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Acupuncture Today – April, 2013, Vol. 14, Issue 04

Ten Cardinal Sins Acupuncturists Make

By Christian Nix

The era of healthcare reform is upon us and not a moment too soon. Many prominent and venerable professionals have labored and waited this historic shift for decades and—of course—patients wait with baited breath to see if the quality and scope of care will improve as intended.

Acupuncturists and holistic medical professionals all across the US are seeking ways to establish professional relationships within mainstream settings. But, what very few yet realize is that your clinical skills are not enough.

Clinical skills are not the main issue when seeking collaboration within the mainstream.

Don't misunderstand me. There is no doubt that excellence in-clinic is still the best "calling card" you can make for yourself. But, inclusion in the mainstream has more to do with how you present yourself and explain what it is you do than it does with clinical outcomes. No matter how good you are in-clinic, the only way you will get a chance to display your skills is if you can clear the essential hurdle of your self-presentation to your mainstream colleagues. This is no trifling issue.

Don't Show Up And Throw Up.

The more an acupuncturist, TCM or holistic professional knows about their own system the more tempted he or she is to talk about holistic theory and concepts. Usually this is done with little clarity or real world understanding and is – not surprisingly a regurgitation of what they learned in school -- and a New Age one at that!

Talking about '5 Elements' (a favorite topic but total misnomer with a damaging misapprehension); yin and yang, qi, etc; this is the single best way to get dissed and dismissed.

It is equivalent to the sales person who shows up and starts spewing product knowledge. Who the hell cares?

Who cares how much you know about your system.

Not physicians.

This is not to suggest you should not know it. You better know it cold. But your expertise must be implicit and not discussed in front of conventional professionals. They will know whether you are a real pro or a total faker. They can smell a phony and they will likewise respect you if you know you are for real.

Telling physicians about holism is not reaching them where they are. There is a time for it but it is at the back end, not upfront.

Reaching physicians is about asking and then shutting up and listening.

Turns out physicians only really have about 1-5 legitimate questions you must know how to answer.

That's good news. Learn what those questions are and you will be right ready to unspool a seamless response that will win their esteem.

To 'Assume' Makes An Ass Out Of U And Me

Holistic professionals assume a lot of wrong-headed things about physicians.

  • They assume physicians care about holistic theory.
  • They assume physicians can grasp holistic concepts which have no easy or obvious equivalent in conventional medical theory.
  • They assume physicians should be interested in learning about holism.
  • They assume physicians only care about the financial bottom line.
  • They assume physicians don't care about the financial bottom line.
  • They assume physicians have no weight in the formation of hospital policy.
  • They assume physicians have too much weight in the creation of hospital policy.

As I create the above bullet list, I am aware of just how many and how complex are the elements one must consider when presenting to physicians – many of which stand in contradiction.

This is exactly why you must make a point to ask questions at the start of each talk.

Make no assumptions about them. Ask and keep asking about what and who is in the room until you have created a kind of buy-in and rapport. It tells them that you are there to talk to them and not about yourself.

The time to find out about their specific questions, their fundamental grasp of your topic, and their prejudices is before you begin, not after you are done.

If you discover their interests and biases at the back end it is because you did a lousy job uncovering this at the front end.

Peeling the Onion

Physicians don't know what they don't know. They actually don't understand what questions they have.

Not even close and almost without exception.

You can present to conventional physicians for years and not find even one who understands the issues and confusion surrounding integration holism into mainstream medicine. They are simply too busy to ponder such non-sense and too convinced of the superiority of their own training.

Even the above statement gives most of them a lot of credit because it assumes they have pondered integration even that far.

All this is starting to change.

Still, the truth is that the questions they will ask you are never the questions they actually need answered.

They're real questions are at least 10 layers beneath the initial question.

How do you get to the real questions without coming of pedantic or condescending? Good question. This is the question when presenting to physicians.

First deal with the superficial part of their question; but use it to reveal deeper aspects they had not thought to ask. In other words, teach them by asking further questions about the question they asked you.

Remember that the crux of integration is simply this:

Reductionism treats disease; holism treats patterns. That's it.

The implication of this difference is so profound that I wrote an entire book on the subject. (see Tao of Integration: )

The better you know about the implications of this difference, the better you can address the real confusion.

Nothing endears you and bonds you with physicians better than knowing their questions and confusion better than they do.

The Handshake And 'So What Now?' Aspect

I learned this one when I began to realize how essential it is to market my knowledge and services.

Do not give any formal presentation to physicians or hospital administrators without further options or steps for them to take.

They may decline; but always have something further in-store.

That offering may be to have another meeting. It may mean that you come visit my clinic or office. It may mean that the physician / administrator comes for a trial session to get treated.

It may mean that they come observe in-clinic; it may mean that they interview patients we are treating.

But is must be something concrete and actionable.

When a physician tells you they will 'get back to you,' that is not clear. That is not an agreement. That's just vague and un-actionable.

If you have a conversation with a physician you must have clarity and mutual agreement about what's going to happen next.

Don't be shy about this. Be polite but insist that you get a concrete 'next step.'

To Chase Or Not To Chase?

If you have bonded with a physician by doing well with numbers 1 thru 4, you may disregard the reference to chasing.

Nonetheless, it is still your job to follow up and persevere.

It is your job to build the bridge; not theirs.

That said, you may find that many (most?) physicians will not return your calls nor keep meeting appointments with you.

What do you do?

Do you chase them?

How does it make you feel when you chase after someone?

It is one thing to follow up. It is another to chase.

If you have ever played this game of trying to get ahold of a physician or administrator, you know how it can go.

How much time did you waste following-up with people who won't take action anyway or who have no authority to do so? You want to get to the decision maker. If you are pitching anyone else but the decision maker, your pitch should be designed to get you to the decision maker. That is a different pitch.

Be careful not to chase. Chasing has a tremendous price with regard to your mental wellness.

Chasing after people who have no authority anyway degrades your confidence.

When you chase after a physician or administrator their interest is likely to go down.

If they hear through strategically planned releases about your progress (articles and testimonials you submit to various locations and then send to them more or less anonymously) and they know of you from others, they are more inclined to be interested.

It is not unlike the dating game. We are in that game.

Bottom line: There are several hundred thousand physicians in North America. I would bet something valuable that not even 100 can say something intelligent about integration.

If you know your stuff, you don't need to chase.

Move on.

There is a strange attractiveness to not needing these respected and well paid individuals.

In the end, if you play your part well, they will chase after you.

On The Topic Of Money

When speaking with physicians or hospital administrators, you must, at some point, get to the issue of the budget and how much money you need and they will have to spend.

There is not one right way to make this topic work in your favor. You must think for yourself to decide which strategy will work best.

It is a smart idea to ask for money from them for getting the clinic started. But the truth is, you may not need it and you can always fall back and retreat by telling them that you can get it started yourself. This is exactly what I did.

So long as you are the owner / operator and you are an outsourced service for the hospital, you can make your money on the back end. The best part about community-style clinic is that is costs next-to-nothing to get off the ground.

The issue of money will come up when you talk to physicians and administrators about implementing a clinic.

Be ready to discuss it. Have documents already created which detail how much it cost to start and run your clinic. Don't be afraid to ask.

Hospitals have money and they are used to dealing with much greater sums than the amount that we need to get a clinic like this u[ and running in a mainstream setting.

One thing you want to avoid is having a discussion of money too late when you find out that it is a deal-breaker.

If that happens you'll have to default to the "I'll do it all myself" routine; but it in that case you will end up looking weak.

You don't want to start with a discussion about money because then it seems like you're not seriously interested in the service you are providing but simply there for the business aspect.

So don't get to it too early. Don't get to it too late. But do make sure you discuss it.

It is better to ask and clarify how much you need and then be able to take that piece off the table by starting the clinic yourself if that's what you need to do.

Remember that once you are up and running in a mainstream setting, everything changes since your marketing cost essentially nothing.

And if you negotiate a sweet arrangement with the administration regarding the cost of rent for your space, your expenses will be next to nothing.

The main point that I want to make on this topic is don't be afraid to talk about money.

Mainstream professionals will respect you more for having your facts and figures in place and for having the courage to bring it up and discuss it frankly.

On Different Personalities

There are several different character roles you will find in conventional medicine.

Few people fit into only one category and there are many shades and nuances; but these are the major ones.

  • The champion – show value and jump
  • The politician – avoid them but stay clean and take the high road with them at every opportunity
  • The chief – show value and touch them lightly (viz. above all, do nothing to waste their time)
  • The subordinate – politeness and genuine consideration with interest (these people run the day to day operations; knowing them and understanding their motivations and interests and then tailoring your behavior and interactions with them accordingly is the mark of a true professional)
    Thinking that you must be the same personality to each of these character roles is not only stupid, it is stupid in the dangerous way.

Why? Because it says that your professional persona is focused on you who you seek to portray and present to others.

Forget this approach (if you are even aware of it); and if not then, read and think carefully about how to design your professional persona.

Instead of creating your professional persona around your ideals, create it around the ideals and motivations of the people with whom you interact.

The chief is super-busy and wants no demands made.

Make none and show value and support for their vision.

Get to important things before the chief can ask about them. Report your progress.

If you do report a concern or problem, make it bloody brief and tell the chief your expert solution.

Never complain without offering your solution to the problem.

When dealing with hospital staff, take the time to learn everything you can and to discuss how the administration aspect works.

This is a free education and a valuable one.

Remember that they want to feel good at their work environment.

They don't want extra work from you but will do it if it is part of their job.

They want 5 p.m. to come so that they can get on with their lives and go home to be with their families.

So be like family to them.

I could go on, but hopefully you get the gist.

On Not Taking 'No' For An Answer

Once you know and truly understand the problems and concerns of hospital staff, physicians and hospital administrators, you can really go after solving their problems in a way that makes it difficult for them to say 'no'.

Of course there is a whole packing order and so it is essential to insist without coming off as though you are insisting.

The basic formula for not taking 'no' when presenting or even when talking to a physician or administrator in an elevator is this:

"Doctor _______, it seems clear that the problem you and the hospital have is facing _______. This is causing ¬¬¬_______ and costing you $______.

Our solution costs $_____ and consistently delivers ________.

You said you are committed to improving care for this segment of the patient population.

So I would like to ask you if I can share more about the specific ways in which we could help patients with _________."

Be specific and make your promise big.

Now, this is pure your sales training.

You are selling your service.

Physicians and administrators can be are fickle and (again) totally unaware of what we do and how it works and how effective is it actually is.

Keep your attitude focused on how much value you are going to bring to them and to their operation.

This approach works no matter what venture you are involved in. Be polite; but be persistent to the point of making them decide.

Don't take no for an answer unless decide it is best to wait and to cultivate them with more information and personal contact and follow-up.

On The Issue Of Image

Most holistic professionals are like unwanted step-children.

Question: Who would you hire if you were a hospital CEO? Would you do business with a person who offers service for free? Who cannot state her true value or explain exactly why they need her service and what problem this service is going to solve?

Or would you rather hire someone who is so confident and certain of his value and worth that he is even willing to walk away if he doesn't find a particular hospital situation amenable and the offer accommodating to his standards for successful collaboration.

I can tell you from personal experience which approach works best.

Hospital CEOs and physicians want to work with real, bona fide professionals who are strong, on time and get it done. You must become that person (or at least pretend that you are until you become it).

You must act the part until you truly feel yourself in that role with no pretense. Nothing else will fly in the conventional model.

Remember, the conventional model is actually looking for you.

It's not the 'you' that is worried about making rent and finding the next client.

No. They want the 'you' that you must project – a calm and self-assured hospital-quality professional who denounces New Age nonsense and who can explain and deliver hospital-quality medical acupuncture.

Suit up and fill that role because your opportunity has never been greater for making a serious leap in your career then in the next 2 to 5 years.

Reinvent yourself to be a superhero of integration. Walk it, talk it and really play it. Go in like you run the show and tell the CEO how you were going to help her, help her people and patients by saving the hospital money and delivering mad satisfaction to all the patients who need your service.

The System Is The Solution

At this stage I think it is a safe bet to state that acupuncturists really don't have a system for approaching hospitals and mainstream settings.

In fact, most acupuncturists – veterans or recent graduates – don't have much of a system for anything to do with their business.

When you have a system, you have a way to:

  • Track your progress
  • To discover where things went wrong
  • To make changes to your approach
  • To act with smooth confidence
  • Approach multiple administrators and settings with pre-prepared documents (all of which communicates professionalism to your prospects)

By putting a system in place, you can de-brief failures to discover where thngs went wrong and to augment changes for your next attempt.

"Where did I lose this Hospital CEO? Let's see, she baled at the word 'alternative.' I will use the term 'holistic' instead next time."

It seems to take forever to create a system. It is still a shorter way than the alternative of throwing darts in the dark.

Documents you create for one prospect can be used to approach another. There is a lot of 'one-time expenses' for making a system; but without one, you are guaranteed to:

  1. Look like an amateur
  2. Flail about without any means of correcting your approach for the next try

Having a system practically guarantees that you will be setting the agenda for your meetings with the Hospital CEO or clinic supervisor / director. They will appreciate this professional touch.

As you grow, your system will grow in complexity and richness.

Remember that the inclusion of holistic medical services in the mainstream is only in its infancy. There is currently neither any real professionalism nor any industry standard of note in this area.

By setting yourself up as an early adapter, you grab a position of real authority for the years to come when these services will be accepted and acceptable on a more or less universal scale.

Decide now, because decide you must whether you will lead or follow.

It is always more interesting to lead (and more fun and profitable as well).

Good luck.

Christian Nix has launched the first Hospital Based Acupuncture Residency Training program in North America and his Community Pain and Stress Center is the first private model of community-style practice to be integrated into a major hospital system. His new book, Tao of Integration is a fresh look at much of the misapprehension hindering professional quality integration in medicine. Christian travels and teaches throughout the world.

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