Community Acupuncture Movement
Project Street Address
Project City
Project Province/State
Project Postal/Zip Code
Project Country
Focus of activity
Service/process
Year the initiative began (yyyy)
2006
Which of these barriers is the primary focus of your work?
Health care not consumer friendly
Which of the principles is the primary focus of your work?
Democratize access
If you believe some other barrier or principle should be included in the mosaic, please describe it and how it would affect the positioning of your initiative in the mosaic:
This field has not been completed
Name Your Project
Community Acupuncture Movement
Describe Your Idea
Define the innovation
We are disruptive in almost every possible way, because we:
1) Leverage patient communities to relocalize medicine and decrease dependence on large corporations (such as Big Pharma and Big Insurance);
2) energetically address class barriers in healthcare -- instead of assuming that people who can't afford to pay for a service require that service to be somehow subsidized, we have figured out how to simply lower the price of the service, so that consumers retain the dignity of paying for what they are using;
3) focus on an ancient, low-tech intervention rather than a modern, high-tech one, which means both a) offering patients a choice beyond surgery and pharmaceuticals, and b) working to integrate acupuncture into American healthcare by means of a grassroots movement rather than seeking to become accepted by the medical establishment/ be paid for by insurance companies;
4) fund our initiatives with lots of small increments (bottom-up) rather than a few large infusions (top-down): consumers pay modest fees for service which allows us to operate without grants;
5) base our fee structure on trust and reciprocity between practitioners and patients. Most community acupuncture clinics use a sliding fee scale of $15-$40 per treatment with no income verification required or requested. This means that within certain parameters, patients choose what they pay. Many patients who pay at the low end find creative, nonfinancial ways to support their community clinic (outreach, marketing, publicity, volunteering their time to answer phones) thus enhancing their self-esteem as community activists rather than passive recipients of charity.
Context for Disruption:
The Community Acupuncture Movement is the rapid spread of 1) a fee-for-service business model that simultaneously makes acupuncture widely accessible to people with ordinary incomes and makes it possible for acupuncturists to earn a living; 2) a set of ideas and practices that empower patients and break down class barriers in healthcare delivery; and 3) a model for low-tech, inexpensive healthcare that targets issues that Western medicine often handles poorly, such as prevention, pain and stress reduction, and the management of chronic illness.
The beneficiaries are 1) the estimated 90% of Americans who cannot afford complementary/alternative medicine at market rates; 2) the estimated 75% of acupuncturists who cannot currently earn a living due to lack of patients; and, ultimately, 3) the American healthcare system itself, which is burdened by rising costs and increasingly marked by inequalities of access and over-reliance on unsustainably expensive technologies.
Acupuncture itself is extremely simple and cost-effective treatment for a wide range of conditions such as pain, fatigue, anxiety, depression, asthma, allergies, hypertension, digestive disorders, and a host of other problems. Community acupuncture reduces the cost of an acupuncture treatment from an average of $100 down to $15 to $40. Delivering treatment in a community setting directly addresses the isolation many patients experience in dealing with pain, stress, and/or chronic conditions. Community acupuncture is a grassroots movement that leverages the power of patient communities to create viable, accessible, non-pharmaeutical care; it differs from other complementary/alternative medicine models because it is genuinely affordable to a wide range of consumers, does not depend on insurance reimbursement, and is not in any way a charity.
Delivery Model
Within the Community Acupuncture Movement, there are two organizations that work in complementary ways to spread the business model and the practices of community acupuncture: Working Class Acupuncture, the oldest, largest, prototypical clinic, and the Community Acupuncture Network, a nonprofit membership organization for practitioners, patients, and friends of community acupuncture.
The Community Acupuncture Network operates primarily online at this point, using forums for practitioners to open-source their ideas and practices in creating accessible clinics and to support each other in the challenging process of starting their own businesses. CAN currently has 284 members, most of them licensed acupuncturists who are either operating, starting up, or contemplating an accessible community clinic. CAN is in the process of converting the information that is spread out over more than 3,000 posts in the forums into a community acupuncture wiki (user-maintained online encyclopedia) to more easily disseminate the information as the organization grows. CAN also created a group blog that is open to the public in hopes of influencing acupuncturists who are not members to join the discussion.
Working Class Acupuncture is primarily the source of conferences and trainings, though other members of CAN are beginning to offer trainings as well. Since October 2006, 165 acupuncturists from the US and Canada have received training in the community acupuncture business model. We know of more than 50 clinics that have adopted at least some aspect of our model, and we estimate the actual number to be about twice that. We are beginning to use online video as well:
http://video.google.com/videoplay?docid=9047189640000596709&q=wca+patien...
We also have written a book ("The Remedy: Integrating Acupuncture...") which has sold over 500 copies in 6 months, and is available online as a download: http://www.lulu.com/content/466287
Key Operational Partnerships
The current key partnership in the Community Acupuncture Movement is the partnership between WCA and CAN. Acupuncturists who attend a WCA workshop are able to join CAN in order to receive continued support to implement the practices that they have learned. WCA is currently the most successful example of the community acupuncture business model in action, providing about 350 treatments per week to patients. Patients wishing to make acupuncture accessible to their family and friends in other areas of the country can use the CAN website to find a practitioner or a clinic who is either already practicing or might be receptive to creating a community acupuncture clinic.
As word about community acupuncture is spreading, acupuncture schools are beginning to invite WCA to do trainings onsite for their students. WCA has also provided two trainings in partnership with two state acupuncture associations, in Maine and in New Mexico, and will continue to explore that option. WCA is also in the beginning stages of a partnership with the African American Health Coalition in Portland, OR, an organization that also targets wellness issues, chronic illness management, and stress reduction.
Financial Model
The essence of the community acupuncture business model is to take the conventional acupuncture business model of charging high prices for individual treatments, and reframing it: instead of treating one patient per hour for $100 in a little cubicle, treat 4 to 6 patients per hour for $15 to $40 in a community treatment room. The larger number of patients creates a more stable cash flow and makes it easier to maintain the clinic. Creating a clinic which is culturally accessible to a wide range of patients means making a physical space that is simple, comfortable and welcoming -- a significantly less expensive endeavor than making a physical space that is sterile,medicalized and intimidating, or shiny, upscale and intimidating.
Similarly, the model for CAN is to charge reasonable membership fees to acupuncturists (sliding scale of $45 to $100 per year for practitioners, much less for acupuncture students and patients) and to encourage them to think as a community and to share information about business practices instead of hoarding out of fear of competition. The fees pay for the maintenance of CAN's website.
100% of the operating costs of the Community Acupuncture Movement comes from earned income: patient fees for treatment, acupuncturist fees for membership, and tuition for conferences and trainings.
What is your annual operating budget?
370K
What are your current sources of revenue? (please list any sources that are foundation grants)
See above: patient fees for treatment, practitioner membership fees for CAN, and tuition for conferences and trainings. No grants, no donations, nothing but fee for service.
Effectiveness
This time last year, in summer 2006, we estimated that the total number of patients receiving acupuncture in community acupuncture clinics was about 250 nationally (WCA plus a handful of "early adopter" community clinics.) Taking what we know about how many patients CAN clinics are seeing, we estimate that currently about 1800 patients nationally are receiving acupuncture each week in community acupuncture clinics. We know that hundreds of acupuncturists and acupuncture students are now aware of the possibility of an alternate way to run their businesses that is more equitable. We have not yet influenced the acupuncture establishment to make fundamental changes in the way that students are educated about business and access -- but we will.
Which element of the program proved itself most effective?
Three elements stand out for us as effective:
1) the Community Acupuncture Network practitioner forums, for creating a sort of "group mind" about how to create an accessible clinic as well as promoting an open-source atmosphere of collaboration and support;
2) the conferences and trainings; at least half of the practitioners who have attended conferences have opened or are working on opening a community clinic;
3) Lisa Rohleder's book "The Remedy: Integrating Acupuncture Into American Healthcare" for helping practitioners and patients think more clearly about classism in complementary/alternative healthcare. Having the book available for download has made it accessible to readers in the UK and Canada. We know of at least three clinics that happened solely as a result of practitioners reading the book.
Number of clients in the last year?
About 3,000 patients at WCA; we estimate 15,000 patients in CAN clinics nationally; and 284 members of CAN. We know that the innovation of the business model has spread widely and is being used by acupuncturists who don't choose to join CAN, so the number of patients nationally who are now receiving acupuncture, who couldn't previously afford it, is probably significantly higher.
What is the potential demand?
Before the Community Acupuncture Movement came along, the unchallenged conventional wisdom in the acupuncture profession was that patients who claimed not to be able to afford to pay $100 out of pocket for acupuncture simply did not "value their health" sufficiently to make treatment " a priority". It is difficult to measure the true demand for acupuncture in this country, due to decades of this kind of classist thinking among acupuncturists which has caused them to focus on a ridiculously narrow segment of the potential patient population. Acupuncture has by and large been marketed as an exotic luxury therapy for the truly discerning (meaning, wealthy) consumer, which means that very few patients have been able to experience for themselves the potential value of a nonpharmaceutical intervention that is effective not only for pain but for any number of common problems. Virtually no marketing technique for acupuncture is effective apart from simply offering patients the opportunity to experience it. Only lowering the price of entry will make acupuncture widely used.
In 2005, USA Today and Stanford University released a poll that indicates almost 20% of Americans suffer from chronic pain, and 44% suffer from acute pain. This makes pain a public health problem of huge proportions. In 2006 the Centers for Disease Control issued a special report on pain, because they found it to be so prevalent among Americans interviewed for the CDC's national health status report. The potential demand for inexpensive acupuncture for pain alone is enormous.
In 5 years, WCA has gone from 12 patient visits per week to 350 patient visits per week. If acupuncture is presented appropriately to consumers with ordinary incomes, a similar expansion in demand should occur nationally.
Scaling up Strategy
We have two priorities for the next 3 years:
1) support the "regional nodes" of CAN -- the geographic areas where there is a concentration of community acupuncturists who can support each other and network locally. By next year we plan to do large regional conferences (300 + attendees) which both train acupuncturists in the basic business model and help those who have opened clinics to develop their skills in community organizing and leveraging volunteers to help grow their businesses; and
2) develop a blueprint for patients who wish to initiate organizing a clinic and recruit a suitable practitioner after the clinic exists: the patient-generated clinic model. Once this blueprint exists we can begin to train patients in a similar way as we have been training practitioners.
One of our strategies in general is to design self-sustaining and self-replicating systems. Once we have a design for large conferences that can be easily replicated in different areas of the country, we will have a means for simultaneously training practitioners, increasing our visibility, and promoting the coherence of the regional nodes -- that pays for itself. Similarly, once we have a good blueprint for a patient-generated clinic and a group of patients to implement it, it will seed the development of similar clinics by word of mouth.
Stage of the initiative:
1
Expansion plan:
Since we have been expanding pretty rapidly already, we plan to keep doing what we're doing. One area of focus is to make better use of technology and the Internet than we already have. We have 2 videos on Google that thousands of people have seen:
video.google.com/videoplay?docid=9047189640000596709&q=wca+patient+panel&total=1&start=0&num=10&so=0&type=search&plindex=0 and
http://video.google.com/videoplay?docid=-8437007730452187420&q=wca+at+OC...
Our next plan is to use our volunteer filmmaker to create "video tours" of as many community acupuncture clinics as possible, so that acupuncturists who do not live close enough to a clinic to visit can get a visual perspective on the different ways a clinic may be set up. We will post these videos on Google. Our filmmaker is also working on a documentary about community acupuncture; we will likely post portions of this documentary on Google as well.
Another focus is to develop CAN's group blog and the community acupuncture wiki to get information to more practitioners without spending more one-on-one time answering emails or phone calls.
Origin of the Initiative
In 2002, two licensed acupuncturists, Lisa Rohleder and Skip Van Meter, opened an acupuncture clinic in their working-class neighborhood with the goal of making acupuncture financially and culturally accessible to their neighbors. They devised a fee-for-service business model based on offering simple, frequent, regular acupuncture treatments in a comfortable community setting, using a sliding fee scale of $15 to $35 per treatment. In 2005, Lupine Hudson joined the clinic (renamed Working Class Acupuncture) as a community organizer and volunteer manager with the goal of spreading the business model nationally. As more and more acupuncturists and patients became excited about the idea, the Community Acupuncture Network came together in 2006 as a national organization and the Community Acupuncture Movement took off.
This Entry is about (Issues)
What are your two main challenges to finance the growth of your initiative
We have been successful in meeting our funding needs so far. If we had extra money, however, there are two areas where we could use it:
1) small grants to help start new clinics. The start-up cost of a community acupuncture clinic is potentially only about $2000. Most practitioners can come up with that, but grants would encourage them.
2) funding for research to establish community acupuncture as a public health innovation. There is a small study currently being done within Kaiser Permanente on the community acupuncture model within a pain clinic. What would be really helpful would be to design a study to show the impact that an affordable acupuncture clinic has on the health of a community. At WCA we know that our patients are taking fewer prescription medications and missing less work due to having acupuncture available to them; it would be great to quantify these observations.
How did you hear about this contest and what is your main incentive to participate?
Last year, Lisa Rohleder entered WCA in the Changemakers competition "How to Improve Health for All." As a result of the competition, we met several acupuncturists who started community clinics; we received our first hate mail; and we absorbed a lot of great ideas which we subsequently implemented.
Do you have an annual financial statement?
Yes: tax returns for WCA and CAN.
Do you currently have an annual financial statement that tracks profit/loss?
0
Please describe the amount (and/or type) of funding you need to implement your initiative, at year 1 and at year 5.
 | Lupine Hudson said: Thank you, Ralph! You might like our group blog too: www.communityacupuncturenetwork.org about this idea. - 991 days ago read more > |
| Ralph Soldano said: I agree acupuncture is a great intervention for many ailments. I have used it myself to help control my asthma, it is inexpensive and it ... about this idea. - 991 days ago read more > |
| Lupine Hudson said: Here is the link to a video that we have posted on Google of some of our patients talking about the Community Acupuncture Movement: ... about this idea. - 992 days ago read more > |
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