When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
That experience opened new doors for her that would lead her to a profession based on ancient philosophy. Komarow was in the midst of applying to nursing programs with the goal of becoming a certified nurse midwife. But, she quickly changed her career course to help people heal with Traditional Chinese Medicine.
She received her Master's Degree in 1994. And, in February of 1995 she became the fourth person licensed as an acupuncturist in Virginia, and has been in private practice ever since.
"I love what I do. I've seen incredible things – people experiencing relief from pain that has been intractable, women conceiving when they had all but given up hope, people finding new strength dealing with ongoing illness, and people finding peace when life is difficult," Komarow said.
In addition to having a private practice, Komarow has been active in the areas of health care policy and acupuncture regulation. She has been part of her state professional association, AAAOM and POCA, and has served 10 years on the advisory board of acupuncture at the Virginia Board of Medicine. Komarow said she is looking to promote a healthy profession able to provide effective and safe services to the public. She keeps her peers up-to-date with her blog, The Acupuncture Observer, which explores health care policy and issues facing the profession. Komarow spoke to Acupuncture Today about what she has learned along the way and gives tips on how practitioners can advance in their private practice and for the good of the profession.
AT: Tell us about how your education in acupuncture school helped you launch your career. What are some of the important steps you took?
EK: The school I went to (Tai Sophia Institute, now the Maryland University of Integrative Health) was unusual -- students were responsible for finding their own patients for student clinic, had to have a certain number of patients return for a certain number of visits to meet the requirements, and they were responsible for scheduling, collecting payments, and paying "rent" for the use of the treatment rooms. Not everyone loved this model – it was especially difficult for those of us who did not live close to the school. But it was great training. I learned that even when people are interested in acupuncture there are the logistical issues of money and scheduling and convenience to address. It taught me to be generous with my colleagues – if a potential client couldn't come when I was available, I could refer them to a colleague. Rather than seeing it as a competition with my colleagues I saw that we could help each other.
A very important step for me was getting involved in health care policy and politics. I was in school at a time of great change for the profession, and some of our teachers spoke about the implications of some of these changes for our medicine and our profession. I was living in Virginia at the time, and there was not yet licensure in the state. I was participating in my state association, connecting with politicians, and attending hearings while I was still a student, and I was lucky enough to see our efforts succeed when the law passed just in time for my graduation.
AT: What advice would you give to those who have just graduated from acupuncture school?
EK: There are many areas that are severely under-served by practitioners. Please, consider practicing in areas where there aren't practitioners available.
The blanket rules of "if people really want acupuncture they will find a way to pay for it" and "don't discount" should be discarded. An initial course of treatment at "market rates" is going to be out of reach for significant portions of the population. Insurance is based on discounted services. Yes, find your comfortable limits, but what a person pays you does not equal how much they value acupuncture, especially if you don't consider their complete life circumstances (which are not really your business). Unfilled hours in your schedule cost you far more than hours spent treating people for a discount, especially since word-of-mouth is the best way to build a sustainable practice. If discounts get people in the door, then they can be very good for business.
Simple acupuncture is effective. Developing your skills and knowledge is a lifelong journey. Be curious and continue to learn, but also know that simple, straightforward treatments on a regular basis will help the majority of your clients. ACAOM acknowledges that it generally takes 5-7 years to establish a health care practice. I hope your school prepared you for that! There are more options than ever, so spend some time exploring them. If you are going to work in another practitioner's practice, make sure you understand your rights/the rules about being an independent contractor versus an employee.
AT: As an acupuncturist, what is the most important business lesson you have learned?
EK: Mostly, I've learned that it can be worthwhile to question some of my heartfelt beliefs. Having a sliding scale and taking myself away from judging where people "should" be on the scale has led to a busier, happier, more profitable practice. If I want a full practice, I need to find out what prevents people from choosing my practice and my services, and then do something about those things. Also, after 20 years, my business still ebbs and surges. I've learned not to panic, to take good care of myself during the surges, and to focus on learning, organizing, improving systems, and doing outreach during the ebbs.
AT: As an acupuncture advocate what do you think are some of the mistakes practitioners make?
EK: They act as though "the system" owes them a business on their own terms. They overestimate the importance of hours of training and number of credentials to the consumer, and underestimate the "leap of faith" that's required for the average consumer to make a significant investment of time and money in a treatment that is new and different. They don't educate themselves about the regulations and laws that may impact their practices now and in the future. They are too quick to take positions on complex professional issues. They see the embrace of acupuncture by other professionals as a threat rather than an acknowledgment of the power of the medicine and an opportunity to build referral sources and mutually beneficial collaborations.
AT: How can practitioners ensure the acupuncture profession remains viable in the United States?
EK: To remain viable we need to increase the number of acupuncturists and find ways for those practitioners to stay in business and serve the public. Unfortunately, increasing the length and expense of educational programs and credentialing means that too many practitioners have significant debt and significant limitations on where they can practice. Combine that with schools that hide the challenges of entering the profession and too often lack quality business programming and alumni support services, and we've got a perfect storm. Students go into debt for educations they may barely be able to use, and people who want acupuncture may be unable to find a practitioner convenient to where they live.
AT: What do you think is the most important business lesson most acupuncturists need to learn early on in their careers?
EK: You are, in effect, selling a service. If people aren't buying it you need to figure out why not. And your first attention should be on the things you can do right now that can overcome those challenges. Also, a few good referral sources can make a huge difference in the success of your practice.
AT: What tips would you give a new acupuncturist trying to build their practice and get into their own business venture?
EK: The Acupuncture Observer isn't really a business venture. So far it is my charitable contribution to the profession. I suppose it's taught me to set my priorities. My advice would be to focus your energy on the most efficient way to get you where you want to go, while still keeping an eye on the big picture.
Editor's Note: These are all personal opinions of Elaine Wolf Komarow, L.Ac. and do not reflect any official positions of any boards or organizations with which she is affiliated.
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.
| Digital Exclusive
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?
| Digital Exclusive