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Musings From a Senior Practitioner

By Felice Dunas, PhD

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The Risks I Took

We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval. Maybe the cost of schooling, the challenge of being self-employed, or the isolation of living in a small town without a network of colleagues nearby gives you pause. Whatever it is for you, risk is inherent in being a practitioner of TCM and the ultimate behavioral reflection of yin and yang.

Without sticking your neck out, there will be no progress. And while you have to weigh risks vs. benefits, sometimes you just have to dive in with the belief that you can make magic happen, even if the odds are stacked against you.

I've taken a lot of risks in the past 45 years, and I thought I would share some of them to help you feel inspired, less alone or smarter.

Risk #1

I told a patient what he needed to hear not what he was ready to hear. Michael was an actor. He came to Los Angeles to make it big and he came to me to stop smoking. Cigarettes were, he told me, sabotaging his professional progress. He would loose focus at auditions because he craved them, he smelled of tobacco on set, which his fellow actors and directors didn't like. Completely perplexed as to why he couldn't stop, I was the third acupuncturist he had been to after having tried several detox centers and working with everything physicians had to offer. He asked me why I thought he still smoked and, wanting to succeed for his sake or mine, I told him, after an extensive initial interview, what I really thought.

If he quit, he would have no excuse but to succeed in his chosen profession, a terrifying pressure for a young man. He was, I suggested, so afraid that he would fail that he used smoking as a way to avoid facing that ultimate dilemma. His parents had not approved of his choice to move to L.A. to try his hand at acting, and he felt he had to rebel against their disapproval. If he failed professionally, he would prove them right. Smoking was a way to avoid the terror he felt about failing.I felt, after listening to him very carefully, that I was right. From his reaction, I was assured that my evaluation was accurate.

Did it work? No, I lost Michael immediately after I answered his question because the truth was too much for him. I called to follow up and he was friendly and promised to come in, but I never saw him again.

My teachers have taught me that you must give the patient what he can handle, not what he needs. If he is severely blood deficient, for example, you nourish him very slowly, as small amounts are all he can metabolize while being weak. If you give him the intense herbal formula that will quickly remedy the problem, you make him worse. The same is true for all organs and all people. This concept is true in reference to body temperature, as well. Someone who is nearly frozen to death must be brought back to a healthier temperature extremely slowly as a pace that is quicker will kill them. Pacing is key. Too much of the right thing can make you sick.

I am not suggesting that every time a patient asks you a question you should avoid answering. Only that you may wish to feed information and treatment based upon the amount someone can metabolize, not based on the severity of their need. Giving in the dose the patient can handle may take a long time, but by being true to the pacing of the patient's body and mind you are more likely to succeed.

Risk #2

I approached my stepfather about getting acupuncture into Kaiser.

My stepfather was one of the founding physicians at Kaiser Permente, the hospital chain developed to provide care, originally, for Kaiser Steel employees and later, to become the country's first and largest HMO chain of hospitals. He was an internist but went on to become director of Kaiser's Los Angeles hospital and then to run some of their dealings on a national level. Telling him about my "little hobby" as he originally called it, was bad enough. But to elicit his support in bringing acupuncture into Kaiser was down right scary. It took me years of casually mentioning data on new research, showing him the East West Clinic founded by Steven Rosenblatt at UCLA, and showing him my cases whose results justified the use of acupuncture for pain relief. In essence, I pushed and wouldn't let up.

Did it work? After years of effort, Kaiser was amenable to using acupuncture as a pain control option in certain circumstances. There are now systems in place to facilitate acupuncture for Kaiser patients at many of their hospitals. Unfortunately, it altered my relationship with my stepdad, and not for the better. I pushed too hard for something outside his comfort zone. As a pioneer, fighting upstream to build a profession, I used my connection and won. As a stepdaughter asking for help, I went too far. Though not entirely damaged, our relationship never fully recovered. He and I paid a personal price for our profession's gain.

Sometimes it's worth pushing for what you want, but that doesn't mean the cost isn't going to be high. In other instances, professional aspirations aren't worth the personal sacrifice. When you have professional decisions to make that are going to effect your personal life, think hard. Is professional glory or wealth worth what you think it is when considering it's costs? The people you love and who depend upon you are the one's who will be with you throughout life. Professional glory rises and falls.

Risk #3

I changed the format of my practice. Once our profession had some infrastructure, schools, curriculum and licensing, I decided I wanted to devote myself to creating a demand for the services of our newly educated and licensed acupuncturists. No one had ever offered me a job, because such things hadn't existed, and I wished they had. So, I set out to create jobs for all of you.

In 1991, I did my first lecture with the idea that I could introduce corporate presidents to what we did and they would want to hire us for their business wellness and addiction programs, which I would help design. Though I had intended to work in the U.S., my first opportunity came from Tai Pei. Deepak Chopra, the Dali Lama's physician and I were on a panel discussing Indian, Tibetan and Chinese medicine, respectively, to corporate presidents from around the world.

Before I headed to London, followed by Hawaii for my first solo lectures eight months later, I decided to change my practice structure by letting go of my office and starting a house call practice. This would facilitate my availability as a speaker and eliminate office overhead.

To do something this crazy I had to believe I could get lecturing to work financially while maintaining a practice, even if I was gone for a big chunk of each month. Would my patients stay with me? What kind of cases could I take on if I wasn't going to be there every week? Would this idea result in no practice at all? It required that I charge more money per treatment, as I couldn't see as many patients. I also had to adjust to being in patients' homes, which is a very different way to work. How do you maintain authority, boundaries and credibility when in someone's bedroom or den? And after spending more than two decades building up a clinic practice, was I throwing it to the wolves on the bet I could become a consistently paid speaker, a career for which I had no training whatsoever? I couldn't afford to pay the costs of running a clinic and be gone half the month so, if I was going to make this career transition, I had to step off of one boat before placing my foot on a second one.

Did it work? Yes and no. Overnight, I doubled the cost of treatments because they were conducted at patients' homes. Amazingly, I lost very few patients so I had a big, busy, low overhead and high revenue practice instantly. My clinic was in an area where patients had lots of money and that is why this worked. If you decide to offer a high end service like a house call, be sure patients can afford the higher price point before you depend upon their doing so. Or, start a group acupuncture practice and keep costs low but work out of one patient's home. I did this for a while also. One patient had a little "treatment party" every few weeks. My patients got to know one another and they enjoyed visiting at her home. My work became part of a socializing event, which kept the fee low.

As for the public speaking, I have succeeded, now having lectured in more than 80 countries around the world. But the learning curve for this second profession was steep and scary, the cost to my social life was high, as I missed so many events at home, and my love life was negatively affected. It's not easy to cultivate a solid love affair between airplane flights and single mothering. I developed friends who also lived on the road. We would meet in Milwaukee or Bogota, Phoenix or Hong Kong.

If you decide to do something as crazy as I did, where teaching becomes a big part of what you do, be sure you enjoy the many components of that profession. For example, I am not a big applause person. It is more important for me to be impactful than to be a star. That is why doctoring one person at a time and having a strong impact on that person feels natural and good to me while rousing applause after a speech isn't my motivator. Some people thrive on applause and feel great if they get that standing ovation. If you are one of those, public speaking may be a great choice. I have learned to use my lectures to set up private sessions, 2-hour meetings with individuals or couples from my audiences who wish to make progress in their lives and health. This is one of the ways I have made sure to get the pleasure I need from this career style. The lectures do not nourish me as much as the private sessions, though they are more lucrative financially.

I hope my little stories remind you of the power in taking risks, both for good and bad. For every step taken there are possible wins and losses. Yin and Yang work together so one cannot anticipate only sunshine or rain, success or failure.

There isn't one successful practitioner in our field who has not been willing to take risks on both small and large scales. Perhaps you can take comfort in knowing you are not alone when, like myself and countless of your colleagues, you take your weight off that which is stable to find balance on the next step of your path.

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