Articles about

Culture of Safety

Not a Weapon

January 10th, 2021 — Part of a culture of safety is the sense that we don’t have to hide our mistakes, and in fact we don’t want to; what we want to do is learn from them, together.

Let Us Tell You about Our AERD! No, wait, come back...

January 1st, 2021 — Granted, you have to be a true safety nerd to get excited about an adverse events reporting database. Given that the acupuncture profession has never actually had one, though, we thought when we made one back in 2018, everybody else would be at least receptive. Not quite.

Reflection: Harm Reduction

January 27th, 2021 — Like trauma informed care, harm reduction is a public health approach that employs a non-punitive concept of safety. Sometimes safer is a better goal than safe.

Anatomy of a Safety Incident #1

January 4th, 2021 — A veritable cornucopia of misunderstandings, stray needles, and boundary issues.

Two un-answerable questions

December 30th, 2020 — Power can get confused with control, and bodies don’t respond to control. Thinking they do creates unsafe conditions for treatment.

A Queer Perspective on Acupuncture Safety

December 28th, 2020 — I’m going to argue that all of us need to learn how to think and talk about acupuncture safety in the same way that a lot of people in the queer, poly, and kink communities have learned how to think and talk about sex: without shame, without judgement, enthusiastically and in a lot of detail.

Homemade Swiss Cheese: Making (Imperfect) Safety

December 31st, 2020 — This post is the first of a series about lessons we learned from dealing with COVID that also apply to acupuncture safety in general.

Billy, Don't Be A Guru

May 14th, 2021 — Safety requires transparency, and transparency requires that we actively and intentionally disengage from the role of Guru in our patient relationships.

Why Write about Safety Incidents?

May 21st, 2021 — Approaching safety issues from a structural and a trauma-informed perspective requires significantly more effort and more communication than the approach of “something scary happened, let’s find somebody to blame!”

Work in Progress: POCA Tech Needling Policy

March 4th, 2021 — A crucial aspect of becoming a practitioner is learning to navigate safety and risk. Declaring a practice legal or illegal is not the same thing as making it safe or unsafe. Regulation and safety are not identical, though many people in the acupuncture profession believe they are.

"How Bad Is It REALLY to Date a Patient?"

May 26th, 2021 — The practice of acupuncture involves a certain amount of intimacy between humans, in the context of a society that’s just beginning to learn about consent, with capitalism telling us all that there’s never enough of anything good. (Spoiler: it's still a bad idea to date patients.)

Pneumothoraxes and a Culture of Safety

August 9th, 2021 — We can’t make good individual decisions about risk unless we have better collective conversations about safety.

IM4US Conference Recap (and Intro to the Blob)

October 3rd, 2021 — Acupuncture as medicine and acupuncture as a profession are not the same thing. The acupuncture profession has been making a concerted effort for about fifty years to argue that they are, but if you look closely enough at their respective histories, you’ll see that they aren’t. And the difference between them is particularly important for community acupuncturists -- as well as anybody else who is interested in acupuncture safety -- to grasp.

Trying to Be Trauma-Informed about Everything

November 30th, 2021 — One thing I know about trauma is that recovering from it requires facing as much of the truth as you can. You might not be able to stand much truth at first and so you have to build up your tolerance over time. Facing the truth, like other forms of healing, is often a slow, incremental process. But I’ve learned that I can count on the truth to show up as a relief and also as a friend -- eventually.

Mercury Retrograde

January 21st, 2022 — Mercury retrograde indicates a period of “review and reflection”, particularly in relationship to challenges that have come up in the past. We seem to be having a review of past safety incidents -- not all safety incidents, just the epic ones!

Why We Do This, Part One

March 22nd, 2022 — If we’re going to practice “energetic medicine” we need some kind of routine and some kind of container to deal with unexpected outcomes that we can’t explain or anticipate. It’s better for punks to not be at a loss when we have a “WTF, why did that happen?” moment, because those moments are just an unavoidable part of the job.

Clean Needle Technique, Social Safety, and the Benefits of Being a Safety Nerd

April 12th, 2022 — The idea behind Clean Needle Technique is that an acupuncturist needs to approach every patient as if they had all possible bloodborne diseases. This is important for your individual safety as a punk because you can’t depend on patients to 1) know their status or 2) tell you. But approaching every patient in the exact same way is also crucial to the social safety of the clinic -- and the bigger the clinic, the more people involved, the more concerning the potential consequences become for *not* treating every patient in the same way.

Why We Do This, Part Two

April 20th, 2022 — It’s hard for students (and also licensed acupuncturists!) to wrap their minds around the range of ways that people can respond to acupuncture, which in turn makes it challenging for them to learn how to manage risks associated with treatment. It’s hard to take risk seriously when it doesn’t feel real! And often the only thing that can make risk feel real is firsthand experience of an unintended outcome.

AERD 2022: the Year in Review

January 1st, 2023 — Sometimes "go home and rest with tea" is the exact wrong thing to say to a patient.

Your Mom Doesn't Work Here

January 30th, 2023 — Acupuncturists (at least in the US) have a lot of trouble navigating the tension between autonomy and security. We struggle to understand the tradeoffs between the two, and this can result in a weird, tortured, destructive relationship with organizations.

AERD Report 2023 Q1

April 5th, 2023 — So many bruises! Also, an error without an adverse event, and some intriguing "symptoms worse" reports.

Four Stages and Safety

May 22nd, 2023 — Legally, we’re responsible for managing adverse events in our practices, not just avoiding mistakes. Lots of acupuncturists are confused about that. Insisting that safety incidents only happen as a result of bad practitioners (see also, “undertrained physical therapists”) does everybody a disservice.

Four Stages and the Acupocalypse, Pt 4

May 30th, 2023 — Leadership is less about making decisions and more about making things happen, with and for and through other people. Contributing through other people creates interdependence and requires surrendering some of your independence and autonomy -- which a lot of acupuncturists really don’t want to do.