Shayla Thompson, MAOM, LAc, Dipl. OM
In the U.S., acupuncture continues to establish itself as an effective treatment option. Many citizens were born before acupuncture was first practiced here in 1971. It is safe to assume that you will encounter potential clients who have not only never had a treatment, but also have little to no knowledge about acupuncture.
Each patient we treat successfully, especially for their first time, sets a standard of care. This exposure, along with increasing insurance coverage, will standardize our field of medicine over time.
In seven years of post-graduate practice, I have had the privilege to give 675 people their first acupuncture treatment (as of mid-2024, when I wrote this article). Not included in that number are the numerous clients who trusted me to try acupuncture again after an uncomfortable or impersonal session.
My goal is always to remedy these negative stories. An analogy I often use is that I’ve had many haircuts – some were great, others were not, even though all of the hairdressers went to hair school. The same is true for acupuncture.
As with most human interactions, communication is key every step of the way. Of course you have an informed consent, but that does not replace invaluable face-to-face explanation. Traditional Chinese medicine shines with preventative care and chronic case management, as opposed to urgent or emergency care, which should encourage practitioners to slow down and communicate.
Tongue / Pulse Diagnosis
This begins when I diagnose tongue and pulse during intake. Most clients are only familiar with Western diagnostics and assume you are looking at their tonsils or only checking the pulse rate. Describing the difference not only builds trust, but also helps distinguish the fields of medicine. It can be brief, but I promise patients will thank you for it. Below are samples of what I say:
- Tongue: “The tongue is the only internal organ we can see without cutting the body open, so its shape, coating, and color are ways we can understand the internal environment.”
- Pulse: “In addition to rate, we are feeling for size, depth, and shape of the vessel in six spots, which gives information about how to best treat your unique body.”
After the simple description, it is important to mention something you saw or felt. This is a great way to discuss lifestyle medicine. Compliance is usually enhanced, especially with the tongue because it is objective and they can monitor it on their own.
There is no need to explain everything in one session; that would be overwhelming. I generally tell them what looks good, and contrast this with one aspect they can work on. If you are not taking tongue and pulse in your sessions, you are missing a real opportunity to help your patient and highlight the genius of TCM.
Mechanisms of Acupuncture
Communication continues with mechanisms of acupuncture. Even if the client doesn’t ask, I always describe what will happen to the body during a treatment. This is another way to enhance efficacy because we are conscious beings; getting the mind on board will amplify the basic physiological response with psychology. In other words, employ the placebo effect.
Due to the partially abstract nature of TCM, I have multiple ways to describe mechanism, depending on the client. Scientific descriptions, backed by research, are always my foundation. From there, only if a patient is open-minded, I might discuss TCM theory, but not always. Below are samples of what I say:
- Science: “Needling causes microtrauma that flushes the area with red and white blood cells, helping the tissue repair and decrease inflammation. Within minutes the neurotransmitters in your brain and hormones in your blood respond by producing things like endorphins, which help with pain, mood and sleep.”
- TMC theory: “There are many things I have seen acupuncture do that I cannot explain with science yet. I believe as more funding is put into the research, we will understand more about qi, meridians, etc.”
What Patients Can Expect During a Session
Next, I make sure they understand what to expect during insertion and the rest period. The goal of incorporating all of this is to minimize their questions, potential fear, and any hesitation to receiving.
Increased transparency will help your client relax, which will result in them getting better faster. Below are samples of what I say and do:
- Insertion: For a new client I always ask if they are curious to see the needles or not. Most have a strong preference either way. Before placing any needles, I mention that there will be pressure and awareness, but that nothing should be prickly, pokey, or uncomfortable; they should tell me if it is.
- Rest: I provide all clients with a bell so they are able to communicate with me when I’m out of the room. I make sure clients know that any sensation a nerve can create (hot, cold, vibration, pressure, etc.) can be felt even where we did not place a point, and that is normal.
Many clients have reported that their treatments with me are the best acupuncture they have ever received. I believe this is not only the way I lead the experience, but also related to the empathy I have maintained by continuing to treat myself and receive treatment from other acupuncturists. My observation is that practitioners who are no longer on the receiving end become more rough and cold. Being a patient will help you better understand your patients.
Editor’s Note: Part 2 of this article (December issue) focuses on assessing constitution in first-time acupuncture clients by reviewing multiple clinical cases.
