Category Archives: Acupuncture Practice Building

Best of TCM Research in 2019 – Drs. Doran and Barzilay

 

Hi, I’m Virginia Doran, host of To The Point, generously hosted by the American Acupuncture Council. Today, my guest is Gil Barzilay, and if you haven’t heard him speak, you’re in for a treat. He has a big following internationally, and besides a diploma in Chinese Medicine, he also has studied Chinese and Macrobiotic Nutrition, Kiiko Matsumoto-style Japanese acupuncture and he actually went to college in London at the Imperial College there at the University of London. Has a PhD in from Oxford in Cancer Research and European Medical Biology, post-doctoral fellowship at the Weitzman Institute. He’s got 11 peer-reviewed publications in leading medical journals.

He brings a special dual knowledge in the field of cancer research as well as other kinds of research. He works in Tel Aviv in Israel’s leading complimentary alternative medicine clinic, Rehovot, and he teaches acupuncture, Chinese medicine, research issues all around the world. He’s part of the International Committee of Chinese Medicine, ICCM, which holds an annual conference, which I hear is just fabulous. He also works with the Evidence-Based Acupuncture Foundation and writes regularly, reviews and newsletters.

You can see him on Facebook at DrGilTCM and/or contact him through the ICCM or Evidence-Based Acupuncture. Anyway, without further ado, I would like to introduce everyone to Gil Barzilay.

Thank you, Virginia.

Sure.

What a long introduction. Yeah, that’s all right.

Well, you have a lot of credentials.

Thanks for that.

I wanted to ask you, what makes a good research study in your opinion and why? The studies that you’re going to speak about today, why are those your best of?

Okay. There’s about a thousand, I think, publications that are published on Chinese medicine every year. I get those alerts on Google twice a week. There’s a lot of information, but I think [inaudible 00:03:41] Western medicine research apply for Chinese medicine research without going into the debates, include having randomized controlled studies. So having a control, comparing a compounder to something.

There’s been a lot of debate on sham acupuncture, and I’ve seen some of the speakers that you’ve had before. I’m sure the debate of what sham acupuncture is and whether it should be controlled has been up there, so I’m not going to go into that, but there has to be a good control of some of the subs that have chosen to date had not been in any could control. They have to have a good number of patients. So of course if these Jersey studies are made in China, they sometimes can have thousands that are conducted in North America or in Europe. We’re probably talking about a hundred patient, maybe a few hundred patients.

Also, the third component of whether the study is good or not in my opinion, is having objective and [inaudible 00:04:47]. So we’ve seen a lot of placebo research that has been conducted actually in other universities around the world. One of the ways to better understand whether something works or doesn’t work is having objective and subjective measures. Because when you ask patients only, “Has your quality of life improved?” or something like that, it really depends on the data in the hospital or the clinic, so the answers can be so confusing and really not good enough for measuring the effect of an intervention.

Having a mix of both of them, these are the three that I’ve chosen have these within them.

Mm-hmm (affirmative). You know, I just wanted to interrupt for a second. I’m hearing a reverb. I don’t know, are you hearing it at your end, kind of like an echoing with the technology?

I’m fine. I can’t hear anything.

Well, hopefully the viewer won’t hear it. Okay, good. I guess there’s a little bit of one, but as long as we can still understand you. So tell us about your criteria for a good research study and why these ones are your best.

So, these are the three that I’ve chosen, but I wanted to start with putting things in little bit in a context of where we are now in terms of, not the world we live in, never talk about global warming, but I did want to share some slides. So let’s move into the slides that I’ve created. One second. Have I done something wrong?

Thank you so much for making these slides because it really helps the viewer to anchor that information.

One second. I need to put my glasses… new share.

Oh, I see the slides. Alan sees the slides.

See the slides, but they’re not moving forward.

You can’t see them.

No, I see them, but they’re not moving forward. Oh, now they are. Okay. Okay, no, something’s not working.

I see the title but not the content.

What’s up with the slide?

It says stopped sharing.

Okay.

All right, good.

Now it is on, but okay, let’s see. Okay, so I wanted to put things in context because I wanted to say that one of those things that has been… One second. Not working, yeah, I know. Okay, so one of the things that we’ve seen this year is that of course there’s some things coming about Chinese medicine for the fact that is making it into the clinics with the World Health Organization a categorization of acupuncture as a medicine. Of course that got some good headlines, and then some nasty headlines like the integration of quackery with real medicine.

We have, of course, on the right side you can see Novak Djokovic during the tennis U.S. Open bragging about being treated with acupuncture and the moxa. You see Lady Gaga showing you off her cosmetic acupuncture, but at the same time you have some bad news like Spain planning to ban alternative medicine in health centers. You have an article here that was published the Forbes Magazine that says, “Don’t do this: 156 medical practices that are all failures,” and saying that acupuncture is quackery again. Then you have this silly photo on the bottom right hand that shows guy and says that veterans deserve better than as something that doesn’t work like acupuncture.

On one hand you have some good news, but on the other hand you have some… And some people supporting us like Novak can maybe Lady Gaga and others. On the other hand you have some bad headlines as well. At the same time though, the treatment landscape is really changing. There’s a lot of issues with the opioids, you know it very well, especially in the States, but also in Europe, very high numbers of people dying and if not at least coming to the ER.

But it’s not only the opioids, FDA has put additional box warnings and contraindications on the insomnia medications. You have Xanax, which is now the number two problem after the opioids.

Really?

Yeah, and of course the nonsteroidal antiinflammatory drugs that look like Advil or Neurophin, that look very innocent, but actually increased double and even more than double the chances of having a heart attack. Even more common drugs like Advil and others have have real health issues coming in with them.

That means that people are seeking out alternative. When we have the evidence with research, whether we are really interested in conducting research or not, it can actually support our case with the different organizations and with the health authorities. You can see that treatment guidelines all over are now embracing acupuncture as well when the evidence was solid enough.

You have here the American College of Physicians are clearly stating that acupuncture is one of the treatment options guidelines with clear recommendations on a first and second level that acupuncture should be one of the ways to treat chronic and acute pain. You have NICE, which is the British body of excellence, clinical excellence, recommending that treatment will be given prophylactically for migraines. You have ASCO, you know the American Society for Clinical Oncology in dosing, acupuncture for breast cancer patients.

We have the American College of Rheumatology embracing acupuncture, and now you also have the Adult Stroke Rehabilitation and Recovery using acupuncture. So when you have research, perhaps not all the doctors, perhaps not all the medical community’s aware of it, but when you have evidence bodies and health authorities listen to you, and then they recommend it and may even include it, and I’ve seen throughout this year that several insurance companies in insurance bodies in America have also included acupuncture now as one of the modalities of frequent, so that can only happen when you have good research.

Absolutely.

After all of this introduction, I’m going to go into my top three for this year. So I chose top three that are not within a typical pain and migraine and other areas that we already have enough evidence that acupuncture works and there’s no point in repeating with an additional study that may demonstrate that acupuncture works for pain. We know it does.

I wanted to show some studies that perhaps not everyone is aware that exist, and are pretty solid, and I recommend that people go and read them in full. The first one is a study from Italy that looked at the effectiveness of acupuncture on pain and functional disability for people with rheumatoid arthritis. The studies from a group of medical doctors in Rome, they included 105 rheumatoid arthritis patients that were divided to get either real acupuncture or [inaudible 00:12:53] acupuncture, which I don’t usually like, but they included that. Acupuncture outside meridians or have a wait list, so not receive any acupuncture at all, while at the same time the entire group were continuing with their own treatment, whatever they had already for the RA. Either it was a nonsteroidal drug or a disease-modifying or biologics or any other analgesics that they were getting for their RA.

They received a treatment for three weeks and they were followed for additional four weeks and the points that they use there adjusting people are short of reading the study itself, it was Triple Burner five and Goldwater 39, Hartswean Keeper seven. Just to show you when I was talking about objective and subjective measures, I know this look complicated but it’s actually quite easy to read.

You have in a solid line those who receive real acupuncture, and the dash line, those who receive control acupuncture. You can see that they were doing some auger battery and arm strength as well and quality of life and pain. They were trying to assess pain. They were trying to assess the ability of people to move their hands and to feel pressure and how much pressure they can take on their hands. Of course also asking questions about quality of life. You know all these parameters acupuncture was better than a wait list or sham acupuncture. In fact, they were also looking at the number of swollen and tender joints, and there were also significantly decrease in those who received real acupuncture.

We know that acupuncture is good for lower back pain, for knee pain, whatever. This is one of the few studies that I’ve seen on rheumatoid arthritis, and it’s good also to see that it’s not only the pain but the also the functional, mobility of the patients to do things, to do normal things we do every day. That’s the first study.

Well, that’s good. I was going to ask you to explain to the audience what control acupuncture is. I haven’t heard that.

So control acupuncture, in this case it’s the sham acupuncture. They were asking if you saw on the first slide they were using acupuncture points that were not on the meridians that were relevant to RA. So that’s one of the options. One of the issues, of course, with that type of control or what is called sham acupuncture that we’ve seen in the past it doesn’t work. When you stick a needle in someone, something happens, it talks to the brain and it tells the brain, “Oh my God, you know, something has happened. React.” So just because it’s outside of the Meridian doesn’t mean there’s no reaction. That’s what we’ve seen over the years when the original studies came 30 or 20 years ago with acupuncture, we’re comparing to what they call placebo puncture.

They were comparing to needles that are at two points that are not supposed to be relevant to the disease that we’re talking, but they did actually work in a way. And so all the ones that don’t like us and think that we’re quackery or with some sort of holistic voodoo medicine, we’re saying, “You see, it doesn’t really work.” It works, even when you put needles in a place that shouldn’t work, it does work a little bit. So this whole thing, acupuncture is just not real medicine.

When they moved into doing better controls and/or comparing to people who are continuing to just take their medicine or not receiving any additional treatment, they could actually see the real effect. That’s how, in my opinion, studies should be conducted. But in this group took the double approach. They did a sham control and they did a waiting list as well. In both cases it was working better than either. So that was a good control.

Great.

Okay, so the second study, it’s actually something, and that’s why I put two studies here, but I’m not going to go through both of them, is a phenomenon that we’ve seen over the last almost 10 years. When you do acupuncture to patients who are depressed and are taking SSRIs, the results are faster, better and with less side effects. Some of the reasons from a mechanistic point of view, people have said that if you put needles then since we have seen already the effect that needles do on increasing serotonin levels in the brain, that could relate to that, don’t really understand the [inaudible 00:17:47] of why acupuncture actually helps for patients who are depressed and are already taking SSRI, but that’s effect.

This is a study that was trying to compare manual versus electro acupuncture as an add-on therapy to SSRIs. What they did, it was more than 400 patients. 156 were taking SSRIs only. 161 were receiving manual acupuncture, and 160 patients were receiving treatment with needles, with electro acupuncture. The patients were all on the usual dose of Paxil and Seroxat statin they were taking for six weeks, and the patients received treatment over six weeks with three sessions a week, and they were followed up for an additional four weeks. The points that they were using, you can see here is GV20, the Yintang, GV16, bilateral Goldwater 20, GB14 and bilateral pericardium six and spleen six. When you look at the results, they both showed that manual acupuncture together with the SSRIs or electro acupuncture were both significantly better than SSRI.

At six weeks the response rate for the SSRIs was better. There was an early onset. The level of depression that was assessed is one of the markers as well. Side effects were lower and also the number of patients that had to have their SSRI dosage increased was lower with those who received acupuncture. So acupuncture really does good for patients. I think it’s a good thing to know because I’m pretty sure that there are quite a few acupuncturists that when the patients ask them, “Do treat depression?” or “Is it going to interfere with my therapy that I’m taking now?” The answer is clearly, “No, actually probably it’s going to work better.”

Mm-hmm (affirmative). Now, would it affect the dosage they would need to be taking?

It may affect over time. In this specific study, they actually showed that the number of patients who had to have their SSRI dosage increased over time was less when they received acupuncture, so there was no need to even go and increase your dosage. It’s only one study that actually assessed this. I wouldn’t see that as the key outcome of this study. But the fact that it’s keep on repeating yourself is quite interesting. I think that many people, we’re all very easy sometimes on treating pain because we know it works, but some of the more, life [inaudible 00:20:41] it’s good to know that if a patient or a relative asks, “Does it work with [inaudible 00:20:47] or clear with my therapy?” The answer is definitely not. It may actually even enhance it, and you may even have less side effects.

Mm-hmm (affirmative).

So that’s good news.

Yeah. Definitely.

Okay, let’s go to the third study. This study made a lot of noise in the last year because it was published in JAMA internal medicine, which is a very important journal. It was looking again at acupuncture as adjunct therapy for chronic stable angina. The reason why it caught some attention is because the results were too good or there was a community to relieve. So there was some nasty headlines I’m not going to go into, but if you just Google it yourself, you’ll see some nasty headlines on WebMD and other website of people really unhappy with the results.

Mm-hmm (affirmative).

Yeah.

Antithetical to what it should be. Instead of being happy there was something for patients, they’re more concerned about the political aspects of it.

Well, the thing is that I never really understand it because if the results were choose acupuncture, don’t take drugs, I would have understood it. But actually this studies acupuncture together with the existing drugs. So there’s no competition here. Always saying is, Let’s integrate,” or “Let’s see whether acupuncture actually even improves what the drugs are doing,” because the drugs can only do up to a certain point and they don’t even work very well. [inaudible 00:22:31] we’re not taking off the presses. Don’t worry about it.

[inaudible 00:22:36] pharmaceutical. We’re just suggesting that if you add acupuncture, you can even have better results and your patients will be happier. We’re not taking their job or their sales, but that’s the way it is. Yeah. So these were again, 400 patients. It’s a nice number. They were divided into receiving acupuncture on the disease on meridian. These are [inaudible 00:23:05] bunch on the non-affected meridian sham acupuncture, which was a not real points and no simulation and wait list. In my opinion they’ve done a little bit much [inaudible 00:23:19] after all, but the [inaudible 00:23:22] we had more patients than what they chose to do.

It was four weeks, three times a week, and then six weeks follow up. So that’s a long followup as well. You can see all in all, it’s about four months. And again, no harm to the patients. All received their anti-anginal whichever day were making them ready as recommended by the doctor. So you could be a bigger block. It could have been [inaudible 00:23:57]. So I feel safe.

Yeah.

Now, if you look at the results, you can see here the frequency of angina attacks, and you can see here that the patients who received the real acupuncture and the reduction is significant. [inaudible 00:24:14] well, attack to less those received and none acupuncture. Meridian had also some reduction, but down to 10. Sham acupuncture down to 10, and those who were on the wait list had a reduction of one attack, one and a half attack.

Now, the interesting thing is that, remember that all the patients are continuing to take their anti-angina drugs, but they don’t work. Because you can see they started with almost 14 attacks, and they ended up with about 12. When they had acupuncture, it was halved, so the number of angina attacks you had was down by half.

Like I said, WebMD, [inaudible 00:24:59] it didn’t matter, and you don’t call [inaudible 00:25:06] top cardiologists, Americans in Europe saying that this results are too good to be true. Since this study was not done in America, you never know what happened, who conducted this study and whatever the results were, made up or something. So that’s the way it is.

That’s amazing. That’s a really dramatic one. Yeah. I like that.

Yeah, and that’s a reason perhaps they didn’t like it is that you can see that since since the patients were taking the drug and it didn’t really work, they were seeking additional options, but there are no real additional options. You can go to natural path, you can go to your homeopath or I mean, or acupuncture. That’s about a few of the alternatives. [inaudible 00:26:10] do to drugs obstacle therapies. So yeah, the results are too good to be true, but that’s the way it is.

The reverb was a just occurring a lot. Alan said to ask you if you have a cell phone maybe nearby.

Near? No, no, no, it’s two rooms away from me.

Huh, okay. All right. I have one nearby, but I don’t know that that’s it. I can’t read what… Okay. So you know, with a little bit of time that we have left, can you talk about acupuncture and the research that’s relevant for the opioid crisis that we have. I mean it’s really an epidemic here. It’s so unfortunate and the politics don’t really support the real regulation of the drug companies with the pharmaceuticals that have… Not that that’s the whole root of the problem, but that’s a big portion of it, how it became so big. Can you speak about that from your knowledge?

Yeah, Alan has written something that is important. Cell phones should be off no matter where it is. Okay. It’s off. It really is off. I was a good boy before.

Yeah, so I’m just curious, is there much research for that? Things that we can give to doctors or patients? I mean, there is for pain, but what about addiction?

There is some research on addiction as well, especially the one that was done with veterans in the U.S. with the veterans’ associations and several of them. I think there isn’t enough research that has been done. That’s perhaps part of the problem, because I think in the first few years after the opiod crisis has become such a crisis that the people, you know, the American Physicians Association and others had to react to that and seek alternatives.

The first instance was for an alternative and so acupuncture would be an alternative for treating pain. And that’s correct, and that’s worked. The American ACP and also the American Medical Association, all the other associations, including a bunch of also one of the ways, one of the modalities people will notice. Then only since about 2016 or ’17 you start seeing research being developed and done now on whether [inaudible 00:29:16] in addiction.

We begin to see the results now. The results are interesting and positive, but I think the studies that I’ve seen to date are quite small, and so [inaudible 00:29:32] happy with with. It’s interesting and it’s going in the right direction and perhaps it’s even not even surprising but I don’t think there isn’t enough publications to wave and say, you know, we can also help with coming off addiction.

We can definitely do that and we know we do that, but the research is still, I think, [inaudible 00:30:00] to available. Talked about it.

Is there anything else you wanted to say in conclusion? We’ll have to have you back at another time to talk about things and get that sorted out.

I would just recommend for people to once in a while, I mean if you’re not interested in looking for research or if you don’t know where to look for it or read it, look at for example, the summaries that we are doing the evidence-based acupuncture website, because that has a lot of resources for people who don’t have the time to read or really not interested in research, it’s too complicated. [inaudible 00:30:47] and all of it is okay.

We summarized the highlight and we tried to make it accessible so that every therapist, wherever they are in the world can actually discuss it also with their patients, because we know that when patients sit in our office or lie on the bed with needles, they start asking questions for their brother, sister, mother, son, neighbor, and sometimes it’s beyond what they themselves came for. But there’s a lot of evidence out there and so if you can’t be bothered and that’s totally okay, go for example the DBA website and have a look at that, or look for research courses.

I’m sure there are in America, there’s some online as well and there’s plenty of research around that we can use and convince people. Local hospitals, local clinics. [inaudible 00:31:47] integration. No one is saying that acupuncture is better than drugs or that drugs are better that well. pharmaceutical companies are saying that drugs are better than [inaudible 00:31:58], but I think that if we integrate, it going to work really well. This is where we have integration in all hospitals, it’s really amazing, in oncology, in pain, in orthopedics and some psychiatric.

It’s working quite well. It took 10 or 15 years of fighting with the evidence. So you need to know the evidence for that.

But you know, we owe people like you and Mel Hopper Koppelman and John [inaudible 00:32:31], so many people, I can’t even name them all, but it’s really a gift, what they’re doing for the field, and we need to support that. It’s a really great organization and it’s for the sake of all of us.

So, anyway, thank you so much for coming, even though you’re in Tel Aviv and I’m in Connecticut, but thanks for taking your time to share your knowledge and we’ll hope to have you back again sometime.

Thanks so much for having me.

Yeah, I’ll just say goodbye to everyone. Again, I’m Virginia Duran, your host and my website’s LuminousBeauty.com and Gil Barzilay. You can see by his Facebook, DrGilBarzilay is it?

No, DrGilTCM is the easiest way to find it.

DrGilTCM on Facebook, and of course the Evidence-Based Acupuncture site. So thanks again, and we’ll see you after the New Year. Okay.

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3 Strategies to Grow Your Practice – Lorne Brown & Jeffrey Grossman

 

 

All right. I’m glad to be back on the AAC to the point webinar, giving you practice management tips and advice. My name’s Lauren Brown and I’m a doctor of traditional Chinese [inaudible 00:01:06] CPA. I practice in Vancouver, British Columbia, Canada, at Accu Balance Walden’s Center, and I’m the founder of Healthy Seminars. Today I have a guest with us. His name is Jeffrey Grossman. He is an acupuncturist and is the founder of Acupuncture Media Works and AcuPerfect websites. So we gel well because we’re both acupuncturists with an entrepreneurial spirit. He’s been doing this since 2002. He’s been creating, sharing patient education materials, marketing tools, practice building materials and websites for the acupuncture profession. What I love about Jeffrey is that he understands that many practitioners think that marketing and sales and we’re going to talk about this today and something they just really don’t enjoy doing. However, it’s necessary because if you don’t sell yourself, who will?

His goal is to make the business of building a healthy, successful practice, fun and easy, and in a way that feels genuine and stress free. So with integrity, it is his passion to help practitioners grow their practice so that they can help more people spread the message of both the powerful health benefits of acupuncture and change the world. So we share that value that the world needs more prosperous acupuncturists to help end the suffering in the world. So let’s bring on Jeffrey Grossman. And we decided that we’re going to talk about the three strategies that he likes to grow your practice, both in slow times, they’ll basically in time. So Jeffrey, welcome to the show.

Thank you so much for having me on, Lauren. I really appreciate it. I enjoy doing these types of talks or interviews or trainings or whatever you call them with you. Because you said, we do share a similar passion and without people like us and others in the world, and helping motivate and support the profession in their business and their marketing skills. The profession I feel will struggle a little bit because we’re not bred to be business people. We are bred to be healers, right? It may have taken us many different [inaudible 00:03:05] to become the practitioner that we are today. But being an acupuncturist you also have to be a businessperson and you are by that an entrepreneur and you’ve got to wear multiple hats. That’s and one of those hats, as you know you mentioned, it’s business and marketing. That’s what we’re here to talk about today. A couple of strategies that can help build your practice in slow times or pretty much anytime.

All right, well let’s talk about this because we know there’s a yin yang relationship to help when yin yang separate or there’s a disharmony, we get disease where we die. And the same thing with our practice. If you only focus on clinical, we’re not saying not focus on clinical, you need to be an excellent practitioner. But if you only focus on clinical neglect the business, your yin and yang of your business starts to separate and you suffer in practice or you have to find a new job. So let’s start off with… you talk a lot about how to easily build a referral practice without sounding salesy. Because I think that’s where a lot of us, in the culture of Chinese medicine, we just feel uncomfortable telling people why they should see us. So can you talk a little bit about how we can build a referral practice and feel good about how we’re doing that?

Sure. Well, one of the things I teach at practice management class in Washington here and one of the things I talk about with the students is how to ask for referrals. And it’s really pretty simple and really straightforward. The biggest thing you have to do is just ask. That’s really what you have to do is just ask for the referrals. And the best time that I have identified when to ask for referrals is just when patients come off of the treatment table. Because they’re feeling different, they’re feeling shifted, they’re feeling a little more energized or a little more pain-free or whatever it is that’s going on with them may have shifted a little bit. So they’re little more available to receive this conversation.

And when patients come up with treatment table and you ask them how they’re feeling, and if you’re asking them if they’re… let them know that you are trying to build a referral based practice and that you now have some openings to receive some more referrals and if they’re willing to help you out. And I think it’s been an important conversation that I’ve had with my patients over the years is to get them involved with helping to build the practice in the community. Because a healthy community keep… a healthy practice leads to a healthy community, which leads to a healthy environment for people to live in. And its been on of the thing-

I’ll add to that Jeffrey. I want to add to what you just said for them to really apply this to the clinic. So as Jeffrey’s saying for this referral is ask for it. So basically you’re letting your inside voice come outside. Because really if a patient comes off the table and I often will do it when they say, “Oh my God, you fixed my back”, or, “My eczema is gone”, or, “You helped me got pregnant”, or whatever it is. When they are telling you how happy they are, what you’ve done, my inside voice is, “Oh great, I wish I could treat more people like you. Would you please let them know about me?”

All Jeffrey is suggesting is let that inside voice be your outside voice. Because they’ve just given you praise and so you really [inaudible 00:06:19] it this way, “Hey, I’m really glad you benefited from the treatment. If you have any family or friends that are struggling with the same thing, can you please let them know about me? Because I like treating people just like you.” All right, continue on Jeff. I just wanted to give him a [inaudible 00:06:33].

No and that’s exactly it, Lorne. That’s the conversation to have. Because the thing is, I’m going to talk about this later on too, but you’ve got these levels of patients practice, A patients, B patients and C patients. A patients are the ones that you love, that you look at your schedule and you’re like, “Yes”. Your energy is like really resonant with them and it goes up. The C patients, you look at your schedule, you’re like, “Oh, okay, I can pull this together, I can work on these people.” And I was doing a talk just to one [inaudible 00:07:04] not too long ago and I talked about this very thing and I got a bunch of giggles because people get it, they understand that there’s these levels of patients, the ones that you really resonate with and the ones that you don’t.

And those are the patients that are really willing to refer to you and that are really open to it. And a lot of times patients don’t even know that you even have the ability in your schedule to receive patients. So that’s important to even let them know that you are now able to accept more referrals, that you have time in your schedule. And again, that all goes back to just asking patients at that opportune time, when they’re feeling better, when they’re feeling a shift, and literally having a conversation with them that, “Hey, I’m really glad that you’re feeling better and we helped many people like that with the same condition that you’ve been suffering with. And if you could think any people around off the top of your head who can benefit from the type of care that we’ve been offering you, if I give you some of these cards to hand out to those people, would you be willing to give those to those people?”

So just [inaudible 00:08:18] expectations with our listeners as well, is we get that it feels uncomfortable, especially at the beginning. That’s why you’re not asking because it feels uncomfortable and you don’t want to feel uncomfortable. So just to let you know, you’re going to have to find some courage to do the ask. What Jeffrey is saying you got to ask otherwise they don’t know. And then it’s nice to do it after they have just had a great benefit and just say you would love to treat people like them if you know any friends and family, end of story. All it is is your internal voice coming into your external voice. The other expectation I want to let you know is not everybody is going to send people, so don’t take that personally, but if you don’t ask, you’re not going to get that anyhow. Any other tips for easily building referral practice? Otherwise, I’m happy to go and ask you some… pick your brain on a few other topics.

Yeah. Well, I just want to add one more thing about that. So when you start planting the seeds for referrals in your practice or anytime type of marketing for that matter, basically what you’re doing is planting the seeds and it’s not going to produce growth overnight. Every type of marketing activity that you do, every referral you ask for, every healthcare you attend, every talk you do, whatever it is that you’re putting out there in the world isn’t going to reap benefits immediately. So don’t get discouraged when you go out there and you do your health fair and no one comes in or you don’t convert people to be a first time paying patient or if you ask for referral and you’re not getting those immediately. Because again, it takes time and something that you mentioned Lorne, is it takes comfort and confidence to make that happen.

And I know a lot of practitioners are very introverted and they might not have that ability or that comfort level whether do you feel confident enough to ask these types of questions? One little insight I would love to share with you that changed my entire life of being in practice was joining Toastmasters. That shifted my existence and gave me the confidence and the ability to really probably even stand up and do this conversation today. I’ve been doing it for years and years so I feel super comfortable standing in front of a camera.

But when I started joining Toastmasters, and there’s a Toastmaster in every single city all around the world, I believe, and it just changed things for me. It gave me more confidence, I felt more assured of myself and my speaking abilities. So that’s one little tidbit I would love… if you guys are feeling unsure or not confident in your communication skills, check out Toastmasters. And check out a couple of them before you actually commit to one of them because there’re multiple ones probably within your zip code.

Good tip. Now we got about 10 minutes left cause we like these to be short, and powerful and impactful. So hopefully we can get through some of the questions I had for you. What do you recommend to position yourself as the go-to acupuncturist in your community, what advice do you have for our listeners?

Great. Well, a couple of things. I think getting out there as the go-to acupuncture is in your community you need to create a presence out there. You shouldn’t be just hiding behind your clinic doors day in and day out and just going in and leaving at the end of the day. You need to be out there, you need to be doing some health fairs, you need to be doing talks. That can really help position you as that go-to acupuncturist authority figure in your community. And, excuse me, and hosting internal events in your clinic, like patient appreciation days or end of the year holiday events and things of that nature. And one of the things that’s really important about doing any type of these external activities, whether it’s a health fair or a talk and you’re putting yourself out there, if you need something that you could be using to direct those people back into your practice.

I’ve talked about this plenty of times. We brainstormed it with probably you in the past, Lorne, but also in my practice management class, we are creating specific calls to action that get people from the outside world to step foot in your practice. And these are really important because with all the marketing that you do, you don’t want to just go to a networking event or a talk and at the end just be like, “Okay, see you good bye.” Or not have anything that you can hand out at networking events. You want something that you could literally hand off to people, whether it’s a practitioner to give to their patients or whether a prospect who might become a patient that will literally get them to step foot in your practice.

So aside from becoming… doing all the external marketing and getting your name and your face out there and being the voice of reason when it comes to health and alternative medicine in your community, it’s having something that you literally get people to take action to step foot in your practice. In the past we’ve talked about offering free mini stress reduction treatments, reduced rate clinical exams, comprehensive evaluations that are either free or low cost or something like that. So it’s something that can you easily create, there is Vistaprint out there, you can put something together, you can talk with your local printer or create a gift certificate itself. But it’s really a big piece I feel, of the marketing puzzle, that is overlooked in many practices.

So you’re suggesting, and I love this, always have a call to action and just get yourself out there? So doing talks, writing blogs, writing articles for third parties. I love your acupuncture happy hour that you recommend for that stress reduction in the clinic. And you can check of Jeffrey’s website because he’s got material on that and some PowerPoints on that idea. So it’s a fabulous idea. Patients get introduced with the minimal obstacles to come to your practice. They get to come in and have the relaxing stress free treatment is kind of a fun phrase. We call it Acubalance, my clinic Acubalance happy hour. You call it acupuncture happy hour, but it’s great. All these activities I want to remind you guys as well is, if you love what you do and you’re doing it to give rather than to get, then it’s really positive and you have a good experience and the vibe goes out to the public and the patients.

If you’re doing it to get, then you’re coming from resistance and they usually don’t work out so well, to be honest. It’s funny how that works. So you do it and it’s just that give or gain. Just having faith that it will come back to you. So you love the medicine and you want to help your community heals, so that’s the mindset. So now write an article to educate them, write a blog, an article for a third party, the happy hour, doing a talk and you’re getting yourself out there. And as Jeff said early on, a lot of these things, we call these stepping stones, as in they’re not like you do this and somebody automatically comes to your clinic, but if you do these several things and you do them over a period of time, months and years, you really get a cumulative effect, a compound effect.

So it’s not like, oh, you do a talk and you say, “Oh, it didn’t work.” Yeah, if you do one talk, you can’t assess that. Just like a patient comes to you and you do one treatment and they say it didn’t work, it doesn’t usually happen that way, right?

Right.

So it’s the same idea with this. So great idea with these call to actions.

Right. And I wanted to say one thing, one quick thing about the acupuncture happy hour. That has been in the past been one of my go-to tools to get people to come in to try the medicine and convert them to becoming first-time patients because it serves multiple purposes. It gets people in your clinic, it helps them overcome the fact these objections about acupuncture. Okay, most people have multiple objections about the medicine and it helps them overcome the fear issue that needles hurt because I use serin red, half inch needles, super tiny, super flexible in the ear, two point, point zero shenmen, right?

So they’re feeling that the problem is pain free. It overcomes their objection of does it work because they’re actually leaving the space, they’re shifted. Because I mean, I’ll ask all of you practitioners right now, if you do Point Zero Shenmen on your patient, are they going to feel different? Would they feel shifted leaving the space? They will. There’ll be on cloud nine or maybe cloud seven or getting up there either way, but that’ll help overcome that other objection. And those are the two main objections I feel like offering some type of event like that does. And it’s a great way to offer from a top or a healthcare class is come on in for free mini stress reduction treatment and a happy hour event. And then one other thing I wanted [crosstalk 00:17:00].

I love this as an objection for patients that, “Oh, it hurts”, or, “I don’t know if it works.” So this is great because you as a practitioner love the medicine and you want to help people, you want them to feel relaxed. They just have to get two points and then they feel it, experience it and you can’t describe that in words. So really, I love this happy hour in these two point Shenmen and Point Zero to really let them see how simple and how they can really experience that relaxation with acupuncture. Because a lot of people think, “How am I going to relax with needles in me?” Great idea. What’s the last last point you had there?

Oh, the last point is okay, so you mentioned this earlier that we as acupuncturists have this tremendous gift of healing, of transforming lives. I can talk about multiple people’s lives that I helped change over the years. I’m sure you can too. I mean, you’ve probably made many babies and families in the world here, right? And all of you out there, probably have experiences where you allow transformation to occur in your patient’s lives. Now my question to be hide that? Why not shout from the rooftops that this medicine is amazing because it absolutely 100% is safe, natural and effective and it shouldn’t be hidden.

So our marketing then should be standing on the laurels of the fact that this medicine is transformative, it’s amazing, it changes lives and that we have this gift from the tip of our needles that makes that shift happen. So knowing that, knowing that you are affecting change in a positive, creative way, why hide that from the world? I understand that people are self conscious and that you’re not feeling confident and that you’re not sure about what to say or communicate, but there are people out there, there are courses out there, there are ways to shift that conversation that many of us have been having all too often in our own lives that hold us back from being an amazing practitioner that we could be.

A great point. And this is that idea of marketing is salesy. So maybe just change the terminology because what you’re really doing is education. So Jeff said it so nicely, there’s people that will benefit for what you have to offer and you got into this profession because you want to help people. And so being quiet, you’re actually a disservice to your community because they don’t get to know about you. So just think of this as educations rather than you’re trying to get them in for your benefit. Think about it differently that educate the patients, if they know about you and they now understand the benefits, they get to choose whether they want to see you or not. So it’s not like they have to see you but they’ll never know about you or have the desire to see you if they don’t know about you and don’t know how you can help them.

So just call it education because that’s what marketing is, it can be just public education. Get yourself out there. Ask for referrals. If you get a compliment in the treatment room, just saying you want to see more people like you. And as you mentioned, keep investing in yourself. You talked about courses on practice management. So at healthyseminars.com we got more courses. Keep investing in yourself because that’s what’s going to make you attractive to your patients as well. Constantly build your confidence, constantly educate yourself.

And as we discussed this at the very beginning there’s a balance. You got your clinical skills, keep working on that. But we tend to not look at our business skills at all and most of us are struggling. Many people are struggling or have to find other careers and that’s not a service to the public either. So now’s the time to start to add a little bit of that, investing in your entrepreneurial skills. And so that way you can do what you love, which is treat people versus sitting in an empty treatment room.

We got to close up here, Jeffrey, any closing remarks? And [inaudible 00:20:57].

Yup, one last closing remark is thank you Lorne for having me here. I really appreciate that. The last closing remark is we owe it to our patients currently in our practice to market our practice to get out there because if we don’t we might not be in practice for very long. I’m not trying to scare anyone around this, but other people, if we don’t market our business, they’re going to find help elsewhere and maybe not the best kind of care that could be afforded them. That’s my last little insight into that. I’m sure you and I could talk for a long time about business and marketing so-

We’ll do this again on the… if you’ve seen this on Facebook, make a comment, actually what topics would you like me to have on the show? And I can do with Jeffrey if you have somebody else you want me to interview as well, post that in the comments as well. I’m happy to have other guests that you want to hear from and have a discussion with. Love to have you back again, Jeffrey, as well. I want to let everybody know that next week on the AAC to the point webinar, we have Virginia Doran, so tune into that.

Thank you Lorne.

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