Last month, I received an e-mail message from an acupuncturist in Riverside, California in regards to my article "Ending A Doctor-Patient Relationship," which appeared in the May issue of Acupuncture Today. The acupuncturist asked a number of relevant questions about possible situations described in the article -- so relevant, in fact, that I decided to share her questions (and their answers) below to help inform the profession.
Doctor-Patient Relationship Q&A
Question #1: What is the amount of time you consider to be "sufficient notice" to give a patient to allow them to arrange to receive care from another acupuncturist?
Answer: There really isn't a preset amount of time for giving a patient a discharge notice. It depends on the patient's condition. If the patient has a life-threatening condition, the doctor would be required to give sufficient notice so that the handoff of patient care does not in any way damage the patient's condition. This is not the typical situation encountered by acupuncturists. If routine acupuncture care is being provided, a week to 10 days of written notice that the patient will need to find another acupuncturist should be quite adequate.
Question #2: How many times does a patient have to miss an appointment without giving the acupuncturist notice to be discharged from an acupuncturist's service? What is the procedure for discharging this type of patient?
Answer: This is more a question of office procedure than loss prevention. You have every right to decide if you no longer wish to continue an acupuncturist-patient relationship if your patient misses even one appointment, if that is what you do as a matter of policy. The only limitation to this would be that you employ the same notice procedure as discussed in question number one when discharging this type of patient.
Question #3: Is the acupuncturist obligated to the patient to provide him/her with another acupuncturist's name and address?
Answer: I strongly recommend to my acupuncture clients that if they elect to withdraw from treating a patient, they should provide the names of at least two other licensed acupuncturists in the area to the patient who is about to be discharged. There is no legal requirement to do so, but it does help eliminate any potential claim by a patient that they felt they were abandoned because in the time period allowed to them, they could not even find another acupuncturist in the area.
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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