Ways I Have Lost Patients

     Not intended to be a comprehensive list, but helpful to me to look back on.  I imagine everyone has their own list. Also, this seems to be what happened from my perspective; it could be these patients left for entirely different reasons that I will never know.

     Before I practiced CA,  just about the only way I “lost” patients was because they couldn’t continue paying for treatment. If they could afford it, we got along swimmingly and I gave it my absolute all every time, trying to be as wise as Yoda and cure everything that had ever gone wrong with them. I still give it my all, but there is time to breathe, time to figure out things, and just… time. To see patterns  and relationships develop. That is no small thing. Very often, as symptoms recede, important elements and signs emerge, and we get to work on them in a more thorough way.

1. Laughing when a patient said that her pastor said acupuncture displaces Jesus Christ as lord. I’m an Earth type, and if you surprise me I’ll often laugh. I didn’t laugh alot, or purposely, but any laughter was wrong. I could list 2-10 as religious reasons patients left treatment of either acupuncture or Tuina massage, as I began my practice in Wichita, Kansas. But that would be tedious.

2. Not acting concerned enough about the upcoming tax season and the economic downturn. Patient got very mad, and ended by saying I wasn’t living in reality. I laughed (surprised, again) and said, “Well, I’m living in one of them.”

3. Not being a …. now I don’t even remember the team… baseball fan. I said, “You tell me who to root for, and that’s my team, too.”  This was not satisfactory.

4.Letting a patient hold her dog during treatment. She really needed boundaries, and I should have made them. It was kind of ridiculous,really, but I was in the mood to go with it. It didn’t work out at all.

5. Saying, “I don’t know why this happened”, when the patient wanted a definitive answer. Her symptoms had a strong emotional content, and I didn’t feel qualified to “go there”. I now see I should have phrased it in way that inspired confidence. To my mind, it didn’t mean that I couldn’t help solve it, but that isn’t what she heard.

6. Grabbing a patients’ broken left foot. Completely accidental, of course, but I have dyslexia. Now I often say, “My left is your right” as I’m working, and that solved it.

7. Telling patient(s) their favorite food/habit/nutty regime was making things worse, like the patient with Reynaud’s disease who was putting his hands in ice water. I’m okay with that one. 

     Okay, I’ve run out of steam with that list, though I could dredge up more if I thought about it. I’m happy to say that 2 more fertility patients at WorkSong are pregnant, and one is very safely fastened at 12 weeks. I like helping women with all aspects of gynecology, because it is one of the things that drew me to Chinese Medicine. I remember when an acupuncturist told me that he could solve menstrual cramps, I thought he meant something along the lines of making the pain bearable. It was stunning to find out firsthand what this medicine can do. That same practitioner also told me, right as I walked into his office, that I couldn’t afford as much treatment as I needed. I’m glad I’m not in that position, and that I have a chance to grow and learn from my mistakes. Not just in theory, but in time and with the real people who are coming to see me.

Isobeau Trybula
Author: Isobeau Trybula

Related Articles

Survey of CAN clinics

Skeptics in the acupuncture community say that CA clinics can’t be successful.  A variety of reasons are cited – prices too low, patients want one-on-one attention and wouldn’t like treatments in a room with other people, Dr.


  1. Why in the world was someone

    Why in the world was someone with Reynaud’s putting his hands in ice water?  That sounds like torture.

    I have gone as far as putting little Rs and Ls on my chairs for their right and left, I feel like such a moron always going to the wrong side. 

    Thank you for sharing this, we all have these lists, it’s an interesting part of working closely with humans. 

  2. I know…

    Doesn’t it make your fingers ache to think of that?! Yikes. I get impatient, but then have to slow down and understand how divorced some people are from the bodies they are living in. How to stop this war on the body, which doesn’t even ask very much of us? I taught a lady some qigong today to spread liver qi, as she sits at the computer for 6 hour stretches. She looked up at me and said, “Well, that’s gonna do the trick, isn’t it?” Just beaming and twinkling. I love working with people, one at a time, and I don’t understand the argument that CA doesn’t give you enough time with patients. I have more than enough time to give them what’s important, to set a process in motion, and for them to get sick of my jokes. Enough, and enough said.

  3. Left vs. Right

    I’m glad I’m not the only one who can’t tell right from left. I always have to visually confirm that I working on the correct side. I didn’t have a problem before Acu school. Maybe it twisted my brain around. It feels silly to have so much information in my head, but still have to stop and think about which is right and left.

  4. What a great blog

    I am with all of you on the left and right.

    I lost a patient by being overly concerned and it came across as pushy. 

      When we started People’s Acupuncture, I naively thought that everyone would get it–cheap acupuncture means everyone will come in and they will keep coming back.  Not so!  I learned from Sam, watching his schedule stay constantly full, that you need to check in with patients.  He calls his patients when the mood strikes and he has encouraged me to do the same.  Last week and the week before was the first time I in awhile that I did over 50 treatments in a week.  Calling patients who hadn’t been in in awhile really worked.  This week is looking a little slower, but it’s Monday and I’ve been doing the check in phone calls inbetween patients this morning. 

  5. calling patients

    That’s a good idea, and it has worked when I’ve been brave enough to do it. People get so many things going that they don’t keep up with things they’ve started, like acu tx. I think it would help to hear from us when they’re wild-eyed and stressed (’cause all we do is stress tx, after all Wink). I’m going to do more of that this summer, and see if it makes a difference overall. I’m doing an average of 40 patients a week, but need more consistently to pay Sallie Mae every month.

    I’ve also lost patients to being overly concerned. I haven’t yet learned how to get around that very gracefully. I want to help very badly, and usually give my card to people on crutches. If I were a dog it’d be a working/helping breed, like a St. Bernard or a Border Collie.

  6. that guy and his stupid stress comment

    When I have patients who go out of town, I make a note on the calendar when they will be back and call them around that time, if they haven’t already scheduled a follow up.  I’ve decided to start telling people that I may call and check in on them if they tell me that they just want to come on an as needed basis.  Calling just to say, “I was just wondering how you were doing.” is a good way to let your patients know that you care.  I know that initially it feels like your just pitching and promoting.  Sam constantly reminds me that we are providing a service.  A pretty valuable one.

     Having an open house is a great reason to call patients who have not been in inawhile. 

    Let me know how it goes.


  7. Left and right

    I am not yet practicing the recliner-delivery CA model so I’m still tabling my peeps. I occasionally get sidedness wrong when they go from sitting to lying prone. They’ll ask, “Aren’t you going to treat my right side?”, after I’ve loaded a tx on the left. At which point I’ll usually say, “It’s a good thing I’m not doing surgery!”