Friday, February 17, 2012

Community Acupuncture is Integrative Medicine

I came across a story highlighting a recent survey of integrative medicine centers in the U.S. “One of the most striking, though perhaps predictable, conclusions of this study is that integrative medicine is, in fact, integrative. It integrates conventional care with non-conventional or non-Western therapies; ancient healing wisdom with modern science; and the whole person — mind, body, and spirit in the context of community” (italics mine). What communities are they talking about?
Its highlight, and self-fulfilling, statement: “Integrative medicine is now an established part of healthcare in the United States.” An established part of healthcare based upon a survey of 29 integrative medical centers. Twenty-nine? That's not even one for every state. It seems to me that they are missing some communities. (In all fairness, they were able to identify 60 integrative centers nationwide, but only surveyed 29.)
It made me recall a book that a friend gave to me: We've Had a Hundred Years of Psychotherapy...And the World's Getting Worse. It's co-authored by James Hillman and Michael Ventura. (Ventura currently writes a bi-weekly column called Letters @ 3am that appears in the Austin Chronicle.) The book is a collection of dialogues—conversations, letters and phone calls—that look into the role of therapy. Right off the bat Hillman points out that we are ignoring the impact the environment has on us: “By removing the soul from the world and not recognizing that the soul is also in the world, psychotherapy can't do its job anymore. The buildings are sick, the institutions are sick, the banking system's sick, the schools, the streets—the sickness is out there.” Ventura takes it a step further and says, “Our inner knowledge has gotten more subtle while our ability to deal with the world around us has [...d]istnegrated.”
Disintegrated? Sounds like we need something that's integrative. And so these integrative medicine centers have been popping up and trying to re-establish the foundation of modern healthcare: take our technological breakthroughs in Western medicine, which look at the individual as a machine made up of discrete parts, throw in a dash of “ancient healing wisdom” that knows that the whole is more than the sum of the parts, and voila: ideal healthcare.
Integrative medicine centers are more “patient-centered” and address the “full range” of health issues, because it sounds like that is one of the big missing variables that will help fix the healthcare boondoggle—or at least make those who can afford the doggle happier. But these centers are palaces, generally slick and high-dollar. What community is that in the context of? I look and see that the “regular per session cost is between $115-$124” for acupuncture at one of these centers. That range is so small you should just say it costs $124, you’d save it in employee time wasted on explaining who is at the high end and who is at the low end.
But my main point isn't even about dollars and cents. Practitioners can charge what they want to charge and if people are willing to pay it, then that's no fault of theirs. However, the survey also pointed out that “63% of patients seen are self-referred.” That means more than half the people who get treated with “alternative” or “complementary” therapies are initiating the search themselves—some of them from within that particular healthcare system itself and some who are just looking around for it and an integrative medicine center is all they can find or seems the most credible. “If I’m going to pay a lot of money for this, I’d rather go to a Center.” And that’s really the main point: integrative medicine centers are popping up because people want these alternative options. It’s a market. Something their communities have not had before.
Integrative medicine centers do some great things: they are more apt to be part of the cross-talk between mainstream medicine and alt-stream medicine; they conduct research on alternative therapies to try and examine what has essentially been learned through tradition; and they are on the front line for a lot of patients within the system who have decided their healthcare community is not providing everything their soul needs to be healthy. Yet, is that changing the healthcare environment enough?
I find that one of the great things about the community acupuncture set up is that it goes beyond the idea that a market is available and wants to re-integrate the idea of health with the environment—at least the immediate environment where you are getting care. We often admit here at South Austin Community Acupuncture that we have health concerns, and while we don't overtly talk about them all in front of one another, we do put the healing process in a more public setting—to me that gives soul to healthcare. Gone is the doctor's office waiting room where everyone avoids eye contact with everyone else, because you don't want to have anything to do with someone else's illness. From Hillman and Ventura: “The illnesses are your teachers...[d]evaluing the illnesses and suppressing them removes you from these figures.” And in real communities, illness is not isolated.
At the community acupuncture clinic, in the large treatment room we are all focused on wellness. It creates a web of relationships that is often missing from the health care system today. And that is probably why community acupuncture has exploded onto the scene over the past few years. When South Austin Community Acupuncture opened five years ago it was one of the first ten or so community acupuncture clinics in the entire country. Now there are 161 across the United States. That’s an incredible growth rate. It’s the kind of growth rate that speaks VOLUMES about the “context of community.” It also speaks volumes about the state of the acupuncture profession to create jobs, but that’s beside the point. Whether you come in with friends or strangers, you still find something in this community. And community is, as Ventura calls it, “simply the actual little system in which you are situated.”
-- and here's Ventura's column from earlier this year remembering his friend and collaborator, James Hillman