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Acupuncture Today – August, 2008, Vol. 09, Issue 08

Is It Billable?

By Gregory Ross, LAc

Highland General Hospital in Oakland, Calif., is a teaching hospital. Most days, about 35 to 40 medical students, interns and residents attend what is known as "the noontime conference," held in a room next to the hospital cafeteria. While they wolf down their food, a specialist lectures.

The medical executive committee finally agreed to allow the expansion of the scope of acupuncture practice beyond treating chemical dependency. It allowed doctors to "prescribe" acupuncture for both outpatient and inpatient services. One of the first things I did was to get on the "noontime conference" speakers list. Nine months later, I was presenting.

I was told not to start until 12:15 p.m. because people would be getting food and to leave 15 minutes for questions. Quite a challenge, considering this left me only 30 minutes to explain Chinese medicine to a room full of Western medicine students and practitioners. However, all they really needed to know was that they now could refer patients to the acupuncture clinic. Whatever I could explain to them that would help get referrals is what I planned on doing.

At 12:15 p.m., I introduced myself and the patient who volunteered to be part of my demonstration. As I discussed the particulars of the post-stroke, one-sided paralysis for which this patient was being treated, I put in the needles. The patient then spoke about his response to the treatments he had been receiving for the last few months and the slow, steady return of his function.

When he was done talking and answering a few questions; I began my speech with an analogy to the Jesuit priests who first brought Western medicine to China. I explained how I felt for their plight - trying to foster their practice in a foreign and occasionally hostile culture.

I then drew the tai ji symbol on a chart pad and began to discuss yin/yang and balance, and their relationship to treatment. At this moment, a third-year resident looked up from his lunch as if he was finally hearing me and said, "Excuse me, but what is the relevance of this lecture. Why am I sitting here listening to this? Is it billable?"

He did irritate me a little bit with that statement. So, I got right to the point. I told him this was relevant because I had something to offer his patients. Then I explained the referral process and ended with, "Yes it is billable." The anger I was feeling loosened a memory of my first powerful personal experience with qi. I decided to tell the students about when my mother died.

During the week of proficiency seminar exams (which were required to graduate), my mother was hospitalized. One doctor said it was lupus, another said it was scleroderma and a third was convinced it was Alzheimer's disease. Whatever it was, she was deteriorating fast. Shortly after I finished my exams, I was on a plane home to Lancaster, New York, just outside Buffalo. My father and one of my sisters met me at the airport and we drove straight to the hospital. Once we arrived, my other sister informed me our mother was on 100 percent oxygen. In short, the machines were keeping her alive. My father and sisters left the room as I stood by the bed and looked at my mother in a coma.

I had seen death before, but this was my mother. I sat and held her hand. My thumb, of its own accord, found Large Intestine 4 (he gu) and pressed. The monitor above her bed showed an increase in pulse and blood pressure. I let go, and they went back down. I walked to the foot of her bed and began to apply pressure on Kidney 1 (yong quan) on both feet. Her blood pressure and pulse went up again. A minute later, she opened her eyes and looked at me. Her spirit had not been evident in her body for most of a decade, but there was my mother looking at her firstborn. I was crying and smiling. My mother looked at me with recognition in her eyes and smiled. Then she turned, looked at the machines keeping her alive and gazed at me with the look that every child fears: the angry mother. A few seconds later, her features softened, she closed her eyes and I let go of the Kidney 1. I joined my sisters and father. My sister told me our mother had not wanted to be kept alive on machines. A short discussion later, the machines were turned off and my mother died.

I found myself telling the group I doubted qi before that moment - and I had because of my inexperience. I knew it worked well on low back pain, but we never had anyone in a coma come to our school clinic. I told the room there was no scientific evidence or lack of evidence as powerful as making eye contact with my mother who recognized me after almost a decade of dementia and being able to say goodbye before she died. I tried pressing the Kidney 1 again a few times before my family agreed to turn off the machines, but she would not revive again.

When I finished talking about my mother, I would gauge the room was divided evenly from facial expressions and body language. Half seemed bored or irritated; the rest seemed moved. One young woman wiped a tear. As I was gathering up my supplies, an anesthesiology resident asked me if I would "show him a few things, some points." I was so taken aback by his blatant opportunism I didn't know what to say, but luckily, I didn't have to. The chief resident suggested to the anesthesiologist that he would not want an acupuncturist doing anesthesia after being shown a "few things" and she did not think it was appropriate for him to suggest such a thing.

Within a week, my referrals went up by 35 percent and young doctors, who I can only assume were at the noontime conference, were saying hello to me in the hallways.

Click here for previous articles by Gregory Ross, LAc.

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