Sunday, November 6, 2011

Wiki've got a leak.


This will mean nothing to most people. But to those involved in the study of acupuncture and Oriental medicine and AOMA Graduate School of Integrative Medicine specifically, it might mean a little something.

What follows is an email distributed by an AOMA student recently in reaction to a 3% tuition increase.
My comments on this email are this....

I graduated from AOMA in 2004, and am up to my eyeballs in student load debt. I didn't have to not work while in school. I didn't have to borrow the full amount I could. I could have borrowed only the amount of tuition and I'd have about half as much debt. But that's not what I chose to do. I OWN that, and I don't whine about it.

And so, to "Wiki Qi" I say:

First, if you are so all about OWNERSHIP, then speak for yourself instead of hiding behind the moniker of "Wiki Qi" and claiming to represent anyone other than yourself. I guess there's safety in numbers, even if they are imaginary. Talk about transparency issues. If Wiki Qi actually represents numbers of students then say who you are. What are you afraid of? You state below in your ridiculous email that whistle blowers cannot be retaliated against. One could construe from your language that you are actually implying AOMA is corrupt and/or breaking the law. Seriously.

If your perspective is that AOMA is a business and you their customer, and you are not a happy customer - and your dollars are your only leverage - then TAKE YOUR BUSINESS SOMEWHERE ELSE.You seem to view education as a commodity. So go find the better deal. Or better yet, do something else entirely if this is so disagreeable to you.

Your attempt to draw parallels between a 3% tuition increase at an acupuncture school and what has gone on recently with the financial sector in this country is beyond absurd. "Acupuncture schools are flourishing"? What planet are you on? You think somebody's lining their pockets with your 3% tuition increase? You have no idea what you are talking about.

Get a clue, and put your efforts into actually learning something instead of trying to tear things down you don't even know anything about. Talk about arrogance and ignorance.

Here's the "private" email that was sent around:

From: Wiki Qi <>
Date: Thu, Nov 3, 2011 at 3:09 PM
Subject: Raised Tuition AGAIN?! Occupy AOMA! (Please read. This is YOUR education! Own ALL of it!)

Occupy the Bank of AOMA?
     The Bank of America was “bailed out” by the People -- the taxpayers -- and then it raised their fees as thanks.  The public was incensed and protested.  The bank recanted.

      Does AOMA seem to be acting similarly by raising tuition again?  Will they recant?
It seems there may be clear comparisons to protests all over the country and activities on campus:  Arrogance and ignorance?
(Come speak your mind at the meetings this week!  Follow each other and post your problems regarding this AOMA issue and others on Twitter:  @wikiqi.)
Points of concern:
     - Why did AOMA ‘build’ the school if they can’t afford it?  Why should students “bailout” another poor administrative decision yet again?
     - How has this new campus really benefited the student who, according to AOMA’s own numbers, will still be making only $20,000+ one year after graduating?   (Typically an education this expensive yields higher rewards/income and such an institution typically offers you more assistance.   We get little and the future is even declining.  AOMA needs to be investing in ventures that benefit careers and reduce expenses, not just spending money on poor landscaping.)
     - What other cost savings can be employed instead of using “bailouts” from students?  Shouldn’t AOMA pay it’s “fair share?”   Example:  The recent website and branding re-launch was quoted conservatively as costing $30,000.  Could we have used such funds more efficiently?  Where else have we wasted money?  (What about using some of those funds for online registration so we needn’t pay 7 staff members to write down schedules on paper and dry erase boards?  Technology=reduced costs=benefit to students.)
     - We are in a recession.  We just lost subsidized loans.  We had moving costs with the new campus.  The dollar is devalued.  The list goes on.  Yet the AOMA  administration frames the increase as if it is only a small percentage, when our overall costs have gone up and we have received many increases in total.  That is a manipulative and short sighted portrayal.  A key tactic in marketing:  Get them to take a little bite at first, then you can cram more down their throat.
Facts and Questions:
     - Acupuncture programs are flourishing, but their students are struggling -- and not just in the U.S.  Is that a symptom or a disease?  What is the root?  Should we be getting charged more money for a diminishing return?  Shouldn’t the market dictate that we adapt and not raise costs but lower them?  It seems if you want to make money in acupuncture, you need to get into administration or teach, not practice.  (If a person could be making more money not teaching, many would likely would not be teaching...)
     - On average an AOMA graduate finishes with over $100,000 in debt yet will make just $20,000+ a year after graduating while a Family MD’s median payout for his/her doctorate is $150,000 yet he/she will be making on average $207,000.  Granted, we knew this was not Wall Street and we like that!  But should the disparity be growing and the schooling getting more expensive?
     - The new school still lacks true quiet study space, a consolidated campus, more room, an improved clinic -- all the reasons they cited for moving!  It is marginally more pleasant, and it benefits AOMA, the business, and their pursuit of a  doctorate program that will pad their pocket books.  But the true benefits to an studen are negligible and to a graduate, next to nothing.
     - Academia functions like a business in a safe bubble.  Much like “greedy” banks have TARP funds.  Colleges get paid by Uncle Sam and have to adapt much less to the real economy of the real world.   Businesses have been hurting everywhere and downsizing, but AOMA aims to grow and make more money off their private, monopolized market:  The Students.
     - Increased student jobs on campus are provided by the government more than AOMA and should lower AOMA costs for personnel and therefore tuition.  
     - AOMA has family and investors under it’s employment that benefit from such increases.
     - AOMA constantly has administrative and transparency issues -- like not giving students loan money for months at a time!!!  This is not acceptable in a school this expensive, much less an increase of those costs!  Generally:  You pay more, you get more.  What do we get?
     Bottom line:  As students pursuing a career and a future we must be more vocal as customers in the present.  We are indeed customers and our dollar is not only a vote, it is our only leverage!!  
     Are we getting what we paid for?  Paid -- that is the key word.
     The school holds all other cards.  The one thing that balances is our identity as a customer -- and this identity position has been definitively defended in courts of the U.S. and 3 other countries, for both public and private institutions.  
     It is less about the reasons (and excuses) the school and the administration spout about costs and expenses.  It is about their lack of responsibility.  It is about their poor management and planning.  It is about them placing the desperate needs of the educational institution and our careers as high on the priority list as their business and money making pursuits.
     In the end, this is an acupuncture school and not Bank of America.

*This is a private letter from students to fellow students, initiated by Wiki Qi -- a student organization that meets outside of the school and thinks outside the box.
Thank you for your time.  Good luck!  This is a great profession!!!  We have to speak up and own it.

     -YELP, Better Business Bureau, Federal Trade Commission =  Since you are a customer and AOMA a business, you can complain here and retaliation is legally suspect if not an outright violation of the Consumer Protection Act and or Free Speech Act.
     The same applies for most comments on social networks.  There was even another case recently decided in favor of a student out of Florida. 

     - FAFSA, Texas State Board of Acupuncture Examiners, Texas Health Department = If you have complaints about the school or it’s finances or clinic practices, this is where to go.  Retaliation is a legal violation of the Whistle Blower Act.
Note:  It was recently defended in court that the Freedom of Information Act applies to colleges/universities.  The defense stated that by cooperating and meeting regulatory requirements for federal financial assistance, such programs are, in so far as financial assistance is concerned at least, in effect arms of the government and subject to it’s laws and requirements.

If you want financial numbers, file a petition.  They must comply.

Thursday, November 3, 2011

Special things

As a community acupuncture clinic we largely rely on patient word of mouth to keep this thing going.
Recently, we've come up with a couple of ways to say thank you to existing patients for their efforts.

First, we are rolling out the SACA Frequent Poking Plan. Tres simple: You get nine treatments, and your tenth is free! These are available at the front desk and look like this:

We also have a referral program we're trying out. With this, you hand out cards to friends who haven't tried us yet. These cards will have your name on them. When we get five of them back, you'll get a free treatment. These look like this:

This is a great way for you to help spread the word, and get a little something extra for your efforts.

If there is anything else you can do to help, all help is appreciated. Pick up a few flyers next time you're in. Wear you're SACA "I sleep with strangers at..." t-shirt. Display your SACA bumper sticker proudly.
Anything, and every little thing helps. We are, after all, all in this together.

Wednesday, October 19, 2011

The Party of Special Things to Do or... The Great Good Place

Yesterday I turned 48. It was a particularly good birthday, celebrated pretty much all weekend. Kelly and I had a first little gathering at our home we've been making together, I beautifully landscaped a corner of the yard I'd been struggling with for years, and I spent my actual birthday doing what I love to do the most - lots of acupuncture for lots of people. The Party of Special Things to Do indeed (a Captain Beefheart reference). Wrapped it all up doing another one of the things I do quite expertly - watching TV in my sleep on the couch. Woke up to a lovely PBS segment on surgeon turned potter, Cliff Lee.

Last week I had a patient tell me his brother used to be a cook at Armadillo World Headquarters. As a result he got to sneek in to many great performances there...Van Morrison, Frank Zappa and Captain Beefheart, and on and on...He was telling me this because he noticed the clinic's armadillo logo and domain name (Acupuncture World Headquarters) and he got it. It's not so often people get the nod to the 'dillo which is our homade branding effort, so it's always fun when they do.

There's another thread that runs through all this though, which was made crystal clear to me during the recent community acupuncture workshop held here in Austin, put on by the fine folks of Working Class Acupuncture with an additional hand from Alexa of East Nashville Community Acupuncture. What I'm talking about here is the notion of "the great good place" as put forth by urban sociologist Ray Oldenburg. Thanks Alexa, for sharing this.

Turns out what Ray Oldenburg is articulating is what community acupuncture clinics are doing. Who knew?

I have at various points attempted to make this connection. I've added language to our website, I've taken it away. At the end of the day, this is what the Armadillo references are about - the commonality of the great good place. The 'dillo brought people together in a strange sort of way - bikers, hippies, cowboys, students. Music was the great leveler. Community acupuncture brings people together in a similar sort of way. In our case, acupuncture is the great leveler (or maybe it's the recliners!). I never cease to be amazed as I look around the treatment room at the variety of folks there: the fireman, the teacher, the grandmother, the cancer patient, the musician, the mom, the job seeker...all doing their part, just by being here together, to make this the great good place it is.

So happy birthday, and
Good night Austin, Texas - wherever you are!

Friday, October 7, 2011

#OccupySouthAustinCommunityAcupuncture (or the cheesy bandwagon post; or the unlimitables)

I don't really know the hashdot. Wait, hashtag apparently. I swung by city hall last night just to see what was happening, it was a nice night out after all. Now I don't really care to speculate here about what the Occupy movement (or post-post-post-grad school graduation party) really will mean for everyone when it's all said and done, but it definitely re-emphasized a lot of what South Austin Community Acupuncture, and all the other community acupuncture clinics, have been practicing for awhile now: People getting together in a big space, hanging out for awhile, looking for, and often finding something to be different by the end of it and coming back again to occupy and fill that space up another time. This is what makes community acupuncture effective: the consistency of the occupation. And the occupation of the big room is strong because even when only one person is there they are welcoming the many and when many are there they are welcoming the one.

The economic frustrations that are pushing the Occupy crowd are an element that pushed the community acupuncture movement. It makes acupuncture available at a cost that the 99% of people can actually afford. Acupuncturists often emphasize the need to actually get acupuncture to see it help. But help you can't afford isn't really going to do the job. So we've made acupuncture affordable and the most important part of that equation is that it's still effective at this affordable cost. Call us a factory that just sticks needles in people over and over. It's a factory that hums a lot. The waking-up-in-the-morning-like-you-want-to-wake-up “hum”. (You may have forgotten about it, but it is a real phenomenon.)

Patients have simple demands for large problems: more sleep; less sleep; less stuffy nose; make me poop; help this rash; prevent me from going ballistic on my co-workers; standing up without pain would be nice. We limit barriers to these demands when so many other avenues have come up short. These barriers are financial. They are physical. They are psychological. All those types of barriers that patients know about like only they can. So come, unlimit yourself. Bring a friend, occupy a recliner.

Friday, September 30, 2011

The Underbelly of the Deal

I grew up in a flower shop. It was at the front of our house. My mom, who was widowed at 46 and still had four kids at home, ran it. These were my first lessons in business. She was (and is) an incredibly strong woman. From her I learned to stand up for myself and not take shit from people.

People often ask how the Groupon we did went. It went great. Even Groupon was surprised by how well we did, and we got a good number of new and dedicated customers out of it. That's why businesses run deals: to promote themselves.

What is not so great is dealing with a Groupon when the deal ends. Turns out, the end of a deal can really brings out the worst in people.

One woman called right as the deal was to expire and claimed she had called and left numerous messages, but because we had not returned her calls she could not get in on time. 

Another called the last day of the deal, and said that other clinics had honored the Groupon as long as an appointment was scheduled by the expiration date. Clearly, a seasoned veteran at not using her Groupon on time, when I explained how we had decided to handle the missed deadline ($10 off first visit), she said, "So I'm not getting anything out of this." Huh. She could have gotten 50% out of it. Instead she chose no treatment and to loose $20 instead of just $10.

Then there was the woman who happened to be particularly -  kind of crazily - high maintenance (we're not a high maintenance kind of place), who came on a friends Groupon for the allotted two treatments, and then got upset when we called her out when she tried to keep going on another of her friends Groupons. She acted like she thought what we were doing with how we run our clinic was such a great idea. In truth, I think she just liked getting something for free.

Another, who had used one treatment, but let the deadline pass on the other, declined her second treatment when we told her that past the expiration date we'd give her $5 off. People are funny. Apparently they'd rather get nothing and be disgruntled about not having the terms of a deal honored (terms they themselves are not honoring) than get something.

Yet another emailed and said she had never purchased a Groupon before, and so didn't know they expired - even though the first line of the deal is the expiration date. Come on now....

Probably one of the more fascinating (and yes, slightly annoying) things about this whole deal phenomenon is how people apparently don't even know what they are buying. They only know it's cheap. They don't read the terms of the deal, however brief. And they don't so much as click through the link to the businesses website to see if what they are getting into is even something they might want to do.

One woman was so aghast at being still with her own thoughts for a few minutes while she got acupuncture that she actually got angry. One of the weirdest things I've ever experienced as an acupuncturist for sure. I'm glad someone else was around to witness it.

So, where we're at in all of this is...if people continue to be assholes about their expired Groupons we're just going to shut the whole thing down and just call it over - because we're already a deal.

We are affordable. We are not, however, cheap. And we will not be cheapened by consumers running roughshod over us because their coupon expired. To quote a patient of mine, "Oh give me a break! ALL COUPONS EXPIRE."

Friday, September 16, 2011

Groupon ends Sept. 21

For those of you who purchased a Groupon back in March, the deal ends Sept. 21st.
As of today 273 out of almost 500 purchasers have redeemed their Groupon, and about half of those have used both treatments (the deal was for two treatments). So here's how we're going to deal with stragglers:

If you failed to use your Groupon by Sept. 21 (that's 6 months after purchase), we'll give you a $10 credit towards your first visit. That's equal to waiving our new patient fee, and what we made on the Groupon in total per individual purchase. From there, we're back to our usual $15 - $40 sliding scale (you pick what you pay).

If you used one of your treatments, but not the second one, we'll give you a $5 credit towards that second treatment.

If you are an existing patient, but didn't read the terms of the deal and didn't catch the 'New Patient Only' part we'll give you a $10 credit as well if you haven't come in by the 21st. We were telling people they could use one treatment but they had to give the other one away...but we're kind of running out of time on that front now.

We'll honor these terms until the end of the year.
Hope to see you soon.

Thursday, September 8, 2011

Reflections on Being 5: Part 1

In a couple of months, it will be five years since South Austin Community Acupuncture first opened it’s doors for business. A good time to reflect on what we’ve created. Lately, one thing I’ve been thinking about a lot is how there are things unique to community acupuncture that we have kind of downplayed over the years - in part intentionally, and in part this is just how things evolved. There’s a lot involved here, so I’m going to take on chunks over the course of a few blogs. Here we go:

Community acupuncture as a return to tradition

One thing you will commonly see on many community acupuncture clinic web sites is some kind of statement about how community acupuncture is a return to how the medicine is traditionally practiced in Asia. I’ve never been to Asia so I don’t know. I make no claims to tradition. From what I hear though, I suspect  treatment in China, Japan, or Korea while not uncommonly lacking in privacy, doesn’t particularly look like what we’re doing here. So, even though it’s central to what we do, I don’t make too big deal out of the fact that we treat in a group setting. To us here at SACA it’s as normal as anything, and we want it to be as normal as anything to our patients. Besides, we see tons of people who have never had acupuncture anyway, so as far as they know what we are doing is normal. I like to let people sort of put together the pieces of how this is a good idea at their own pace. Most get it. A very few do not.

Another aspect of this whole notion of community acupuncture being a return to how acupuncture is traditionally practiced, is the stated reliance on traditional methods of taking the pulse and looking at the tongue rather than talking, which you also might see on the occasional clinic website. While this is a handy way to signal that not talking too much in the community acupuncture setting is helpful, and to give an idea about what goes on in a community acupuncture clinic, I have deliberately shied away from such statements because in truth it’s not what I do – at least not consistently. 

I am trained in these traditional diagnostic methods – pulse and tongue – and my process is an ongoing one of corroborating what I see on a day to day basis with my learning. The problem with these methods is they are incredibly subjective and often enough don’t match with the patients symptoms. Sometimes they are very informative, sometimes not. In a sense this is the biggest challenge and one of the most unique aspects of Chinese medicine - this being ok with inconsistencies. I am to a certain extent. Bodies are not consistent. Why would a medicine that reflects the natural order of things be? My understanding also is that really, these methods (assessing pulse and tongue) are historically more the domain of herbalism anyway (which is usually when I use them).

So I’ve downplayed this whole, “This is how acupuncture is traditionally done” thing, and I’m ok with that. 
I actually see community acupuncture as a movement away from tradition.

Wednesday, September 7, 2011

The possibilities are endless and a recliner makes all the difference

I started volunteering here after they had been open for almost a year. I remember there was a one-year anniversary party with a miniature horse and he stepped on my foot pretty righteously as I helped get him into the SUV that was going to take him back to the farm. I knew that was as good a sign as any that this was the right place for me. Wally and Kelly set up a wonderful acupuncture clinic on South Lamar and then Wally kept it running strong mostly by himself, with only me or the occasional volunteer to be around to keep him company and hear him rant.

Fast forward 4 years. Somewhere in the hubbub of last night I gave my 1,000th treatment at South Austin Community Acupuncture. Snap. My mind is still wrapping itself in and around and through those zeroes. That's like 15,000 needles. I remember my first day treating here. I saw 3 people in 8 hours, and I was on top of the world. Then I didn't see anyone the next two days. Awkward. Then I saw 5 people in one day and that felt like the water was just up to my shoulders. Now I see 5 people in a shift and I feel like I should be doing more. I look back now and check up on some of those first patients of mine. Some haven't come back. Some come and see Wally. And some still come and see me at the clinic from time to time. And that's the way it goes here.

Occasionally, patients will ask me how long I've been “doing this.” I try to reassure them (and myself) by telling them that, I've been treating out of here since February but I have been giving treatments in the student clinic at school for three years. But let's give this some perspective: over my time in the student clinic while in acupuncture school, I saw 450 people, or just slightly upwards of that. So in 7 months at SACA, I have treated more than double the number of patients that I saw in 3 years. Some more perspective: Wally and Kelly opened this clinic up in the fall of 2006. In their first seven months (11/06-6/07) they saw just over a 1,000 people combined. Note: Wally now gives about 2,000 treatments in 7 months, so I have a lot to work up to.

I'm not bringing this point up to brag, although I do feel immensely proud and fortunate that I am in this position. I'm bringing it up to show what is possible. I knew almost immediately that community acupuncture clicked with me. Its concepts of affordability and healing with other people instead of in isolation from them, re-invigorated the motivations I had for getting onto this side of the health care equation in the first place. I was just lucky I happened on to the place as soon as I did. I may not practice this way for the rest of my life, but at the moment I can't think of a better way to provide acupuncture to people. So thank you community acupuncture model. Thank you Wally and Kelly for starting the clinic and letting me come in and work here. Thank you patients for coming in. I'm having a great time.