The Unasked Questions

One of my long term fibromyalgia patients told me that a doctor had referred her to acupuncture a few years before she came to see me. She told me she waited because she felt so ignorant about the subject that she didn't know what she could expect at her first appointment.

How many other people are like this patient? How many others don't even know what to ask? Worse, maybe they asked the only thing they could think of, which is usually "How does it work?" Rather than having a practitioner turn the focus of the conversation back on them, these people may have gotten a 30-second education into the theory of acupuncture.

Trying to educate someone about acupuncture in 30 seconds is really minimizing the education that goes on in acupuncture school. Acupuncturists spend a lot of time learning the intricacies of the theory. Why do we expect patients to understand what we are talking about after a 30-second explanation?

As a practitioner, it is important to speak to the patient at the patient's level. There are people who really want to know how acupuncture works. There are other people who are asking simply because they have an interest and they don't know what else to ask. Answering the question asked rather than ascertaining what the patient wants to know misses a great opportunity at marketing and at educating the public.

If someone hears I'm an acupuncturist and they look surprised and then search around asking how it works, I'll often ask them how long they have. I explain that acupuncture is a medicine based on a very different way of viewing the world, which means the language is different from what we are used to in the United States.

Then I'll ask an open-ended question along the lines of, "Do you or someone you know have a problem you think acupuncture might help you with?" This will often illicit a response for a specific condition and I can then talk about my experiences working with other people who have that condition.

In cases of people who generalize, saying they just want to know what it treats, I often respond that acupuncture is a complete medicine that has been used for thousands of years. It has the potential to help with most types of health conditions. I may also add that most people consider acupuncture for pain conditions, but my specialty is internal medicine.

In the treatment room, specific patients may actually have an interest in learning more about acupuncture. Those people I educate more thoroughly, but I pay very careful attention to where their attention seems to be. I also try and find out the kinds of things my patients already know. The way I answer a tai qi or yoga instructor is very different from the way I answer a computer engineer or retired mill worker.

I find that using language the person is familiar is not only a teaching tool, but a tool to make them feel more comfortable in the office. Acupuncture is an unfamiliar procedure and it takes some courage to go out on a limb to try something completely new.

I'm the person who always gets the really strange questions. I have been asked if acupuncturists chant and if the patient can request we don't chant (apparently chanting was against this patient's religion). I have been asked if it's okay if they are Christian and not Buddhist. An office mate was once asked to let them use their own CD lest hers have subliminal messaging.

It's hard not to laugh at some of the questions. When I know someone is working up to a question that is off the wall, I'll usually make them ask it. They tend to know it's a ridiculous question. I want it asked first and I do my best to take it seriously. I told the lady worried about chanting that it is not typically part of acupuncture, although there may be some practitioners in the United States who also use Tibetan Medicine, which does use chanting. However, I do not use it.

Nervous patients do best knowing that you care that they are nervous and that it's normal to be nervous in an unfamiliar place. I try to say something outside the scope of the expected when I have a nervous patient. My first acupuncturist used a lot of dark humor about the needles. I realized that in a strange way that actually made me trust him more not less.

My practitioner wasn't afraid of hurting me. If it poked a bit, that was probably normal. In fact, the scary, slightly painful sensations were so minor, he could make jokes about them. I do try and honor the fears of my patients but I find myself using humor to calm down particularly nervous patients. If I can laugh at what's going on, it can't be too scary. Of course, the more relaxed the patient is, the less likely they are to have a particularly painful treatment.

Understanding that it is the unfamiliarity of the medicine that is scary rather than the needles is important. It is important to make potential patients trust, that as a practitioner, we understand what we are doing and that they don't have know everything. Acupuncture has become more mainstream, but there are still thousands of people who can be helped who won't try acupuncture because it's too scary. The fear isn't about the needles, but in the unknown and the unfamiliar. The needles, however, are an easy familiar frame of reference to be afraid of.

Acupuncturists shouldn't always take themselves so seriously. Heart centered, loving healing is important. Remember, laughter is about the heart. Being open means being able to laugh with our patients and connect with them as they go through their healing process. Our openness lets us touch the patient's spirit as they make the first steps down a journey towards better health, no matter how afraid they are.