On Selling Out
venture capital + community acupuncture + hellstrips
Recently I crossed paths with someone I haven’t seen in a long time. We were catching each other up on our lives, low-key stuff, when they abruptly said, “I’m so glad you haven’t sold out.”
I didn’t know what to say to that (what DO you say to that?), and the more I thought about it later, the more it seemed like a writing prompt. That statement reflects a lot of misunderstandings about the intersection of acupuncture and small business. To be fair, this person isn’t an acupuncturist. But I have the sense that some acupuncturists think like this too.
Merriam-Webster defines “sell out” as “to betray one's cause or associates especially for personal gain”, for example, “the band sold out its faithful followers, abandoning its edgy style for a more commercial sound”. It hadn’t previously occurred to me that anybody might be worried about WCA or POCA Tech selling out, but okay.
I have a story about what happens when you combine venture capital funding with the community acupuncture model in hopes of commercializing it — but before I tell that story, I want to reiterate that I’m always more interested in what could happen than what should happen. I’m always more focused on expanding what’s possible (especially for people with limited resources) than on achieving an ideal. And I could write a dozen posts about how I’ve disappointed various people over the years with this attitude. I have a laundry list of disapproving responses, starting with, “you should be more like Mother Teresa” (this was before it was widely known that Mother Teresa was clinically depressed, but I don’t think it would’ve mattered) right up through “I can’t figure out if you’re a socialist in capitalist clothing or the other way around (but either way you bother me)”.
I think the first time somebody suggested I try to franchise the community acupuncture model was in 2005, and I think it was my CPA, who is a smart person. I said, “I don’t think that would work” and she said “why not?” and I said “because most acupuncturists have no money to speak of plus lots of school debt, I can’t see them paying for a franchise” and she said “okay but what about people who aren’t acupuncturists” and I said “yeah, I still don’t think it would work”. Nonetheless I did want the model to spread, so not long after that conversation, WCA started experimenting with open-sourcing the idea (and its associated systems) however we could. Which eventually led to the POCA Cooperative, a knowledge commons for community acupuncture.
Anybody could join POCA, and eventually somebody became a member who was more optimistic than me about franchising — and they maintained their membership just long enough to mine POCA’s online forums for what they thought was gold. A franchise called Modern Acupuncture was the result. And so we got to find out what a commercialized version of community acupuncture would look like.
In 2016, they issued a press release: Modern Acupuncture™ Announces First Location, Plans 150 Franchise Locations By 2020. Created by Former Key Leaders from The Joint Chiropractic, Modern Acupuncture™ Has 95 Licenses Sold or Pending Across the U.S! In 2019, they secured venture capital funding. Cameron Diaz became an investor! It seemed like this was a story about small-scale entrepreneurs (us) who were too pure, too obstinate, or too clueless to sell out — and so we lost out on a huge opportunity.
At the time, some people were disappointed in me for not being sufficiently upset. I won’t lie, it’s weird to see somebody selling a funhouse-mirror version of the thing you love, but worse things have happened in my life and mainly I was fascinated. Somebody was taking my road-not-taken! And they were doing it so publicly! I couldn’t wait to see what the outcome would be.
It was pretty much what I expected (though the pandemic sped things up). It was a business disaster. As of today, Modern Acupuncture appears to be barely hanging on with just 21 franchise locations, and I can’t imagine how they could recover. I’ve talked with some very, very unhappy franchise owners. It sounds like some people lost their life savings (probably not Cameron Diaz, though).
Modern Acupuncture franchises tried to wring a profit out of doing almost exactly what WCA does but for higher prices, in upscale locations, targeting a wealthier demographic — and most of them went belly up, even before the pandemic. Meanwhile we’re still here, plugging away. So I don’t think it’s actually possible for me to sell out.
And I also don’t think the selling out/not selling out binary is particularly useful or interesting or even applicable to acupuncture, but you know what is? Hellstrip gardens. (Which I can’t seem to stop writing about, sorry.)
My theory is that acupuncture occupies a place in US society not unlike a hellstrip (the semi-public space between the sidewalk and the street curb): liminal, rocky, vulnerable, overlooked. It doesn’t matter what kind of acupuncture you do or what you charge for it, almost every acupuncture practice is a small business with small business problems, and at the top of that list is usually survival. Successful acupuncture businesses at any price point are difficult to scale up or replicate. High-paying jobs for acupuncturists in other medical settings are scarce as hens’ teeth. The acupuncture profession likes to lament how unfair all this is, but lamentation hasn’t made any difference.
The trick to hellstrip gardening is to make peace with the lack of resources and the impossible conditions. You have to be willing to live with limitations until you can, little by little, outgrow them; you can’t just ignore them because you think they’re ugly. A hellstrip garden can give you something to love and someplace to do good work, but it isn’t something you can sell out, or cash in.
A central paradox of entrepreneurship seems to be how thoroughly you have to invest in something that doesn’t yet exist. You have to accept the risk that it might never exist while believing in it so hard that you get other people to believe in it too. You have to pour your effort into making it real both to yourself and other people, while still living in and being responsive to a world where it’s not real, not yet. Modern Acupuncture lost track of that last part. And they proved that you can’t transcend the hellstrip by throwing money at it, not even undisclosed quantities of venture capital.
Good to know.
Today is May Day, International Workers’ Day, and WCA is celebrating as usual with a free day at all our clinics. We’re giving away as many treatments as we can. We’re celebrating spring and solidarity and survival, all the valuable things you can’t put a price on. We might be on a hellstrip, but today we’re in full bloom.