I’ve graduated from acupuncture school, I have my malpractice and liability insurance in place, and I’m waiting on a couple of documents from my college so I can complete the registration that allows patients to submit my treatments to their health benefits.
So lately I’ve been spending a lot of time figuring out what I actually want my practice to look like.
And I’ve fallen pretty deep down the community acupuncture rabbit hole.
I was pretty sure community acupuncture wasn’t for me
Before school, almost all of my experiences with acupuncture were private, one-on-one treatments. Quiet room, treatment table, lots of individual attention, often spa-like.
I eventually went to Florenceville Community Acupuncture Clinic in Florenceville-Bristol to experience community acupuncture for myself. I had genuinely great, helpful treatments with Paul, and I often recommend him to friends. I just remember thinking afterward that this wasn’t how I wanted to practise. I loved the intimacy of private care too much.
I also don’t think I really understood what community acupuncture was.
In my head, community acupuncture was something acupuncturists did occasionally to “give back.” A pop-up clinic, a low-cost day, a special event. I hadn’t really wrapped my mind around how it could function as the actual business model of a clinic, even after I’d been treated in one.
Then I went through acupuncture school, observed Traditional Chinese Medicine in China, spent hundreds of hours in student clinic, and started digging more into how Chinese medicine has actually been delivered historically and in rural communities.
My thinking started to change.
Student clinic changed the way I thought about affordability
Our student treatments were inexpensive, which meant people could actually come back. Someone could come several times a week and complete a course of care instead of having one or two treatments, feeling better (or not, because they didn’t complete the full course of care required), and disappearing because they couldn’t afford another appointment.
I saw so many people get relief from things they’d been struggling with for years, and I started thinking about how different their experience might have been if they’d been paying full private clinic prices.
Sometimes acupuncture gives really impressive relief after one treatment. I’ve seen that plenty of times. But sometimes that relief only lasts a few days, and getting lasting improvement with a chronic problem can take 10 or 12 treatments, sometimes more.
Now do the math on that at $110–$160 per appointment.
Even someone fortunate enough to have $500 a year in acupuncture coverage can burn through that pretty quickly. I keep thinking about the people who need ongoing care, especially older people, working families and people living with chronic conditions. How many ever get enough treatment to find out what a full course of acupuncture could actually do for them?
Then there was China
One of the things that really stuck with me while studying there was how ordinary it was to see care happening around other people. Hospital departments were busy. Patients were being treated in shared spaces. Practitioners moved between people. Treatments could be quick. There wasn’t necessarily an hour-long private appointment wrapped around every treatment.
Since coming home, I’ve also been interested in reading about rural healthcare in China and the history of Chinese medicine more generally, and it has made me laugh a little at the idea I had somehow absorbed in North America that private, one-on-one acupuncture was the “pure” version of this medicine.
Pure according to whom?
Maybe if I were treating an ancient emperor I’d have a very different setup.
For most ordinary people, though, Chinese medicine has had to function as actual healthcare. It has been practised wherever people were, often under practical constraints, and adapted to the needs and resources of the communities being served.
I still love the beautiful private treatment room. I love having lots of time with one person. But I no longer see that setting as inherently more authentic to Chinese medicine.
Seeing hospital care in China and learning more about the history of the medicine has made a busy room full of people receiving treatment feel a lot less radical.
I started looking at community acupuncture as a business model
Once I started looking at community acupuncture through that lens, the business side started making a lot more sense too.
A higher-volume clinic means treating more people. As a new practitioner, that’s exciting to me. More patients means more patterns, more responses to treatment and a lot more opportunities to develop clinical skill. I learned an incredible amount from treating at volume in student clinic, and I can see how valuable that could be in my first few years of practice.
There are other business opportunities that come with volume too. A small retail area with thoughtfully chosen products becomes much more viable when more people are coming through the clinic.
And then there’s word of mouth.
If someone can only afford two treatments, gets temporary relief and then has to stop, they may never get to experience the result you were working toward. If treatment is affordable enough that they can actually follow through with the 10 or 12 visits you recommended and they finally get lasting relief from something that has been bothering them for months or years, that’s a very different experience of acupuncture.
Those are the stories people tell their friends.
But I’m building this in rural New Brunswick
I live in a community where a lot of people are incredibly self-sufficient. Many of us are off-grid homesteaders. People grow food, build things, barter, share resources and help their neighbours. It’s a way of life that doesn’t necessarily result in a lot of extra cash flow, and there’s a pretty strong preference for staying close to home.
I love where I live and the people I share this little corner of the world with. I would really love to make acupuncture accessible here.
That has also had me thinking a lot about mobile care.
One of the ways I’m planning to start is by bringing private acupuncture directly into people’s homes throughout Carleton County. There are things I really like about that idea. People don’t have to drive after treatment. Someone who is older, exhausted, in pain, caring for children, or just doesn’t want to make another trip into town can receive care in their own space.
It also lets me begin without immediately taking on the overhead of a permanent clinic.
But the more I work through the logistics, the more I realize mobile care has its own costs.
I have to drive there. I have to carry a treatment table and supplies in, set everything up, treat one person, pack everything back up, load the car and drive to the next appointment. Rural New Brunswick is not exactly a collection of houses conveniently stacked five minutes apart.
Suddenly an hour of acupuncture can occupy a much bigger chunk of the day.
I still think there is a place for mobile care. In-home acupuncture could be incredibly valuable for the right patients, and it gives me a way to start building a patient base across the communities around me.
I just don’t think I want my eventual practice to depend entirely on me hauling a massage table around the county forever.
Down the community acupuncture rabbit hole
All of this brought me right back to community acupuncture.
I’ve been reading, watching and learning everything I can get my hands on. I found this free webinar on community acupuncture, and it is absolutely packed with information.
Then I found Dr. Michelle Hamilton’s free Community Acupuncture Masterclass, which gets into the logistics of running community acupuncture and making the numbers work. She also has paid programs available for practitioners who want to go deeper.
And then I discovered that Autumn Institute of Health has Michael Hall, R.Ac. coming to Nova Scotia to teach Community Acupuncture 101.
I can’t invest in more paid education right now, but I was ridiculously excited to see that kind of training happening so close to me.
The free resources have already helped me understand the part I was missing before.
Community acupuncture can actually be a really efficient clinic model. Several people can be resting at the same time, the practitioner can move between patients, and the cost of the practitioner’s time and clinic overhead is spread across more treatments. Patients can pay considerably less per treatment without requiring the practitioner to earn less.
That is VERY different from the version of community acupuncture I had in my head a few years ago.
Accessibility cannot depend on me working for nothing
I’m passionate about loving on other people and I want acupuncture to be accessible to people who might otherwise look at the price and immediately decide it isn’t for them.
But I’m also not interested in becoming a martyr for my community.
I want to make good money. I want a practice that supports my life. I want enough time, energy and resources left over to enjoy the life I’ve worked really hard to build.
I really believe that the more I thrive, the more I have available to pour into the people around me.
Right now I’m looking at three models: private clinic care, in-home mobile care and community acupuncture.
I can see a purpose for each of them.
I still LOVE private care. I love sitting down with someone for that first appointment and having the time to really hear their story. I love putting all the pieces together. I love having the time and privacy to use everything I’ve spent the last few years learning. And there are things I want to offer, especially cosmetic acupuncture, that I definitely want to keep private.
Mobile care brings that individual attention directly to someone’s home and gives me a way to reach people scattered throughout the county.
Community acupuncture creates a way for people to receive frequent care at a price they can realistically sustain, while allowing me to treat enough people for the numbers to work on my side too.
Maybe my practice doesn’t have to choose one.
So what am I actually going to do?
I’m still figuring that out.
I would love to bring acupuncture right into my home community. I want to treat the people I share roads and gardens and school events and community dinners with. Finding an appropriate permanent space here is difficult, though, and I’m realistic about how many people from the greater community are going to drive out into the country to see me.
So I’m playing with all of it.
Could I have private or mobile clinic days in the larger communities around me and a community acupuncture day close to home?
Could I serve different communities on different days so I’m not driving all over the county every day?
Could I eventually have a permanent private clinic while continuing a weekly rural community clinic?
Could mobile care eventually become something I reserve for the patients who genuinely benefit from having me come to them?
I’m starting with very little money, so whatever I build needs to grow gradually. I don’t have the budget to outfit a gorgeous community clinic with a room full of recliners right now.
But I have my malpractice and liability insurance. I have needles and supplies. I have the training. I have a much clearer idea of the kind of care I want to offer.
And my community is also the kind of place where people bring their own dishes to a potluck and their own mats to yoga. A first version of community acupuncture where people bring a mat, pillow and blanket really isn’t that weird here.
Maybe I don’t need the finished version of the clinic to start figuring out the first version.
I’m a brand-new acupuncturist trying a few different ideas and figuring out what works in the real world.
I want the depth of private care. I want to experiment with bringing acupuncture directly into people’s homes. I want to see whether community acupuncture can work in my tiny rural community. I want to make good money doing this, and I want the people around me to actually be able to afford enough acupuncture for it to make a difference in their lives.
I’m pretty sure the practice I end up building is going to look different from the one I pictured when I started acupuncture school.
And I think I’m actually really excited about that.
I’d really love to hear from other new grads figuring this out too, and from practitioners who have experimented with private, mobile or community models.
What did your practice look like when you first started, and how different is it from what you originally imagined?