A personal experience exploring the benefits of treating multiple patients in one communal setting.
In the final year of my degree with the Australian College of Natural Medicine an option available was to undertake a 6 week internship in Nanning, China. It was an exciting time full of study, observation and practice. All the clinics we were interned at were similar in that there would be a number of treatment tables in one large room with many patients being treated at the same time.
I have also worked at a clinic in Thailand treating Burmese refugees where we had a large open space and multiple bamboo mats on the floor for the patients. These clinics were in marked contrast to a typical Australian clinical setting of one patient per room. At that time no one used the term community acupuncture but that was what was happening in China, as the norm.
Flash to Australia today and we do have a few community acupuncture clinics available. But not many, and they are seen as somewhat of a specialist clinic.
Over the past 6 years or so I have worked at three separate community acupuncture clinics. The set up is based on multiple chairs or treatment tables in the one space, just like in China.
The benefit of this group setting of course is that the cost to the patient can be reduced. In fact currently at the community clinic in Brisbane we charge $10 per patient. Obviously this is a fee achievable only because we are subsidised by our patron Micah Projects. Of the other community clinics I worked at, one ran on a donation basis where patients could pay $30-45 depending how they felt, whilst another clinic charged a flat $30 per treatment.
There is a very successful clinic in Bondi,Sydney that is called Acupuncture Collective. On my visit there some years ago I noted around 16 treatments tables set up in a large nondescript room. You enter, pay and lie down on a vacant table (if there is one) - when I attended, the clinic was going off. The clinic is run very quietly requiring everyone to whisper only. I got into trouble for speaking too loud, twice. There were two practitioners on duty, both very busy whose only diagnosis was tongue and pulse. Given the volume of patients at $30 each it seems that this model is viable.
It is pretty obvious that low fees are unsustainable for most practitioners unless there is a large number of people being seen per hour, or it is a subsidised setting. The Brisbane clinic I am working at sees around 10-18 patients per four hour block, and this is run three times a week with myself, Kirsten Baker and Danielle Rush as practitioners.
Disadvantaged people in need of regular acupuncture treatments find the community acupuncture model extremely helpful. Its low cost makes it affordable, the benefits of treatment are usually felt by the end of the treatment and importantly the group experience enhances the treatment effect. For many it is a highlight of the week and it is a way to interact socially.
Acupuncture points are selected on the arms and legs only and hence there is no need to remove any clothing. This is a non-threatening environment. Common presentations at my community acupuncture clinic include pain, anxiety, stress, depression and some chronic disorders.
There are however limits to this sort of work. Back treatments are not possible so chronic disorders like vertebral issues are problematic, as is using common points on the torso. Some people also find the group setting too confronting. One of my private patients attended once and vowed never to return as the open questioning about their main complaint and being near some questionable characters was off-putting.
For the practitioner the work can be intense, given three or more people are being treated at the same time. The patients can also be very demanding, sometimes wanting 100% attention all of the time. However personally I find the work very rewarding and enjoyable. The challenge of having to diagnose and plan a treatment very quickly keeps me on my toes, plus without sounding corny, it develops humility.
For this article I also contacted Paul Nebauer about his experience at Bellingen Community Access Acupuncture and Shiatsu (BCAS).
This clinic has 8 treatment tables for acupuncture with Shiatsu happening in an adjoining room. Paul is the primary acupuncture practitioner while Matt Sincock mainly does Shiatsu and some acupuncture.
The clinic is busy with up to 30 patients once a week coming for a variety of complaints from musculoskeletal, reproductive, gastrointestinal, psychosocial, endocrine and sleep disorders.
Patients pay between $30 -70 per session as they choose and can have both acupuncture and shiatsu.
The atmosphere of the clinic is deliberately kept very informal and matter of fact. Whispering is actively discouraged, patients are encouraged to talk in normal voices about what’s happening and there is lots of conversation between patients on the tables. Laughter and jokes are a feature, as are tears. People bring their kids, babies are nursed and even dogs sometimes are present (but not treated!). In this way patients are able to contextualise their challenges as part of the normal human range of experience. It helps to de-catastrophise whatever is happening for them, and they are able to offer each other information and support, thus reducing their subjective distress.
Paul and Matt provide a high level of care with remedial massage, cupping, corrective exercises and counselling incorporated into the sessions. They both work very hard and are probably not paid accordingly, but do have the great reward of contributing in a very real way to the wellbeing of their Bellingen community. There is some spill-over work in their private clinics, though this is often limited to the more financial patients.
Paul finds the community model of practice incredibly satisfying and rewarding enabling him and Matt to deliver affordable care for the less financially endowed members of their community. Equally, wealthier clients attend because they enjoy the communal atmosphere and regular treatments. It is a model that benefits both patients and practitioners, and it can be both profoundly moving and great fun!
Practitioner Raf Nathan is degree qualified in acupuncture and Chinese herbal medicine and currently works at QuIHN Brisbane, Wellwood Health and Inclusive Health community acupuncture clinic in south Brisbane.
He has recently published a new book titled MAP - Main Acupuncture Points
available as an app or hardcover. Contact via email@example.com