Re-framing how I think about my role as an acupuncturist in the clinic

I have been learning about/discussing the concept of what are the fundamental skills of a busy and successful community acupuncturist with Lisa and Skip and others recently insome WCA meetings. Lisa is compiling information on what it takes to do this CA work really well so that we can train new CA folks more efficiently and effectively. The movement is only getting bigger, so we are putting our heads together to see how to help folks “get it” in CA clearly and easily. I wish I had beena part of thesediscussions years ago! Here are some of my thoughts so far:

I was driving home on the freeway recently and it occurred to me that how I was thinking about driving was similar to how I think about working with patients in the acupuncture clinic.  Working in a communityacupuncturesetting, I have had to develop a habit of taking in the general activity in my environment as a whole as well as the specific activity in front of me.  Perceiving information in my environment through a mix of both generalized and specific fields of vision helps me take in and respond to the information that I perceive around me more effectively. I have noticed that this habit of perception helps me move through my environment more efficiently to achieve my goals in many areas of my life.

When driving, this global perception translates into being able to maintain a relatively medium-fast speed in transit. I change lanes as needed to accommodate my chosen speed of travel-based on my overall data of the ways the cars are moving around me.  In clinic, this global perception translates as noticing what patients need at any given moment in the whole treatment room and then prioritizing how I choose to meet my patients’ needs efficiently and effectively.  As a side note, I would add that I have to identify which patient needs are realistic relative to what I am offering as a community acupuncturist, and then prioritize the order that I meet the specific needs I choose to meet.   All of these choices are part of the global perception I experience in the community treatment room.

Returning to the car analogy for a moment; making the choice to move into a faster lane when I see cars slowing down ahead of me on the freeway is similar to the experience of choosing to hold my focus on maintaining a relatively fast pace by holding good boundaries while I am treating patients in clinic.  In the clinic, I maintain my rhythm or pace by communicating with patients in a way that is clear, caring, and efficient. This is a summary of my process of maintaining healthy, a.k.a. professional, practitioner-patient boundaries.

The idea of how to think about what and how I observe as I work in the clinic leads nicely into the concept of first developing and then maintaining a ‘healthy” momentum in my acupuncture work. Whether I am driving on the freeway or helping patients in the clinic, I find that once I have built up momentum in thinking and acting in a way that I like, I have to do what I can to maintain that current momentum. I have to keep choosing to drive at a relatively fast pace if I want to be aware enough to make the adjustments, the lane changes, necessary to maintain my speed. In the clinic, I have to constantly maintain solid, healthy boundaries in my practitioner patient relationships to maintain my pace and rhythm during and between treating patients.

My basic thought to share is that I find it takes regular/consistent focused attention on personal well being to become an effective anchor/stabilizer for my acupuncture patients. I find it easier to maintain my current healthy momentum, in both mind & body, than it is to play catch up with my health after running my energy down too far.  Healthy momentum maintains my resource of extra energy that I keep available for caring for patients. Speeding up (car analogy) in a car to move from a slow lane to a faster lane takes a huge surge of energy output. Likewise, quickly making a leap into a healthy level of mental and physical vitality, after falling away from disciplined habits of self-care, takes immense energy in thes hort term. I find that it is relatively more stabilizing and makes more sense long term to maintain my current state of health and thus “patient magnetism” than to regain lost ground all the time. All the Same, this process is alearning curve and I am still figuring out what kinds of habits help me personally to stay healthy and grounded.

The freeway analogy is something like the difference between active and passive listening.  It takes effort andrepetition to become proficient at actively listening. It’s a skill that can be learned, but it is not necessarily easy. You have to want to actively listen for some self-motivated meaningful reason or you won’t likely put the effort in every time you are listening to someone speak.

In theNapoleon Hillbook Think and Grow Rich, there is a passage that states: “success is not an accident, it is a habit”.  What this quote means to me is that I can learn to think certain ways, and those ways of thinking can open me up to behaving in certain ways, and those behaviors can lead me to my goals. Those ways of thinking and acting are habits. If my goal is to have a full schedule of acupuncture patients each shift in clinic, I can write out the habits of thought and action that enable me to work well in the clinic and then make a conscious effort to maintain those productive habits consistently. It’s simple enough, but it ain’t easy. Habits take courage and determination to form. I need to want my goal enough to make changes in my ways of thinking and acting.

If I think about some of the qualities of an effective acupuncturist, here are some ideas that come up:  think clearly about who you want to be and what you want to accomplish; slowdown; pace yourself; develop endurance by picturing your goal of who you want to be in your mind every day; be allowing of process; be ok with slow progress; recognize that your needs may be different than your patients needs; developsolid boundaries in communicating with people; be authentically yourself in all interactions with people whether at home or at work; build momentum in your personal health and then develop specific habits that help you to maintain that momentum.

After defining how I want to change my thoughts and actions, I simply focus on these new ways of thinking and behaving with regularity. Eventually, these habits of thought and action lead me predictably to my goal. 

The process of developing new habits is scary, but it’s also kind of exciting to learn new information and rewarding to become powerful enough personally that you are able to help others consistently, all the while maintaining personal sanity and well being.

Moses Cooper
Author: Moses Cooper

hello POCA family, I found community acupuncture in the early days of Working Class Acupuncture. I was lucky enough to be the first trial employee at WCA in 2005 after Lisa and Skip survived a string of uncomfortable independent contractor acupuncturists. I remember showing up during a clinic expansion painting moment and grabbing a brush. I was feeling grateful to be working with folks that were so obviously helping people of all kinds afford pokes. That was a very attractive bottom line at the time, and still is! I consider my family roots working poor where I come from, so I was both familiar with and willing to 'walk through the fire' to figure out how to punk. I was a well-meaning, yet slow and mentally mired punk in the early days. I made all the communication mistakes you can make as a newbie poker... It took all of my energy to develop a punk mindset and clinic awareness. I often felt like I was on trial both from my employers and my patients as I figured out the basics of being a real punk. Having solid boundaries instead of being over-comforting; connecting with subtle body language as much as...

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  1. hmm…

    I guess until I figure out how to use the proper input formatting, interested readers will have to mentally pry apart some of the text to understand it. Oh well!

  2. identifying healthy habits

    Mostly what I would like to bring up with the above long post is that the qualities that effective CA acupunks possess ought to be defined. I am still clarifying what these qualities might be for myself, hence the longmeandering post to share ideas.


    Anyone out there have thoughts about what habits are worth developing in order to become an effective community acupuncturist?

  3. Ten eyes

    eight arms, forty or so fingers, one (sharp) mind and a heart full of compassion. Seriously though…not an easy question…thanks for giving it a ‘stab’ Moses.


  4. waiting

    being a waiter and bartender for ten years, the habits and skills i developed in that environment have been so very helpful for me in learning to do CA.  i think learning to focus on the task at hand, whether communicating with people while taking an order, punching it into the computer, running food or making coffee, knowing that you have at least five other things to do and that your money depends on doing it well, hones your skills at multitasking.  Like your driving analogy, a waiter has to have ‘soft eyes’; you need to let things happen, allow for the chaos to unfold and ride it like a wave.  There are always priorities, but chaos being chaos, the unexpected, whether someone dropping a fork or the car in front of you blowing a rear tire, requires that a waiter or a driver or a CA punk be a conductor of sorts, all while being ready to adapt to the unexpected.  

    as it has been such a powerful preparer for myself, i will look very highly on restaurant experience as we get ready to hire.  the skills in each environment, while somewhat different, are very interchangeable.  i don’t know that i would so readily have the boundaries you describe, the soft eyes, the ability to multitask or the ease of interpersonal communication without my previous restaurant experience.  I remember being slightly horrified when I started my first gig at TGI Fridays on Long Island at the idea of just talking to soooo many people.  I got over it.  But initially, it was something I had to work on: context appropriate conversation/interaction.  I think that a lot of CA work is managing conversation well and popping in some points, all while knowing that you have to be somewhere else and being ok with that steady workflow.  

    hope i made some sense. 🙂


  5. surfing the chi waves

    Hey Larry,

    Some real jewels in there:

    “…context appropriate conversation/interaction.  I think that a lot of CA
    work is managing conversation well and popping in some points, all
    while knowing that you have to be somewhere else and being ok with that
    steady workflow.” 

    “you need to let things happen, allow for the chaos to unfold and ride it like a wave.”

    That sums it up pretty well for me. Of course, there are a bunch more things to consider – from Lisa’s books, the forums….but…to throw in another analogy…

    It’s sort of like being a juggler with people’s energy…all the while, keeping a bowl of oil on your head (which represents your composure, your kindness, your integrity and ethics)…intensely focused so that not a drop of that is spilled…and popping in points.

    To use a more direct example…today I had a pretty bunched up schedule around the 5 o’clock hour…I was expecting a mom and her ten year old to show up for treatment any minute…there was one guy almost done with his forms…three or four people cooking in the room to various degrees of done-ness. Anticipating that a lot was about to happen, my mind very quickly made a calculated move –

    I asked the man if he was almost done with his first visit forms (he’d been at them for 15 minutes.) I was very careful to avoid any tone or body language which suggested that I was in a hurry – or that he needed to be. It was just simple, matter of fact, direct question.

    The interview was very focused…probably a bit briefer than usual….asking him “where is your pain” pretty much summed it up. I noted that he talked in a very loud voice, and knew that I would at some point need to ask him to turn down the volume…so I filed away that little detail for the right moment…which turned out to be in another 15 seconds as we walked into the treatment room…as we were entering, I said…”so this is a community room, and it’s important to keep your voice down”…with a gentle but firm tone.

    The boy and his mom came in, others were done and there were brief conversations with essential information exchanged….”everything okay?”…”would you like to reschedule for another appointment now?” (we don’t have a full time Ilse yet to do this before the tx)….

    The loud guy (much less loud now) was really happy after his tx and ended up rescheduling for 4 more over the next 2 weeks.

    And….horror of horrors….I probably wrote and answered a few emails in the midst of all that.


  6. ah ha ha…



    your description of the way you used your body language and tone of voice to project your intentions in clinic were spot on to how I feel when I do the same. Always making a long series of calculated while still compassionate decisions as I help people in the tx room. Definitely some graceful orchestration going on. Did I ever mention that I used to juggle many years ago?


    Thanks also to Larry for the restaurant comparison and clarity.


    – M 

  7. juggling

    At the annual folk festival here in Seattle, I watched a pair of guys toss six machetes back and forth simultaneously. Hmmm…maybe you could start a road show Moses….juggling two inch 30 gauge acupuncture needles while doing tricks on your skateboard, all the while talking up CAN. Nationwide tour perhaps? 

  8. maybe teaching CA hopefuls

    maybe teaching CA hopefuls to juggle machetes would help them learn about developing and maintaining good boundaries for interacting with patients? This could be good…

  9. To throw out another analogy

    I keep finding my past experience as a dj bearing on being an effective acupunk.  Time keeps moving forward, need to select the next record, then get the tempo matched, and drop it in at just the right moment so the structures line up, then gracefully blend the two, and finally know just when to pull out the old record so that the energy transfers smoothly.  All while paying close attention to the dancers and the general energy of the room.  That’s where I learned to really operate from my heart and my gut, and let my mind watch (mostly) and direct when needed.

    To expand the analogy further… I never liked to plan out my dj sets ahead of time.  Like waiting to feel the pulse and listen to a patient before deciding what points to use, I like to pick the perfect record in the moment.  On a good night, the records literally pick themselves, jumping out of the box into my hand.  Then there’s those nights when my hands stumble and I can’t decide where to go next.  That’s when it’s nice to have a few versatile, long records that can go just about anywhere and work, kinda like a Miriam Lee treatment.  I’ve also found that in acupuncture, as in music, the longer I do it, the more minimal my taste becomes.  Less is more, and leaves room for the patient/dancer to fill in with what they bring to it.

    Co-sign on restaraunt work… never waited tables, but working a busy kitchen as a line cook forces one to learn how to do lots of things precisely and in just the right order.  It’s not so much doing a bunch of things at once, because you have to do one thing at a time and pay close attention to it, but picking the right sequence out of many possibilities.

  10. “…picking the right

    “…picking the right sequence out of many possibilities.”

     well put.  i have to give a shout out to the folks on the line, as well as prep and dish.   

  11. To echo Larry

    my high school experience of waitressing at a busy road side diner as well as working for years as a nurse on busy hospital floors teaches constant reprioritizing and a distant and simultaneous near focus.    Also instant connection with others.  I’m adding job history to my list of things to ask of a hire.

  12. Another analogy

    I was in aviation for 20 years, first as an air traffic controller, then as a dispatcher and management – remember Lloyd Bridges character in Airplane (“I picked a bad day to stop sniffing glue”) – that was my job.  It basically consisted of managing many resources to keep from cancelling or delaying flights.

    I find acupuncture (and herbs) to be much like that – logistics optimization (I was waiting for a chance to use that word) – what resources are available and how can they best be deployed.  That applies to the patients’ inner resources as well as to the running of the clinic. 

    I think that lots of people starting out fresh from school tend to forget their earlier types of experience, or not realize how similar the situations are.  I don’t know about others but I learn best when I can say to myself, “Oh, it’s like X situation in these ways, but in these other ways it’s different”, then I can concentrate on the differences and make it a priority to assimilate the new parts at first.

    But I really liked Moses analogy of driving!


  13. I found the analogy of the car very helpful. I’m currently plowing my way through as much stuff as I can as I’m currently making the transition from Sole practitioner to the Community Acupuncture Model. It’s easy to start to feel overwhelmed by the amount of new stuff to learn…this post really helped me take my foot off the gas so to speak. Thanks.

  14. Larry G I love the bartending analogy. I spent a long time thinking I was “just” a bartender until I someday started my “real” job. Now I know I was actually in training for CA. By the way I also worked at Tgif on Long Island about 12 years ago, which one were you at?