe any truth to the above statements.
In opposition to these views, rather than radically changing traditional Chinese medicine theories and treatment, we are just creating "social innovation," which creates social value by "combining existing elements in new ways" and upholding ideals of community and network support within the acupuncture profession (Young 2006:66-69 in White 2015)
Rather than exclusivity and inaccessible health care, we can ensure more people access this beautiful medicine. The National Institute of Health (NIH) has emphasized community collaboration and empowerment as essential tools to improve health and eliminate health disparities (Minkler 2012:7 in White 2015).
Acu-Hub: A community Acupuncture venture
I have experienced many benefits from Chinese medicine and am passionate about this wonderful medicine. Naturally, questions arise; How can I bring this to the people who may need it but may not be accessing it due to low income, geography, or lack of education about how Chinese medicine can benefit them?
I know that practitioners like myself need to make a living. Simply put, we need to charge money for treatments. In the future, our medicine may become integrated into the Medicare system. It will reach more people, but for now, there needs to be an exchange between the client and practitioner for their experience, knowledge, and care.
My desire to make Acupuncture affordable for a wide range of people within my local community stems partly from my financial limitations. At times I would choose not to visit an acupuncturist because funds would not allow it. During my initial years of practice, I recognised a need for frequent and extended healthcare that could be provided affordably in a safe space using the community acupuncture model.
Acu-Hub started on the outskirts of Adelaide during the throes of a pandemic and the middle of winter. It didn’t work out but nonetheless was a valuable learning experience. The new and improved version of Acu-Hub is situated in the Adelaide hills, in a church community hall in Crafers. The transition from a secular and exclusive luxury for those who can afford it to an inclusive and open medicine for anyone with the inclination and the courage to step out of their comfort zone and try something new.
In the United States, a popular model is a sliding scale. An example of this is paying what you can afford, between $20 and $40. I have chosen to use a fixed price and have settled on a fee to sustain the practice and keep it affordable for the clientele.
Another popular idea is to use comfortable recliner chairs. I have chosen to use a mixture of new portable adjustable beauty tables that recline, massage tables, and standard chairs to keep them sanitary and pack them away easily at the end of the day.
In any given session, I will use between two and ten needles; occasionally, I employ the use of a heat lamp and moxa. This allows time to ask questions, assess the pulse and tongue, formulate a pattern and treatment plan quickly and smartly, pop the needles in, and move on to the next person. This can be seen as a simple and effective but somewhat attenuated version of a private consult. However, it does not have to be compared with other models but rather taken as it is.
The community Acupuncture model is practical; there are no airs surrounding the giving or receiving of acupuncture with your fellow human community; it is a humbling experience. It demystifies but does not diminish the medicine.
As one Acu punk states:
‘It’s important that you-you're not leading your patients to believe that it's you who are somehow this really amazing creature that just gets rid of insomnia. You're allowing people to sit with themselves, and sit with the needles, and allow the body to connect with itself and heal itself. And you're there to help people and support people and create a safe place for people to do that (Personal correspondence, August 2014).’
People often ask questions and are curious about the function of the chosen points and channels. Time allows for the practitioner will explain this to the client so that they can better understand the medicine and themselves.
In my view, Community Acupuncture potentizes the healing experience. Creating a safe space where individuals can come together, begin, and continue their healing journey.
I stand with other acu-punks within the community acupuncture movement with the fundamental belief that access to health care is a human right. We have a long way to go to make this happen, so let us roll up our sleeves, lay aside our egos, and step into communion with our communities.
Maria T. Chao, Kimberly M. Tippens, and Erin Connelly.Utilization of Group-Based, Community Acupuncture Clinics: A Comparative Study with a Nationally Representative Sample of Acupuncture Users.The Journal of Alternative and Complementary Medicine.Jun 2012.561-566.http://doi.org/10.1089/acm.2011.0128
Tippens, K.M., Chao, M.T., Connelly, E. et al. Patient perspectives on care received at community acupuncture clinics: a qualitative thematic analysis. BMC Complement Altern Med 13, 293 (2013). https://doi.org/10.1186/1472-6882-13-293
Ahpra - Report - Chinese medicine practitioners – a snapshot as at 30 June 2020 file:///C:/Users/User/Downloads/Ahpra---Report---Chinese-medicine-practitioners-%E2%80%93-a-snapshot-as-at-30-June-2020.PDF
White, K. E. H. (2015). " Punks" of the profession: the community acupuncture movement, health care reform, and oppositional identity. https://arminda.whitman.edu/_flysystem/fedora/2021-10/_Punks_of_the_profession_the_community_acupuncture_movement_health_care_reform_and_oppositional_identity.pdf
Caspian lives in Crafers West in the Adelaide Hills. He loves growing veges, foraging for mushrooms, cycling and reading and of course all things Chinese Medicine.