Classism and Marketing Conversation (Part Two): the Ravings of a Self-Righteous Hippie, or Cautionary Tales about Doing Good

It's interesting that this conversation got back to motivation, and the original point of this whole thing, because I was just thinking about that myself...

As I said somewhere in the original post, the reason I started this all is that I'm teaching a class at OCOM, and all term we've been talking about classism and how it affects how you run a clinic, how you interact with patients, how you communicate. Because there are so many potential scenarios and because some of the most pernicious classism can be really subtle, all term people have asked me for examples and all term I've been trying to be as specific as possible. The most recent class we had was spent entirely on communicating with patients, and doing role plays. At the end one of the students came up and told me that what would be most helpful to her would be to have examples of what NOT to do, and is there any way we could make a video of people communicating with patients in ways that would ensure the patient would not come back. I completely agree with her about the value of a teaching tool like that, especially since so many patient interactions in community acupuncture are compressed into a couple of minutes, and every nuance, every bit of body language, every word counts. Unfortunately, I can't imagine how I could set up a video like that (she suggested that I solicit acupuncturists with poor social skills to help) -- so we keep coming back to the importance of really reflecting deeply on your attitude towards your patients, since you can count on your attitude being expressed in every possible way when you communicate with them. And you can count on them picking up on it.

So in that way, a whole lot about this conversation has been extremely useful to me, in terms of being able to cite concrete examples of what won't work. (For an egregious example, there's Jeremy's quote from the other thread, "it's business first and healing second!") This thread, however, and our unnamed "Guest"'s comments are even better.

I want to note here that my motivation in all this is to give students as much of a heads-up as possible when they are doing something that, in my experience, won't work if they want to have a community acupuncture practice. That is part of my responsibility as a teacher. They may still choose to do it, and that is their right, but they paid for me to give them, at least in theory, the benefit of my experience. Also they have been showing up faithfully at 6pm on a Monday night after having been in school all day. They deserve my best effort. Yeah, classism infuriates me in general, but I actually do have an awful lot to do, and I really wouldn't have spent so much time on this marketing blog thing if I hadn't made a commitment to trying to get some stuff across, really thoroughly, in the OCOM class, and if I hadn't felt like it was hard to accomplish. As we all know, community acupuncture is only financially viable if you can attract and retain patients in large numbers, so it is really, really important to learn how to do that, and -- the negative corollary -- to learn how NOT to alienate patients and drive them away. So this isn't just theory. It's about people's ability to make a living.

So I was very excited when I found that article on "Inessential Weirdness", which is in another May blog post below, and which talks about the ways that people who identify as "alternative", generally from upper middle class backgrounds, alienate working class people.  Dear Guest -- the original Guest -- I don't know what your background is, or even if you are an acupuncturist, but the tone and the content of your comments are a perfect illustration of what that article was addressing. For all I know, you may have a working class background like me, but you have learned to communicate in the way that people with privilege often communicate to people without privilege. You may not be an acupuncturist, but you sound like one; and your comments are the perfect example of how acupuncturists should not communicate with working class patients, if they want to retain those patients. (Are any of my OCOM students here?) I said that I was angry about something concrete, statements about patients which I perceive as demeaning to my community. You responded with an abstract discussion about why anger in general is bad. There's a strong flavor of you telling me this "for my own good"; you point out that what I'm doing is not necessary or healthy. I was personally confrontational; you are lecturing me from a position of higher wisdom and presumed detachment (without disclosing your identity). This is a beautiful example of a culture clash, the exact kind of culture clash that generally repels working class patients from acupuncture clinics. 

I'm not surprised that you are a CAN member. This is my concern, as the community acupuncture movement grows, it will attract more and more people who are uncomfortable with discussions of class, privilege, and anger. I don't have to live inside your head, so I don't care that much what you think -- that really is your business. As I've said, though,  for now at least I feel a responsibility to say something when I see acupuncturists doing things that will ensure that they will not attract working class patients; I still see that as my job. Because I want people to succeed. I probably won't always see that as my job, and this little interlude for sure makes me think fondly of the day that I don't. And maybe you have figured out a way to create a clinic where you can ignore class and treat it like it doesn't matter. If you're successful at that, great. I would hope that if you are, you would reciprocate my effort -- and other people's -- and say exactly who you are, exactly what you do, and exactly what specific procedures made you successful -- because that is the point of CAN, to share what works. My success came out of a determined focus on class, and I talk about it because that is my experience of what works. I see acupuncturists fail because they don't get it, so I keep trying to find different ways to communicate it. If you are sincere, I would ask you to do the same -- thorough, detailed explanations of how to make "inclusion" real, but without addressing class privilege and the anger of people who don't have that privilege. I'm not talking about abstract theories here, I'm talking about myself, my experience, and my clinic. I ask you to do the same: names, details, procedures, scripts; and how about a video of your patients talking about their experience? I'm not joking. If you can make class disappear, a lot of people would be interested in exactly how you do it -- but that is not a theoretical discussion.