Picking It Up Again

Last month I wrote about how things had slowed down quite a bit in June, and how, at the time, it led me to re-consider what I might be able to improve on.  I think that the slowdown and the time to consider my work was a bit of a blessing in disguise, because it really did get me thinking about what I could do better – and fortunately I had many wonderful suggestions from many of you to fuel my thoughts and subsequent actions.  As always with my practice so far, much like a patient's health improves with acupuncture, there hasn't been a steady linear progression in my acupuncturist skills, but more of a progression-steady-regression-progression-etc. kind of path.

Now in the last 3-4 weeks things have been getting busier and busier, to my busiest point yet, and I find it ironic that it is occuring in August – a time that I hear is classically the slowest month among acupunks.  In any case, I feel grateful that things have turned around, and that most of the turnaround is something I attribute to this wonderful network.

What has caused this change?  For starters, I have gained a new gut-level understanding that it is truly imperative to communicate with my patients how often they need treatment, and to stay on top of this with every visit.  I have been recommending more “aggressive” treatment plans (greater frequency) – much like many of you do and as I have heard repeatedly from Dr. Tan, but somehow always sort of skirted around because I thought it would sound too pushy and that nobody would really want to follow through with such an obligation of time (i.e. 3 times per week or more).  When I realized that NOT communicating the necessity of a thorough treatment plan would truly be a DISservice to my patients and would be maligned with the way acupuncture really works, I decided it was time to try and be more clear about the need for frequent treatment and why this is.  For me it was getting over a fear that this would not be well-received, but l gave it a try and saw that this actually wasn't the case.  Also, I have been more clear about exactly when patients should try and come (i.e., rather than saying “come twice next week,” saying “it would be best if you could come as early in the week as possible – preferably Monday, Tuesday at the latest – and again on Thursday or Friday) and then always offering to schedule patients directly after their visits as much as possible (rather than having them just walk out and go home to do it on their own without any clear direction on when to return).  I have found that although the majority of my patients do use the online scheduling and are very enthusiastic about it, there are some who need that little extra push to commit to their next treatment right after they've had their visit.  So that seems to help, also.  Finally, I have been checking in with people following their first visit (the next day) with a quick and simple email to see how they felt and to let them know that I'd be happy to answer any questions they have or help them reschedule, etc.  I know that many of you might consider that this would not be a good idea as it would be too time consuming, etc., but so far it seems to be okay for me.  We all have systems that work for us – and so far it seems that people are really grateful to be reached out to and cared for.  It seems to me that in this case, a little effort goes a long way.

Aside from the whole practice aspect, I'm still working on relating to patients on a more personal level – particularly those who are in the most severe conditions, who seem to have reached the ends of their ropes.  While I believe I have always been able to convey a good sense of empathy, and have done my best to listen and offer the appropriate words in response whenever possible (this is tricky sometimes!), I have had some patients with extremely difficult cases who I definitely have felt challenged by – who I need to pep-talk and convince not to give up; who I need to remind of how far they have come, even though they still have a ways to go; and yet this doesn't generally occur with too many words as a community acupuncture clinic is more about being with yourself, your needles and other quiet needle-nappers in a community room.  I have certainly seen some real acupuncture “miracles” of patients with some extremely difficult cases, and each time this occurs it helps me to gain a new faith in the medicine and know that it is possible for the next challenging patient, which is always helpful.

And so, I just really wanted to share some personal explanation of my path of growth in this medicine.

Oh, and to say that despite things becoming busier and busier, I am feeling that the work is not at all difficult or stressful, but is truly becoming more fun and easy (as we all know in any line of work – it's more fun/easy when you're busy then when you're bored), thanks SO much to my incredibly helpful volunteer and student assistants – who I really could not otherwise practice without!

AND lastly – in the last several weeks I have had several new patients who have been referred by many of YOU living in different cities!  THANK YOU!!!  I've had ones referred from Providence, Philly, WCA and Oakland, CA – each time I get a CAN referral I am so excited – it always makes me so happy Laughing  Keep 'em coming!

Justine_Myers
Author: Justine_Myers

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Conference Keynote: Breaking the Ceiling

The theme for this conference is “Breaking Barriers”. You know, there are so many barriers to break in acupuncture that it was really hard to choose which ones to talk about for this speech. But since I’ve spent so much time talking about classism as a barrier, I thought it might be fun to shift gears a little and talk about numbers.

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  1. slowing down, gaining clarity, more refined talking

    Thanks for sharing this Justine. I completely agree on your excellent reminder on a familiar imperative which is easy to overlook – letting patients know they need to come for regular acupuncture, not shying away from giving it to them straight – yes, you need to come 2-3 times a week…if that’s what the situation calls for.

    I find that it helps me to recheck my motivation frequently, to remember that I’m not doing this in order to be famous, or make money. Of course, we need the money (a modest amount) to feed ourselves, etc. so that we can serve. But if our basic motivation is to help others, to facilitate their healing, then that will genuineness and sincerity removes any fear from speaking the truth to our patients in asking them to make a commitment to the process.

    Talking to the difficult cases, the patients who need more encouragement – that can get tricky, and I’m certainly no expert, but again, checking my motivation is the guiding light. 

    I had to tell one patient recently that I couldn’t engage in lengthy conversations with her on the phone and in the office before and after treatments because I didn’t have the luxury of time (besides the fact that it served no useful purpose). It takes a while for some people to get it that the main event is them getting quiet with some needles, letting the Chi cook so that it is refined and flows more easily…releasing the pain, the stress, etc. etc. 

    When the clinic is busy, with lots of people cooking, I need to explain that less and less – the clinic space does all the talkin’ necessary to help people get it.

  2. also turning into a busy August here…

    Glad to read that things are picking back up for you, Justine.

    Finally watched all of “Finding Normal” over the weekend… one of the most obvious lessons I took from it was that the counselors use a very direct style of communicating.  They also manage this without exactly forcing their will on their clients.  I have a hard time telling people what to do (please, oh please don’t ever ask me for diet advice) and that has translated into some less than clear communication about treatment frequency.  The more I see how much of a difference treatment frequency makes, the easier it gets to tell someone “you’re in alot of pain, and to get you out of it, you need to come three times this week.  Can you do that?”

    Seems like experience underlies the ability to communicate sincerely and directly.

  3. Yay!

    Thank you so much for posting this, Justine. That thing about communicating that acupuncture is a process and you really, really want patients to come back — I see that as PIVOTAL to the success of any community practice and it’s something that so many acupunks struggle with. I am sure that your decision to focus on that is what has led to your spike in numbers.

    It makes me gnash my teeth in frustration that this is something people have to learn the hard way, by and large, after they graduate. Why is this not an area of major concern in acupuncture education? It’s not like this is an issue unique to community practice, either. Acupuncturists have to be able to connect with patients around the reality of a treatment plan, and most haven’t got the faintest idea how to do this. This is a skill that ought to be right up there, in terms of priority, with needling technique, because you’re right, you can’t help them if they don’t come in enough. Communicating — and really connecting — around the treatment plan is an ESSENTIAL CLINICAL SKILL, not some marketing manoeuvre or something extraneous tacked on to the end of a treatment.

    I would bet you anything that the absence of this skill is a huge component in the failure of most acupuncture practices. Not just because patients don’t come back, but because acupunks don’t realize that they are missing something really important, and they start to lose hope, thinking that the problem is that they need to go to more workshops or spend lots of money on advertising or whatever. They think the problem is with their technique or their office decor, or they think that people want more personal attention, more bells and whistles, and so they start massaging everybody or doing aromatherapy or you name it, getting more and more elaborate, when the problem and the solution are incredibly simple. Acupuncturists think the part of the treatment that matters most is the part that they, the professionals, are doing — but the part of the treatment that matters even more is the part that the patient is doing — showing up. If you don’t treat the showing up part with the respect that it deserves, nothing else you do is going to matter. And it’s not even a matter of just saying the words, “acupuncture is a process”, it’s a matter of leaning in with your whole self and telling someone, “I really want you to come back “(because I really want to help you) — so that they can feel it.

    Why, oh why, does this not get talked about in school.

    Anyway, congratulations! This post also makes a nice pair with Nora’s post about listening. 

  4. “When I realized that NOT

    “When I realized that NOT communicating the necessity of a thorough
    treatment plan would truly be a DISservice to my patients” – so true, Justine, and a good reminder.  I’m STILL figuring out how to communicate this to everyone, too – 7 years out of school, and four or so years into Community Acupuncture.  I like Lisa’s point about it being a clinical skill, and Whitsitt’s point about just keeping it simple and direct. 

    Keep up the good work and keep sharing these kinds of posts!

  5. It’s probably not talked

    It’s probably not talked about at school because most of the teachers are not good clinicians…