Category Archives: Acupuncture Practice Building

AAC To The Point - Lorne Brown

Re-opening and Bringing Patients in the Door Now

Click here to download the transcript.

Thank you again to the AAC for inviting me to present on these informative webinars. My name is Lorne Brown. I’m a doctor of traditional Chinese medicine. I am the Clinical Director of AcuBalance Wellness Center, I’m the founder of healthyseminars.com, and also the author of Missing the Point, Why Acupuncturists Fail and What You Need to Know to Succeed.

Today’s webinar, I have a special guest, Chen Yen. Many of you may know of he. For those that do not, a pharmacist by trade. Entrepreneur is her gig now. And she’s been helping health professionals for years be successful and build their practices so they can be of service to their community. Because as you know in my book, Missing the Point, when the yin and yang are out of balance, when it’s all clinical, you don’t have the business skills, even though you have the potential to help so many people, if you don’t have a running clinic, if you don’t have patients coming in, you’re not able to help them. And she’s created a business around helping people like ourselves so we could thrive and see the people that we want to serve.

And so, I asked Chen Yen to come in because she’s been sharing a lot about reopening your practice. We’ve been in isolation for a while because of COVID-19. And now as we reopen, the question is how do we invite and bring back patients into our practice, how do we build our practice. And so, what I plan to do now is I’m going to cue up a video in a moment of an interview that I did with Chen Yen. And the reason she’s not alive is right now she’s in Taiwan,. and it would have been in the middle of the night for her, for her. But again, her being and having that entrepreneurial spirit.

Just the other day, we got on the Zoom, we did this recording’s about 13 minutes. And she’s going to share with you marketing strategies that are working in this climate, some of the strategic planning that you could do now in the coming months, and then just some of the critical keys to bringing your patients back into your practice. And then after the video, I’m going to share with you what I’ve been doing in my practice at AcuBalance in Vancouver. And so I’m also going to share how we reopened and some of the things that we’re noticing and that we’re doing so we can be of service to our communities. So, let’s start that video now, and please stay tuned because I’m going to give you about five minutes after this some more pearls to support you in your reopening.

… how helpful acupuncture. You talk about how helpful acupuncture is. So, those are …

So, what are some of the marketing strategies that you’ve been sharing in your mentorship that you can share with our audience to help them, again, get their practice going and attractive again to patients that are, well, now that their practice is open. So, I’d love to hear some of your marketing tips, because I know that you got some gems.

Yeah, so I would say at first looking at low hanging fruit, and then looking for new areas of opportunity to reach potential new patients. So low hanging fruit, a couple of key things. One is how can you keep your existing patient base in understanding of how just overall even outside of these COVID-19 times the different health issues that could be beneficial to where acupuncture can help with. And then reminding people to book appointments if they want to come in. So, for example, in our opening email templates. So, you can send out emails, you could send out texts. You could also be educating or encouraging people to come in on Facebook or social media posts if it’s kosher with the laws of your state and profession to be doing things like that. And then in terms of emails, for example, it could be book your appointments.

And so, what I was going to say about emails is, first, a piece about something that educates about the issue, and then something with a call to action with a reason to come in. So, for example, it might be book your appointment now and get in for first line … I mean get yourself first in line for your choice of appointments as we’re reopening here, or it might be something like take care of yourself by putting yourself first and book an appointment, especially still as important now to take care of your health as it has ever been, or it might be that book your appointment space because of the health issue that you’ve been having that you haven’t been able to get checked out or get help with until now because we’ve been closed. So, there’s just kind of a reason why to be rebooking that that is brought up, and that can be helpful.

You could also look at collaborating with other practitioners. So, our clients who’ve been doing really well in getting referrals from other providers, whether it’s medical doctors or other kinds of practitioners, holistic practitioners, other kinds of practitioners is as they reopen, many times they had a good relationship with them even prior to opening. So, if those of you who have relationships with providers who’ve been referring you before, reaching out to those providers and reminding them that you’re there and how you could be of benefit to their patients is one way to go.

If you haven’t had a relationship with other providers before, for example, maybe you would like to be getting referrals more from MDs because medical doctors could be a great source of referrals for you. They have many patients who could benefit from what you have to offer, but many times their patients don’t really know about you or the doctor doesn’t really think about referring people to.

So, what can you do in those situations to build new relationships? So, something that I was working with one of my clients on was to create a short video. Because the thing is, doctors are really busy. Right? And so, if you’re able to create a very short couple minute video that starts to explain something about your area of expertise and some research tied into why this could be beneficial for those kinds of health issues or with helping support immunity, then that can also be sent off to a physician. And that way it’s just you’re more on the top of their awareness. So, really, the key is concise, short, and really to the point of how you can help their patients get better outcomes.

Another thing is to look at … you can look at interviewing other practitioners, too. So, in times where people are getting back into reopening, there’s a lot of opportunity for you to collaborate with other practitioners, because people still need help with their health issues, whether it’s during these times or not during these times of COVID. And so, it’s a matter of how can you continue to educate the public about different kinds of issues and what your services can really help with and your modality. And so, then being able to collaboratively interview other practitioners about, perhaps in particular, health topics.

So, looking at whether it’s interviewing medical doctors or nurses, nurse practitioners, tied into the different of health issues that you treat can also bring in more visibility for your practice. And it can automatically be an opportunity where if you’re interviewing another practitioner, you can encourage them to share that interview with their patient base, too. So, you’re ending up being able to reach more people with your message collaboratively there. So, that’s more of, I would say, lower hanging kind of fruit, because it doesn’t take up a lot of your energy and time to really set up.

And then other kinds of things that you can look into beyond that initial low hanging fruit could be writing Facebook ads. So, I’ve had clients, acupuncturists, who are running a combination of Facebook ads that are bringing them … It’s amazing the kind of return on investment that they’re getting for it right now. And it’s a combination, as far as what’s working right now, combination of Facebook Live video with using some of the strategies that I work with our clients on, being really strategic about what’s said in the video, plus Facebook posts alternating with that. And then, again, getting people educated, getting people to build that relationship with your practice. Yes, and then also having people be interested in booking.

Another thing is anything tied to speaking. So, we talked a little bit about interviewing. And whether it’s during these times or beyond these times, one thing that you’ll always have is your mouth. And one thing you will always have is what’s in between your years, which has been all the knowledge and training that you’ve garnered all over the years and the expertise that you have which could still be helping people, even if your practice was to be closed down in the fall, because we really don’t know if that might happen. And so, when you are able to continue to educate just as it were pre COVID-19 times as well, the more you’re able to educate people and reach more people. There’s still people who have a need and can benefit from your services. So, anything tied to speaking, for example, webinars, doing interviews, doing podcasts can be good online. And then as we get back into reopening, even doing small kinds of things even with just a handful of people can still be helpful to … to be helping others and your practice.

And then one thing I would say in terms of marketing wise. Whatever you do, there’s an education process involved. And a couple of quick tips in terms of as you think about … Because have you ever, whether it’s written an article or you have spoken about something, you’ve educated people about something, or you’ve done whatever, think about all the kinds of different marketing that you’ve done in the past. Have you ever felt like you have been so good with teaching people about things, but then they don’t necessarily book? So, here are a couple of questions that you can think about working into what you educate people about so that they end up getting more interested in booking and coming in.

Let me actually just show this to you also briefly, to pull this up here for you to see as well, which is … Let’s see here. So, this is the five stages of the buying process. And so, people need to first have awareness about that they actually do have a problem. And then they might be considering it and looking into different options at the next stage, but they’re still gathering information here. And then then they might be evaluating, for example, in terms of, okay, maybe this option and this option, what are the details of that and which provider am I going to be seeing. Then finally, more of the decision making and then the post-purchase evaluation.

But what sometimes we don’t think about as much is that there might be people in different parts of the spectrum, whether from problem awareness, who don’t even realize they have a problem, right, or they are further along in the process, but they don’t really understand what to look for between different providers and that kind of thing. So, whenever you’re making educational kinds of things available to people, think about what different stages that they might be, and how can you provide content or educational things that can help educate in those areas.

And one thing, also, a couple of quick questions to think about would be like, what do they need to believe about their health, or what do they need to believe about themselves? What do they need to believe about you? Because if these questions aren’t answered in a way that they feel comfortable with, they’re not going to come in, no matter how helpful you talk about how helpful acupuncture is. So, there’s just a few quick tips about as we look at marketing and reopening that are working well for our clients right now.

Chen, I want to thank you very much for those tips and points. And I think we’re going to have to get you on healthyseminars.com so we can spend more time with you, because we just got a little bit and this was quite valuable. What’s the best way for people to reach you? Because I’m familiar you have like the Introverted Visionary website and your Fill Your Holistic Practice. Can you share the best website so people can get more information and learn how to contact you, please?

Sure. You can go to introvertedvisionary.com/AAC. And so, introvertdivisionary.com/AAC. And then you can … I’m going to make available some templates that are going to be helpful for you, for example, reopening email templates that you could use for email or texts. And also, we brought up a couple of situations of what people might be concerned about with coming in. And there are other ones that I’m going to share with you as well that acupuncturists clients of ours have been experiencing. And then also like a cheat sheet for that, right? Like how do you address these kinds of common objections that people might be having about coming in as well. So, I’ll include that.

Excellent. So, to be continued, she’s going to provide us with more value. So, you just go to introvertedvisionary.com/AAC, and she’s going to have some more handouts for you to help you prepare yourself as you build up your practice again, it’s great news for most of us just to remind everybody that you’re not starting your practice over again. You just kind of took a holiday that you didn’t choose to take, and now people are getting ready to come back. And these are just great tips that you can use any time of your practice, not just after a pandemic. So, Chen, I really appreciate you making the time to tune in and share this with our audience today. Thank you very much.

Yeah, it was great to be here today. Thanks for having me here.

Great. And we’ll get you on Healthy Seminars so we can get you to expand on a lot of this and more, because you’ve got really good marketing tips. And for the introverted, because a lot of people don’t want to do public speaking or they say, “I can’t, I’m not outgoing. I can’t do this.” And I know you’re introverted and you have techniques and tools for people that want to educate, but feel I’m too shy to do that. And the takeaways here from earlier on, you talked about outreach. So, email contact, like start contacting your patients on a regular basis again. You talked about education, so keep educating them on the benefits and what you can do to support them during these times. And you talked about collaboration as well. So, collaboration is great. And some of the way you even outreach is through webinars, Facebook, emails, talks, so that’s great. So, thanks for sharing those tips with us today.

All right. So, again, thank you to Chen. And as I promised, I want to add a few more pearls for you guys as you open up your practices. Some of you are getting ready to open and some of you have. So, in my clinic at AcuBalance, and just to prepare some of those that are just getting ready to, I will let you know that it was more stressful in the preparation of getting all the PPE, all the safety equipment and policies in place than it actually was implementing it, so that’s great news. If you’re really overwhelmed about what’s going to happen, it’s nothing like … it’s much worse preparing for it and anticipating than it actually was doing it.

Now, what we did at our clinic when we started, we opened up on May 19, so after being closed for two months, and we decided … So, I’m going to share with you the attitude because it will make a difference for how you experience your reopening, and then I’m going to share with you some tips on rebuilding your practice. So, first of all, our attitude was safe, soft reopening, emphasis on safe. So, we got all of our equipment, we set up our policies, and what we did is we chose to open up our clinic at 25% capacity only. And we did this so we could be calm as we cleaned rooms and figured out how long it took getting our masks, getting the patients to sign their consent and wash their hands, all that stuff, we didn’t want to feel rushed or tense about it.

So, we really set up that first week with very little expectation for profit. We did not care, actually. Our goal was, let’s be safe and can we be of service to others? So, that’s what I invite you to have that mindset. You’re not going to have when you reopen, most people are not going to have what they had pre COVID. And so, just to have that expectation, to be kind to yourself so you can enjoy this reopening. And so, we were a soft, safe launch.

And so, that first week at 25% capacity only, it allowed us to work through our policies and see where we could streamline things. And then the second week we were open, we went to 50% capacity because we saw now how quickly we could clean the rooms properly and put patients in and out of the rooms. And a big part of the process for us was for the physical distancing. Everybody has their own room, so they’re distanced. And we’ve timed it so we don’t have a bunch of people in the waiting room. However, the key was in the clinic how the doctors are all situated so we had physical distancing. That was what the main criteria was, how is it that we’re in a clinic all day that we’re properly physical distancing as much as possible.

And I will let you know because our energy was calm, the patients that came to us … I was going to compare it to a colleague that had a different experience. We came in with the attitude of service to others. My colleague came in needy, like, “I need to be busy now,” pretty stressed. Our patients came with their own mask. We asked them to, and almost everybody came with their own mask. Now what we did is we bought cloth masks and we had surgical mass. The doctors all wear the surgical masks, our patients can choose surgical or cloth, but they must wear a mask in our clinic, that was one of the recommendations policies we have. And if a patient did not have a mask, they had two options. One is they could get a surgical mask which they take with them, $2 fee, or they could get a cloth mask. And if they leave the cloth mask for us to laundry, that it’s free. If they don’t leave it and they want their own, because some wanted their own, it’s a $5 charge. So, we just passed the cost onto our patients. We had zero complaints.

And our patients were great coming in. They were so happy to see us. The energy was great. They signed the consent. And it’s been a very positive experience for my team and my patients. And we didn’t come in like needy, “We need to see our patients.” We came in, “Let’s be of service to others. Let’s see who’s ready to come back out of isolation here in British Columbia.” Where my colleague really tried to pressure their patients to come back and was coming from neediness and they were quite stressed and stressing out their patients, their patients were fighting about the mask. It was just a totally different experience. And I believe the reason is the attitude, the vibration energy that you’re putting out, for one.

Now, when patients contact us and they’re a little stressed about what’s going on, we educate them. So, we let them know all the things we’re doing, all the cleaning, et cetera, how we’re doing the physical distancing, what we’re doing to minimize the risk. But what we’re not doing is telling them, “Oh, come, don’t worry. You’re going to be safe.” Actually, we do the opposite. If any patient comes across on the phone or email as concerned, worried, or stressed about COVID and coming to our clinic, we encourage them not to come because we know we can’t guarantee your safety. All we can do is minimize the risk as best we can, and that does not mean that COVID will be prevented. We can’t guarantee that, we cannot do that, nobody can do that.

And so, we realized half the population … I’m making up the number … but half the population will be comfortable coming into our clinic and half the population will not, but they all pretty much want to know what we were doing for safe measures. So, rather than trying to over impress them, like “You need to come in and this is what we’re doing,” we let them know all the safety measures we’ve put in place, all the systems we have in place. And they get to even see it on the back of one of the doors where they’re in the room, the door that holds the needles, there’s a checklist to show that the practitioner’s checking off all the cleaning things we do so it’s not forgotten, we have a system, and they get to see that.

But we don’t pressure our patients to come back. If their worried, we say, stay home. If you’re worried about COVID, then do not leave your house. As soon as you leave your house, you’re put at risk. And because we’re not pressuring them to come in, a lot of those patients, once they hear what we’re doing, still choose to come back. And those that are really worried, we don’t want them in the office. We don’t want that energy, that tension in the office anyhow. And so, we realized some people are going to be ready early on to come back and some people not.

The other thing I want to remind you is, it’s still the same education marketing practices you always do. People are going to come and seek you out if you are a benefit to them, if you are a value to them. So, it still goes back to the same model of just good education. Now what I think is important is to work on the stress response that your patients are going through. Because of the change in the loss of control and some loss of liberty in a very short period of time, some people consciously are aware of their anxiety and stress and some people are not. So, if you ask them first to educate them about stress and how it impacts the immune system, how stress impacts sleep. So, check in with your patients via email or phone calls, “How’s your sleep, your digestion, muscle tension or headaches? We know how it can lead to inflammation which can cause other health issues.”

So, maybe your patients, like Chen said, that first thing, maybe they’re not even aware they have a problem. So check in. Are your patient’s having sleep issues? Are they having digestive issues? Are they having muscle tension, headaches? See if they’re having these and let them know, this could be related to stress and how you can support them in reducing the stress, because we know stress, exasperates many diseases and leads to many symptoms. And so, your goal is to help them with their quality of life and to show them that you have value and you have tools.

Right now, conventional Orthodox medicine does not have a solution for COVID except for isolate as much as you can, right? Physical distancing as much as you can. And so, you can educate them on the lifestyle and things that they can do to help give their body the best chance of being healthy, radical well being. We’re great at talking about diet. So, you can set up consulates for diet and lifestyle, exercise, sleep, and meditation, acupuncture for circulation and stress reduction and hormone balance. So, there’s a lot of things that you can do to help with the radical well being.

And that way if they are out and about, at least their relationship with their environment, because that’s what we’re doing with Chinese medicine, is strong so they can hopefully handle whatever comes into their external environment, whether it’s CNN News you’re watching causing stress, or it’s a virus that’s out there, that your body is at its peak radical well being so it can deal with it as best as they can. And you can’t tell them or promise them that if you come to my clinic that you will prevent COVID or you’re treating COVID, because there’s not evidence that exists yet that you could do that. However, you can definitely help them with radical well being.

A great example is obesity. We know in general obesity leads to many health issues and diseases. And with COVID-19, we know obesity is a comorbidity. That is not a good thing to be, no matter what your age is. If you’re overweight, this is a time to lose weight. So maybe in your practice, you can start doing getting fit and healthy in the summer so people have the best chance of being healthy, whether they get any virus including COVID-19.

So, remember, people choose you because they see you have value, you have benefit. And so, first of all, do you have value and benefits? So figure out where you do, because you do. And then communicate. As Chen said, send out emails, do talks, collaborate and do stuff, and just take your time. The good news is, for most of you, this is not like you just started your practice. You had a forced holiday, as I mentioned in the video, and now you’re reopening, and people are just getting comfortable in certain places where you live to go out.

And so, read the room. Don’t dismiss their concerns or fear. If you can read the room and realize some of your patients, even though you may not be, are very concerned about this pandemic and come to your clinic. Hear them, and hear their concerns, and validate their concerns. Let them know what you’re doing to mitigate risk and be transparent and let them know that you cannot guarantee safety. And if concern or safety is their main issue, then they should stay inside. Okay? They should isolate. And if they’re comfortable going out to the grocery stores and other things that are not essential, grocery store is essential, but if they’re going out, then they may be comfortable coming to your practice as well.

And you want to keep your safe, so have your boundaries with your patients. We have some patients that don’t believe mask waring is necessary, but it’s a policy in our clinic. We don’t challenge their beliefs, whether masks are valid or not. The science as you go, as of today, the science is masks can mitigate the risk because it limits your exposure time. The amount is dosage and time. So, if you’re going to be in the room with somebody for 20 minutes, 20 minutes without a mask is much more exposure than 20 minutes with a mask, and so that’s why it’s being recommended. And in our practice, it’s okay if you don’t want to wear a mask in general and you don’t believe in masks. However, you can’t get treated in our clinic at this point in time unless you wear a mask. That’s not negotiable.

So, we have our policies, we’re strict with them. And so, I encourage you, too, to have your policies, have kindness in your heart, focus on being of service to your patients. Don’t worry about your bottom line now. In July, hopefully your practice is definitely back and you’re seeing it profitable. But if you just opened in late May or beginning of June, just be of service to people, educate them, be a value, and trust within a few weeks you will be back to hopefully 75% or more of what you were before COVID and profitable again. And therefore you can exist and be of service to your community, which this is all about.

If you’re looking for more information on COVID-19 and being back to practice. Under the healthyseminars.com website, it’s healthyseminars.com/resources., we have several past talks, verbal and acupuncture, and more coming up. We’re constantly listing them all the time. We’ve got lots of free resources for you, stuff on telehealth as well. So, do check out healthyseminars.com. And also, if you’re looking for all my assets, my clinic information, Healthy Seminars, and the conscious talks I do on lornebrown.com, go to that website, lorenbrown.com, because that links to all the things that I’m involved with.

Again, I want to thank you for listening. I want to thank the AAC for inviting me for this practice management series. Some of you don’t know, but my background before a doctor of Chinese medicine is a CPA, so a public accountant. So, I like to bring both hats to the room for you guys to share both as a clinician and then as an entrepreneur and accountant so I can share what I know with you so you can be prosperous and successful and serve your community. Stay tuned to next week’s webinar because there’s more coming. AAC’s got great webinars and they got great hosts. So, make sure you come back, like their Facebook posts, and tune into their next webinar. Thank you very much.

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Jeffrey Grossman Thumbnail

5 Actions You Can Implement NOW To Prepare To Reopen

Click here to download the transcript.

Hi, folks. Jeffrey Grossman here from Acupuncture Media Works and AcuPerfect Websites. I am thrilled to be here. Thank you American Acupuncture Council for inviting me on here to conduct a program on their To The Point live training series on Facebook. I’m really glad to be here. I’m really glad to be a participant and a presenter here. We’re going to be doing some future programs, and I’m going to be talking about creative solutions to grow your practice using simple, effective, and sleaze-free strategies. I know that marketing is something that is imperative to help you grow your practice, and I also know that as an acupuncturist, you might not be that thrilled to participate in the marketing world.

But yet as an entrepreneur and as a healer, that which you, everyone who’s watching this who’s an acupuncturist, you are both of that, you will need to participate in and embark on and embrace both hats of being the entrepreneur and the healer. My goal through this program that the AAC is putting on is to provide you with some tools moving forward to help you market your practice, attract patients, reactivate your inactive patients, and to essentially grow your practice in a way that makes you feel comfortable, that allows you to reach some of the goals that you want with growing your practice, and to achieve some of the financial goals you’re looking to obtain with helping more people in your community with this beautiful medicine.

Again, thank you American Acupuncture Council for having me here and inviting me on as a presenter. Today, I want to talk about five different actions that you can implement now to prepare your practice to reopen. I also want to talk about a couple of things that you can be doing now to pivot your practice, so when this crazy time happens again, hopefully it won’t, but my feeling is that we’ll be going through waves of what we’re experiencing now with this crazy pandemic. One of the things that I want to encourage you all to do is to consider about different ways that you can pivot your practice now so when things happen in the future, you’re already there. You’re already prepared.

You already know what to do and how to keep the patients flowing and some finances coming in based upon what you’ve doing now to prepare yourself for the future. One of the things that’s really important is that it’s important to market your practice now while the competition is low. Because a lot of people right now are pulling back their marketing dollars and all of their marketing outreach because they’re scared or they’re frightened or they want to save and conserve money. But I really feel that now is not the time to be conservative in your marketing efforts. In fact, I think you should be putting a lot more energy into that right now, and I’ll talk about a couple of things that you could be doing in order to make that happen.

One of the things I also feel is really important that you could be doing right now is to educate yourself now on what you’ve been wanting to learn in the past. Whether or not you want to educate yourself on website basics or email marketing basics or specific acupressure points or tapping techniques or things of that nature, those are some important things that you could be incorporating in your life right now during this time that we have to reset and refocus because we’re forced to stay in doors, to really tap into those things that you’ve been needing to do in your practice. Five actions that you can implement now to prepare your practice to reopen. One of the first things that I really encourage you guys to do would be to maintain your digital awareness in order to stay on top of mind awareness.

The biggest thing I want to encourage you to do right now, which many of you may have been putting off and many of you may have already been doing this already, is to evaluate your website. Now, why evaluate your website? Well, good question, because your website is the calling card that everyone is going to be looking at and tapping into whenever they hear about you. Any future referral or any future word of mouth or any type of marketing that you’re going to be doing in the future, everyone is going to be going to your website. It’s going to be important for you to take this time to use it as wisely as you can. One of the things that I suggest you do is to make whatever improvements need to happen to your website now. Here are a couple of things I want to encourage you to do.

Explore your homepage, okay? What happens when people visit your website? What is the first message that comes across to them about what you do and what you have to offer for them? Is it easy to navigate? Do you have a message that comes across to them when they hit your website? Do they know that you’re a specialist in sports medicine or a specialist in fertility or that you’re amazing in helping support immune health or that you’re really good for stress and anxiety relief? Many of you might not be specializing right now, but I encourage all of my students in my practice management class and all of the practitioners that I’m mentoring to figure out something that they can specialize in.

The reason is is because every acupuncturist is trained to be a general practitioner, which is great. We can help so many different conditions. This being a specialist means that you are able to focus your mind, your money and your communication processes and your messages on specific niches. That’s one thing I would really encourage you to do. Also, make sure that your blog posts are current and up to date. Maybe you could take some time to write a couple of blog posts now about immune health and about staying calm and about how to be productive, what points are good for immunity, what points are good for keeping you stress-free, and what points are really good for helping you stay motivated and productive. Okay?

Also, you want to check to make sure that your website has multiple calls to action. If you’ve seen any past webinars or trainings that I’ve done, you’ve heard me talk about calls to action. These are specific calls that are on your website that make people take action. Maybe you people visit your website and they might not schedule with you right away, but maybe they’ll give you their email address in exchange for a free eBook on immune health, or maybe they will click to download a low cost complementary evaluation or exam that you may be offering. On your website, you need to have multiple calls to action, little buttons that say, “Click here for this. Click here to schedule for this. Click here to download this.”

If your website doesn’t have that, I encourage you to take that into consideration. One of the first things I really want you to do is to audit your digital awareness and evaluate your website. If any of you are interested in getting a free website evaluation, feel free to put some comments in the box below the videos here and I will reach out to you. I’ll have some team members reach out to you to provide you with a free website evaluation because that’s something that we do that’s near and dear to our hearts. Okay? The next thing that I think is really important for you guys to do is to tap into some technologies now that you can learn how to use and learn how to work with your patients that you could use now and also into the future.

Because, like I said, I don’t think that this is a one and done kind of thing. I think this is the kind of thing that’s going to be coming back to us. Telehealth, that is the big buzzword these days. Doxy.me is one of the easiest platforms that you could be using in your practice. It’s really easy to set up. There’s no downloads that need to take place. Clients, they just click and they access your telehealth portal. Exploring technology is important. I think one of them would be making sure that you’re familiar with telehealth, and the other one is to do videos.

I think doing something like this where you could actually put on a camera or use your phone and sit there and educate about immune health or educate about tapping specific points for calming anxiety or stress or improving insomnia or helping to support the immune system. You have so many tools at which to educate and teach on. Don’t hold back, okay? Maybe you’re scared about getting in front of a camera or maybe you’re scared about what you should be saying. But the thing is, I feel like this whole crisis that’s been happening now, people are becoming less judgmental and you don’t need to be a model and look handsome and beautiful in order to be behind the camera.

Just showing up and being real and offering really solid content and making sure that you’re there to support your community, people will get that. They’ll really resonate that with you. I encourage you all to tap into the technology of using videos for your marketing prospects and to help grow your following. YouTube is the way to do that. There are so many different ways. You could turn on your iPhone and take a couple of videos. You could have other friends and family members or other practitioners even interview about a couple of things. One of the things I would encourage you all to do is to jot down some of the points that you know that are really great for supporting immune health, right?

You could name a few off the top of your heads, and put together a short little video. It could go something like this. Hi, my name is Jeffrey Grossman, and I want to share with you about how acupuncture and acupressure can help support your immune health in these crazy times. I’m really committed to helping people in our community to stay well and to stay healthy. Many of you might not be aware of the fact that acupuncture is really great for supporting immune health. What I want to do is I want to walk you through three acupressure points and how to use those points to stimulate immune health. That’s it. Really super simple, right? That’s one video I would definitely encourage you to do.

Also, those of you that work with herbs, what herbs are in people’s kitchen right now that can help with lung health or coughs or immune health or raising the chi in any way? I am sure you can think of some. Do a video on these kinds of things, okay? Those of you that are frightened about doing any types of video, but you want to do them, again, drop a comment below here and I’ll reach out to you because I’m committed to helping practitioners find success during this time and to overcome some of the fears that are keeping you back because this is the time to not be stagnant, right?

This is the time to tonefy and to move forward, to move your cheese so you can get out there, so when this whole thing is over and it’s going to come to an end and it looks like there’s a silver lining on the clouds right now, for many of us in the different states that we’re at. Things are going to eventually get back to normal for the most part, although there’s going to be things that aren’t going to be as normal as they are right now. I’m encouraging you to tap into these things that might make you feel uncomfortable. Because when you hit up against that wall of discomfort, you know you reached your limit, but moving beyond that is where you need to go. It’s not that hard to do. Okay?

You need support, you need some mentoring, you need some guidance, and maybe even just a short little script or some ideas on how to do that. That’s what we’re here to do and offer you. All right? Technology is really important to tap into, telehealth, putting up some videos, and also email marketing. It is the lowest hanging fruit that you have right now in your practice. Most of you that are listening to this have some semblance of an email list for your patient. Use it. All right? Tap into this knowledge. Again, if you do a video on immune health, you could use that same content to put on your website, to put on your social media pages, and to also put as an email to your patients. Because what else are you doing?

What else are they doing right now? If you’re providing solid content with them that is encouraging and engaging and inspiring, they’ll eat it up. They’ll really enjoy that. Sending emails out to your patients now is really important to stay in top of mind awareness so they don’t forget about you. Because if you’re not doing it, somebody else might be and somebody else is going to be getting in front of them. When this whole thing blows over, they might not come back to you because somebody else kind of captured their attention. Don’t lose their top of mind awareness of you. Okay? You want those people back. All right? The other thing I want to talk about, one of the other actions that you can be taking right now is to tap into your goldmine. Okay?

Now, your goldmine are the people that already know you, like you, and trust you. Those are the patients that you already have in your practice. Now, I want to encourage each and every one of you when I’m done with this video is to write a list of all of your A patients. Your A patients are those patients that you love. Whenever you saw them on your schedule, your energy raised up. You’re like, “Oh my God, I want to clone my practice with every single one of that kind of patient,” right? Those are your A patients, the ones that raise your chi. Now, your C patients, the ones when you see them on your schedule you’re like, oh my god, how am I going to do this? Okay, I can muster up that energy. It’s the end of the day. Okay, I can do this. I can do this, right?

Maybe some of you are giggling right now because you can resonate with that. Make a list of your A patients and call them. Simple conversation to have. Here it is. Hi there, Jeffrey. I am just checking in with you. I miss seeing you here at the clinic, and I just want to see how you and your family are doing during this crazy time. I also want to let you know that there are a couple of new offerings that I’ve been tapping into here at the clinic. We are now offering telehealth, and I’m hosting a class on four points to support immune health. I also want to share with you on certain specific herbs that are really helpful that you probably have in your kitchen that can help support your immunity. That’s the conversation. Just call up your A patients and just check in with them.

In my group mentoring class that I run each month, people are doing that, and the practitioners are surprised that they’re getting such a great feedback from their patients. They’re like, oh my God, thank you so much for reaching out to me. How many other doctors have reached out to you during this time? I mean, I imagine probably none. Okay? For your patients to hear from you when you’re just, “Hey, I’m just checking in and seeing how you and your family are doing. I want to let you know about some really cool offerings that we’re having here at the clinic,” that’s cool. That goes a long way. Make a list of your A patients, reach out to them with a phone call, and then with a follow-up email, simple conversation.

Really that’s all we need to have with them. The other thing I want to talk about would be consider diversifying your offers. Okay? Now, what do I mean by that? By diversifying your offers, what else can you think about that you can offer now and in future times when we might have to close our practices because of this craziness that you can offer? Can you offer herbal consult? Can you learn about EFT tapping techniques? Can you learn about specific acupressure points that you could teach more deeply and more widely? Can you learn about like breathing techniques to stimulate the chi or qigong? Okay?

What kind of off things can you offer now and in the future that you can potentially charge for, that you could teach online classes for when and if we get to this place again where you’re seeing your patients through the internet? Okay? A couple of things that you might want to consider too is offering more retail. When this whole thing is over, one of the things that you could be selling still would be herbs that get drop shipped to your patients and retail like supplements and other types of things from like Emerson Ecologics that you could drop ship to your patients. That’s a great way for you to generate a little bit of income now and to still be in top of mind awareness of your patients.

I want you to ask yourself what kinds of changes can you make today that will manifest for you now and also into the future? Because I think this is going to happen and I want you to be prepared. I don’t want you to get stuck and like become a deer in the headlights at some other point. Okay? I want you to be prepared now. Where can you pivot your practice now in order to come out of this positively in the way? Don’t get stuck. Don’t stop marketing. Don’t stop the communication process now. Stay in top of mind awareness however you can in order for your patients to remember you and to be reminded of all the good things that you have to offer them. Don’t assume that everything’s going to go back to normal because they might not. Okay?

Determine what you can do to survive and thrive during the now and also how you’ll come out of this in a powerful way and into the future. Thank you so much again for the American Acupuncture Council for hosting me on the first training that I’m working with you guys on. Thank you everyone for watching me here. You can reach me at jeffrey@acupuncturemediaworks.com or in the comments below here or even through our websites at acupuncturemediaworks.com or acuperfectwebsites.com. Feel free to reach out to me there. Make sure you join us next week for the next To The Point by the AAC. Thank you guys so much. I really appreciate it. Stay strong, stay connected, stay focused, and do not stagnate. Okay?

Do what you can now in order to manifest your future, so when this whole thing ends, you come out of this smelling like roses. Be strong. Stay healthy. Talk soon. See you next time. Bye, bye.

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Dr. Virginia Doran

Using Chinese Herbs in the Various Stages of Toxic-Heat Invasion

Hi, I’m Virginia Doran, your host this week for To The Point, a show very generously produced by the American Acupuncture Council. We had another show scheduled for today, but considering the time that we’re living in right now with COVID-19, we decided to have another guest, and that is someone that many of you will be familiar with, Jake Fratkin. He’s going to talk about Chinese herbal treatment in different stages of the virus and various practical tips of products that are available from various sources. And he’s been an educator, an author in the field for decades, and practices out in Boulder, Colorado.

Many accomplishments, too many to list here, maybe he will enlighten us, or you can see on his website. And because there’s so much information to cover, I want to turn it right over to him. So, Jake, please inform us practitioners of your ideas for Chinese herbal treatment for this virus.

Okay, I’m ready to talk. Am I on? I’m on. You can hear me. Okay, so hi, everybody. I want to thank the American Acupuncture Council for inviting me. It was kind of short notice, but I’m happy to share the information that I’ve been pursuing about how to address the various stages of the virus with Chinese herbal formulas or herbal products. Now some of you out there do raw herb customizing or work with powders and do raw herb customizing, and so about the half the information or more is going to be directed to you, because you have the ability to customize formulas to patients at the various stages.

If you don’t customize formulas, you have two choices, one of them is to get herbal products that are already made and we’re going to talk about, or to ask one of the companies that does make formulas like Crane, and Lotus, and Mayway, that they’ll make the formulas up for you to give to your patients, so that’s one caveat there. We have a lot of groundwork to cover. I am certainly not going to go into detail, but the whole PowerPoint lecture that you’re going to see can be downloaded off my website. You’ll see it. If you go to my website you’ll see it in the lower right-hand corner, the way to download the lecture notes from this lecture. So that’s what we’re going to do.

And that’s called fratkin.com?

No, it’s at the end of the lecture, but it’s drjakefratkin.com.

Okay.

D-R, no period. Okay, let’s get started.

And you know, we want to just remind our viewers if you don’t have Chinese herbal training then you shouldn’t be doing this. You will want to do everything in accordance with your license in the states where you live or licensed in. And we’re not curing, and we want to be very careful not to state or misinform our patients that we are curing.

Yeah. The COVID-19 virus is very patent-protected by the FDA. You can’t advertise that you’re treating COVID-19. You can’t mention the words, because they will go after you, so I’m just calling it toxic heat invasion and working at it from there. I don’t know if my PowerPoint’s up because on my screen I can’t see what’s exactly up. I don’t see my face yet.

They’re not up yet.

They’re not up yet. And is my face up on the screen, or no?

Allen says they are up, but I don’t see them yet.

Yeah, you have the yellow box around you, but I don’t. So I don’t know if my face-

He says we’re up.

So I want to get my face up. I want to get the PowerPoint up. So let me know when you see the PowerPoint, Virginia.

Okay.

Do you see it? No.

No.

No. Okay, let’s just start it now.

Allen, you see it, but we don’t.

Okay. In general, the worst is going to come starting in about two weeks. Some of you may be seeing corona patients right now. I am over the phone. Everything I’m doing is by phone, webinar, phone consultation, and then I’m working from the material to send people herbal products. Now the way I work is I combine herbal extract powders. I use extract powders, and when I make a formula I make 100 grams. So I never like to make a formula that has more than 10 or 12 ingredients in it, 12 would be my max just because in 100 gram mix, you just can’t get the strength of enough herbs if you go more than 10 or 12 herbs. In a decoction you can put in 20 or 30 herbs, they don’t care, you just add it to the pot.

Virginia, do you see my face or no?

Yeah.

You do? [inaudible 00:06:30].

He’s saying that the audience can see things that we can’t.

Okay. All right. So I’m working with 100 gram powders and the formulas that I’m going to show are very large, they’re huge formulas, 15, 20 herb formulas, so I really recommend that if you have training in Chinese herbs, don’t give the whole formula unless you’re going to do raw soup decoction, which most of you don’t do. If you’re going to do powder extractions, then you have to whittle down the suggested 15 herbs or so into 10 or 11 herbs or so. So that’s up to you. I would not go the full formulas that they’re recommending unless you’re doing raw herb. If you don’t do powders or custom, then you default to the products.

Now, we’re going to have some products to offer, they’re not going to be as strong as these other formulas. Virginia, do you see my PowerPoint up?

Yes.

Okay, good. So these things come from two sources from China, one is Guidance for Coronavirus Disease. This is a wonderful, 140-page manual. It’s actually available on eLotus down here. I think they have a download so you can see the whole thing. Which if you’re a raw herb prescriber, there’s a lot of notes in there I’m not including, so you might want to get that document. The other document is what John Chen and Lori Hsu did, which is called, How COVID-19 is Currently Treated in China. So there’s two Chinese sources we’re working with here.

The first group is called Medical Observation Period. There’s been no lab confirmation of COVID. This is where people suspect, they have a couple symptoms, they’re not sure. So we divided those into two groups, not we, the Chinese. One is fatigue with GI upset, so there’ll be some diarrhea, there’ll be some abdominal cramping. There may or may not be fever. There’s fatigue. The formula of choice is Huo Xiang Zheng Qi Pian. These are, if you go to my book, this book which we’ll talk about, it has all the manufacturers of any formula, so it says Huo Xiang, it’ll name every manufacturer that makes it. Another phase will be-

Including American brands?

Yeah. It’s mostly, in this book there’s only GMP formulas.

Okay.

It’s only products made, pretty much put together in America, or they’re GMP otherwise. So the other one is fatigue with fever. We can’t get any of these recommendations that they’re talking about, but they’re very similar to one of these three, Gan Mao Ling, Zhong Gan Ling, or Yin Qiao. If you are not familiar with those, my book will talk about them in detail. Now for what they call confirmed or highly suspected cases, they throughout, they have this foundation formula so I can’t see… yeah, it’s hard to see the ingredients there, hard to see the ingredients. Can we move the pictures over a little so-

No, we can see.

Oh, okay, okay. So the lung-clearing detox soup is kind of like a foundation formula that they will use in all cases, mild to severe, but this is too many herbs. You have to reduce them according to how much heat you see and how much dampness you see. So this is really going to be an interplay between heat, between dampness, and between toxic heat. So toxic heat are herbs that go after viruses, and regular heat is heat in the qi, so for example Shi Gao is used a lot to bring down fever. So in this stage there’ll be coughs, there’ll be maybe some dampness. And then, of course, kind of a foundation there, Xiao Chai Hu Tang. If you’re going to work with products, probably the best combo here is Xiao Chai Hu Tang, mixing it with something called San Ren Tang, and not a lot of people have San Ren Tang, so I think you can mix it with Huo Xiang Zheng Qi Pian, Xiao Chai Hu Tang and Huo Xiang.

But as you’ll see when I go back to my other references, you always want to give toxic heat herbs, so you can always use these Gan Mao Ling, Zhong Gan Lings as part of it. Yin Qiao’s not strong enough, but it’s helpful in other ways.

I just want to ask a question here. Some people are getting it or at least starting with more of a wind cold damp scenario.

Yeah. Yeah, yeah. We go into that.

Okay.

Okay. So now in the early stage where it’s mild, there’s two presentations that I’ll show, cold dampness into the lungs, and the second one is damp heat into the lungs. So for cold damp they’re using this formula. Again, if you’re making it, really reduce it. You can’t put all these into a 100 gram bottle, there’s no way. They recommend Ephedra in all these cases, Ma Huang, which we cannot get in this country, so I’m substituting Cinnamomum, Gui Zhi, instead. This will reduce heat, it’ll dispel wind, and it will clear damp, so it’s a good general formula, cold dampness affecting the lungs. There’s maybe slight fever, it’s not real bad. There’s some cough, the chest is tight. The key symptom is nausea, nausea. So if there’s nausea, we think that there’s a damp accumulation and the stomach qi is not descending, so this formula addresses that.

If you’re going to do it with product, you use Huo Xiang Zheng Qi with something called Jing Fang Bai Du, which is in my book. For the heat stage, still the difference isn’t the fever, but now their body’s very achy. You have headache, you’re achy. There’s a dry cough, maybe a sore throat. The mouth is dry, the chest is tight, again, nausea. The stools could be loose or constipated. So this one is more cooling with herbs like Huang Qin and Lian Qiao, Qing Hao, Ban Lan Gen. So now we’re really starting to address the heat toxins, the viral toxins, Isatis, Ban Lan Gen, Forsythia, Lian Qiao, plus you also have a Xiao Chai Hu Tang basis in there with Chai Hu Huang Qin. For products, can use Xiao Chai Hu Tang with either Gan Mao Ling or Zhong Gan Ling for that stage. This is early, still considered an early stage.

In the general stage, now this is the bigger stage, it’s not hospital-level, but this is where people are sick. So this stage is called damp toxin, stagnating the lung. The fever is now starting to go up. The cough is getting more. There’s difficulty breathing. The abdomen is uncomfortable. The tongue will probably start to be more red with a slight yellow coat, but not always. Tongue doesn’t always, tongue confirms, but it doesn’t rule out. If the tongue is not red or not greasy it doesn’t mean they don’t have this, it just means it hasn’t shown on the tongue yet, so don’t require the tongue to confirm. But if it does confirm, then more power to you. The pulse is more rapid and slippery due to heat. Again, they’re using Ma Huang, again I’m substituting.

Now we’re addressing cough with Xing Ren and getting heat out of the lungs, Shi Gao, so there’s still an attention to dampness. If you have to go with products, you want to use Huo Xiang Zheng Qi, but now we’re going to use Qing Zao Jiu Fei, or things like that. I’ll talk about this stage a little bit in a minute. Cold dampness, no fever or very low fever, but again you have this cough and chest tightness and nausea. But the tongue is not red, the pulse is not rapid. And we give this, which is much more addressing cold and dampness, and again here we can use Ban Xia Hou Po Tang with Ge Gen Tang or Gui Zhi Tang. Ge Gen Tang and Gui Zhi Tang will push out the wind cold, Ban Xia Hou Po will neutralize the phlegm and dampness.

All these are on these notes which you can download from my website. Now when it gets really severe, this is the stage people want to go to the hospital. In two or three or four weeks, the hospitals are not going to take everybody. There’s going to be someone at the door saying, “Okay, you, not you.” It’s because they don’t have the beds. They don’t have the beds. Here the fever is high. This is the lung blocked by epidemic toxin. This is where the viral toxin really cranks, and this is usually seven days after their first symptom, after their first symptom of feeling fatigue and achy. After about seven days it’ll crank, and you’ll get a high fever with redness, a harsh cough because the heat now is going into the lung.

There may be some sticky phlegm, there may not. Very hard to breathe, painful to breathe. Dry mouth, there may be damp symptoms such as nausea. Now a lot of these Chinese formulas come out of Wuhan and Hubei, very damp place. Now if you live in the East Coast, that’s going to relate to you. I live in a very dry area in Colorado. We don’t see that much, we just don’t see that much dampness, but here they’re very sick. Now we have high fever, harsh cough. This is the recommended formula. They’re still trying to get rid of wind cold with Ma Huang and Xing Ren, but they’re moving again to Shi Gao. It’s a very similar formula. If there’s constipation, you work with the Da Huang, and here we can use Chai Ge Jie Ji Tang combined with Bai Hu Tang and Liang Ge San.

I talk about who has these products later. Flaring heat in the qi and yin is beyond just the lungs, this is very high fever. People will be trying to get into the hospital, but there are going to be people turned away from the hospital, and this kind of has a Bai Hu Tang foundation, Shi Gao, Zhi Mu. They’re using Shui Niu Jiao, which you’ll only get if you’re a raw herb herbalist. I think you can get this by powder form. Okay. They have cooling herbs, Xuan Shen, Lian Qiao, and Huang Lian, Lophatherum and Zhu Ye will bring down systemic heat. So if you have fever, this Zhu Ye is an important herb and Shi Gao is an important herb. You’ll see on the raw herbs that they’ll be going 30 to 60 grams in a decoction. That’s a lot. That’s a lot.

We’ll never approximate that in a extract powder, you’ll never get that much. But I would, on an extract powder, do at least 12 grams of Shi Gao. Here we would use Bai Hu Tang with either Gan Mao Ling or Zhong Gan Ling or one of the other anti-viral formulas that I’m going to talk about.

Critical stage, you’re not going to see this. This is where they’ve collapsed, they’ve collapsed. They’re not going to survive without a ventilator. The TCM people are recommending the combination of Ren Shen and Fu Zi for collapsed yang and qi, Shan Zhu Yu to bring it into the body. You won’t be seeing these patients. They’ll be in the hospital or dead.

Now my recommendations for illness with fever, you want to use heat toxin herbs. You want to use Wu Wei Xiao Du, and here’s the availability. This is everybody that carries that product. This is how my yellow book is organized. I’ll take a formula, I’ll say, who’s got it? So an asterisk means it’s based on, it’s a variation on a theme. Chuan Xin Lian is very good anti-viral, it’s a three-herb combo of Isatis, Ban Lan Gen, and Andrographis, Chuan Xin Lian and Tara Xacum, Pu Gong Ying. These are all the people that have it. Gan Mao Ling, here’s who has it. Zhong Gan Ling, here’s who has it. But there are a lot of products that are in my book that people don’t know about. All of these are anti-viral, all of these products.

I put asterisks in the ones that I think are stronger and more appropriate. Okay, Seven Forest has a lot of these products. They have Patrinia 7, Paris 7, so on. But all these companies, and then Golden Flower has Viola Clear Fire, it’s a great, great product. But all these are good, and they’re just heat toxin herbs, so you add this into what you’re doing. Let’s say you’re on a Huo Xiang stage, but you want to get the heat toxins, the virus, you really have to default to one of those or one of these. Those are very important to combine heat toxin herbs with the more classical formulas.

Lung fire, this is a painful, barking, dry, harsh cough. Qing Zao Jiu Fei is helpful, Huang Lian Shang Qing is helpful, and Qing Fei Yi Huo is very helpful. American-made products, Seven Forest has two products, Bellamcanda 15 and Stemona, they’re very good for heat. I have a product called SVP Lung. It’s good, it sort of like medium. And then here’s the codes, if I said GC it means Guang Ci Tang, if I said GF, it means Golden Flower, so on. These products can be found at Crane, Golden Needle will have them, other distributors will have all of them. But-

And what are you hearing about availability with the demand?

Don’t know. It’s not yet running out, but it will be. That’s why if you have a raw herb pharmacy or extract granule pharmacy, you can work with that. I had trouble getting some extract granules from my supplier so I went to another supplier and was able to get what I wanted. You can either stock up, or you’re going to reach a point where you’re just out of herbs. eLotus, that’s John Chen’s and Tina Chen’s group, Evergreen, they translated numerous articles from China for treating COVID-19. This is that link, or you just go to their website, eLotus.

And they have a wonderful hour and a half free presentation about it, when-

Oh, yeah. Yeah, yeah. So this sums up their information. So they took a document called How COVID-19 is Currently Treated in China, they translated it. They divided that into four phases, prevention, influenza, pneumonia, and recovery. So I’m just summing up their stuff here because they give a lot more detail, but pneumonia prevention number one, they had this formula. Influenza phase, they said patent medicine you can combine Ge Gen Tang or Chai Ge Jie Ji Tang. I would combine it with one of the anti-viral formulas based around Gan Mao Ling. Flu formula number one with headache, with dry throat. These are not strong enough in my mind. They’re good, but I would combine them with a strong heat toxin formula that we just talked about.

Then toxic heat attacks the lungs, they give a recommended formula. This is a good formula, I like this formula. Damp cold in the lung, it’s not going to be acute. I mean, it might be. It’s a difficult differentiation here, because when they’re feverish, you think everything is heat, but here there’s more of the damp side, the distension, nausea, diarrhea. Remember in China, they have a lot more damp presentations than they have in most places in America, but that’s their recommended formula. With this again, you could default to Huo Xiang Zheng Qi or Ban Xia Hou Po Tang.

I understand that the testing of people’s lungs who had severe cases of it, they found like thick, rubbery, congealed phlegm blocking the airways. So yeah, phlegm is really important to treat.

Pneumonia phase, this is a special phase. It’s kind of a Shaoyang stage with accumulation of damp. Herbal formulas you can use are Xiao Chai Hu Tang, San Ren Tang, or Gan Lu Xiao Du. Pneumonia phase, again it’s Xiao Chai Hu Tang with some, it’s sort of like what you see up here but in a customized formula. Finally, damp heat, another pneumonia formula. You download this, print it out, keep this as your reference. Now these are smaller formulas, so you can just make this just like it is, changing these doses here for soup. You have to adjust that for 100 gram bottle if that’s what you’re doing.

Toxic stagnation, this is where there’s a lot of fever, here’s the formula. You’ll have to look at it and look at it closely. This is the end-stage abandonment. You won’t see this, this is definitely in the hospital or dying. These patent medicines you cannot get anymore in the United States. I had them in my original patent medicine book, An Gong Niu Huang and Zi Xue San for fever that’s killing you. And you can get them in Chinatown, but you’re not going to get them from any of the GMP-type distributors.

This last phase is just collapse. It’s ginseng Ren Shen and Aconiti Fu Zi. There is a recovery phase, and they’re basically recommending Sha Shen Mai Dong Tang as a recovery formula. That’s available. A lot of people have it. Here is if you customize it, that’s how you would do it. All right. So all those products that I mentioned, they’re in my book. You can see who’s got it, you can see what’s the applications, what are the contraindications, what’s the historical origins, and so on. I guess that’s about it.

The handout notes are available from that link, which is drjakefratkin.com/toxic-heat-invasion/. But if you go to my site, it’ll be on there. All right. Virginia, any questions?

I really want to thank you for putting this together on such short notice and bringing your expertise. Your original patent book was the first book I read on Chinese herbs in the early ’90s before I studied it in-depth and it was really invaluable, and now I’m glad to see that you have another, more in-depth version. You really contributed a lot to the field, so I want to thank you for that, as well as what you’ve done for the show and what you’re doing right now.

Only one thing I want to say about this book. I made the mistake of not calling it essential Chinese patent medicines because it’s just about products that are available in our country, so there’s 133 classical formulas, and 83 modern formulas. These modern formulas, people who just study the classics have missed out on what China’s been doing since 1950, which is developing a lot of new products. The best ones have come out as patent medicines, so there’s 83 of them in this book that are GMP. Everything in this book is GMP. They’re GMP in China, but then usually a lot of them are tested when they come to this country. I can guarantee you they’re clean. There’s no heavy metals, there’s no pharmaceuticals, and so on.

And a lot of companies sell these, and so you want to look at this document and stock up on what you think you’re going to need, okay? All right. Thanks for your time. I hope this was helpful, and I want to really thank American Acupuncture Council for sponsoring these shows and for giving me an opportunity to talk and share my information. And it’s not mine, I just compiled it, I just compiled what’s out there.

And for people who do have an hour and a half to watch John Chen’s webinar, it’s really useful, and he gives some research studies behind things. And he talks about how, for practitioners, it’s really early-stage and recovery that we are probably best apt to treat and most likely to be treating. But it’s good to know this, because as you say, if the hospitals are full, people will be desperate for something. So I’m grateful, and thank you again to the American Acupuncture Council, and we will see you again soon.

Slides: https://aacttp.click/ov7

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AAC To The Point - Lorne Brown

The Magic Word That Gets You Committed Patients – Lorne Brown & Chris Axelrad

Lorne Brown, I’m your host. I’m a doctor of traditional Chinese medicine. I have my practice in Vancouver, British Columbia, and Canada. I’m also a CPA and an author of Missing the Point: Why Acupuncturists Fail and What They Need to Know to Succeed.

I’m very excited and fortunate to have a colleague and friend on today, Chris Axelrad. Chris is a leader in the industry. He has been the president of the American Board of Oriental Reproductive Medicine. I can tell you he knows his stuff and he shares his stuff, evident by the fact that he’s taught all around the world in US, Canada, and Europe. He’s spoken on healthyseminars.com. He’s been a presenter at the Integrative Fertility Symposium as well. This man, this practitioner follows his heart. He beats to his own drum. This is also evident by the fact that his family, his late father, his siblings, his uncles are all medical doctors, and he chose to go into acupuncture against their will and their desire. So there’s the man that follows his heart, his dream. He is very successful, and that’s why we have him on the show. He has at least four clinics, the Axelrad Clinics and growing with many associates. Now he also mentors acupuncturists so they can be successful. Chris, welcome to the show.

Thanks man. It’s awesome to be here. Appreciate you inviting me.

I want to hear about this topic that we chatted about that you’re going to share today on the magic, the magic word that gets you committed to patients. Can you start off with what do you mean by a committed patient?

Well, committed patient is somebody who shows up and is really serious about getting help. So they’re not kicking tires or just kind of looking, to see what it might be like to get some acupuncture or to get some herbal medicine or whatever. They have a serious problem. They’re seriously interested in solving the problem, and that in and of itself just lends itself to a different kind of attitude, a different kind of willingness to be led and to be really taught about the things that are going to help them to escape their problems. As opposed to patients, and I know all of us have had these kinds of patients before that are just sort of kind of showing up but then asking a lot of questions and constantly having doubts and constantly never know if they’re going to show up for their next appointment, things like that. So that’s really after a while of being in practice.

I think most of us start to realize that it’s going to be really tough to have not just a successful practice but a practice that we enjoy and a practice that we really feel is fulfilling if that’s the type of people that we’re attracting into our practice all the time, people who are just not at a place where they’re really serious about the process that we have for them. So to me is someone who’s committed.

It reminds me of one of my teachers that used to say, “The client has to want it more than you do, and the client has to work harder than you do.” You’re still showing up giving 110%, Chris, but you’re saying you want that patient not only to match it but to exceed that.

Well, here’s the thing, I mean, to a point, to a point. I think that for most, most people are just not aware of the amount of self-care and kind of work on themselves that goes into their process of healing, especially if they have a really serious medical condition. So sometimes we can’t just like in any way in my process, which has proven to be pretty successful by the fact that we do have four clinics, and I’ve trained three other people in my process and they do it pretty well. Our process is really predicated on not overwhelming people with and making them work, like they don’t even realize they’re working that hard. So it’s like this stealth kind of way that we go about it that gets them on board doing the most important things.

A lot of times they don’t realize how many things they are changing but, yeah. I mean, the bottom line is that you’re right. I mean, a patient can’t want it… If a patient doesn’t want it, we can’t want it for them. We can’t want the results on their behalf. A lot of people do make that mistake, and it’s a very draining way to go about practice because at the end of the day when you want it more than your patient wants it, you’re just going to a well that has no water in it trying to get water. So it just gets to a point where it’s fruitless.

So in this magic word, they get you committed patients. You mentioned when we have a committed patient then so they do want to do the self-care, and you have a system in place that stealth-like. So they’re making the changes and it’s not considered extremely hard work. What is this magic word you’re referring to when you say the magic word that gets you committed patients?

Well, I thought about it after I presented that idea. There’s really two magic words, but the first magic word is the name of their problem, the name of their problem that they were told by doctors, right? So I think what happens in our industry a lot is people avoid common terminology for diseases. Because sometimes maybe it feels like, “Oh, that’s not really Chinese medicine. That’s not really holistic. That’s not…” So we aren’t going to use that term. What we have to understand is that someone who doesn’t know anything about Chinese medicine, which by the way is 99.999999999 many nines you want to think about, a percentage of people in the West don’t know anything about Chinese medicine. So the terminology that we put out there if it’s not in their language and in their sort of meets them where they are, then they don’t pay attention to it.

So someone goes to a doctor and they’re told that they have, let’s say infertility, you’re in fertile. Okay, granted. I know in the fertility world there’s a lot of people who think that that’s a bad word, infertility, and I get that. The key is that to a person who has been told that by their doctor, that’s the label that has been sort of put on them and that’s the key word that’s going to get their attention when they’re starting to look for help. That’s the word that’s going to get their attention.

At same thing with, for instance, Crohn’s disease. So there’s a lot of people who want to brand themselves like, “I help people with digestive problems. I help people to have awesome digestion.” Well, no one’s looking for help with digestive problems per se. I mean, if it’s a digestive problem, what most people think of is, “Oh, a little reflux, a little upset tummy,” a little whatever. I can just go to the drugstore and spend five bucks and buy an over-the-counter medicine for that. Like I always say, if you’re competing with Zantac, Advil, Tylenol and all these things, Claritin, you’re losing. You’re going to lose because that’s not a fair fight.

When you start to call out the names of serious problems that people can’t go to the drugstore and buy a pill to fix Crohn’s disease, ulcerative colitis, not just headaches, not just neck pain but migraine, chronic, recurrent, severe, some type of severe headache; I’m not an expert in headaches but I’m sure there’s a million different terms for headaches besides migraines, or spondylosis or herniated disk, not back pain. Because again, the average person with back pain, yeah, back pain it sucks. No one likes to have back pain. At the same time, the average person with back pain is probably just taking over-the-counter meds or stretching or doing something like that.

When we start to call out real problems that have a connotation of a different level of severity, number one, when those are the words that we’re using, the terms that we’re using all the time whether it’s in our marketing or advertising or public speaking, whatever, then it connotes a different level of expertise, connotes a different level of skill and a different willingness to solve serious problems. That’s how we want to position ourselves. I mean, we don’t want to position ourselves as an accessory, as an alternative, as the cute little acupuncturist down the street that helps people relax. I mean, I don’t take that personally. Of course, I’m happy to help anybody who comes into my office.

When it comes to building a big practice, if you’re not really reaching out and offering to solve serious problems, it’s going to be a tough row. Because, again, the level of commitment. If someone comes in and it’s like their back hurts a little bit, you can probably fix that. I know for sure I can fix that in one or two treatments almost every single time, and then you just had patient come through and do two visits. It’s like, “Well, okay, now I’ve got to get another patient.” When that person goes out and just tells their buddy or their friend whether it’s a guy or a woman or a man, “Hey, my back’s better now. I went to acupuncture,” and all their only friend reference is this really easy problem that you help them fix and they tell their friend who has easy problems, “Well, guess what,” you might get a few more people in. They’re going to do three or four visits, and they’re going to quit. Why? Because they’re better, which is fine. That’s totally cool.

If we really want to have successful practice, we have committed patients that are coming back that are really working on a problem, then we have to actually use the names of those problems and not be afraid to use the big scary words like Crohn’s disease, again, getting into eczema, psoriasis. Again, infertility is a big one, endometriosis, you name it. If you call out these big problems, then people will start to pay attention and people who are really actually in need of our help. Because at the end of the day, a lot of these are chronic problems that Western medicine has no answer for. Because, as we all know, not that Western medicine is inherently bad, not that we should avoid Western medicine all together, however, Western medicine is like a sledgehammer sometimes. Sometimes you’re applying a nuclear bomb to a problem that just requires like just a basic, “Oh, no. I don’t want to use an analogy of a pistol.”

I am in Texas by the way, so you know. So you don’t need to bring a nuclear bomb to a gunfight, okay? If one little bullet will fix it, there’s no point in bringing all this power. That’s where Western medicine sometimes has a problem. That’s where we can come in and do amazing things to help people’s natural, innate healing process to kick in and fix the problem itself. The people who need that help the most are people who have had Crohn’s disease for 15 years and are on five medications, and the medications themselves are almost as bad as the condition itself. They’re really tired of that, and they really want something that’s going to give them a real way out.

When you start to brand yourself that way and you start to use those words, it brands you as an expert. It brands you as a high-level authority, and that’s what gets you the reputation and then, of course, you have to actually treat people. What I’ve found honestly is that our medicine, despite what a lot of people would tell you and even people in our own field might say, our medicine is immensely capable of helping people with these kinds of problems and in not that long of a period of time. So people will really, really start to buy into what we do more and more as we call out these serious problems and are willing to go out there and actually attack these serious problems and build ourselves that reputation of being able to solve these serious problems, so.

Let me see if I got this then I’m going to summarize what I think I’m hearing. You’re talking about a committed patient and also known as a motivated patient. So if you’re going to treat, you talked about eczema aforementioned. Eczema is something that somebody really wants to get rid of that usually. It’s more of a complicated serious problem versus somebody who got hives from eating something. If somebody’s got hives, they’re going to try something over-the-counter antihistamine and see if that would work. If somebody’s got a chronic condition, people with chronic like migraines or eczema or infertility, then looking to get good at even specialized like you’ve done with fertility is find an area where the patient is committed. So skin conditions, somebody has skin conditions especially around summertime, they’re going to want to make that clear if they’re going to put on T-shirts and shorts if it’s on their arms and legs or even on their face.

So am I hearing that right? You’re committed patient, you’re motivated patient, you’re looking for things where there’s not great alternatives for them. There’s not this over-the-counter quick fix. These are people that have chronic conditions, and they’re going to be motivated because of their condition. It’s interfering with their quality of life. They’re going to be seeking out help and a lot of these chronic conditions, although allopathic conventional medicine has done wonders. We’re alive here past age 40. It does great things. Cubed carrot is great. Some chronic conditions, Chinese medicine can treat effectively also, and we’re an option for that. So did I get that correct?

Yeah, exactly. I think it just has to do with, again, using these terms that are very specific and that connote a different level of problem. So it’d be like saying, “I treat allergies.” Allergies is a very general term most people don’t really feel. If you just say allergies to somebody, they’re going to think, “Oh, hay fever,” or just a little bit of a head cold one day taking antihistamine. When you start saying things like eczema, when you start saying things like severe allergic recurrent rhinitis or severe allergic sinusitis, I mean, again, I’m not an expert allergist, but there are lots of different conditions that are allergic conditions that we can certainly help people to balance their immune system more, help their immune system be less reactive so they may not need as much medication, things like that. But we’ve got to actually call that out.

Now the other secondary benefit of that is that if you say, “I can treat Crohn’s disease. I can help you with the symptoms of Crohn’s disease,” or, “I can help you to feel better with Crohn’s disease,” right, what does that say to the person who doesn’t have Crohn’s disease but has some type of digestive problem as well? It may not be Crohn’s disease, but maybe, I don’t know. They haven’t been diagnosed with that, but they just know they don’t feel well. They’ve been to doctors, whatever. What does it say to those people? Well, it says… It’s this kind of thing where it’s like, “Wow. If this person is offering to help people with Crohn’s disease, my problem’s going to be pretty easy for them.” Like I should definitely like check this out, right? So you kind of get this bigger benefit.

It’s called aspirational marketing, where you really call the big shot and what that does is it, and even people who don’t necessarily need that much help will still see you as an expert and someone capable of helping them.

For the practitioner, you’re going to want to have some, for me anyhow, some form of passion in treating that area. So Chris is sharing that. Use the terminology that the patient’s going to be familiar with, so be patient-centered focus. So use the terminology and the terminology will be some of the Western diagnosis they have received from their medical doctor. For example, if it’s Crohn’s that they received from their Western medical doctor, well, in Chinese medicine that is a disease category diarrhea, bloody diarrhea. This is something, it’s not called Crohn’s in Chinese medicine. However, we’re able to pattern differentiate the symptoms into your Chinese medicine and so you’re still treating the Chinese medicine pattern. You’re treating the individual. You’re not treating Crohn’s. That’s just the map that Western medicine has given that body, right, but that’s what the patient’s going to understand.

So that’s what I’m hearing. You say, Chris, is use the terminology that they’re familiar with. I’m adding that because Chris does a lot of work with fertility as do I in my clinic. We’re passionate about helping bring in healthy babies into the world and helping this population. We find it fun to work with hormonal imbalances and work with women and men wanting to have children. So it’s something that you’re going to need to have passion for because you’re going to want to do all that additional learning and studying, and you’re going to see so much of it. You’re really going to want to like it if you’re going to see that much of it.

Yeah. But I would say also I’ve gotten to a point, Lorne, for me anyway, this is just me and maybe it’s because I’ve been so heavily involved in helping people with their marketing and their practice management stuff over the last three years since I started my program. To me, the passion is seeing that smile on someone’s face when they start to realize like they found something that’s working. The fulfillment of the fertility thing is amazing to know that you’ve changed someone’s life in that way. It’s just as life-changing for someone who has suffered with a severe chronic illness for years and has not really been able to have a really good quality of life to suddenly feel empowered and realize that they’ve got something that is really truly changing their life.

So I always encourage my clients not to focus so much on the specific thing, the problems so to speak. Because sometimes we can’t decide what problems are going to come to us. I mean, it’s like the market is going in some ways make that decision as well. The main thing is to have a positive attitude and not focus so much on what you’re getting out of it and your own thrills, but focusing on like just the service aspect and certain people and empowering people. So when we’re more focused on that, then the specifics of exactly what we’re specializing in, to me, that’s what drives any successful practitioners, just the joy of knowing that you’ve changed someone’s life.

Sometimes that life change is very subtle. It’s not this really big obvious thing like a child, which is a super obvious change. Sometimes it’s a very subtle change that they’re no longer having trouble sleeping through the night. They’re waking up every day. They’re able to focus more, and that’s going to change their life in millions of ways going forward, I mean, so-

I think you hit it with the service to others. Because in the spiritual books, they talk about service to others. In the law of attraction books, it service to others. In the entrepreneur books, to be an entrepreneur, it’s about service to others. I think one in the Bible said, “Do unto others as you want them to do on to you.” It’s all about service to others. If you can do something that’s going to help the masses and it’s more about them than yourself, you’re on the right track. That seems to be a common theme in most of [crosstalk 00:22:01].

That’s it, man. So like there’s a lot of people who want to have a specialty fertility practice and maybe that’s just not going to happen because of several factors. Could be competitive factors. Could be just that in their city or their market, there’s just not enough people that have that problem to really have a whole practice revolving around that. So we’ve got to learn how to be humble and not want to make it all about ourselves and [crosstalk 00:22:34]. This is amazing that I’m helping you with this really simple, easy problem, but watching you grow and watching you overcome this. I’m not saying I’m saying this in patients, right, but just in my own mind. I mean, that to me gives me a lot of fulfillment.

I wanted to say real quick because I know we’re up against time-wise, but the other magic word that’s really important is actually a magic phrase is, “Yes, I can help you.” You need to learn how to say that even when you’re not sure, and here’s why. Because nobody’s ever sure. Even when someone goes in for IVF or someone goes in for a sinus surgery or someone goes in for to take a medication for that, as much evidence as there is that that procedure works, no one’s ever sure it’s going to work for that person until we try it. So we just say, “Yes, I can help you,” so that people will trust us and will be willing to try it out.

What I always do, look, and this is very counter what most people would say to do, but let me tell you why. Let me tell you why. I have chosen and I have realized that I always want to be the person who believes my patient can heal and be wrong. If I’m wrong, I will accept that. But when my patient is sitting here, I believe in them 100% and I’m not going to hold that back. I’m going to tell them, “Yes, I can help you. Yes, we make this happen. Yes, well, let’s do this.” I will take the hit of being wrong rather than being the person who holds back and says, “Well, I’m not sure. Maybe da, da,” and be right.

That’s not who I want to be. I don’t want to be the one that predicts or hedges against failure. I’m going to be the one that hedges for success. So you’d be surprised, man. I’ve never had a patient come back to me who didn’t get pregnant when I told them that I was really confident they could get pregnant. Honestly, I felt that way. I’m not lying. I feel that way, and we can’t control who gets pregnant. We can’t control who overcomes their Crohn’s disease or overcomes their eczema, but I’ve never had a single patient come back to me and tell me and tell me I lie to them or anything like that. In fact, I’ve had a lot of my patients who never got pregnant working with me, they still referred to me to this day. They refer people for other stuff. They even refer people to me for fertility.

So what they want from us is full effort. They want to know that we’re on board, and we believe in them. In my opinion, not one shift can bring you, I mean, at least double your referral rate if you just show up that way, because people want to know that you’re an advocate for them.

Speaking of the referrals. So you’re looking for the motivated, the committed patient, and you’re a practitioner that you feel you can help people with certain conditions you want to serve others. What are you suggesting they reach these patients to let them know they exist to get them into their clinic, this idea of the magic word to get committed patients? Do you have some suggestions for our listeners?

Well, yeah. I mean, we use a lot of paid advertising in my clinic. We’re hardcore about that. Last year, I want to say for 2018; I don’t have my books for 2019 yet, but for 2018 we spent almost $40,000 on advertising. What you have to understand is that’s for the entire year. Our monthly revenue is somewhere between 80 and $100,000, so you take that 40 grand we spent for the whole year. The point is, is that we’re spending that money and we’re paying Facebook and Google. We don’t do YouTube ads yet, but I want to be doing that this year.

To put the word out there in front of thousands of people every single day, every single day, here’s what we can help people with. Here are the things we help people with. What’s really cool about that is when you do that, you do it consistently over a period of time and you don’t like stop. That’s the thing. A lot of people make the mistakes like, “I run an ad for a month. It didn’t quite work. I’m going to stop.” Well, number one, you got to say the right thing in your ad. Number two, you can’t just advertise then disappear. Sometimes it takes six weeks, eight weeks, two months for people to see your name and get comfortable with you enough to actually take action. So you have to be consistent, especially at the outset.

What I was going to say is that we use those terms, we put them in ads so that people will see that word which applies to them. That’s like the leak in the chain that makes them stop and go, “Oh, wait, this is about me. Let me read this. Let me pay attention to this. Let me watch this video. Let me click this link and go see what this person has to say.”

When you know how to build this ecosystem of advertising and remarketed stuff and all that, you build a really powerful system to get people into your clinic. Like I said, we spent half of one month’s revenue per year on our ads. We never worry. We never ever, ever, ever, ever worry about whether we’re getting new patients. We get at least three to five new patient requests every single day, some days more, every single day.

You know what I’m doing? I’m in here treating patients. I’m at home. I treat patients two days a week. I see about 50 to 60 patients a week in two days. I have my associates. None of my associates are seeing less than 40 patients a week. One of them sees 70 patients a week, and it just rolls like that. I’ll have to check my ads every couple of weeks just to make sure they’re not getting stale, especially on Facebook. But other than that, man, I mean, it’s fun.

You’re having fun, and that’s a big part of it as well, having fun while you’re doing all this.

Yeah, it’s fun, man.

I want to thank you, Chris, for coming on and sharing. People, if they want to get to know more about some of the mentorship that you’re doing for acupuncturists on building practices, can you give us a website please?

Yeah, it’s chrisaxelrad.com. Axelrad is spelled A-X-E-L-R-A-D, so chrisaxelrad.com. I don’t have a big fancy website. Actually, the homepage is just a video, because I have a busy practice. I don’t have this whole thing, this whole big fancy operation-

His picture, it was good. I had a chance to see some of his material. So you’re right on, Chris. I know colleagues that have been doing your program and you’re transforming their practices, and I care about that because I want prosperous healers. I have a mission to help heal the planet, and you heal the planet by healing yourself, that was a self-care. So I think Chinese medicine is part of that as other modalities are as well, but Chinese medicine is part of that. It’s part of the plan. I think it has so much to offer on a spiritual, emotional, mental, physical level. So thank you for joining us.

For those you want to check out, I have healthyseminars.com is my website for Lorne Brown. I also just opened up lornebrown.com where I have conscious talk, so you can check that out at lornebrown.com. Next week, checkout To the Point. I’m at the AAC webinar series. We got Virginia Doran. Thank you guys very much.

Please subscribe to our YouTube Channel (http://www.youtube.com/c/Acupuncturecouncil ) Follow us on Instagram (https://www.instagram.com/acupuncturecouncil/), LinkedIn (https://www.linkedin.com/company/american-acupuncture-council-information-network/) Periscope (https://www.pscp.tv/TopAcupuncture). If you have any questions about today’s show or want to know why the American Acupuncture Council is your best choice for malpractice insurance, call us at (800) 838-0383. or find out just how much you can save with AAC by visiting: https://acupuncturecouncil.com/acupuncture-malpractice-quick-quote/.

Sam Collins for HJ Ross

Proving Medical Necessity Dr. Sam Collins & HJ Ross

 

Hi, everyone. Happy New Year and welcome to 2020 and to the first episode of To the Point for the American Acupuncture Council. I welcome you in, and I want to make sure we have a clear vision for the year. Of course, I’m going to probably overuse the 2020 reference, but nonetheless, let’s make this a good year and let’s make sure we’re understanding what’s going on [inaudible 00:01:16] make sure our practices are doing okay and better, but also how do we make sure we’re dealing with when someone says, “Are your services medically necessary?” How do we determine that? What does an insurance look for? What does it really mean? I think ultimately we know what it means in the sense that we have to show the patient is better, but ultimately what does an insurance company want? So let’s really focus on that today.

So let’s go to the slides. Take a look here, and I start off with insurance medical necessity for acupuncture. And this is really based upon an insurance company. Whether we agree, disagree for the most part doesn’t matter because it’s what the insurance companies say. So here are the medical necessity factors as per insurance, and this is specifically through Cigna, though you’ll see this is a repeat with almost every insurance. It says “Medically necessary services must be delivered toward defined, reasonable, and evidence-based goals.” In other words, they want to see that we’re going towards something that we can have an expectation of reaching a specific goal.

“Decisions must be based on patient presentation, including diagnosis, severity, and documented clinical findings.” So if you think of it, diagnosis and severity are only a part. The clinical findings help determine the severity and the diagnosis. So what I will say is it’s always ultimately best to have something that you can quantify clinical findings to show the patient is better.

One of those clinical findings could be a pain scale, but that’s not as accurate because I’m sure you’ve noticed, some people will tell you their pain is a nine, but yet clearly it’s not a nine based on their function. So I want to focus a little bit more than that. It goes on to say, “Continuation of treatment is contingent upon progression towards defined treatment goals and evidenced by specific significant objective functional improvements.” And I think it’s interesting to note here it doesn’t really focus as much on pain as we might think, but more about functional change or outcome assessments. And the reason why I think is that’s something we can measure. A pain scale, though it’s something that gives us a feeling of where the patient is at, it’s subjective. We want to try to focus more on objective factors, so outcome assessment scales and range of motion certainly will do that.

In addition, realize that certain conditions could be severe enough, maybe they’re going to be co-managed. By example, the company Evercore, which manages a lot of the Anthem policies, now covers things like mental disorders, post-traumatic stress disorders, anxiety, but you probably won’t be treating that just by yourself, but part of a co-treating. So, in those instances, making sure if you’re getting a diagnosis of say post-traumatic stress disorder, you’re not making it alone but co-managing along with another healthcare professional.

But it says, “Medically necessary services, including monitoring of outcomes and progress with a change in treatment or withdrawal of treatment if the patient is not improving or regressing.” So the idea is that the patient should get better with care, and if we withdraw care, they’re not getting any better or worse, clearly it shows the care as not medically necessary.

So that all sounds well and good, but really what are they looking for? They’re looking for the patient to have a treatment plan individualized. Now, obviously there’s going to be a lot of similarities with similar conditions, but it should correlate with the clinical findings. The more severe condition, the longer the plan may be, the more intense the care. Think of someone with simple back pain. They just woke up with a little back pain. It’s not going to require as much care as someone with say cervical disc degeneration. That’s chronic. So realize that some of those goals are going to be based on some of those factors as well and how much.

So ultimately, those should be this. Treatment is expected to result in significant therapeutic improvement over a clearly defined period of time. So, when you’re making a treatment plan, please make a plan. Tell me how many visits you’re expecting to see this patient. For instance, you might say, “I want to see them two times a week for four weeks,” meaning a total of eight visits. But then what are the expectations of that? Make sure you’re defining what do you expect to see? Do you expect 100% improvement or maybe a 50%? And that’s kind of where you want to go with it. Don’t have expectations that always says, “I expect the patient to be pain-free within X number of visits.” But you should see a clearly defined improvement.

So, by example, maybe after three to six visits, a 25 to 50% improvement in the pain, as well as a 25 to 50% improvement in function. The difficulty is the pain scale is easy, but how do we define function? And that’s what I really want to emphasize, what insurances will look for.

So, when planning, they say they want therapeutic goals that are functionally oriented, realistic, measurable, and evidence-based. So my takeaway here is to make sure that, when we’re writing a treatment plan, don’t simply focus on the patient having a decrease in pain. That’s certainly fine, but it’s not enough because they want something that they can measure, and it’s evidence-based. And again, the pain scale is too subjective to really accomplish that.

There should also be kind of a proposed release date or end time. That doesn’t mean that’s going to be the absolute. If I say I’m going to treat someone two times a week for four weeks, certainly, hopefully I’ll get them well sooner than four weeks or at least by four, but that’s not carved in stone. Realize potentially, after four weeks, the patient may have improved 75% but may still have a little bit more. The point here is have at least something that kind of gives an approximation.

What insurances are leery of is when someone says, “Well, I don’t know, I’m just going to treat until they get better.” There should be something that kind of gives you some type of feeling towards what are your expectations, and a lot of that is just based on your good old experience as a practitioner. What has been your practical experience for when patients have similar conditions how long it takes to respond? And, of course, there’s always all types of complicating factors.

So here’s what we need to do. In fact, this is what is directly stated in the Cigna guideline for medical necessity. It says, “Functional Outcome Measures, when used, demonstrates Minimal Clinically Important Differences from the baseline results through periodic reassessments.” So, in other words, what an outcome assessment does, it’s an easy way of measuring function. It’s not so much how much does the pain hurt, but how does the pain affect you doing certain tasks, maybe getting in and out of bed, sitting for long periods, doing your work, doing home chores, and those are things that we can certainly measure and manage.

And then it says, of course, “Documentation substantiates the practitioner’s diagnosis and treatment.” That’s kind of a given. Certainly what we’re going to be treating with the exam should demonstrate that. What I’m going to emphasize to you today is start implementing something beginning this year where every patient that you’re going to treat with insurance and going to treat for any extended period of time, you want to begin using outcome measures, and these are things like [inaudible 00:07:40], neck disabilities, which frankly are a little complicated for most patients. But nonetheless, you want to have some type of instrument to help you do that because here’s what they want is demonstration of progress towards an active home care, meaning the patient gets to a point where they can help themselves at home. Maybe you’re going to start with back pain and then eventually get to where they’re going to do more stretching, yoga, Tai Chi, so they can really kind of deal with it on their own, or they really maximize it.

Ultimately, they want to make sure that, if you’re going to continue care, maximum therapeutic benefit has not been reached. How can we measure that maximum therapeutic benefit has not been reached without an outcome assessment? Think of it much like a person on a diet. If you put someone on a diet, the only way to show that they’re losing weight is to measure that, and you want to measure it in a way that is quantified. So clearly, the simplest thing for weight loss would be putting someone on a scale, and that scale will say they weigh 150 pounds, and as they lose weight, they obviously will lose weight, 150 to 145.

The key is it has to be significant. We can’t certainly say the patient weighed 150 pounds, and now they weigh 149 and eight ounces. That’s really not going to be a significant amount. So we want to have something a little bit more than just that, but something that we can measure.

So here’s another example. Now, I just gave you what was Cigna’s. This is the one from the company Evercore. So, if any of you deal with a lot of the Anthem Blue Crosses, and I’ll let you know also United Healthcare and Optum Health use this company. And here’s what they say for when it comes to functional assessment. And it says, “Documentation of a patient’s level of function is an important aspect of patient care. The documentation is required in order to establish the medical necessity of ongoing acupuncture treatment.” And they go on to state, “The patient’s specific functional scale is a patient-reported outcome assessment that is easy and appropriate for acupuncturists to use. This so-called PSFS has been studied in peer-reviewed scientific literature and has been proven to be a valid, reliable, and responsive measure for a variety of pain symptoms, including neck, back, knee.” I would say you name it. It probably works with anything, even headaches.

But notice that they’re giving us a tool. They’re saying they want to see the patient’s specific functional scale. So my rule would be, if that is the type of protocol they want to see, let’s make sure we give that because notice they’re going to give you the objective findings that they also want to see. Notice it says, “inspection, palpation, range of motion, motion palpation of spine, orthopedic testing, neurologic testing.” Now, this, of course, would be a person with back pain, but I want you to notice none of this really focuses on the pain as much as the result of pain, their level of dysfunction.

So I’ll give one more. The veterans program, I’m sure you’re familiar. Many of you are probably treating VA patients through the PC3 program, formerly known as Veterans Choice. And here’s the two things they say on the standard episode of care for acupuncture. It says, “The result of care should result in significant durable pain intensity decrease,” and they actually say on a VAS scale of zero to 10, so that’s good. We still want to use that. But to go beyond that, we have to have a little bit more because notice the next thing they want is also “functional improvement by clinically meaningful improvement on validated disease specific and outcome instruments or return to work or improvement in activities of daily living.”

So you’ll notice the pain scale is a part, and when that pain scale is positive, we’re going to have improvements here. So, at the very least, even if you’re not using a validated form, please make sure you’re documenting maybe three or four activities that are being affected by their condition and as that condition improves, how those improve as well.

Do always make sure you compare apples to apples. I used earlier the example of weight loss. So let’s say you put someone on a diet, and week one you put them on a scale, and you weigh them. But then week two, you don’t weigh them. You measure their waist circumference. Well, unfortunately, because we’re doing two different types of measurements, comparing those two will give us no idea of how the patient’s changed. So do be consistent. If you’re going to do some functional things that are not on a validated scale, please make sure to make them consistent. Whether or not it’s the activity you come up with or the patient does, so long as we have some consistency, it’s going to show the functional change.

The other thing the VA says though, and this is something that is worthwhile to do with any patient as well, is “documented decrease utilization of pain-related medications.” Now, of course, we’re not going to tell a patient that they should or should not take them, but we want to monitor the levels. When a patient’s in a lot of pain, they’re probably taking many more. As they’re getting your care and improving, all of a sudden they may say, “Hey, I’m no longer taking it at all, or maybe taking far, far less.” Notice all these demonstrate the changes of the patient. Instead of relying on “I feel better,” let’s rely on something that we can measure that no one can dispute.

So, by example, here is the patient-specific functional scale. And you’ll see here it’s simply just a questionnaire. And what this questionnaire does, it talks about your initial assessment, followup assessments. But what I want to focus on, notice it has a scale here that says “patient-specific activity scheme.” If it’s a zero, they can’t perform it at all. If it’s a 10, they can perform it fully.

But what’s nice here is notice you’re just going to score this maybe every two weeks, but you have to indicate what type of activity. The activity could be sleeping. The activity could be how long you’re sitting, lifting, bending, carrying for home activities, any of those. It’s your choice to come up with it, but notice what this allows you to do is to take something specific to your patient and then beginning to grade their changes because all they’re looking for is did you make the patient better? The easiest way is by function.

So this is the patient-specific functional scale. I like it, but because it takes a little bit of extra work to come up with those activities, you may well like something like this one. This is called a general pain index. Now, general pain index, you’ll notice at the top, it says, “We would like to take a moment to see how your pain presently prevents you from doing what you would normally do.” Notice it’s not talking about how much it hurts but activities.

But just like the patient-specific functional scale, you’ll notice this one already has the activities listed. Notice, family, recreation, social, employment, self-care and so forth, and if you go to the bottom here, life support. The one thing that is different though with this one, completely able to function is a zero, unable to function is a 10, so it’s a little bit opposite from that standpoint. But notice what it simply does is give us a way of measuring how the patient is doing. I really like this one because I pretty much don’t care what I’m treating the patient for. Whatever you have, even abdominal pain is going to affect these things, and as those get better, the function’s going to improve.

Now, along with that, the VA has given us, of course, a pain scale. The one thing about this pain scale that I think you want to see is it’s not the traditional pain scale many of you are used to about, well, the 10 is when its at its worse. But I’ll just have you notice these indicate things more about activities. Look at number five. Their pain level is five because it interrupts some activities, whereas number seven, the focus of attention of the pain prevents you from doing daily activities. So it’s not that it’s not pain, but it’s more functionally based. And what’s very nice about this type of form, it’s two-sided, and there’s four questions on the back that goes over how it affects your activity, your sleep, your mood, or your stress from a zero to 10 scale.

Now I’m going to offer you this one, if you’d like. Just text AAC Network. You’re going to text to the number you see 714-332-6926. And when you text that number, you’ll get a little bounce back that’s saying, “Hi, how are you, what’s your email?” And then once you send your email, we will then send you a copy of this form, and then that way what I would suggest to do is print it out and use this now as your pain scale, which means you’re getting away from talking about how much it hurts, but also how much it hurts and how the patient is functioning as a result of that.

And I do like this one quite a bit because it doesn’t just focus on activities of daily living, but sleep, the patient’s mood, their stress level, and those all certainly are going to play a factor, and I think many acupuncturists ask those questions. So certainly, if you have a moment, go ahead and text us. We’ll send you a free copy, no charge to you. It’ll be in color. I suggest print it out, maybe blow it up to a poster size.

Ultimately, do keep one thing in mind. Acupuncture is considered not medically necessary for these two things, and do bear in mind treatment intended to improve or maintain general physical condition. Now, as a person that likes to keep himself healthy, I think this is the thing most people should do, but this is just not something that we do directly with treatment. But this is lifestyle. So once a patient has reached a point where you’re doing this, certainly you want to put them on maintenance. And I do believe there’s a benefit to getting care, but it has to be paid by the patient, not insurance.

And then, of course, it says maintenance services when significant therapeutic is not expected. Now, one thing I would suggest on this last one, there are times that could be supportive care, so by example, the VA even indicates this and will allow chronic care. Let’s say you withdraw the services. When you withdraw the services, maybe after two to four weeks, the symptoms get much worse. They may well allow supportive care. And I want to be clear, I’m saying supportive, not maintenance.

Ultimately, medical necessity for acupuncture, in my opinion, is quite simple. Acupuncture really helps a patient decrease their level of pain, and as a result an increase in function. If you focus on both factors, the pain and the function, that is the easiest way to demonstrate true medical necessity because it’s not just the reliance on “I feel better.”

So I wish you the best. Please take a moment to download some of those forms. Ultimately, American Acupuncture Council is here for you. We offer lots of programs, whether it’s coding, billing online, whether it’s a live seminar with [inaudible 00:17:45]. but we also are online. If you want to go to Instagram or Facebook, we’re there, and we put out news. We’re not there just to promote a program, but to really make sure that you’re doing well. Our goal at American Acupuncture Council is to make sure you’re successful. Ultimately, if you’re not successful, we don’t have our own ways of dealing with making sure we have a business. We want to make sure this profession moves forward, and to give you a highlight, the acupuncture towards Medicare is still moving forward, so there’s a lot of positive things happening. And I’ll see you next time. This is Sam Collins, the coding and billing expert for the American Acupuncture Council, and I wish you the best.

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