Public Health Concerns: Q & A

Thanks to readers for your letters and questions. We've selected two questions this month that reflect the public health-related concerns of acupuncturists.

Q: I recently received my acupuncture license and am still not sure if I want to set up a private practice, or find a position in the public sector or a group setting. I am considering taking a few months off to travel and regain my own balance. Is this a bad business move, and should I be worried that my acupuncture skills may deteriorate without practice for a few months?

A: Self-care is essential for us to be good practitioners. So, you will do yourself and your future practice some good by taking time off before your begin if it is something needed to rebuild your qi before starting your practice. Once you are responsible for an office space lease and monthly bills, taking time off becomes more difficult ... so if you are dreaming of the sands of Fiji, in the words of Goethe, "Begin it now."

There are ample opportunities as a private practitioner to take vacations, and you should schedule these regularly. However, in the startup stage of a new business, the loss of income and marketing energy may be a deterrent. Burnout is a real threat in any care-giving profession, however, and, as we heed in our medicine and in public health - an ounce of prevention is worth a pound of cure. A key to burnout prevention lies in early detection; therefore, we serve our practices and ourselves best when we are vigilant with our own diagnosis and preventative strategies. Many factors can contribute to burnout, including academics, business ownership, clinical practice, and events in our personal lives. Once established, burnout is not something that will subside after a mere vacation, and can lead to a fatigue of body, mind and spirit. With that said, only you know yourself and whether you have the ability to self-motivate once the school momentum is over to get your practice going.

If you do decide to take some time off, our suggestion is to create a strict timeline with goals and objectives in advance of your trip so that when you return, you know exactly where to begin and have a well thought out game plan for your practice success. Your acupuncture skills will not "deteriorate" - in fact, many graduates wait months before receiving a license to practice. However, practice is a lifelong study, so you can certainly continue to read and discuss Asian medicine during your hiatus. You can also pull out some of the more enjoyable goals and objectives from your list to work on during this time. When consulting for older practices where burnout may be a culprit leading to business stagnation, we help practitioners think through ways to combine pleasure, vacation, inspiration and learning. The same encouragement can be applied here.

For instance, map out your travels, contact the local acupuncture or wellness school, and sign up for a short continuing education class that interests you. Use a search engine like Google or consult the local Yellow Pages for the area you are traveling in and set up a half-day observing/assisting with a local practitioner. This can build your network of potential mentors and provide you an opportunity to see how other people manage the business aspects of their practice while also observing clinical treatment.

Investigate where and when the national or international conferences are held for specific conditions you have an interest in learning more about, or any type of conference that will benefit your practice. To really tip the inspiration scale, include a stop during your travels to an area or clinic that is doing progressive work you may have a special interest in, such as a pediatric or oncology hospital- based program, or perhaps one of the international programs we've written about in impoverished areas such as India, Africa or Guatemala. Not only will you benefit from a full or partial tax write-off (consult an accountant for current deductions) for work or educational-related expenses including airfare and lodging, but you will rejuvenate your spirit in a way that honors both your need for adventure and your desire to stay engaged in your learning.

For information about observation or postgraduate internships through our program in Boston, e-mail the specifics of your stay and we will work with you to create a dynamic learning experience, whether you are here for a half-day visit to an intensive three-month internship.

Q: I am one of a few acupuncturists in my area and have developed a fertility following based upon word of mouth. I would like to develop this as a specialty in my practice, but as a male practitioner I am a not sure how potential female clients or my fellow colleagues in the area would perceive this.

A: When we allow the qi of our practice to flow freely, it, not us, may dictate our areas of specialization. Some of us remain general practitioners; others go on to provide substantial expertise in a particular arena that can help to contribute richly to our profession. Be open to your practice's qi - let it be your guide and your teacher. If you feel that you have garnered enough experience and knowledge in working with a particular condition (in your case, fertility enhancement), do not let gender or any other consideration limit sharing that with as many as possible. Marketing, however targeted, remains simply the ability to share of ourselves in a way such that others "get it." With more choices, female patients may in fact be inclined to find female practitioners for their health care. Ultimately, gender aside, the patient wants to enlist the service of the provider with the most experience and highest expertise in their area of need. Some of the greatest contributors to the Western medical fields of obstetrics, gynecology and reproductive endocrinology continue to be male physicians. We would not consider a nonathlete unable to perform acupuncture for sports medicine, or the youthful unable to specialize in geriatrics. Bring your skill and your compassion to the treatment table - and let the consumer decide her preference.