A patient walks into your office with years of IBS and headaches. They want to feel better. You do your full questioning, make a diagnosis and give them an amazing acupuncture treatment. And then what do you do?
Do you ask them when they want to come back? I hope not! Why? Because you should be telling them exactly when they need to come back, not vice versa. If you're letting your patients do whatever they wish in terms of your care, then you are doing them a huge disservice – because they are not the expert, you are. It's your responsibility to advise your patients in their best interest as an expert.
What Patients Want: Your Expert Recommendation
One of the amazing things about our medicine is how thorough our intake questioning is. A thorough intake makes you extremely qualified to make a personalized expert recommendation for your patients. And that's exactly what they want from you – a personalized recommendation from an expert.
We think people don't want to be told what to do, but they do. That's why they came to you – not to be stuck by needles, but to have their health issue transformed.
You must make a recommendation as to when your patient needs to come back, how frequently they should be getting treatments, and give them an estimate of how many treatments they should expect it to take. This is practicing good medicine. It's just as much your job as inserting needles.
If you're not doing this, it would be like a doctor giving their patient antibiotics and not telling them how many to take or when to take them; or a doctor not telling their patient how long to keep the cast on for their broken bone to heal. It's reckless and not in the best interest of the patient.
How many acupuncture treatments will it take?
It can be difficult for acupuncturists to estimate the number of treatments it will take. (I feel this should be discussed more during our education.) It would be impossible to predict exactly the moment when your patient will experience significant improvement in their symptoms. The good news is that you don't need to predict it precisely; but you do need to give an estimation.
I teach and coach acupuncturists; these are the guidelines I give them for estimating how many treatments it will take:
There is a beginning, middle and end to a course of treatment. The beginning is how many treatments it takes for them to start seeing improvement. The middle is where you make most of the progress. And the end is making it stick. If the beginning stage takes longer, you know the middle stage will take longer, too. You can adjust expectations based on the progress you see.
My simple rule of thumb: When in doubt, I recommend telling your patients that it should take around eight treatments.
What Your Colleagues Say
I thought it might be helpful to see what other acupuncturists experience with treatment numbers and outcomes. So, I created a Google Survey and asked acupuncturists what their experiences have been – how many treatments it usually takes to see significant improvement for various symptoms. I received more than 180 responses. Here's what some of the data shows:
Other Considerations
I know there are a lot of variables we should take into account. Did the patient do herbs? How frequently were they coming in? What is their lifestyle like? If a doctorate student would like to pick up this research, that would be fantastic. I think this information is incredibly helpful for acupuncturists, and worth the time to research it properly.
Don't Doubt The Medicine
The reason I want to share the results of this survey is not to compare or make people feel pressure to get results within a certain number of treatments. On the contrary, it's because I want to take some pressure off. I want more acupuncturists to be patient and give themselves and our medicine adequate time.
I've found that too many acupuncturists are underestimating our medicine, saying things like, "Let's give it three treatments and see how you do" (or worse, not making a dosage or frequency recommendation at all). If their patient hasn't seen improvement in three treatments, they think acupuncture isn't working for that patient. Then that patient leaves thinking acupuncture didn't work for them, when they very likely could have been helped with just a few more treatments.
As a result, that acupuncturist might doubt the medicine and doubt themselves as a practitioner. It's tragic because our medicine is powerful and amazing, and I'd wager the practitioner was doing everything right except for one thing – having confidence in their medicine, and advising and leading patients in their best interest.
So please, it's your responsibility to do this. You must make a recommendation as to when your patient needs to come back, how frequently they should be getting treatments, and give them an estimate of how many treatments they should expect it to take. It's irresponsible not to do this.
Your patients come to you because they want a result. You duty is to confidently and compassionately insist, guide and lead them to receive the number and frequency of treatments that are going to help them get the most benefits. When in doubt, recommend eight treatments, not one, two or three.
This is one of the keys to your patients' success, as well as your success in practice. You won't get those word-of-mouth referrals if people aren't sticking around long enough to experience the results of your care. So, this is just a friendly reminder to have confidence in our amazing medicine, have confidence in yourself, and please dose your medicine adequately.
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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