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!

#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.

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."

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.

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.

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.