‘Punks’ Have a Point When It Comes to Health Care

Community acupuncture movement has a home in Providence

Editor’s note: Fourth in a seven-part series about creating a sustainable health-care system for Rhode Island.

By KARINA LUTZ/ecoRI News contributor

There are about 300 acupuncture points on the human body.One experiment in developing a sustainable health-care system, the community acupuncture movement, is alive and thriving in Rhode Island. Providence Community Acupuncture opened in the city’s Jewelry District as a “social business,” according to owner Cris Monteiro, with a “mission to provide lots and lots of acupuncture to the community.”

Her support staff and fellow “punks” — as the community acupuncturists affectionately call each other — are passionate about serving people who wouldn’t ordinarily have access to acupuncture. The business uses a high-volume, low-cost approach rarely found in the alternative health field in the United States.

“We’re here to provide living-wage jobs and affordable acupuncture,” Monteiro said.

In its seven years in business, Providence Community Acupuncture has proven it can do both, and this past fall, Thundermist Health Center invited Monteiro and her staff to set up its second office within the Thundermist low-income primary-care clinic in West Warwick.

In China, hospitals routinely use acupuncture, even in the operating room. In America, most acupuncture is provided in a treatment room much like the examination room in a doctor’s office, or in a spa. The acupuncturist inserts tiny metal needles into muscle along the “meridians” — or energy channels identified by traditional Chinese medicine, which connect the systems of the body.

The placement of the needles stimulates or guides the body’s own healing energy and removes blockages to its flow. The patient must rest with the needles inserted, and the acupuncturist will return after 20 minutes or more to remove them. One acupuncturist usually attends to one patient at a time, even though there is a long time when the patient is just being, well, patient.

Providence Community Acupuncture relies instead on an outside-the-box business model spreading throughout the country with the help of a cooperative called People’s Organization of Community Acupuncture (POCA). In the POCA model, many patients are treated at once, in rooms with several recliners covered with blankets. Patients come for appointments, but there may be as many as 15-20 patients being served by three or four punks, inserting needles here and taking them out there in an unorchestrated flow resembling the dance of servers at a well-run restaurant.

“Private-room acupuncture does well in places with tons of resources,” but this model is sustainable because “all you need is space, chairs, needles, cotton balls and punks,” Monteiro said.

Acupuncture is still “a foreign thing” in the United States, not quite adapted to the culture. “What will it take to allow it to naturalize here, in poor, working-class, middle-class neighborhoods?” she asked.

Another way Monteiro and her colleagues assure access is to offer sliding-scale rates. In Providence, it’s up to the patient to choose how much to pay — between $15 and $35 per session — after a $10 first-time fee. In West Warwick, due to Thundermist offering the space free, the sliding scale will run from $5 to $25 ‚ after a $5 initial fee.

Critics call the community acupuncture strategy an assembly line. But the group experience is part of the healing, according to Monteiro. “You come as an individual, but you are part of a group,” she said. She thinks the perceived added value of private-room acupuncture is information about healthy living, but that such handholding can be detrimental.

“It creates a market of class values that include individualized attention, uniqueness and one-on-one attention,” Monteiro said. “It also creates a one-up, one-down dynamic of the acupuncturist being an expert on the patient’s body.”

She also said people need to take responsibility for their own health. Her attitude is: “Don’t just show up and say fix me.” Patients prepping themselves — finding a seat, getting comfortable, pulling up pant legs and sleeves — is symbolic of this self-care, as well as time- and money-saving.

The community acupuncture movement is part of the alternative health field that is moving toward sustainability, while others, Monteiro worries, are “wishing and waiting to get on the sinking ship of managed care.”

“That’s a broken system,” she said. “You can’t rely on it — it’s only a selective solution not a sustainable system. I'm not against allopathic medicine. I'm just against people making huge amounts of profit off sick people. It makes things worse, because now they’re not only sick, but they're in debt.”