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New way to needle

Acupuncturist takes communal approach to her patients

Licensed acupuncturist Lisa Rohleder opened her clinic, Window of the Sky, to remedy an ongoing frustration Ñ that acupuncture, which can can be an effective treatment for many medical problems, can be too pricey for some people.

'There's this amazing medicine, it's so simple, and the most amazing things can happen if people get enough of it,' Rohleder says.

The three-year-old clinic on Northeast Fremont Street provides relatively low-cost acupuncture to treat nausea, chronic pain, sinus problems and a long list of other ailments. Prices are on a sliding scale; the first treatment costs as much as $60, and follow-up visits range from $15 to $30.

Much of Window of the Sky's savings comes from treating people in volume: Clients take a seat in any of the 14 recliners grouped around the living room-size clinic, where they're treated together, though they arrive and leave at staggered times. A side room is available for people who prefer privacy; it also has tables for clients whose treatment requires their stomachs or backs to be 'needled.'

Rohleder also limits overhead by staying out of the health insurance system, though some patients are reimbursed by their health insurers.

'If you want to bill insurance, you automatically add a layer of administration, which you end up charging patients for,' she says.

Though Rohleder accepts Western-medicine accomplishments such as surgery and disease-fighting drugs, she sees acupuncture as freeing up costlier resources for the people who really need it.

'Our vision is that it can be part of the solution to the soaring cost of health care,' Rohleder says.

'That's not an unreasonable assumption,' Portland State University professor of health economics Neal Wallace says, because it relies on many ifs: 'If more information can determine that acupuncture really is effective, and if people will spend their time and money on it.'

Wallace also downplays health insurers' role in rising costs, saying other factors, like prescription drugs, are at play.

Group, low-cost and repeat acupuncture is the standard in China, where the treatment likely began more than 2,200 years ago. Rohleder and partner Skip Van Meter learned about group treatment at the Portland Alternative Health Clinic, where they treated addiction and chronic pain among the homeless and mentally ill. Even so, group acupuncture is rare in the United States.

'It's scary' for practitioners to break the mold, says David Eisen, director of clinical services for Central City Concern, the social services nonprofit that runs the alternative clinic downtown. Other than Window of the Sky, Eisen says 'the only working model for (group acupuncture) is a place like Portland Alternative Health Clinic.'

Departing from the standard also is difficult in a city that has lots of clinics, licensed acupuncturist Natalie Arndt says. Arndt, a secretary for the Oregon Acupuncture Association, estimates that Portland has about 350 acupuncturists. But she speculates that more clinics might choose to adopt a low-cost model if health insurance coverage becomes any shakier for people.

Licensed acupuncturist Samhitra Jones used Window of the Sky as a business model for her own low-cost clinic in Boulder, Colo. Jones says Boulder is saturated with acupuncturists who struggle to get enough clients, yet colleagues still were reluctant to join her, fearing less-expensive prices would saddle them with a low-rent reputation.

'I've personally never had this experience É to be able to treat people two to five times a week, and I'm totally thrilled' with patients' results, Jones says.

At Window of the Sky, the clinic's dimmed lighting, pale yellow walls and soothing music are conducive to napping, and clients can stay for a few hours.

'One time we had half a dozen people snoring in unison,' Rohleder says. 'It was pretty hilarious.'

Some days harpist Elizabeth Nicholson provides the music, and some days she's a patient. Nicholson trades her musical skill for four sessions a week that she says chase away chronic colds and insomnia brought on by a 'hard-to-treat thyroid condition.'

'Thinking about the amount of time I get acupuncture, it's phenomenal,' Nicholson says.

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