Editor's Note: We received considerable e-mail following the publication of "Money Is Qi Is Money" (Felice Dunas, PhD, September AT). Although several e-mails praised her article, the overwhelming majority criticized it. What follows is a representation of the latter type of correspondence, along with a detailed response from Dr. Dunas.
"Embarrassing, Irresponsible and Out of Touch With Reality"
Dear Editor:
While reading this ode to greed by Felice Dunas, I first thought it was satire. I then realized she's serious. It is outrageous, insulting, embarrassing, irresponsible and out of touch with reality.
She does not clarify that the business strategy she advocates - charging as much as one can - works only if the acupuncturist is established, well-known and in demand. The practitioner also has to love and live for money, which leads people astray.
She does not acknowledge the existence and needs of the majority of Americans (the lower-income and middle-class) who want and need, but cannot afford acupuncture at the already out-of-reach prevailing fees of $60 to $250-plus a session.
She seems oblivious to the high attrition rates of acupuncturists in the U.S. Surveys show 50 percent or higher of acupuncturists leave the profession within their first five years. This is because marketing to a small and already saturated market - the upper-middle class and wealthy - is not a smart business strategy for most.
Also, as Ken Rose so eloquently expressed in his recent radio interview, the pricing of acupuncture in the U.S. has "distorted treatment strategies." The prevailing high fees for acupuncture prevent many patients from experiencing the full healing benefits because they do not complete a full treatment course.
David Villanueva
Via e-mail
"Tone of Arrogance and Assumptions"
Dear Editor:
I was nauseated by the tone of arrogance and the assumptions posited in the article by Felice Dunas, PhD, titled "Money Is Qi Is Money." I am currently a student of this medicine and have yet to engage the practice in business. Still, I chose this medicine out of a desire to help people, and feel like one of the luckiest folks alive that I can do just that while engaging in such an art as working with qi.
I am definitely interested in material wealth as well. I will have about 100K in student loans to pay back, want to travel, and would like to afford to buy goods that are much more consciously created than the second-rate environmentally and socially degrading products I currently can afford. I can find financial prosperity and still honor the history of community service deeply rooted in my ancestry. If this need to help people were not important, then I most certainly would have chosen a different profession.
The idea that the best acupuncturists should only be available to the uber rich is disgustingly classist. I can understand a seasoned professional charging a great deal for consultations or lectures. However, to propagate the idea that we should be charging $400 for a home visit when we are at the top of our game, and that anything else is proof positive of a lack of self-worth, is precisely the kind of thinking that has brought us to the current health care debacle. Yes, anyone with a master's degree who is dedicated to their work should be making a lot of money. And yes, anyone interested in benefiting from the powerful healing our medicine can provide should have access to it. Stop presenting these two ideas as incompatible and remember that just because Dunas separated herself from the moral imperatives that guided her first years of practice does not mean we all must do the same to be considered successful. Remember that people define success differently. Stop judging, let each be as they desire, and step off!
Dixie Young
Via e-mail
"Wealth Is a State of Mind"
Dear Editor:
I was shocked to read the article by Felice Dunas, PhD, titled "Money Is Qi Is Money." Although her ground is true, i.e., one should not "devalue" one's work, her view is a great example of wrong thinking. When one treats patients, one charges what the patient can afford - in real terms. For instance, Ms. Dunas can charge her wealthy clients hundreds of dollars per hour to make house calls, as this amount reflects a very small percentage of a billionaire's salary. However, someone who earns minimum wage cannot afford to pay more for one medical office visit than they pay on rent, or food for an entire month. There is a relative limit to what a person can pay for anything and it behooves us as health care professionals to bear this in mind. I firmly believe that health care should not be rationed on the basis of income; sadly, this is the way our health care system is going.
That said, however, this does not mean we must offer our professional services for free, nor that we must live in poverty. Rather, it challenges us to find a way to charge enough to live a decent and self-nurturing lifestyle while providing essential medical services to our patients at the same time. This means that we need to find a method for treating more patients for less per treatment. Group treatment settings, sliding scales, flat monthly fees, etc., should all be considered and utilized.
As for the need to wear designer outfits and drive a Porche - I have never felt the need for these things, although I know others who do. But please, let's not define these as necessities or as markers of success. Wealth is a state of mind.
Allyndreth Stead
Via e-mail
Response From Felice Dunas
"Money Is Qi Is Money," which was written for the September issue of AT, has received feedback warranting response. AT generously offered me the opportunity to clear up any confusion, as the article inspired comment from some of my readers.
The premise for this piece was that it is OK to want to make a good living doing what we do professionally. It is not dishonorable to aspire toward personal wealth. I believe it makes us better doctors if we have several ways to win from practice - by giving of ourselves and by receiving payment for our work
To anyone who was offended by the glib writing style, I apologize. And no, this piece was not satire. Satire is meant to overshadow ridicule with humor. I wasn't belittling or cutting down anyone. My goal was to be lighthearted in my presentation of a heavy subject. I tried to sprinkle humor, some of it self-depreciating, to make the tough subject of earning a living by practicing medicine an easier one to digest. We all deserve to feel pride in generating income and prosperity for ourselves while healing others. I attempted to be playful in suggesting this point.
Let me here address issues brought up by readers. I believe pro-bono work should be part of every practice. Discounting fees so you serve those in need is also imperative. While I make mention of service in the column, this focus was on supporting your own career development by respecting your need to generate a livelihood, not on the importance of lowering fees.
I discussed several activities that were an expansion of my practice outside the office. I have found it lucrative to move beyond the clinic into lectures, house calls, product sales, etc., and I believe you can, too, if you choose. These ideas in no way denigrate the nobility of seeing patients in a clinic - nor do you take unfair advantage of patients when you offer them products to support their healing processes. I hoped to support your creativity as a practitioner by suggesting that there are additional outlets for your expertise that will serve humanity and gratify you as a professional and wage earner. I invited you to step out and see if other avenues for spreading OM inspired you by using me as an example.
As for the section in which I discussed raising my fees, please note that I went out on a limb in doing that. It was, and still is, challenging to raise my prices, and I stated that in the article. This isn't easy for anyone, no matter where they are in their career or what they charge. I attempted to use humor to present this point and for some of you, that wasn't the effective approach to take.
Perhaps you thought the piece overemphasized material gain. One of the pleasures of having a column is that one can write on several subjects over time. All my articles discuss some aspect of medicine or practitioner experience. Each is designed to inspire, educate, motivate and stimulate thought and action. In this one, I simply took a road less traveled. .
This column is just one booth in the marketplace of ideas that is AT. I don't expect readers to agree with everything I say. In fact, I hope vigorous dialogue is inspired by my work. I tend to express controversial concepts and, being as human as anyone, sometime my presentation style misses the mark. If you were offended by this last piece, believe me, I am sorry. Perhaps these same ideas, presented as they have been here, will inspire you to recognize and honor your own value more. That was, after all, the purpose of the column. Now, on to the next one.
Did any of you ever get the feeling in school that it simply was not OK to speak about wanting to be successful? To get into the nitty gritty details of how to make money in practice? Maybe you were even someone like me who was directly told by someone in a position of power that I needed to take what I could get because in private practice, I wouldn’t make money.
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