Practicing Acupuncture in a Multi-Disciplinary Setting
By Sarah Poulin, DACM, LAc, Dipl. OM
As Americans increasingly look to integrative medicine to serve their needs, multi-disciplinary medical centers in which a variety of health care options are offered are uniquely poised to shape the medical landscape of the future.
These multi-disciplinary practices offer a setting in which the patient in search of more holistic minded healthcare can find numerous qualified professionals who can work both independently and as a team to best serve the needs of both their patients and the community as a whole.
The Multi-Disciplinary Setting
I have been in some form of multi-disciplinary setting since I have been in practice and have found it both personally and professionally rewarding. Because there is the potential for great variance in clinical operations among multi-disciplinary offices (in terms of independent contractors vs. salaried employees, and so on), my perspective in this article will not focus on the legal and financial aspects of a multi-disciplinary practice but rather on the more general issues of the practice management concerns of an acupuncturist within such a setting.
While there are decided benefits to an acupuncturist setting up in a solo practice (whether by themselves or with other acupuncturists) branching out beyond an acupuncture-only clinic offers health care alternatives that are attractive to many patients. Those who worry that other health care professionals might not share their views on health care and that profits may be distributed unequally among the different types of services provided do have cause for concern.
Acupuncture has its own unique medical paradigm that is decidedly less familiar to both the American public and other medical professionals than chiropractic or massage therapy. However, for the acupuncturist who is willing to invest the time in developing strong inter-professional relationships and who is devoted to public and professional education, there is myriad of benefits to joining a multi-disciplinary setting.
A multi-disciplinary setting is very appealing to patients. It provides a "one stop shopping" experience for a variety of healthcare options. Rather than having to visit numerous offices, the potential for in-house referrals and treatments ensures that the patient feels confident that one center can successfully address his or her health concerns with a variety of tools.
Having the flexibility to visit different types of healthcare providers within one office building saves the patient time and money in regards to transportation, time off from work, and facilitating communication between their varied health professionals. Marketing these advantages to potential patients is a must for an office committed to success in the multi-disciplinary setting.
The most important aspect to making a multi-disciplinary facility work successfully is inter-professional communication. I am very fortunate that I have a great personal regard and professional respect for my colleagues. When patients see that we feel confident and comfortable within a multi-disciplinary setting, it eases their minds as well.
Even if personal differences may arise (as is the potential issue with colleagues of any stripes), a concerted effort must be made to resolve these issues as quickly as possible; the strength of the multi-disciplinary setting is dependent on the strength of the relationships between the professionals. It is also important to speak respectfully of your colleagues to all patients within the office, notably by using proper titles when referring to them and by demonstrating that you have open channels of communication with the others in the office.
Communication is Key
Inter-professional communication also means that practitioners must work to educate their colleagues, both on their medical abilities as well as any particular sub-specialties or areas of clinical interest. If your colleagues are not aware of the many conditions which acupuncture can successfully treat or even how it works, that role of educator falls to you — it is better to repeat information that they may already have than assume they know the realities of our medicine and lose the opportunity for them to speak confidently about your services.
Accordingly, you must also do your best to become aware of what your colleagues treat well. Have a naturopath who loves working with pediatrics? A chiropractor who specializes in sacroiliac injuries? A functional medicine doctor who excels at interpreting blood work? Make sure you are aware of those practitioner strengths. Knowing in what areas your colleagues excel benefits any mutual patients you might share as well as additionally providing subtle evidence to your patients that your office is one that successfully works together.
Learning Through Observation
In the coursework for PCOM's Doctorate of Acupuncture and Chinese Medicine program, we were tasked with following non-acupuncture healthcare professionals for a number of clinical observation hours. I was fortunate enough to follow two chiropractors that I work with in my office, and the experience was invaluable.
Taking the opportunity to peek into the window of someone else's doctor-patient relationship is a wonderful way to gain a deeper appreciation of and insight into your colleagues' work. I highly recommend that perhaps once a year, you spend a little time shadowing your colleagues during the course of a day if you have never seen them "at work." Not only will you find out more about their clinical skills, styles, and patient relations, you also help yourself become a familiar face to some of their patients as well, personalizing the acupuncture services offered within the facility.
Inter-professional communication is also paramount in coordinating patient care. Given that your patients have given you permission to discuss their case with your colleagues, having brief conferences on mutual patients ensures that the patient doesn't waste time explaining things twice as well as gaining information on the types and effectiveness of your colleagues' treatment modalities.
It also allows for an exploration of how different therapies may combine together to best address a patient's needs. Coordinating patient care also ensures that different therapeutic modalities are all working towards the same goal as well. Additionally, if your scope of practice limits such things as the ordering of lab work or imagining, cooperation with those in-house providers who can order, interpret, and then share the findings of such tests for your mutual patients ensures a streamlined and holistic approach to your patients' concerns.
This inter-professional communication must also extend to the front desk staff. Making your front desk person aware of your scope of practice and conditions treated is your responsibility if that person is not familiar with TCM. Again, the purview of professions like medical doctors or chiropractors are much more commonly understood by most people; the onus of education is on you to make sure that your unique abilities and modalities are made clear.
The last thing that must be considered when embarking on an acupuncture practice within a multi-disciplinary setting is the maintenance of your unique role within the facility. Acupuncture treats such a wide variety of health conditions and concerns that we often confidently treat those patients who have exhausted other resources and who see our services as a sort of a last resort.
We can treat those patients with complex physical, mental, and spiritual concerns in a way that few other medical professionals can. Know your strengths and project that confidence into your professional life. While others may have different titles or a longer history of professional experiences, your clinical training and experience as a practitioner of TCM ensures that you bring a unique and valuable set of services to your patient population.
Additionally, if you are an acupuncturist with a cash-only practice or are only in-network with a limited number of insurance companies, you may not have the time constraints imposed by the insurance system on many other types of medical professionals. While this is certainly no fault of your colleagues, it is nonetheless a fact that you can spend more time with each patient than most types of medical professionals.
Especially with those patients with a complex medical history or the desire to address multiple health concerns during the course of a visit, it becomes a valuable selling point to make it known that you can offer an extended office visit (without denigrating your colleagues who may not be able to offer such lengthy office visits, of course!).
As medicine in this country evolves to meet the desires of patients who seek out a more well-rounded and holistic approach to their medical care, becoming a part of a multi-disciplinary healthcare setting offers numerous benefits for both yourself, your colleagues, and your community at large. Establishing and maintaining your unique clinical role while also celebrating the strengths of your colleagues ensures that you can succeed as both an acupuncturist and as a member of a larger and more modern team dedicated to providing excellent, well-rounded, and informed care to all patients.
Sarah Poulin is a licensed acupuncturist and Chinese herbalist with a private practice in Middlebury, Connecticut. She is an alumna of Pacific College of Oriental Medicine, where she received both her Master's of Science in Traditional Oriental Medicine (in 2012) and her Doctorate of Acupuncture and Chinese Medicine (in 2016). For more information please visit her website at sarahpoulinlac.com.
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