By John Amaro, LAc, DC, Dipl. Ac.(NCCAOM), Dipl.Med.Ac.(IAMA)
As the acupuncture profession continues to become more firmly established, public awareness of the "licensed acupuncturist" (LAc) grows nationally. More and more patients throughout the country are gravitating to acupuncture as a primary method of treatment.
We are seeing successful practices all over the nation as acupuncturists have been instrumental in developing licensing laws and have set up professional practices in the vast majority of states. It is only a matter of time and diligence that all 50 states will issue licenses for the practice of acupuncture by LAcs.
Due to the incredible clinical success and positive press acupuncture has had with the public over 30 years, acupuncture is no longer considered a fringe treatment practiced by questionable practitioners but a valid, medically accepted healing art. Even though acupuncture is often explained with its own terminology with references to traditional Chinese medicine (TCM), acupuncture has been described in contemporary times through sound, neurological, scientific explanations. It is common today for a family medical practitioner or specialist to refer a patient for acupuncture when modern medicine has failed or the outcome is bleak.
Along with the approximately fewer than 11,000 graduate acupuncturists in North America, there are estimated to be more than 35,000 medical, chiropractic, osteopathic and naturopathic physicians practicing acupuncture daily as an adjunct to their practice. This figure does not account for the dentist (doctor of dental surgery) or podiatrist (doctor of podiatric medicine), whose practices are limited to the head and neck or foot and ankle, respectively. These two groups account for an additional 1,500 practitioners nationwide practicing acupuncture. Many practitioners are only using electronic/laser auriculotherapy, whereas the majority are utilizing full body acupuncture with an emphasis on non-traditional Chinese medicine. This method has been described as "contemporary medical acupuncture." To learn of the vast numbers of doctors practicing acupuncture in America is probably not exactly what the LAc wants to hear!
As thousands of doctors are enrolled each year in graduate school programs and the ranks of "medical acupuncture" practitioners swell, there appears to be an increased mainstream interest in acupuncture by more physicians than ever before. Doctors have observed that they are having much better clinical outcomes with a host of pain conditions using acupuncture than they ever saw using strictly allopathic medication or just chiropractic manipulation. Doctors have reported increased patient referrals and satisfaction, and increased income with the addition of acupuncture to their practice. Doctors have also seen willingness for their peers and patients to refer cases to those doctors practicing acupuncture.
As the trend of increased physician interest in acupuncture continues to develop, it is vitally important for the LAc to not feel angered, intimidated or threatened. This may well be one of the most trying emotional challenges of the acupuncturist's professional career.
It is a fact that the typical medical acupuncture program for physicians is 200-400 hours of didactic and clinical applications, whereas the acupuncturist has spent 1,800-plus hours in education. Instead of seeing the medical and chiropractic physician as someone who is untrained in acupuncture and lashing out with verbal attacks as to their incompetence because their education is different than the TCM practitioner, it is essential to have a respect and understanding for the style of acupuncture they practice. Ninety nine percent of medical acupuncture practitioners do not practice what is commonly referred to as traditional Chinese medicine, preferring instead Japanese/Taiwanese meridian style acupuncture. The clinical success created by both meridian and TCM styles of acupuncture produce equally incredible clinical results. The doctor who uses acupuncture as an adjunct to his/her practice, as opposed to a primary approach, practices an entirely different style than the TCM practitioner. Pulse and tongue diagnosis is very seldom used, replaced with contemporary electronic evaluation of dermal electrical resistance at the source (yuan) point. TCM diagnoses such as "phlegm misting the heart" or "damp heat in the gallbladder" are generally not used in place of recognition of the meridian system and a Western diagnosis. In essence, the points used for treatment are the only common denominators of these two styles of practice.
Remember, patients seek us out for very specific reasons, primarily because they have a desire to be rid of pain or to be helped with a health condition. They may have been motivated to come to us because of the reputation acupuncture has enjoyed due to the 30 year love affair the press has had with it. They may have been specifically referred to us through another patient, friend or family member. They may know of the benefits of acupuncture and have seen your office or know you are in the neighborhood. They may have heard of you due to your stellar reputation. In any event, they are now in our office, and what they really want is to get well! They are not interested in petty politics; they want to know three things when they come to us: 1. Can you help me? 2. How long will it take? and 3. How much will it cost?
Patients are not going to be convinced regardless how hard one tries that the doctor using acupuncture is incompetent and that only your style of acupuncture is effective. Like it or not, John Q. Public is enamored with the medical profession. Being critical of a physician's education will prove entirely self-defeating. Criticism of their philosophical beliefs that include how they practice acupuncture will likewise prove self-defeating. Believe me, during the development of chiropractic, in an effort to be accepted, the profession went nowhere with being critical of medical treatment; it only made DCs look ignorant in the eyes of the public.
So what's the bottom line? The one who is the best, wins! The better and quicker the clinical results you and the patient observe, the better you are considered as a practitioner. If you have the best reputation as a healer and practitioner, patients flock to your door.
Take a bit of wisdom from B.J. Palmer, the developer of chiropractic, who perhaps said it best in the early 1930s:
"The fundamental of this clinic is to see how little we can do at how few places, how rarely and how quickly it can be done to accomplish the greatest change in the shortest space of time, at least cost to case, and to know what to do and why we do it before doing it."
Had the chiropractic profession as a whole heeded that advice, I doubt it would have taken so long to become mainstream. These same words are not only still appropriate for the times in chiropractic, but acupuncture as well!
The restaurant with the two-hour wait only achieved that wait through good food, ambience and great service. What about the restaurant in the same block where you can get a table for four at 8:00 pm on Saturday night upon entering the door? This is comparable to the acupuncturist who is barely surviving in comparison to the one who is thriving. Make sure you are the best, that you are the authority. Then it doesn't really make any difference how many practitioners there are in your city, town or immediate location. People will seek you out for you. They will want to be associated with you and your clinic.
If you want to "thrive" instead of just "survive," the key is simple: be the best in your area. This includes getting patients in and out of your office in a timely manner. No one wants to wait more than 10 minutes in a waiting room and, just as important, they don't want to be in your office for lengthy amounts of time. People have too much to do today than to spend half a day in your office.
Take a good critical look at your office from the reception room, business office and clinic rooms as to cleanliness; quality of furnishings; clutter; staff; and most importantly, yourself. As much as you probably do not want to compare yourself to a medical office, unfortunately, your patients do! Take a peek into a typical medical/chiropractic office that has a good reputation. Does your office match up visually? If not, consider making some changes. Remember, you are here to thrive, not just survive.
Can you justify your fees? Just because the practitioner down the street charges a particular fee, are you comfortable charging the same? Some practitioners need to reduce their fees; some need to increase them. It is imperative that you are extremely comfortable and can justify your fees. Don't worry about the practitioners' fees down the street; focus on yours. Fees inconsistent with the quality of service, results and physical surroundings are one of the quickest ways to keep a practice at "survival" mode.
Achieve outrageous clinical results! This is perhaps the most important aspect of a successful practice. Are you seeing the stellar clinical results in your patients for which acupuncture is famous? Patients have been hearing of the seemingly miraculous healing response to acupuncture for 30 years, it is imperative that your office experiences those types of results. Outrageous results are what patients have learned to expect. This is where you "thrive."
Having practiced acupuncture myself since 1971, I have learned, developed and stumbled upon a variety of approaches to a number of conditions, which produce "outrageous" results. In the next few articles for Acupuncture Today, I will focus on a variety of conditions and their treatment approaches that have produced healing responses that are literally second to none. Some of you will see and read things that you have never encountered; others will say, "I knew that!" Remember: even if you see something you already know, it's OK to be reminded of it, especially when it is so good.
Begin reviewing your school notes, far too often, practitioners graduate from school and, other than yearly 15-hour license renewal seminars, never have any educational stimulus. Read the articles in Acupuncture Today to expand your awareness and healing consciousness. Be the best!
There may be a variety of doctors and acupuncturists practicing acupuncture in your area. Just remember: no one is as good as you. Use sound clinical principles, charge a fee consistent with your practice reputation and achieve "outrageous" clinical results. Realize your acupuncture practice has no comparison.
Here's to "being the best" in 2002!
Click here for previous articles by John Amaro, LAc, DC, Dipl. Ac.(NCCAOM), Dipl.Med.Ac.(IAMA).
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