9000 Needles

The Texas Association of Acupuncture and Oriental Medicine is proud to present a screening of the award winning documentary '9000 Needles'. One screening only: Sunday, January 16th, 4:00pm at the Alamo Village on Anderson Lane. The director, Doug Dearth, will be in attendance for Q & A following the film.

You can purchase tickets online here 

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Lisa Rohleder on acupuncture for pain management

Here's a great post from Working Class Acupuncture's Lisa Rohleder on pain management and community acupuncture. She really nails it on a few points (no pun intended): Read it here.

Thoughts and prayers

The night began with the forgone conclusion that there is nothing on television.

By the end of the night I had watched fascinating programs on American politics, the marsh lands of Iraq, Navajo rug making, opera, sports...all on PBS of course, and all slightly inspiring me in some weird way in relation to what I do day in and day out - which is practice a medicine which is of a culture in all honesty I barely know, that involves sticking needles in people, and using plants as medicine. What a life, huh?

The most profound statement of the night came from a Navajo rug maker. She was speaking of the tools used in making wool and rugs, and said, "They all have life giving names." She contrasted that against making rugs by machines, which she pointed out don't have thoughts and prayers.

It was a theme reiterated throughout the evening in different ways, whatever the culture, or the medium.

Made me think about how much the Chinese and the Native Americans are alike in their respect of their ancestors, and the relevance of this notion of "life giving names" to Chinese medicine and how we imbue meaning...

New shirts!

 Looky here now:

 

Rant

A couple of issues or so back, the New England Journal of Medicine published a clinical vignette on acupuncture and the treatment of chronic back pain. They also reviewed the literature and mentioned the German studies where so called "sham" acupuncture worked nearly as well as so called "real" acupuncture. Both the real and the sham involved the insertion of needles into the body.

The conclusion: real acupuncture has not been demonstrated to be more effective than sham acupuncture, and so might just be placebo.

This blows my mind just a little bit. I propose that the question raised by such a study is not whether or not acupuncture is placebo, but what is "real" acupuncture? To my mind they are drawing a conclusion before even beginning to study the problem. There is a bias towards assuming what you do not understand must be placebo. I find that to be just a little bit ridiculous. It seems to me before you can study real acupuncture vs. sham acupuncture, you might first need to understand what real acupuncture is....

Almost as striking were the comments sent in by readers. One was from several Chinese doctors saying basically if you're going to study this stuff, you have to put it in the context of Traditional Chinese Medicine. Another was from a reader who questioned the ethics of recommending a course of treatment that could well be placebo. He makes the point that a course of 10-12 treatments as proposed in the vignette could cost $1000-$1500.

I think these two comments frame nicely the problems this medicine faces in our country, and how community acupuncture potentially offers sensible solutions.

First of all, I don't buy the notion that acupuncture must be performed strictly adhering to the principles of Traditional Chinese Medicine to work, or to be studied effectively. There are too many ways of doing acupuncture that are all effective to some degree or another, and they are not all TCM. In fact, too much of what is taught in acupuncture schools is taught without question, and much of what is taught probably should probably be framed in more of an anthropological perspective. I'm not dismissing TCM, it's just it's hard to see how we will ever arrive at clear inquiry if it is ever necessary to be self referential in order to be valid. To attempt to scientifically study acupuncture through the lens of TCM is to distort the picture from the beginning. There are too many cultural assumptions of validity. Just because it's agreed upon doesn't make it science.

Now to be fair, there is more to Chinese medicine than acupuncture. If I were treating someone's low back pain, chances are I would use cupping, and chances are I'd use herbs. Chances are too, I wouldn't even put a needle in their back! None the less, we've got to start cutting through the exoticism that surrounds this medicine if we truly want it to be widely used. As it stands, most recent surveys indicate about 1% of the population using acupuncture in a given year.

Essentially you've got the white folk saying we don't understand it so it must be placebo, and the Chinese saying you don't understand it because you're doing it wrong and so you'll never understand it.
I think everyone is demonstrating a lack of perspective, but I am none the less hopeful that over time meaningful inquiry will emerge.

Theory and philosophy are one thing, clinical practice another, and scientific inquiry another thing still.

The second comment, about sending someone off for $1000-$1500 worth of treatment indeed raises some questions, and they are obvious ones: At that rate, these would be $100 to $150 per session treatments.  Seriously, who can afford to do that? This is precisely where acupuncturists so often get in a bind. Unless the patient is wealthy, what likely will happen is the patient will likely have expectations around treatment that probably aren't realistic - in part because they can't afford a course of treatment, and in part because they are going to assume you have some special powers if you're charging those rates. The whole thing fosters unrealistic perceptions and expectations about what acupuncture is, and how it works both on the part of the patient and the practitioner.

Acupuncture is either going to help, or it's not. And if it doesn't, it's not because the patient was a non-believer, and it's probably not because the practitioner failed to make the correct TCM zang fu diagnosis either...zang who?

Onward

Busy week

Busy week last week giving free treatments for Acupuncture and Oriental Medicine Day, which we celebrated all week.

It went well...

Mostly it seemed folks were genuinely interested in checking out acupuncture and the clinic, and were supportive of the work we're doing here. 
  
Also did a health fair Thursday at the Texas Workforce Commission. Nice folks, and great hospitality.

Honestly, people are kind of funny about acupuncture, but again, it seemed there were a few who were genuinely interested in what we're doing here at South Austin Community Acupuncture.
 
I also saw some people at the TWC health fair I hadn't seen in a while, like the Jonci Jensen, a naturopath in town I respect greatly, and Antoinette from Texas Seniors' Guides - an invaluable resource for the elderly, or those who have aging family members or friends.

Weekend spent cleaning up the website for hours and days...

work

Que Sera Sera

On Friday, Oct 1st, we got a 6am call from my mom's assisted living in Austin saying they thought she was having a heart attack. Georgia is 92 years old. We met her at the emergency room at Seton Southwest, and there were definitely moments where we thought we were losing her. After a weekend in the hospital, she prevailed however, and we moved her back to her hometown of Richmond, Texas to a skilled nursing facility. Here's a couple of pics of G, in her new digs...still smiling, still singing 'Que Sera Sera'.

Mother and daughters

SACA in Austin Monthly

Well...thanks Austin Monthly.
You almost got it.

Tobacco, Alcohol, Recreational Drugs, and Acupuncture... Seriously?

Acupuncture is a process...

Just as there is a slow food movement, what community acupuncture clinics are doing is a movement towards slow medicine. Acupuncture is gentle, safe, and effective for a wide range of disorders - but generally speaking it takes some doing. As in, you have to actually get acupuncture to benefit from it...it is very much a process.

It's not like we just put the needles in 'just so' and you are magically fixed (well...sometimes). More often than not some kind of course of treatment is required.

One of THE central ideas behind the sliding scale fee structure of South Austin Community Acupuncture is to price treatment such that ordinary people can afford to get acupuncture as often or for as long as they need to get great results.

Why am I saying this - again?

Because: I have had the experience of patients who seemingly understand that their course of treatment is going to be a process - they tell me they are not looking for a quick fix, and that they are ready to do whatever it takes to solve their problem that has been plaguing them for years. Then they come three or four times and disappear...

Mostly, people show up when they have an acute something going on, or when they just feel like getting acupuncture. Then there's a handful that come long term - some for years.

But I'm not writing this for the folks who have already figured out how to best use acupuncture for themselves. I  am writing this to give some perspective specifically to those who maybe are not familiar with acupuncture, or those who tried it once or twice and decided it didn't work...

Many acupuncturists charge $70 or more for a single treatment. At South Austin Community Acupuncture you could get four treatments for that amount of money - or literally a months worth of treatments for the cost of one single treatment at other clinics. Put yet another way, you could come for 6 MONTHS for what it would cost you to go 6 WEEKS elsewhere...By doing this we are making it possible for you to get acupuncture over a period of time and really help you with your problem.

This is huge! In fact it is the elephant in the treatment room.

The community acupuncture people are the only people I've seen have the courage, and honesty, and common sense to point out that maybe the most important thing about acupuncture is not the prowess of the practitioner, but rather the most important thing is simply getting acupuncture.

Getting acupuncture...

Sure, some have more experience or training than others - but at the end of the day acupuncture is at heart a simple yet profound folk medicine. It is not magic! Chance's are it's not gonna work any better if your acupuncturist studied with a Daoist priest who traces his lineage back to 2AD...It's gonna work better if you get it - often enough, and/or long enough.

So, I encourage folks with chronic, stubborn problems to stay with it. You have a unique opportunity with community acupuncture to actually use acupuncture to your best advantage. Things that took a lifetime, or years to develop are not going to be fixed with two or three treatments. Give it some time, and enjoy the process....

Hosptal visit

I had a great experience today.

A patient I had seen a while back called me about her mother, who was in the hospital - readmitted after some post surgical complications. Namely, continued unexplained vomiting. As it was told to me, the doctors could not quite figure out why this was happening.

More to the point of this writing...the daughter contacted me today  before I went to treat her mom to give me a heads up that while my coming had been cleared with the hospital, her dad did not approve. I was warned that he might give me an earful.

Upon my arrival, he made a bee line to me and we took our conversation into the hall. I enjoyed our exchange greatly, and have great respect for this man.

He basically wanted me to know that he was not into any bullshit. I explained to him, as best I could in short order that I was not "new age" or some such, and that yes, what I did essentially was folk medicine, and that yes, while I could not explain how exactly acupuncture worked that there were numerous scientific explanations as to its mechanisms of action....and that in general acupuncture tends to be very restful and restorative at the very least for most people, and that in this case it may be very specifically helpful if the condition were in fact a disorder of function and not a physical anomaly such as a blockage, and that ear acupuncture specifically might provoke a vagal response and rectify the problem of his wife's rebellious stomach...He remained in part incredulous, but gave me his blessing to proceed at least in part because he perceived me as a practical man. Ah, the humanity.

It was a great opportunity to respectfully stand my ground, honor someone else's skepticism, and plainly and simply make an effort to alleviate the suffering of another being. I hope the treatment was helpful. At the end of the day there is no "alternative" medicine - there is only medicine that works and medicine that does not.

They were a pretty great bunch of people.We had a nice visit, chatted about this and that, and I went on my way.....grateful for the experience.

Acupuncture as an end in itself

Continuing on the theme of using acupuncture in a general kind of way....There was a great piece in the New York Times not long ago about happiness. New studies of consumption and happiness show, for instance, that people are happier when they spend money on experience instead of material objects. Also, current research suggests that, unlike consumption of material goods, spending on leisure and services typically strengthens social bonds, which in turn helps amplify happiness.

This totally made me think about what we do here at South Austin Community Acupuncture...and what if more people just used acupuncture as an end in itself?

How to use acupuncture, generally speaking

In this piece I want to focus on how one might use acupuncture to good effect in a more general kind of way.

First of all, as stated previously, acupuncture tends to be uniquely relaxing for the majority of people. So personally, and based on my direct experience as an acupuncturist, I would say one of the absolute best uses of acupuncture is STRESS REDUCTION.

Also, there is a relatively new concept of "subhealth" that has emerged in Chinese medicine which  is relevant here. The idea behind subhealth is essentially that modern life takes it's own unique toll on us. We may not be sick, per se...but with the stresses of modern living we are also not optimally healthy. I think this idea of subhealth touches on two of the best ways to use acupuncture, and two ways of using acupuncture that are highly underutilized: STRESS REDUCTION and PREVENTATIVE CARE.

The community acupuncture model is particularly well suited for using acupuncture in this way because it makes it possible for people to afford to use acupuncture in this way.

If there were one very big message I would like convey to users or potential users of acupuncture it is this: You don't have to have anything particularly "wrong" to benefit from acupuncture. You can use it just to unwind and take care of yourself.

Start all over again...

I came across some images I captured very late at night/early in the morning the week I moved the clinic a little over a year ago. It made me wonder why in the hell I had not blogged the entire existence of South Austin Community Acupuncture. I looked back and my first blog entry was July 21, 2008. We opened for business Nov. 15th, 2006, and by then had already had a dearth of small business experiences to report on. What was I thinking?

Whatever it was, I'll probably look back two years from now and ask myself, why wasn't I tweeting? So, here's some pics of the 'new' clinic from just before opening, a little over a year ago...I like 'em just 'cause they glow, which is what the clinic always looks like to me.

                                         

How does acupuncture work? pt. 1

Let me begin by making some general observations about what happens when people get acupuncture.

First of all, for the vast majority of people acupuncture is extremely relaxing. Most people fall asleep. The sleep one experiences with acupuncture also tends to be extraordinarily restful and rejuvinative.

This is not everyone's experience of acupuncture, but it does tend to be the most common. It is as if acupuncture causes the body to shift from a more heightened, 'sympathetic' state, to more of a relaxed, 'parasympathetic' state. I personally think it is in this state that the bodies finds its balance.

So there seems to be this kind of general effect with acupuncture. The only people I've heard dare to say that the effect of acupuncture is general is a group of practitioners who call what they do 'biomedical acupuncture'. While I don't know that I agree with all of what the practitioners of so-called biomedical acupuncture espouse (they are pretty much completely dismissive of traditional Chinese medical theory), I do agree that the effect of acupuncture is in some broad sense general.

I personally don't think saying this diminishes or minimizes acupuncture in any way. I still believe the effects of acupuncture are potentially profound, I just think it has less to do with me and the intricacies of Chinese medical thinking, and more to do with people actually getting acupuncture - and also how responsive to acupuncture a given individual is.

There is a doctor in England named Felix Mann who has a theory that there are people who respond to acupuncture, a group of people who respond extraordinarily well which he has dubbed 'super-responders', and a small set that don't respond.  My experience has been this as well, so this makes sense to me. There are some people who you do the simplest thing to and they get these amazing results, and there are a few who you can try everything on and nothing happens of any significance.

Mostly, people feel better with acupuncture and basic function improves (they sleep better, they poop better, they have greatly mental clarity and are less stressed), and for most conditions acupuncture is helpful to some degree.

OK! So, other than touching on my direct experience that acupuncture tends to provoke some kind of general parasympathetic response that seems to be beneficial to most people, I haven't really touched on how it works have I? To be continued...

Talking about acupuncture

The work of Portland's Working Class Acupuncture (WCA) and the community acupuncture movement that they have spawned raises many important issues and questions about acupuncture.

Five years ago, when I was fresh out of acupuncture school, the issue I saw WCA addressing was that of how to have an acupuncture practice that thrived - very important stuff when you're sitting on 100K in student loans and entering into a profession where largely there are no "jobs" per se. Apparently most acupuncturists make very little money, and many are out of practice within a few years.

Working Class Acupuncture's solution (a new model of doing the business of acupuncture) was and is brilliant. The fundamental premise: charge less/see more people.

By charging less, many more people can first of all actually afford to get acupuncture where before they perhaps could not. But even more importantly, charging less allows people to use acupuncture more realistically and in ways that get better results - i.e., a short course of  frequent treatments for acute scenarios, or long term treatment over the course of potentially months in the case of chronic problems. It also, of course, makes just dropping in when you feel the need more doable.

By seeing more people, from the perspective of the acupuncturist, you get your hands on more bodies and you gain experience rapidly, which makes you a more confident and skilled practitioner. Also, seeing more people means more people spreading the word about your work - which makes growing and sustaining your business happen more easily.

And lastly, there is the paradigm shift that happens when you make using acupuncture realistically something more widely affordable. Namely, acupuncture in this context becomes less about the technical or healing prowess of your acupuncturist, and more simply and directly about the act of getting acupuncture. This is huge.

Chinese medicine is still very alien to many, including many of those who practice the medicine. The culture of the medicine is steeped in antiquity and it's history abounds with lore about miraculous cures. Out of this arises notions about acupuncture and Chinese medicine and how it works that verge on magical thinking, and often the expectation that acupuncture will work in short order where Western medicine has failed. Sometimes it does, and hence the lore of miraculous recoveries. Mostly it takes a lot of doing.

So this brings us to a couple of other topics: How acupuncture works, and what an acupuncturist does...
Next time.

The grand experiment continues...

I'm continuing to play with business hours, but only on Thursdays. I originally pushed my start and end times by a couple of hours to make them 12-8 so I could garden, putz around the house, and visit with my 92 year old mother...

Well, noon seems to be rolling around just a little quickly. Also, people tend to be taking advantage of the later hours. So, for now anyway, Thursday hours are 2pm to 8pm.

Doing Community Acupuncture in Austin, Texas

It's Wednesday and today the clinic is open from 10am - 6pm. It's about 3pm, and my third patient of the day is asleep in one of the nine recliners in our treatment room. The other eight are unoccupied. It looks like I'll see oh, maybe six people today.

As a micro-business owner there's always stuff to do, and I'm not complaining or concerned about the continued existence of South Austin Community Acupuncture - not by a long shot. Some days are just slower than others. I am, none the less, seeing in an eight hour day today the number of people I could see in one hour. Makes for a long day, and prompts me to do things like blog. Today's topic: Doing Community Acupuncture in Austin, Texas.

Austin is a funny town. In other cities around the country, community acupuncture clinics are getting mainstream press and news coverage, and in one instance at least - a very nicely produced program on the local PBS station (Tucson). It seems in other places community acupuncture is viewed as a community resource, and something worth writing about. Go figure.

In our 3+ years of existence we have gotten exactly one mention in the press, and frankly the writer kind of missed the point. It was a piece about the newly formed South Lamar IBIZ district, and she managed to mention that you could get a mohawk at Bird's for $15 - but that you could get an acupuncture treatment for that amount was lost on the writer. 

The Community Impact newsletter did a spread on the Ben White corridor a few months back. We were not included. The only business mentioned in our complex: Bender Bar and Grill. No Shree Jee Grocery; no Fitness Unleashed; no passport pace, etc., They listed every business in the Southwood Center, west of us, including the wound and rehab clinic, the dialysis clinic, etc., and even went so far as to list every single business in Westgate Village - which is not even on Ben White!!! I emailed the editor about this. Her reply: Obviously, not everyone could be included, and they were trying to feature businesses people may not know about but that they could use. I was truly amazed. Sounds like we fit that profile, given that we offer a service that could truly benefit just about anyone at rates ordinary people can actually afford, and that we occupy a stretch of Ben White where Ben White is underground. If you need dialysis, I think you're going to know where the dialysis clinic is. Seriously, thanks for the information.

Oh well...Look for us in the upcoming Beauty issue of another local rag. No, I'm not kidding. I'll take my press where I can get it.

Next up, I'll be writing about - you guessed it - acupuncture! My observations some 10,000+ treatments into practice, what I think might be some misconceptions about acupuncture, and how acupuncture might be better utilized...oh, and happiness!

Goodnight Austin, Texas - wherever you are....

We'll do it again sometime....

Well folks, we're going to give First Free Fridays a rest for now....

With our move in July 2009 to our present Ben White location we figured we ought to do something to get new folks in the door, since we're slightly more off the beaten path - and thus began First Free Fridays. We did them for about 6 months or so, and I would say they were a  success overall. About 1/4 of folks that came have become regulars (so far). That's a pretty good rate of return for essentially free advertising.

The flip side of this is the acupuncture tourist. They're just passing through 'cause it's free...

Or the folks that bring a family member and gawk and giggle as their loved one gets poked full of pins. Anyone who ever studied acupuncture has likely gone through this with their own family. It's fun, but not that fun!

To all who participated in making First Free Fridays a  success - thank you!

We'll do it again sometime.

I'm just sayin'...

I was recently contacted by an insurance company regarding a claim a patient had submitted in an effort to get reimbursed  for one $15 treatment. One treatment. In this case, I believe the patient was in a moving vehicle accident and was trying to get the other driver to pay for their expenses.

Seriously people.
The time and effort on everyone's part: mine, the patient's, the insurers - quickly defeats the purpose of getting an acupuncture treatment for as little as $15. Please, consider what South Austin Community Acupuncture is about, and why you come here in the first place....

We don't bill insurance because we believe it is a hugely inefficient system that has little, if anything, to do with patient care. That's a big part of why we do what we do here at SACA. We'd rather put our energies into actually helping people, instead of dealing with insurance companies. Any insurance co-pay  is going to be somewhere between $20-$40 anyway, so we simply cut out the middleman and just charge the patient directly what is essentially the amount of a co-pay.

I'm just sayin'....

Studies Confirm that Acupuncture is Not Safe in the Hands of Non-licensed Acupuncturists

Duh. You can read about the study here

New Thursday hours starting in June

In part based on the ups and downs in patient volume throughout the week (Some days I'm real busy, some days I'm real not busy),

in part to better accommodate getting more stuff done in my personal life (Gardening, home projects, getting time in with my 92 year old mother),

and in part to have some after work hours for those of you who can't get away during the day...

We're going to try something different:

Beginning in June, our Thursday hours will be 12 - 8, starting late and ending late.

Montgomery Burns by any other name...

We just paid our old landlord several thousands of dollars to go back into whatever dark hole he crawled out of and leave us the hell alone. So it goes... This, the culmination of three plus years of absolutely the most ridiculous crap one could ever imagine from a landlord. Suffice it to say, he ain't from around here...


This is a huge hit to a micro business such as ours, but we'll survive. We survived being this jerks tenants for three years. We'll survive this.

We had a dispute over a two months difference in interpretation of our lease and went to small claims court trying to get back our $2400 security deposit. For all my efforts, I can't say I did a very good job at conveying my arguments. I was simply too emotionally invested, and I should have called witnesses. We lost.

While our landlord got to keep our deposit, he was not awarded any other monetary damages because he failed to file a counter claim. I thought this represented a fairly perfect symmetry of justice.

Of course, he would not stop there, and further threats of legal action ensued. To the end he was up to his old tricks, trying to get us to pay for things that were not ours to pay for, such as the replacement of a set of exterior double doors, which were upgraded for his new tenant.

That we put about ten grand into refurbishing his building, and left him an immaculate, beautiful space meant nothing to him.

Ultimately, it came down to paying more in attorneys fees to keep going and still have the hassle of this mess in our lives - and still possibly lose, or stop it all now and buy peace.

We chose the latter.
I would rather lose and have my integrity, than to win at any price.

Ironically, we missed out on a property across the street from where we wound up on South Lamar. The owner of that property is one of the sweetest old guys you could ever hope to meet. His name is Ben, and he is a real deal, old school South Austin landlord. It is heart warming that he became a friend and patient. He brought his wife who was undergoing treatment for cancer to us for acupuncture. 


The day I got word we lost in small claims court, I also got the sweetest note from Ben letting me know his wife had passed away and how much she enjoyed her time at the clinic. The duality was striking: The love and humanity of this sweet old guy who could have been our landlord contrasted against the unbridled greed and arrogance of the landlord we wound up with. 

First Free Friday Coming Up

We've resuming First Free Fridays after a holiday break. The first Friday of the month, new patients are free. Coming up: Friday, February 5th...

There are a few reasons we host First Free Fridays:

We want to introduce folks to acupuncture, and the work that we do at South Austin Community Acupuncture.

We want you to spread the word about South Austin Community Acupuncture.  

We are a community acupuncture clinic. Community acupuncture is community supported acupuncture.
Community acupuncture isn't about being free or about being cheap, it is primarily about community - and it is only with the support of the community that we are able to do what we do.

Acupuncture is particularly well suited to treatment in a group setting > treating in a group setting makes it possible for us to see more people > seeing more people, in turn, makes it possible for us to charge less > charging less makes it possible for you to use acupuncture more realistically.

Acupuncture is typically not a one treatment kind of thing. It depends on what you are working on, but generally acute problems require a few treatments in close succession, whereas a more chronic situation may require longer term, on gong treatment. And always, acupuncture is just good at relieving stress. It's very relaxing. So if acupuncture isn't prohibitively expensive, you can actually use it in a way that is most beneficial to you - as often, or for as long as you need to.

So come on out, and spread the word...