My Answer - Why don't I charge a set rate for acupuncture?

I don't generally talk about my life as an acupuncturist on my blog. However, I'd like to address a question I am frequently asked. I also like to explain the surprisingly controversial answer I give in response.

The question is simple: "How much do you charge?" Before people step one foot through my door, this is the most frequent question I am asked about acupuncture. My answer: "I do not charge a set rate. You decide how much each visit is worth and pay me accordingly."

My answer appears to make a number of people very uncomfortable. That is certainly not my aim. My aims are as follows: 1. I want to remove barriers between human beings and quality health care. 2. In an area where the average annual income is quite a bit lower than the average for Texas, charging a set rate might actually harm my business. 3. I support the pursuit of dreams, because it brings happiness and better health. 4. I want to be a responsible capitalist.

There are two barriers to quality health care that affect myself and many of my fellow South Texans: local availability and money. In answer, I have opened a clinic in Beeville, Texas. Here I work as a licensed acupuncturist while my husband grows an olive orchard and builds sustainable answers to energy consumption. If I refrain from charging a set rate, I keep acupuncture an affordable option for anyone.

Bee county's median annual household income is less than $35,000/year. With rents and the cost of living on the rise, I feel that I need to remain flexible if I want to stay in business. Many medical professionals use sliding scale, but that's kind of a classist approach. Sliding scale tends to make some folks feel like they're being overcharged and other folks feel like they're getting lower quality service. And I don't want to know my clients' incomes.

It's safe to say we all know people who stay in jobs they hate for the health care benefits. We also all know someone who accepted a reduced rate of pay in exchange for better health insurance benefits. Ever shopped around for private health insurance? When you do, I hope the heavens are with you. Sadly, if you've had a chronic health problem in the last ten years, if you have a spouse, if you have children: you're going to have a very difficult time finding affordable health insurance - unless you have a job with a good benefits. I propose that we are happier, healthier people when we are free to pursue our dreams and do what we love. If we could do that and not have to worry about whether we could afford health care, probably more of us would. On the other hand, if you have learned to love your job with benefits, or your dream job comes with great benefits I am so truly happy for you! Salud.

Finally, and this is most important: I want to be absolutely certain that I serve my clients with the best possible combination of my knowledge, skills, and care. When my livelihood absolutely depends on it, there is no room in my clinic for shoddy, slightly lazy, or marginally unfriendly service. When I am at less than my best, I might get an instant pay-cut. I have to be at my best every single day! Asking my clients to choose my pay-rate is the pinnacle of responsible (and responsive) capitalism.

Bless you all. Have a happy, healthy day.

our new heaven

I find myself feeling the shy customer at the coffeehouse, like I'm not supposed to be among the super-cool. I'm just visiting, that's clear. I've got my toddler in tow. Really, she doesn't want to be here. Her fidgeting gives expression to my own inward wiggling. I order coffee arabica: black, thanks. I feel a little proud at my plain-seeming preference. I feel like, "Yeah, I know I could have a mocha latte, but I really DO just want a regular cup of joe. Don't hold the caffeine." I only feel a little foolish that I'm paying $2.00 for it.

I don't live in this town anymore: The Live Music Capital of the World. How I miss it, live music on a Tuesday night over ribs. After dinners of ginger pancakes, my love and I shared ice cream made with beer. Sunday mornings meant three miles 'round Town Lake with my best friend. My nostalgia makes my eyes burn. I love Austin, Texas. She was my savior. How could I love her AND leave her?

Olive trees. That's why we left. And goats. Property taxes are too high in Austin to make either dream possible for us. We bought the farm in '05 and hill-billied it to our new heaven as soon as I graduated, a Master of Oriental Medicine in '06. I was awarded my acupuncture license in '07 and we opened Beeville Acupuncture & Herbs in a converted one-room schoolhouse in the autumn of '08. Mike finally bought our olive trees this year. An economy like this one can kill dreamers, or their dreams. We and ours remain.

I wanted to name the clinic, "Prickly Pear Acupuncture." That name still tickles my heart. I felt though that it reminded one too much of the possibility that MY needles, thinner than a cat's whisker, might hurt. Instead I chose to pledge my allegiance to Beeville. I made this choice on faith, before I knew our new home. It was not a mistake. We are comfortable here. If I wave, folks wave back, even if we've never spoken. I often forget and wave to folks in Austin, when I visit. I am reminded then that friendly is sometimes misinterpreted as crazy.

At home, the coastal breeze in the afternoon rushes through the anaqua trees on the south side of the house. The soft perfume of their blossoms often intoxicates me past caring about the finances, or the nearly incessant tending to the animals, landscaping, kiddos, clinic, and all of the maintenance-related quirks of a centenarian farm house. I think we should name the olive farm after the anaqua somehow. They preserve me. Twice a year their scent can stop me and anchor me in meditative splendor. It is enough. Sometimes I tell people, "We are money-poor, but we are wild-flower rich." The anaqua are part of this wealth: the wealth of wild-flowers. It is such a blessing that in those moments we have enough.