Flying Home: Starting an Acupuncture Practice

In which I digress from informative posts in order to express my excitement, apprehension, and good-old-fashioned dorkiness about starting an acupuncture practice (or a couple of them) in Portland, Oregon, the land of acupuncturists…

When I started this blog, I was an excited student learning about the systems of acupuncture, Traditional Chinese Medicine, and various Western medical ideas and research. Now I am a rookie acupuncturist, still learning but in more detail, and also running a business. Well, running 1.5 businesses and working for 2 more businesses. For better or for worse, business has entered my world in a major way, and it kind of feels like I’ve been given a power-wedgie by the finance and marketing sectors.

Appropriately, this image is from the Big Brother tv show.

I’m sure it’s counterproductive to view myself in some kind of power dynamic with these abstract concepts, especially with myself initially as the victim. But after going through the motions of creating business entities and then promoting them, I am sooo ready to be the one who surprises ‘finance’ and ‘marketing’ by pulling their underwear above their waistline and deftly depositing them both on matching fenceposts, dangling by their underwear.

To create a more natural metaphor, I will give you a peek into what my past three months have looked like, approximately:

The noble Goshawk, pursuing a Rabbit

I would like to picture myself as the goshawk here, but I am also a bit like the rabbit. This is the world of business, goshawk-eat-rabbit. If I am the goshawk, financial security must be the rabbit. Or “finishing that stupid google ad” may be the rabbit. Whatever. My job as an acupuncturist is to reach the greatest number of people that need my help, and to provide them with the best medical care possible. However, the way this looks in the real world involves a lot of publicity-creation and seeming self-aggrandizement, just to let people know that I exist. Unfortunately as acupuncturists, we don’t have an established system of facilities into which we are funneled. So we get to reinvent the wheel nearly every time.

We don’t have residencies (or very few), nor old-timey apprenticeships (unless we’re really old school), nor large institutions that will hire us as employees and send a reasonable flow of patients our way. No, we must reach out and educate nearly every patient that comes through our door about this form of medicine and how we can help them. I enjoy outreach and education as much as the next person, and I feel like I can execute a plan of action fairly well, so I’m not complaining about actually doing this work. Instead, I am pointing out the differences between how acupuncturists build their practices and how nurses or doctors build theirs.

As acupuncturists, we must set up elaborate schedules full of health fairs, farmers markets, free acupuncture happy hours, and lectures at local libraries. We must lurk around in coffee shops and surprise innocent latte-sippers with our bursts of enthusiasm about the healing power of tea, or coffee, or how seasonal changes effect allergies and how we can treat these flare-ups. We must memorize the locations of all the natural food markets in our metropolitan area and regularly give talks or post flyers in these locations. Really.

Coffee Talk from SNL. They just learned about the benefit of green tea. I think.

There is a good side to the lack of infrastructure in the acupuncture field: we don’t fall prey to bureaucratic profit-harvesting and the streamlining of services to the patients’ neglect or dismay. But in many other ways it creates a huge waste of time and effort, and the process of building a clientele culls the acupuncturists who may be fantastic clinicians but ineffective business-people. Not everyone knows how to make Linda Richman all verklempt over Chinese Medicine.

This is a sad state of affairs, and in extra-sad news, acupuncturists can’t seem to organize themselves into effective advocates for their own industry. We joke with each other about the difficulty of “herding cats,” but the fact is that we are either too busy trying to build a patient base or too busy treating the patients that have found us, since we generally work diligently and passionately to provide exceptional medical care. Our colleges are just beginning to build real equity and gain foundation-level support, and we have very few acupuncture-specific research institutions.

Why am I bemoaning this state of affairs? To give greater importance to the progress that is being made currently in our field of medicine. It takes a gargantuan effort to educate the public about our form of medicine with the minimal level of funding that we currently have. But we are doing a fairly good job of this. Furthermore, our clinical researchers and leading practitioners in the field have done an excellent job of collaborating with leading colleges and universities to create robust studies of acupuncture’s effectiveness. So, there is a silver lining.

We can still shape the field of acupuncture and Traditional Chinese/East Asian/Oriental Medicine in the United States. We can create an effective organizational structure that maintains the integrity of our approach to medicine (hopefully). As more MDs and NPs, NDs and DOs and RNs gain more knowledge and experience with acupuncture, they have begun to create close referral relationships with acupuncturists and TCM practitioners. Hospitals are hiring acupuncturists for their pain management/pre and post-operative/oncology/ rehabilitation wards. And acupuncturists are finally becoming successful enough to hire associate acupuncturists at a fairly living wage.

Here are a few institutions in the US that are pursuing top notch acupuncture research:

Columbia University College of Physicians and Surgeons

Massachusetts General Hospital

Harvard University Medical School

The University of Maryland

University of North Carolina

University of Washington

Helfgott Institute

Duke University

The Oregon College of Oriental Medicine

The New England School of Acupuncture

And now we have a listing of integrative medical centers featured in the Bravewell Collaborative’s 2012 report “Mapping the Field of Integrative Medicine”- most of which are pursuing research in acupuncture and TCM.

Participating “Integrative Medicine in America” Centers:

  • Alliance Institute for Integrative Medicine
  • University of Maryland Center for Integrative Medicine
  • Arizona Center for Integrative Medicine
  • Cancer Treatment Centers of America
  • Integrative Medicine Program, Mayo Clinic
  • The Center for Integrative Medicine at the University of Colorado
  • Integrative Medicine Center at MD Anderson Cancer Center
  • Center for Life, University of New Mexico
  • Northwestern Integrative Medicine
  • Cleveland Clinic Center for Integrative
  • OSU Center for Integrative Medicine Medicine
  • UCSF Osher Center for Integrative Medicine
  • Continuum Center for Health and Healing
  • Osher Clinical Center
  • Duke Integrative Medicine
  • Penny George Institute for Health and Healing
  • 11th Street Family Services of Drexel University
  • Scripps Center for Integrative Medicine
  • GW Center for Integrative Medicine
  • Simms-Mann Health and Wellness Center at Venice Family Clinic
  • Greenwich Hospital Integrative Medicine Program
  • Center for Integrative Medicine and Wellness at Stamford Hospital
  • Institute for Health & Healing at California Pacific Medical Center
  • Stanford Center for Integrative Medicine
  • Jefferson-Myrna Brind Center of Integrative Medicine
  • Susan Samueli Center of Integrative Medicine
  • University of Wisconsin Integrative Medicine
  • Marino Center for Integrative Health
  • Vanderbilt Center for Integrative Health

So back to the image of the Goshawk and the Rabbit. As you know, my articles here are longer than the normal blog article, so of course I’m including a personal story regarding the goshawk, Accipiter gentilis. The goshawk’s name is derived from “goose-hawk,” since it is used in falconry to hunt large birds and mammals. Yet its scientific name gentilis derives from the same latin root as ‘gentle,’ or ‘noble.’ The largest of the Accipiters, the goshawk exemplifies concepts of the precision and endurance of hunting, the grace of flying through dense coniferous forests at high speeds, the gentleness of a highly devoted parent, and the mystery of a bird that only appears when its young are threatened (and when they appear, they will relentlessly attack anything in a two mile radius of their nest, including humans).

caw caw

So I was attacked by one such goshawk several summers ago. This particular goshawk was famous in the area for making its valley debut by cold-cocking the owner of a local dude ranch on his morning stroll. He was knocked unconscious and awoke in the trail-dust to the warning call of the female goshawk. Unfortunately the goshawk’s nest was located about 500 yards from my family’s cabin, so we commonly crossed its territory on hikes into the mountains. We gradually became accustomed to its warning call after a few instances of dive-bombings in which my brothers were attacked but I was not present. One morning I brazenly took our dog for a walk up the mountain, and I remember its warning call nearby, as usual. This time, the call was cut short, followed by a pregnant silence through which it swiftly winged its hooked beak and knuckled-up talons directly towards my low back at a ridiculous speed. After a moment in which I felt my brain explode in mortal (yet absurd) terror, I hit the ground, flopping down by a log, and felt the bird pass a foot above me. I proceeded to alternately laugh at myself and gulp in hysterics as the bird chased me down a hillside, and I tumbled through bushes and downed trees to avoid the female goshawk’s repeated attacks with fierce speed.

I found myself completely humbled and in awe of an animal that hurled itself bodily towards its source of threat. Goshawks apparently defend their nests from bears and other large animals regularly. They mate for life and have a large range, requiring large tracts of wilderness to successfully reproduce. How does this relate to me? Well I shall tell you. I do not require large tracts of land in order to reproduce, but I do understand the idea of hurtling directly at the goal with fierce speed. As I returned from Bangkok in May of this year, I felt inspired to collaborate with a variety of medical professionals in Portland, rather than just hang my own shingle and build up a practice around myself. This task is daunting to someone completely new in this field of medicine. I took creative collaboration as my goal, and this spirit of hurtling myself precisely towards this achievement has helped me to work with a wonderful team of practitioners here. The goshawk also embodies the idea of creating and protecting a home, and I feel like I have created this home in Portland. Now if the field of acupuncture can learn to gather our resources in a similar way to achieve a larger goal, we could create true collaboration on a larger scale!

So I am going to take the next few posts to investigate and interview in greater detail some of the structures and people in the acupuncture field (US and internationally) that are inspiring to me. Stay tuned!

Now as a reward for yet again making it through the ramblings of my article, please go to 5:41 in this video and watch for 6 seconds. Thank you!

And for another bird of prey’s insights: Thank you Sam the Eagle:


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