My days as an acupuncturist are spent exploring ways to help my patients. Experience has shown, however, that for there to be deep and lasting results, I must teach the patients ways in which they can learn to help themselves. I introduce the concept of participation in the healing process to all patients on their first visit. I explain that for the best results we have to become a team, and that acupuncture will work best for them if it is a collaborative effort.
Good medicine is largely a process of education. There are many motivated patients looking to take a more active role in their own self-care, and many more who would be, if they only knew where their true power lies.
During the course of treatment, my goal is to present a vision of healthy new possibilities to the patient. I begin this process by first establishing a mental picture for myself of the patient that embodies health and actualizes their full potential. Over time, I invite the patient to join me in this vision. Together, we explore their medical history, looking to see if their current complaints are part of a larger, longstanding pattern of disharmony. In a large number of cases, seemingly disparate symptoms make a great deal more sense to the patient if they can be explained in the context of a constitutional or structural imbalance. Ultimately, my goal is to have the patient understand the forces that are shaping their life, and to take greater control in determining the outcome.
Chinese medicine emphasizes the important part that "lifestyle and emotions" play in the genesis of disease. I help the patient see how the manner in which they live and the choices that they make shape their life. Together, we analyze the "big picture" to see which components in their life are promoting, and which are detracting from their health. If the patient looks with honesty at this global overview, it becomes clear what changes they can start to make to improve their well-being.
Another level of "understanding" unfolds during the needling process itself. During the acupuncture treatment, we have the means to capture the body's attention at a deep level. Unlike the external loud and clamorous noise that always competes for the attention of our minds, the "voice" of the needles speaks in a soft whisper to our deepest intelligence. The body is seduced into listening to their message. During the time the patient is on the treatment table, they have the opportunity to step out of their habitual state of "unconscious thinking" and enter into the awareness of the moment.
During treatment, we literally show the patient where in their body the energy has become "stuck" or "out of balance," and how it can be moved to restore harmony. We demonstrate how to reunite with the body's inner knowing and to elicit its healing response. However, for the treatments to produce lasting change, we still must empower the patient to continue this process at home. The patients must develop a greater understanding of how much influence they have over the forces that are shaping their destiny.
Probably the biggest frustration we face as practitioners is seeing patients improve during treatment, only to have their problems continually return over time. To address this issue, we need to focus more on what the patients can be doing for themselves. One way to do this is to teach them home self-care.
In Japan, it is common for the acupuncturist to mark treatment points, sell the patient a moxa kit, and have the family or patient continue daily treatment until the next office visit. This practice greatly enhances the benefits of the treatment, but moxa burns are an accepted component of this system. Here in the West, this method is not suitable for our patients for several reasons. First, many of our patients are becoming sensitive to smoke and odor, and may be fearful of placing burning moxa on or near their skin. Furthermore, this practice is unsuitable due to liability issues in our litigious society.
Fortunately, an instrument is now available that allows us to engage in this powerful practice without the limitations and dangers inherent in "fire-based" point warming. Through this self-care model, patients can not only modulate their symptoms, but also improve their chronic and constitutional problems at their root. This creates a win-win situation for everyone.
Some practitioners may feel that teaching patients "our secrets" could take away from financially profitable office visits. I don't believe this to be true for two major reasons. First, the patients must return to our office so that we can monitor their progress and make necessary amendments to their point prescriptions as their patterns of disharmony change. Second, consider the positive impact that having more happy patients will have on your practice. Satisfied patients that tell people their life-transforming success stories is our best form of advertising. This is one kind of advertising we cannot buy for any price: It must be earned.
A research letter in the Journal of the American Medical Association (JAMA) provides early findings from the most recent (2022) survey on the use of complementary health approaches (CHA). The findings include data from the National Health Interview Survey (NHIS), which conducts interviews both by phone and in-person. The CHA results have been published in 2002, 2012 and again in 2022.
When learning traditional East Asian medicine, we are taught the four pillars of diagnosis: inspection, auscultation and olfaction, inquiry, and palpation. When it comes to palpation, there is often a quick mention of feeling the acupuncture channels, and then the focus moves on to pulse diagnosis. Little to no time is spent palpating the channels – or the skin for that matter.
Topical analgesics (TAs) are effective. In fact, the American Geriatric Society recommends the use of topical agents for localized neuropathic and non-neuropathic pain as a front-line measure. The benefit of TAs is their high compliance, ease of use, direct application to the painful site, and limited systemic cross-reactions. The real challenge is choosing the appropriate topical for each patient given the myriad choices available.
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