Is Community Acupuncture Even Legal?
in case you were wondering
As you might remember, on October 24th there was a town hall/panel discussion for the acupuncture profession about our future. You can watch the recording here; I wrote about it here. Participants submitted questions to the panelists with the promise that they’d be answered in writing, and that document just came out. I was scrolling through it, reading the questions, when I landed on one that made me laugh — well, not exactly laugh, more like huff loudly in exasperation (my dog looked up at me like: what?). After I apologized to the dog I thought, I should unpack this question, because it would surprise many of our non-acupuncturist readers.
The question (on page 12) was: “What about acupuncture tech skills? Their model is community acupuncture, but the tech doesn't have to be a licensed acupuncturist. I don't think that there is any higher education or board examinations. This is very popular now in Portland, OR. How is it legal?”
How is it legal. Pretty much from the moment we opened WCA back in 2002, there were acupuncturists telling us that what we were doing was bad for the acupuncture profession (as in devaluing/degrading/destroying, no I’m not making this up). It was so bad that it couldn’t possibly be legal! To be fair, one of the things that you learn when you’re a small business person is that it’s surprisingly easy to break laws that you didn’t even know existed — that’s why it’s good to have a business lawyer, and I did consult one before opening WCA. And some of what our critics were concerned about might’ve been illegal if we’d actually been doing it, which we weren’t.1
The most generous interpretation of the “how is it legal” question is that someone was understandably confused about three different uses of the word “tech” in an acupuncture context. The person who answered the question did a good job2 of untangling the three possible meanings: 1) an acupuncture technician, also known as an acupuncture assistant, whose role is defined by the Oregon Medical Board and who might do things like remove needles or adjust electrical stimulation; or 2) acudetox/ 5NP performed by Auricular Acupuncture Technicians, which isn’t legal yet in Oregon but we’re working on it; or 3) POCA Tech itself.3
I’m pretty sure that the question was about POCA Tech, and maybe WCA, due to the “very popular in Portland Oregon” — in which case, thanks! It’s nice to be popular. WCA provides about 1,000 treatments every week, give or take, and we feel honored that so many people use our services.
However, POCA Tech graduates would be very surprised to hear that they don’t have to worry about board exams. And I promise you, though many acupuncturists still refuse to believe it, that POCA Tech is fully accredited by the very same organization that accredits other acupuncture schools so I think that takes care of the “no higher education” part. And all of WCA’s licensed acupuncturists are actually licensed! Including the POCA Tech graduates! Though I think what the question is really about — and has always been about — is, if community acupuncturists aren’t doing acupuncture the way conventional acupuncturists do it, what ARE we doing and how can it possibly be legitimate?
So I thought it would be fun to answer that question with a reflection paper that a Cohort 10 intern, PJ, wrote about their first hundred acupuncture treatments in the student clinic. I love these first hundred treatment papers in part because of the “beginner’s mind” aspect, the way that people who are new to something can see it with clarity. PJ wrote:
What to say? I love this. It makes sense to me in very deep ways. It feels very natural.
I totally stop thinking during my clinic shift, which doesn’t happen very often in the rest of my life. Though, it does happen sometimes when I create (cook, draw, write).
My maternal grandma is a self taught artist and she often talks about how her art practice is a form of channeling. She’ll say things like, “I don’t know who painted that, but it wasn’t me.” It was her in some ways; she was there and maintained an open heart, but I like how she frames it as something unexplainable / out of her control. I’m not sure if she was the one who came up with this idea, but she says there is a little creature in the dark corner of her room that tells her what to do. She listens, and when she doesn’t, things go wrong!
Some of her art:
(screenshotted from her website katieleeartist.com & included here with her permission)
I really relate to and appreciate her framing of the creative as a sort of unseen, communicative presence. I feel the flow she describes in all the body/heart felt aspects of acupuncture: which places on the body to needle, how deep to adjust/not adjust, how many needles, etc. This state reminds me of love (a loaded word), but I mean it as in a focused presence, an active acceptance of reality. Similar also to the way people describe higher powers (maybe all one in the same). It is a state of being that requires a renunciation of ego, an acceptance of reality, and immense presence in the current moment. How can you not feel better after holding that space for a few hours!?
Neither holding space nor presence are listed as synonyms for “love” and yet that’s what I’ve found myself feeling during my clinic shifts. Learning to build a container within myself to receive and hold patients’ energy, while simultaneously facilitating patients’ movement toward rest / calmness. I feel hugely supported in this endeavor by the clinic space itself, as well as my supervisor & fellow interns. The clinic space holds energy and does a lot of the containment and mood setting; we (the clinic and I) work as a team. When people come in feeling unregulated I imagine them entering the “clinic womb” where they can rest, experience quiet connection with strangers, and ideally connect with their body in a restorative, or even pleasurable way. I feel my ability to create momentary holding spaces for people to relax into growing.
Experience of my first 100 treatments represented visually:
Ideally, holding space is not only supportive for others, but also for myself; I’ve noticed I don’t feel attached to what people think of me when I’m punking. It feels wonderful! I trust in myself and all the places I ground myself (ancestors, routine, exercise, food) to bring people into my punk orbit.
Punking has reconnected me to a guiding place within myself. This source whispers to me: “we will practice acupuncture, we will support people other healthcare spaces reject, we will be with love through boundaried, container creating.”
Community acupuncture allows me to practice something that I believe in, that is rooted in liberation of people and directs toward life. These are things I know. This is what I have learned from my first 100 treatments.
That’s what community acupuncturists are doing, and that’s what we teach at POCA Tech. I’m glad it’s legal, aren’t you?
Also, as promised, here’s an update on our 25 X 1000 group project. This is what our group spreadsheet looks like:
So far I love this exercise for the way it helps us practice entrepreneurship skills in real time! Stay tuned for a post next week with more details about entrepreneurship for acupuncturists.
And on the fundraising side — thank you so much to everyone who has already donated! Some of you are new donors and some of you were already POCA Tech monthly Sustainers so you’re being extra generous. We appreciate you so much! By my count, as of today we’ve collectively asked about 215 people to donate (or 21.5% of our goal) and we’ve raised about $3550 (or about 14.2% of our goal). We’re off to a good start!
Once again, if you’re getting anything out of this newsletter, or you’re encouraged in any way by POCA Tech’s efforts to re-imagine acupuncture education, will you donate $25 if you haven’t yet?
Here’s the link to donate and the QR code:
A lot of acupuncturists assumed that we were combining our sliding scale with insurance billing and thus committing insurance fraud. There are lots of reasons why WCA has never billed insurance and never will (for excruciating details, see this post and this post). Ironically, the responses to the town hall questions actually mentioned a Veterans’ Administration review which found “acupuncture and chiropractic clinics where over 70% of the claims made were deemed to be fraudulent” (pg 15). It’s really easy to make mistakes with insurance billing, which is another reason we’re glad we don’t do it.
Except for the part where they said that POCA stands for “Portland Community Acupuncture” (huh?) instead of The People’s Organization of Community Acupuncture (an organization whose work goes way, way beyond Portland).
I admit that when we named the school, we knew the name would annoy certain acupuncturists and we didn’t care. But we have some really good reasons for identifying as a technical school.