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Acupuncture Malpractice Insurance – What Is Medical Necessity?

I’m having insurance carriers that are coming back and pushing back on some providers or they’re requesting additional information. How do we define it?

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Greetings, everyone. This is Sam Collins, the coding and billing expert for acupuncture and the profession meeting American Acupuncture Council and you. I’m getting a lot of questions as being an expert dealing with lots of issues from writing articles. I get people asking all the time. How do we make sure we have medical necessity?

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I’m having insurance carriers that are coming back and pushing back on some providers or they’re requesting additional information. How do we define it? But I want to go beyond just the carrier. What really is acupuncture medical necessity? How is that defined? Let’s go to the slides. Let’s get into that a little bit and start to give you a good understanding of how do you want to start to approach this, or at least begin to define it.

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So you can define your care. What is acupuncture medical necessity, and who says? Of course you can have the patient. The patients are going to determine medical necessity. Whether or not they want it or not is going to be part of the necessity. Does it make them feel better? Who also determines it?

You, the provider, the doctor, if you will. You’re defining it. How do I define it? What is it that the person should feel? What should they be better about? Or what are we doing? Are we just getting rid of pain? And then, of course, we have to deal with it from an insurance standpoint. And how do we meld all of these things together to start to bring to what really is a necessity and how we might define it maybe slightly differently depending on who it is.

From a patient standpoint, think of it this way. A patient’s going to say, it makes me feel better. It has value. If you can have a person that had migraines. And they come to you now and their migraines are 75 percent less or not at all. There’s a value. They’re going to pay you for that. That is something that they see a value proposition for.

Do keep in mind though, people do things, and this is something my mom always defined, that’s why I’m quoting her. She says people buy what they want and beg for what they need. Have you ever had someone borrow money from you before? Maybe they’d pay rent or something. And then they haven’t paid you back, but the next time you see them, they’re wearing a brand new pair of shoes and you’re thinking, wait a minute.

How’d they buy a new pair of shoes? Haven’t paid me. Because they begged for what they needed, which was to pay rent, but they bought what they wanted, what were shoes. I want you to think of, for cash patients, You have to be the shoes. The person wants it because there’s enough value. How do we create the value?

Because they feel better. They can see the change. So realize that even applies and of course applies for insurance or excuse me, for cash, but even insurance to an extent. Remember, some insurances pay really well, but what about the ones that don’t? High deductibles. We have to create that the patient can see the value.

For me, for acupuncture, this is where I think our biggest growth can be. As people try acupuncture, They begin to realize how much it works. Realize that in the VA, while not very many people are seeking out VA benefits, but do you know for people who do get VA, 38 percent are going to acupuncturist. What are the responses?

It’s very good. Why wouldn’t a VA patient want it when they can see it makes them feel better? Because at the end of the day, it’s treating someone to get them to go, oh, there’s the value, there’s no longer fear. So bottom line is a patient finds it, did it help me? And how do we define health? Always by, do I feel better?

Does it have any less pain? And that’s going to be either with insurance or cash. But create that so the patient understands what are the expectations of care. And then of course it’s how you define it as the acupuncture provider. What are you defining it as? As chi or energy, the very more of A traditional medicine basis, or are you going to go just into, hey, let’s talk about it from pain or dysfunction.

In fact, if you have a loss of qi, what is it going to mean? Maybe a loss of energy, but pain, dysfunction, functional change. And so setting up what the expectations are, what are your goals? So if someone comes in with a headache, what’s the goal? No headache, lesser headaches, less intense. Less back pain. I had someone that completely didn’t want to go to an acupuncturist a few weeks ago, an athlete, I recommend it.

I don’t know. I’m afraid of needles. I said, you got to try it. Turns out acupuncture has helped her. And she, in fact, she was able to compete this past weekend and win a medal at the world championships. Bottom line is, Once people try it, they know it helps. Here’s the end of the day. How are we defining that?

I think it’s mostly getting to people so that they can see that the care is helpful. At the end of the day, necessity is, I got to feel better. Acupuncture really is genius and simple. How does the body communicate? When something’s wrong, the body almost always communicates with some level of, I don’t care what, he could be cancer, you’re gonna have pain.

So therefore, acupuncture, I think in its genius, has always focused on that communication. But that communication, we can go beyond to say, it’s not just about pain relief, but long term health. Changes to be healthier. Let’s talk about it from an insurance standpoint. What do they see it as? How do they define it?

Insurance says of course, we know obviously it’s pain. It could be acute, chronic, nausea, vomiting, pretty well covered as well. But it has to be medically necessary, must be delivered toward a defined response. something evidence based, like I can show that the patient is better as a result, meaning they want a continuation of treatment that is contingent upon progression towards defined treatment goals and evidenced by specific significant objective functional improvements.

And again, this goes back to outcome assessments. If you’re not using outcome assessments as an acupuncturist, You’ve got to begin. It’s the easiest way to define your changes. It’s the one most accepted because it’s right there. It’s black and white. The patients start off with a 70 percent disability and after three weeks of care they’re down to a 30%.

Yeah, you’ve made them better. Evidence base is going to be your basis. And it says ongoing services, including monitoring of outcomes of progress with a change in treatment plan, withdrawal of treatment if the patient is not improving or regressing. So in other words, simply put, if the person is not improving, it’s not medically necessary.

There’s got to be a change. Now, you could argue without the care, they would get worse. Here’s what it said. Once the functional status has remained stable for a given condition, without expectation of additional functional improvement, any treatment program designed to maintain optimal health in the absence of symptoms or in chronic conditions without exacerbation of symptoms.

In other words, now it’s maintenance. Now, I’m a believer that And health. When you really think of when we say health insurance, is that what we’re really saying? Are we saying sick insurance? And therein lies the difference. And this may be the bridge of getting a patient to understand, are we going to wait for you to get sick?

Are we just going to keep you healthy in the first place? Why eat healthy food? Why go to the gym? Why they have a better lifestyle? All those things are part of health, but we have to start to find where does insurance fit. And it doesn’t always when it comes to healthcare. And there’s going to be a defining difference of getting the patient to understand, which means we’ve got to really understand it from this standpoint.

What are the expectations? Pain. Decrease it. Make them feel better. The body always responds that way. Now, there’s some things that may not be associated. There are some carriers now that even cover PTSD and anxiety. And maybe they’re not painful, but there’s an outcome of change because there’s improvement.

And I don’t care what you have. If you make a person better, they’re going to have better function. Functional improvement, though, best defined by clinically meaningful improvement on validated disease specific outcomes. If you have a headache, use the headache index. You have PTSD, use that index. Low back, use that index.

There’s all types. If you’re a member of our service, we’ve got them all on our side for you. Here’s the bottom line is, show me how the person is better and what they can do in their life or activities of daily living. Of course, any reduction in pain medication. We are the Society of Drugs. How many times do you watch a TV show that they’re advertising a drug?

They don’t even tell you what it’s for, but just say you better look. What about a decrease there? Let’s keep the person healthy. And then objective measures demonstrating the extent of meaningful improvement. So again, always focus on the patient improving because it says here, additional treatment or as an example to reach further durable improvement or ongoing management.

It’s got to be improvement, not stabilization. And of course, anything that you think is causing the patient to have this recur, it’s going to be improved. is going to be an important part because there is a difference between purely supportive care, meaning I’m keeping them even, or flare ups. Flare up comes, we calm it back down.

Bottom line is medical necessity is defined by, am I making a person better? But who is defining it will determine the payment. A patient will define it easy. You’re making me better out of pain? But once I’m stable, the value’s not there. Where do I fit for insurance? The same way. Your goal. Do what you do well for your patients.

Get them better. Define it in ways that people can see it objectively, and in ways that you can repeat. Ultimately, continue doing that job. The more access people get to acupuncture, the more you’re going to see more people, because realize, once a person goes into acupuncture, it’s oh my god, I didn’t think that was going to work.

That’s really our goal. We’re seeing it in the VA and other places. Your bottom line is, Defining necessity by your methods, by improvement, and melding all of those together. They’re not exclusive, but certainly you’re going to have a lot of patients that may not have coverage. Medical necessity is they feel better.

That’s what you do. I wish you well, my friends, and I’ll say the American Acupuncture Council, our network is always there to help you. In fact, we have an upcoming webinar on VA. You can watch it and view it. I want to make sure that you’re doing as best you can to utilize your business, and as your means of a good lifestyle, but the thing you really like doing is helping patients.

Till I see you again.

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Acupuncture Malpractice Insurance – Spleen and Kidney Channels and Lumbar/Abdominopelvic Dysfunction

And this is part two from a presentation I gave on the stomach channel. So we’ll compare the anatomy of the stomach channel with the spleen and kidney channel.

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Hi, I’m Brian Lau, I’m with AcuSport Education, also with Jingjin Movement Training. We’re going to be looking at the anatomy of the abdominal region of the spleen and kidney channel today. And this is part two from a presentation I gave on the stomach channel. So we’ll compare the anatomy of the stomach channel with the spleen and kidney channel.

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So just a little bit of a heads up I have multiple hats like many of us do. One of my main hats is I’m an anatomist. I lead dissection with AcuSport Education, but also with the University of Tampa. Physician Assistance Program. So I do a lot of exploration in human anatomy. So that’s the lens that we’re going to be looking at as we delve into these Fascial layers of the spleen and kidney channel.

But of course all of that gives a lot of clinical relevance So we’ll talk about it from a clinical perspective also. So let’s go ahead and go to the PowerPoint We’ll start looking at initially the spleen channel. So I have these, Additions to Netter’s Atlas of Human Anatomy. They don’t have the acupuncture points on this.

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Like I put these on manually. Netter is just one of the gold standards of anatomical illustrations, and it’s just such great illustrations that I thought I would add the adapt it by adding, in this case, the spleen channel. And as we know, the spleen channel is on the lateral edge of the rectus abdominis so useful information, but we can talk about the significance of that in just a second.

As we travel down to the lower portion of the spleen channel on the abdomen, we have spleen 12, spleen 13 at the inguinal ligament, spleen 12 also, but it’s on that lateral border of the femoral artery. So this will be our first window into understanding the depth in the fascial layer that makes up the spleen channel.

So keep that one in mind as we go to the next image. So what this next image is showing, also from Netter’s Atlas of Human Anatomy, is the arteries. There’s another image for the veins. They run together, but the vascular structures of the anterior abdominal wall. First of all, notice that this epigastric artery in the vein, like I said, runs together.

directly with it. That’s in a separate illustration for Netter, but that’s fine. You get the general idea that it’s running along here. That branches off of the femoral artery, or excuse me, the iliac artery in that region where it’s connecting with the femoral artery. So it’s branching off of that region of spleen 12.

And where does it go? It goes deep to the rectus abdominis, behind the rectus abdominis, And that’s the territory that it travels. In my mind, this is the Chiang Mai. This is the the vessel that you can palpate on the front. You can often feel a strong pulsation, especially if people don’t have good circulation in the aorta.

More blood shunts through this area. So it’s like a reservoir. It can open up or close up depending on the needs of the body. And it runs and follows the trajectory of the Chiang Mai. It branches into the thoracic artery and vein, which go to the breast, kind of one of the functions of the chong mai.

Sends out branches along the intercostal arteries and veins, and then eventually it branches into cervical arteries too that go up into the face. So That’s the territory that we’re looking at for the spleen channel. We’ll look at another image in a second on that. Also the chong mai follows the kidney channel points.

So again, we’re looking at a fascial layer that lives behind the rectus abdominis. And that’s going to be the deeper yin channel territory of the spleen and kidney channels. So here’s the kidney channel points. The kidney channel points are going to be on the medial edge of the rectus abdominis, pretty close to the linea alba, 0.

5 sun. And it’s going into the rectus abdominis muscle, but my target tissue is not at the rectus abdominis, but that posterior rectus sheath. So when we compare that to the spleen channel on the lateral edge of the rectus abdominis, same thing. It might be into the muscle, but posterior rectus sheath is going to be my target.

So this would be an easier image to look at if we can see a cross section to understand that layer. So here where we were last time, when we looked at the stomach channel is following these fascial layers of the external oblique, a little bit of the bifurcation of the internal oblique fascia going on top of the rectus abdominis.

The needle can get into that anterior rectus sheath, maybe potentially into the muscle. But that’s the territory, that’s the depth, that’s the region that I want to address when I’m treating it. Whereas, if I’m in the spleen channel, or the kidney channel, we’re looking at the internal oblique fascia, transverse abdominis fascia that goes posterior to the rectus abdominis.

So this posterior rectus sheath. So if I’m coming in at the spleen channel at that semi lunar line, I’m into this window of tissue that goes deep to the rectus abdominis. If I’m coming at the medial edge of the kidney channel, again, I want that needle to traverse down to that posterior rectus sheath. So I want to affect this layer here, multiple importances of that, but one very simple one is if I look at this bigger cross section, rectus abdominis.

Spine, erector spinae, quadratus lumborum. Is that fascia layer is continuous with the transverse abdominis and the internal obliques? And that’s going to continue to come into a seam at the thoracolumbar fascia as a structure called the lateral raphe. And that lateral raphe is going to separate into a deeper layer that goes between the quadratus lumborum and rector spinae, and a superficial layer that goes above the rector spinae.

So point is when I’m treating this deeper fascia layer, I’m speaking to, communicating with. The musculature like the quadratus lumborum and rector spinae. So there’s a lot of fossil communication between the front and the back through these abdominal fossil layers.

If I follow that posterior rectus sheath up first of all, let’s go back to the anterior rectus sheath. If I follow the anterior rectus sheath, part of the stomach channel, that’s going to go superficial to the ribcage. So I’m looking up at the diaphragm, there’s the xiphoid process, the stomach channel would go on the anterior surface of the ribcage.

If I’m following that posterior rectus sheath up, that’s going to blend in with the diaphragm. So it’s a different layer, only separated by, an inch and a half, two inches, pretty small distance. But but it makes a big difference internally if I’m going deep to the ribcage, and wrapping around to the back versus going superficial to the ribcage.

So this is my interpretation with the spleen sinew channel. It connects with that ribcage, excuse me, connects with the diaphragm, loops around and attaches to the spine through these attachments of the diaphragm called the cruciate the diaphragm. So when I’m treating this fascia layer, I’m going to have a much bigger impact on breathing much bigger impact on spinal health also.

Kidney channel, the kidney sinew channel doesn’t really travel through the abdomen, so I didn’t use that image, but there’s a lot of discussion with the kidney channel of how it loops into this region of related fascia. Especially with the lower rectus abdominis, it has a lot of connections into the pelvic floor, through the abdominal layers, into the multifidi.

This is the low connecting channel. It talks about that channel coming up that layer. We’re talking about posterior rectus sheath following the kidney channel to a point just below the, um, pericardium. The pericardium sits right on top of the diaphragm. So that’s exactly what it does. It comes to a point right to the, just below the pericardium, and then it loops around into the lumbar spine.

Like I said, a lot of anatomy, you don’t have to get in the weeds with it. But there’s much more of a connection with the diaphragm, much more connection with the pelvic floor, much more of a connection with the lumbar spine when we’re treating that posterior rectus sheath. That’s the take home. So let’s look at some pain patterns that are common when you’re treating the rectus abdominis.

We looked at this one with the stomach channel also because you could get trigger point formation in the belly of the muscle or at stomach 25 and this tendinous inscription between bundles of muscle. But very frequently. When there’s dysfunction here, it’s more on the edge of the muscle at that semilunar line, maybe a little bit of the obliques, maybe a little bit of the rectus abdominis fascia.

It’s like a triad between the muscle groups of the obliques, rectus abdominis, and that fascial seam where all of that fascia comes together. That can be a very prominent area for trigger point formation that can give a very gassy, distended feeling when you palpate it. Maybe that’s what patients are complaining about.

They often want to stretch that area sometimes that can refer all around to the back it can refer deep into the pelvis, it can feel like it’s internal in the pelvis. It’s a pretty broad distribution of pain that patients might either complain about or might be a component of their low back pain, for instance.

Or distention, bloating, et cetera. So along the spleen channel is the very frequent aspect of where these trigger points form. Anywhere from spleen 15 to about level of stomach 27 is pretty common. So you’re feeling at that semilunar line, feeling for fibrosity. I usually push a little into the edge of the rectus abdominis.

Another region where there’s common trigger point formation would be the medial edge. Now we’re at the kidney channel. So if I’m at that medial edge, it’s like I can scoop deep to the muscle and, I’m palpating slightly into the rectus abdominis, but I’m really feeling more for that posterior rectus sheath.

It’s like I’m going through that medial edge to get to the posterior rectus sheath. I can direct into the rectus abdominis itself, or I can direct into the linea alba along the REN channel. And same thing, a lot of pain, especially below the belly button umbilicus, maybe halfway between the pubis and the umbilicus is a common region.

It’s not going to always be exact. But along that kidney distribution is a very common area of trigger point formation for deep abdominal pain, especially abdominal pain that’s related to menstrual pain, dysmenorrhea. So for those patients who are having very difficult sensations during menstruation, this is a key area to look at.

You also have this paramedis muscle, which attaches to the linealba. That’s going to be at the lower kind of kidney 11 region that you’d have access to that. That can give a certain amount of pain in that abdominal area that can spread up to the umbilicus. The lower portions. We talked about this one of the stomach channel could be at the lateral edge along the stomach channel because this muscle narrows quite a bit as it gets to the pubic bone.

There’s not a whole lot of space on the muscle left here at the pubic bone, but really often it’s in that mid belly just off the linea alba. That’s where you frequently get this deep radiation bilaterally into the lumbar spine. And iliac crest region that can be its own pain pattern driving lumbar pain, but it might also be a component of things like lumbar facet pain.

Very important area to palpate, usually just above the pubic bone. Sometimes you even have to press the muscle into the pressing it into the pubic bone to elicit this sensation. But it’s a common area where there’s trigger point formation that could be a big component of lumbar pain that you wouldn’t necessarily think if you didn’t know the referral patterns.

Obviously you’d be palpating in the iliac crest, gluteal muscle, sacral area, lumbar spine. There might also be trigger point formation there because of its communication front to back. But don’t forget about this area. Alright, just a good netter image to see that. Spleen channel runs along the lateral edge, stomach channel runs in the middle, but as I get lower down, that line of the stomach channel really takes me to the lateral edge of the rectus abdominis.

If I move over a little bit to the kidney channel, that’s frequently where I’m going to find that trigger point formation right up against the pubic bone. Whoops.

I’m going to go back to this muscle. The other kidney channel points will take me through that medial edge so I can get to the rectus abdominis and feel into that posterior rectus sheath, spleen channel points. Again, I can through that lateral edge of the muscle at that union where it’s going to then dive deep underneath the rectus abdominis.

So any aspect that I’m needling through kidney and spleen, my tendency is to think into that posterior rectus sheath, which is slightly deeper than the muscle. So last time we looked at the motility of the stomach organ. This is looking at the kidney organ because movement in this area, if we can free the movement and control the abdominal movement we can get that flexion extension.

The kidney organ itself moves along the psoas. As I take a deep breath in, that drives the kidney down, it creates a certain amount of rotation in the kidney also, and the exhale and the diaphragm rises, the kidneys rise with it. There’s a movement from diaphragmatic breathing that if I can open that up by working on the the channels, increased breathing, that can be helpful, but it can also allow me to get a more more, efficient movement that can help mobilize the kidney organs, which is going to have good impact on the kidneys themselves, but also with lumbar pain and abdominal type situations that could be involved with the channels.

All right. So let’s look at a exercise that I do and I teach quite frequently. It’s called the spinal wave. I have a video for it. I can talk through some key points. This will be on the PowerPoint. Let me get to that slide. And this is on my YouTube channel, JingJinMovementTraining, if you want a reference, I also go into more verbal instruction on it.

But this one doesn’t have any narration, but I’ll narrate over it. Spinal wave is engaging the rectus abdominus. lengthening it. Engaging, ribcage comes closer to the pubic bone, so posterior tilt, neutral to anterior tilt, posterior tilt, anterior tilt. Same time, that ribcage drops, so this is a different variation where I bring that wave up to the whole spine.

And chest opens, but same spinal wave.

And this video shows variations with the arms and sending that energy out the arms, but whether you get that aspect of the patients, that initial one with the hands on is really the key starting position for patients, there’s a rotational version, et cetera. So you can build on it. Like I said, there’s this instruction is on my YouTube channel if you want to look at it a little bit closer.

All right, so maybe I have a few moments to go over that in my studio. I’m going to exit the PowerPoint and let’s back up and we’ll look at that real quickly.

All right, so let’s look at the spinal wave. I often, when I’m working with patients, I have them put a hand, and I do it myself this way too, put a hand on the lower rib cage and put a hand just below the umbilicus. So lower dantian. The hands aren’t doing anything. The hands are just helping me find that movement in the abdominals.

So the idea is I want to initiate that movement by pulling the pelvis up in the pubic bones. I’ll take me into a posterior tilt. Ribcage descends. Expand. Press. Expand. So I’m using the abdominals to drive spinal motion, drive kidney motion. Inhale, fill that area up. Exhale, compress starting from the pubic bone, rib cage follows.

Inhale, exhale. So you can also start this seated with patients, because very frequently patients are stiff with the spine, or yourself if you’re doing it for your own health. Sometimes they just want to do it with the knees, so they just move the knees or they move the hips or something like that.

But they have to engage the center. So pulling up the pubic bone, down the rib cage. Top hand shifts back, expand. Bottom hand shifts back, top hand shifts forward. Press, expand. Press, expand. So it takes control, takes practice, you’re engaging the front, expanding the front. You actually engage the transverse abdominis quite a bit, this one.

That’s why I like this one for the kidney and spleen channels as you’re starting to engage. Those deeper abdominal areas, exercising, massaging, increasing circulation between the front. Very nice. Thanks for checking this webinar out. Also, thank you to American Acupuncture Council, I always appreciate the opportunity to go over this information.

A lot of fun for me very exciting stuff in my mind hope you enjoyed it, and I will see you guys another time.

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Acupuncture Malpractice Insurance – The Concept of Yin Fire in Pediatrics Part 2

I’m going to be, this is going to be part two of YinFire

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Hi, my name is Moshe Heller, and I’m from Moshen Herbs, and also Jingshen Pediatrics I’m going to be, this is going to be part two of YinFire, and I want to thank the American Acupuncture Council for hosting me. And so let’s go right into the slides. Okay, so the first herb of of this formula, or, and the emperor herb, is Huang Qi radix astragali, and it really works on supporting the, helping the spleen raise the clear qi up, and so it is it actually addresses the main mechanism, and Lidongyuan really like this herb to be included because it also helps support the lung qi and and the exterior and regulate the the opening and closing of the pores, meaning that it helps to close and prevent spontaneous sweating because of this relationship between the spleen and the lung.

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Li Dongyuan said that when the spleen is when the earth is deficient, then the suffering next phase will be the metal or lung. Therefore by support, by choosing Huang Chi, not only are you supporting the main mechanism that’s failing in the spleen, but you are also supporting the lung.

It’s also very interesting that I remember learning with Ted Kaptchuk this learning about Huang Chi, and he said and stressed the idea that if you want. Something. You wanna take something to help you do something? Take one Q. If you try to take RenQian for that thing, it won’t make you do anything, it’ll make you stop and think.

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So RenQian actually works more on this kind of ability to process thought, whereas HuangQi actually activates and make you, helps you, give you energy to do things. So that’s like at the core of this formula Baichu again is another minister that helps in the transformation of dampness and for, and the transport, transportation and transformation process of the spleen Zhegansao supports that too and helps in harmonizing.

It’s very interesting that DongWei is included in this formula because DongWei actually provides a balance for RenShen and FengQi and allows them to be more balanced by supporting the ying qi aspect of the, um, the process. And as we know, dang gui is the herb that supports the qi of the blood.

So it’s the more yang aspect of the blood. And that’s why dang gui is really important in supporting balancing qi and blood. And and harmonizing the functions of formula. ChenP is included also to support the transfer, moving the qi and supporting the transformation and transportation.

Meaning that the tonifying, cloying nature of the above herbs are mitigated by ChenP. And then the most interesting part of Buzongi Chitang is the last two envoys, the Shengma and Chaihu, which together are, they’re both in the warm acrid section and of herbs. So you might think, oh, this is not a great formula or combination for fevers, but Actually, Buzhou Nishitang is a very important herb for combination for fevers, as that’s what Li Dongyuan made it for.

And the idea is that the warm, acrid nature of Shengmai and Chaihu, other than lifting the yang and supporting that kind of uplifting effect it also helps in warming and helping with the issues of the spleen vacuity. So this is an amazing formula. It has a lot of variations and can be used for a wide variety of symptoms.

As when we read about it in Bensky, there are three main symptoms. Patterns that yeah, that it addresses, one of them, the collapse of the central gene, meaning we know it for collapse of organs like hemorrhoids and stuff like that. But originally that was that was an expansion of this formula, but it’s an amazing formula, as I said, and has a lot of application, a lot of variations.

I invite you to check it out. explore it and use it. And it’s it’s quite an interesting combination. Thank you for listening. And please visit first of all, Moshen Herbs. This is my herb, the herb company, which I Buzong Mi Qi Tang is not there, but there are many herbs that you can use and also Jingxuan Pediatrics is where we might present some of those lectures.

So this is the end of part two of the concept of yin Fire in Pediatrics. I would like to thank the American Acupuncture Council for hosting this talk. And I hope to see you soon. Thank you.

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Acupuncturist Business Insurance – Frequently Asked Questions

The fact that you are reading this post means you are aware of the value of acupuncturist business insurance. It provides protection for your business and your professional reputation in several ways. Indeed, it forms part of a well-established acupuncture business.

Here are some frequently asked questions about the benefits of acupuncturist business insurance:

Why do acupuncturists need insurance? No one is immune from malpractice complaints. Even if you are an experienced and highly qualified acupuncturist, it’s always possible that an incident will happen inside your premises. Your business needs malpractice insurance for protection from financial losses that often occur when a patient files a lawsuit.

What types of insurance do acupuncturists typically carry? Premises liability, professional liability, business personal property, and coverage for different professions are some options for acupuncturist business insurance.

What risks do acupuncturists face without proper insurance coverage? Patients may lodge a lawsuit for alleged negligence or errors that can result in costly legal expenses and settlements. You may also face issues like failure to comply with licensing requirements, professional standards, or healthcare regulations. These issues may lead to fines, penalties, or legal actions against acupuncturists.

What factors should acupuncturists consider when selecting insurance providers? Include in your list of prospects insurers with years of industry experience, good reviews, solid portfolios, and a license to operate.

How can acupuncturists find the right insurance policies for their practice? If you already have a list of prospects, the next thing to do is request quotations from each of them and present your specific business requirements. Then, if you already have chosen the stand out from your list, make a follow-up call to discuss more details of their products.

Are you looking for a reputable acupuncturist business insurance provider? Look no further than the American Acupuncture Council. Call us today at (800) 838-0383 for inquiries.

Acupuncture Malpractice Insurance – Secrets of Marketing Your Facial Acupuncture Practice PT2

So there are a lot of different facets to marketing facial acupuncture. And some of them are very similar to marketing any acupuncture practice. Some of them are very unique.

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Hi, my name’s Michelle Gilles. I am an acupuncture physician practicing in Florida, and I want to thank the American Acupuncture Council for this opportunity to speak to you today about marketing your facial acupuncture practice. Now, last time I spoke in part one, I did an introduction to marketing your facial acupuncture practice, and if you missed it, you can check it out.

And today, I am going to pick up where we left off last time, so if you can go to the first slide.

So there are a lot of different facets to marketing facial acupuncture. And some of them are very similar to marketing any acupuncture practice. Some of them are very unique. So today we’re going to talk about mailing and newsletters. blog posts, community engagement, workshops and seminars, and collaboration with other wellness practitioners.

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So when we think about marketing, one of the things, one of the terms that is used is lead magnets. And what that means is ways that you can bring people into your practice, things that will attract more business. So podcasts are a great idea. Things like we’re doing right now, where you either through a short or a long version of a podcast, give some information about a particular topic.

Doing happy hours is a great way to bring business into your facial acupuncture practice. Now, these do not have to involve alcohol. You can do a happy hour where you maybe teach your clients something. And you would have refreshments. And then you can provide Maybe something small like a serum or a little takeaway for them and you would educate them as to the benefits of facial acupuncture.

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You could offer free treatment. Red light treatment or maybe a quick hand microneedling. That’s another way to attract more people into your practice. Creating a book like an actual physical book or an online book with information about facial acupuncture, tips for self care at home. Also, on your website and in your social media, you can do surveys and quizzes.

People love to answer those things and that can bring more business in that way. Additionally, having A webinar where you do something longer online or a workshop where you might perhaps teach your patients how to dermaroll or do facial cupping and gua sha. Those types of things where it’s self care and you’re giving them a useful tool.

Also, going to health fairs is a wonderful way to attract more patients, because you can have people fill something out for a prize, you can do a skin assessment, you can do a health assessment, feel their pulses, look at their tongue, and talk to them about skin care for their particular. constitution type.

For the health fairs, as I mentioned, you can do a skin assessment. You can do little promo cards, and on the promo card you might give a discount on maybe a product that you sell, and then also list the benefits of facial acupuncture. You could give those away. You can have. Other promotional items, little collagen eye masks, massage pens, the one in this picture, where people can roll it on their face, and then the name of your practice would be on there.

You could do a spin the wheel, have one of those wheels, and people spin the wheel, and they get some sort of a prize for winning. Next slide.

Additionally, use your website. On your website, you can have all of your blog posts, testimonials, before and after photos, an ebook. So on your social, you would have a link to your website where people can see on your social. If I click here, it’ll take me to the website and I can see the testimonials, the before and afters, read the blog posts, etc.

Also, you can do mailings. Now, these can be actual in the mail mailings, or you can do mailing through email, and there are several different elements to mailing. You want to have a hook, and the hook might be a question, such as you why do people go to facial acupuncture? That might be the hook, and then people will open it, And maybe on the second line, it’ll say, click here to learn more.

And then once they’re opened, the logo should be on the top. And then in the body of the email, you might want to ask a question, state how you will solve their problem, maybe how they’ll feel after they’ve had a treatment, but always have a call to action. Don’t just provide information. and not tell them what to do.

So the what to do might say call our office, go to my website. Those types of things would be a call to action and always have a link to your website and any social in the email.

So here are some examples of marketing hooks that you might have in your email, like in the subject. So examples are three smart, three things smart people do when trying to, and then you would put in the outcome, tighten their skin, three things smart people do when trying to lose dark spots, or three mistakes people often make when trying to.

And then you put in the outcome. And also magic keys. Giving them like some kind of magical key to fix whatever their problem is. The one thing that I finally did to And then the outcome. Get rid of my dark spots. Tighten my loose skin. This is one thing my patients do on a regular basis. So these are the types of things that are going to cause people to want to click on your email.

Some other ones for your Maybe your blogs or your website or some promotional material that you might hand out. So reveal your natural beauty, rediscover radiance, unlock your skin’s potential. And all of these types of hooks will have a first part and a second part. So goodbye to fine lines and wrinkles Embrace, embrace youthful skin through facial acupuncture.

Shorter hooks can be helpful. Not everyone wants to read a very long hook. So having something shorter, unlock the secret to glowing skin today. And if someone sees that in their email, they’re more likely to click on something that sparks their interest. Your key to radiant beauty awaits. Revitalize your appearance.

Just one click.

When you’re working on your newsletter, there are a lot of different ways to put one together. Many mailing things like Constant Contact or MailChimp have their own way to design a mailing or you can just design it in Word or in Canva and it’s You want to include either part of a blog post or a link to a blog post that will take them to your website.

Have the testimonials in there. Do the before and afters. Write in your newsletter. You can have a contest. You can have famous quotes. These are all things that can, when put together, can really make for a really nice newsletter that you send out. Blog posts should be short. People should be able to read it.

in less than five minutes and sometimes if you put at the top how long it’s going to take to read it that helps as well. You can embed it right into your website and make certain that there is an image and that the image has attributes to it and says what it is. And these are all things that help Google to find your blog post.

Put this in your social and in your emails. So when you take the time to create a blog post, you want to have links to it in as many different places as possible. But the most important thing is that you optimize it for SEO. So don’t just write the blog post and think, Oh, it’s done. You want to make sure that your SEO is optimized so that the when Google is looking for a keyword like melasma, it can find it because you’ve included that in your keywords, but your keywords have to actually represent what’s in the article or it won’t work.

Community engagement is also important. Providing donations to different organizations, advertisements. If there’s local fundraisers going on, join a Rotary Club or any business networking groups in your area. Things like Women’s League. All of these types of organizations can connect you with more people.

And people do business with people that they know and they like. You can also do collaborations with other wellness practitioners. So go to a spa and tell them about what you do. See if they’ll hold on to your business cards. Salons, OBGYNs, they’re all about women’s health and wellness. Massage therapists.

And. You take their cards as well, and cross refer to one another.

This is a list of some of the classes that I teach if you want to learn more about facial acupuncture, and how it can help you to bring more business into your practice. Facial acupuncture is a great way to expand the scope of what it is you do. It’s very popular, and I teach classes. I have a certificate course.

I have an advanced certificate course, and I teach facial cupping in Gua Sha, derma rolling, skincare, microneedling, ethics, safety, neuromuscular treating neuromuscular conditions and even self care for acupuncturists. So once again, I want to thank the American Acupuncture Council for this opportunity, and I look forward to seeing you next time.

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Acupuncture Malpractice Insurance – Stomach Channel and Lumbar/Abdominopelvic Dysfunction

So today we’re going to be looking at the stomach and spleen and kidney channel, primarily the stomach channel.

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Hi, I’m Brian Lau. I’m an instructor with AccuSport Education with the Sports Medicine Acupuncture Certification Program. I’m also help lead the dissection classes. We do a lot of dissection within the program, which is something that’s very relevant to my discussion today. And I’ve been also working on a lot of functional movement patterns organized through the channel sinews which is through Jing Jin movement training.

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So I’m going to present on some of this information today. I want to thank American Acupuncture Council for having me back. I always appreciate this opportunity. So today we’re going to be looking at the stomach and spleen and kidney channel, primarily the stomach channel. We’ll have a part two of this webinar, which will go more into the spleen and kidney channels.

But specifically the abdominal points, a little bit of the anatomy, the depth of the fascial layer that we’re reaching with the needle or manual techniques. Or really your exercise or whatever intervention we’re doing. We want to understand a little bit about the depth, the layer, the target tissue, all of those things.

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So let’s look today at the stomach channel primarily. I have an image up here from Netter’s Atlas of Human Anatomy. So this image doesn’t have these acupuncture points on. It doesn’t have the stomach 27, stomach 25, etc. I put those in manually. Let’s play. But the netter image is really good anatomical illustrations that can give us a little bit of a understanding of the anatomy.

So first thing to notice that the primary aspect of the stomach channel is going right into the midline of the rectus abdominis until I get down lower, we’ll talk about those lower aspects. It also changes as I get up to stomach 18 and goes more to the edge of the rectus abdominis, but by and large.

They’re running up and down the rectus abdominis right along the midline. Another thing to note, looking at the anatomy, is that the rectus abdominis is our six pack ab muscle. For a very lean and muscular, you can see those six pack abs. You can take note that it’s actually eight packs.

There’s a pack up here that’s not very visible, even when people are very muscular and lean. It’s a very flat sort of pack, so there’s actually four on each side, but people see these three. That would give that appearance of the six pack ab muscles. And with that, you can notice these tendinous inscriptions.

So we’ll talk about some of these points that lie right on these tendinous inscriptions. Much more fascial it has a little stronger connection with the surrounding fascial structures. And sometimes I think there’s a little bit more bang for the buck on these points stomach 25, obviously a very big point.

So we can feel and palpate for these tendinous inscriptions. They’re not super obvious in palpation, but you can sense them, you can feel them. You can fall into a slight little valley. off the muscle and that can help guide your palpation and guide your needle angle, needle technique, et cetera.

So we can just initially take note of that, that the points are either in the belly of the rectus abdominis or in these tendinous inscriptions. There’s some variation on the themes lower, And some variation on the themes higher, but by and large, that’s where the territory that we’re going to be in today.

Next webinar, we’ll jump over to the spleen channel and the kidney channel on the abdomen and look at some of the variations of that theme there. So where are we needling? What are we affecting? Multiple things. One is that we have these branches of the thoraco abdominal nerves that wrap around.

They actually travel between the internal and external obliques. They pierce the semilunar line the fascial seam that’s right at the lateral edge of the rectus abdominis. We’ll come back and talk a little more about that next time. And then they, from there, they innervate the rectus abdominis muscle.

They also come back superficial and have cutaneous branches pretty much along right where the stomach channel is. So these would be for T7, T8, T9, 10, 11, and all the way down to 12. Important to note that the, those levels are also the levels where there are innervations for the celiac plexus, for the stomach organ, for multiple organs in our digestive tract, the intestines, et cetera.

So there’s going to be a lot of communication through the nervous system between this innervation of the rectus abdominis and the innervation of things like the stomach organ. So that’s going to be helpful to understand that there can be various visceral, somatic, and somato visceral type reflexes.

Organs are cranky, the muscle is going to get cranky. If the muscles are cranky, the organs are going to get cranky. There’s communication between the two. So that’s going to be part of our effectiveness of needling. These abdominal points is their relationship to the organs. It’s also worth taking note that some of these branches of nerves, like the subcostal nerve has a a bondage.

cutaneous branch that travels in the front through kind of ASIS region, anterior hip, GB29, that kind of area. There’s other nerves from the ilioinguinal and hypogastric that also become cutaneous. So abdominal muscles and the back muscles that are innervated in this area can often refer along these cutaneous branches.

There’s just a lot of communication through the nervous system that’s relevant to the pain patterns. and the dysfunction that we see that would lead us to using these points. So that’s something to notice. These nerves travel between the internal and external obliques. Let’s look at another image and talk about the fascia layer.

All right, so this is an image, both of these are images that I made, so it has a little bit more channel specific language in here. This would be the territory that those nerves are running between the internal and external obliques. If we follow this fascia layer, let’s look at what happens. This fascia, external oblique, all of it goes above the rectus abdominis.

Internal oblique, the fascia actually bifurcates. Some of it goes on top, some of it goes underneath, deep to the rectus abdominis. So for the stomach channel, we’re following this fascia that goes on top of the rectus abdominis. It becomes the anterior rectus sheath. And this is the territory, in my opinion, of the stomach channel is that needle penetrates or as I’m palpating or if I’m doing manual techniques.

I want the target to be that anterior rectus sheath, possibly the muscle itself. So this portion right here. So that’s the territory very frequently. I’ll just bring the needle to that first density on that anterior rectus sheath and try to stimulate a sensation, see if I can get a traveling sensation.

We’ll talk about where we want those to travel to, what we might be looking for those points here in just a moment. But that’s it. That territory of the anterior rectus sheath. Consistent with the external obliques, somewhat the internal obliques also. If I look at that image on the right here.

You can see that would travel through this external oblique fascia. That external oblique muscle does not fascially connect with the spine. As we get into the deeper points in the spleen and kidney, we’ll look at how that really has a much stronger connection into the lumbar region and into the spine through the fascia.

We’ll come back to this next time. But we’re on that target tissue just on top of the rectus All right, so if I follow that anterior rectus sheath and the rectus abdominis up through this channel sinew, if I wanted to look at it that way, the stomach sinew channel, that’s going to travel on top of the ribcage.

So that continuous fascial plane that’s coming up the thigh meets at the abdominal muscles with the rectus abdominis and that anterior rectus sheath will then travel on that uppermost end eight pack muscle, so to speak that goes on top of the ribcage and that’ll follow up into the sternalis and pectoral fascia and then up into the neck.

So it’s superficial to the ribcage, anterior to the ribcage. That’s the full plane. I will bring our focus back here. There is a nice connection to the lumbar spine through the stomach channel, especially the sinew channel that travels up the vastus muscles and into the thoracolumbar fascia here. So this is nice territory.

To consider for lumbar pain, especially when the pain is at the sort of lateral raffae, lateral edge of the the erector to go back to the image just before, when the pain is at the seam right here, that’s a very commonly, you’ll find tension and restriction at the lateral quadricep, that could be a nice distal point to work with that thoracolumbar fascia up here.

But in terms of rectus abdominis, we’re going to put our focus here. That’s going to be consistent with that superficial plane up into the chest as we look at a corrective exercise for abdominal restrictions for the stomach channel. We’ll come back to that idea in a second. All right. So let’s look at some trigger point referral patterns that would give us some indications of when we would consider these points.

Thanks. Locally, at least, we could also add distal points, but we’re going to keep the conversation on the local needling. So let’s start with the upper portion of the rectus abdominis muscle. This is from Travell and Simmons, Myofascial Pain and Dysfunction, Trigger Point Manual, excellent book.

I’m sure many people are familiar with that. This is an older edition image. The newer third edition, they don’t have the X’s on here anymore. This was common areas. where trigger for trigger point formation might form. They weren’t exactly like target tissues, measurable type things. They could, had quite a variability from person to person.

But it was through primarily Janet Trevelle’s experience. Dr. Trevelle would find common areas where trigger points formed and she put the X to somewhat signify that. They’ve taken the Xs out because trigger points can form anywhere in the muscle. I the old version to be honest.

Because there are norms, I guess you can make an argument that if you’re looking for something that you think should be there and it’s not, it can lead you astray. I think that was some of the argument for taking them out. But but I do think that there’s some value in having the kind of go to areas that are fairly consistent.

And this is the case for this upper abdominis muscle. It can have, first of all, a bilateral referral to the mid thorax region, pain that travels horizontally across both sides, pretty common pain pattern that people would obviously think, they would want massage on the back or acupuncture on the back and oftentimes those erector spinae might get a little cranky in response to that because of that noxious kind of irritating signal from the referral of the erector subdominus.

But as you’re working in this region manually with acupuncture, whatever, people frequently feel it refer back to that site of complaint. So first thing is to find it with palpation. The other thing is this area can be common for epigastric type pain, especially in that region locally. Nausea even just irritation of fullness, abdominal fullness difficulty taking a deep breath.

This area can really lock the breath down. Those are all symptoms that I would be considering that would lead me to palpate up in this area. And generally stomach 20, which is one of the points right on this tendinous inscription would be a very powerful point for that. She has the X a little higher up.

Those can be along the rib attachments can also be. Trigger point formation, but I find stomach 20 is the most common sort of go to for that region. So back to Netter, stomach 20, can’t really see that tendinous inscription here. It’s hidden under the fascia in this illustration, but it’d be in this general region as I go.

get into that even with pressure, it feels like it pulls all that tissue down. Almost feels like you’re pulling the diaphragm down. It helps the diaphragm descend a little bit. So this is really useful point needling also with manual therapy, but again, the target tissue would be into that tendinous inscription for stomach 20.

But also I do a lot of manual work here and you can look at the fiber direction that I would want to be able to free the fascia up at this connection of the external obliques and the rectus sheath. So this area can get very congested, narrowed, pulled in, looks like the chest sinks in that region, and I often want to broaden that area by doing a nice deep myofascial stroke away from the midline.

Whoops, sorry, I didn’t mean to click there. But also working on the stomach 20, I’ll show you some variations of some manual techniques I do here in just a moment that I can just do seated on myself. All right, next region is we have this peri umbilical region. This to be honest will be a bigger player when I get into the next webinar it covers the spleen channel because very frequently these will be on the edge of the muscle, but it’s not uncommon to be on the stomach channel stomach 25 in particular can be a really big source of what we’re about to describe.

This can give a very gassy, internal bloated type sensation when there’s trigger points there. And pressure on it will refer all throughout the abdomen, sometimes even into the hip, deep into the pelvis, wrapping around to the back. It can be a pretty broad pain referral. Stomach 25, very useful.

Stomach 27 region is another one that, that’s quite frequently again along that tendinous inscription can be a big component of that type of pain, but we’ll come back and talk about it. Along this lateral edge in the spleen channel and look at the difference in the anatomy next time, right?

So just again back to Netter so we can see the territory for today. Stomach 25 into that tendinous inscription. We’ll look at palpating that. 26, 27, that’s another one that tends to be in that tendinous inscription. So those 27, 25 are the ones that I most frequently find in the stomach channel that gives that kind of gassy, bloated, distended area can be involved with things like constipation working on that area can make it easier for people to have bowel movements.

So there’s just a lot of reflexes between these areas and the internal organs, right? Another kind of region of common trigger point formation we’ll come back to when we look at the kidney channel, these tend to be more medial along the kidney distribution. We’ll talk about the difference in anatomy next time.

So final one, final region is the lower portion of the muscles. And this could be anywhere from stomach 30, which now, because the rectus abdominis is narrowing, now we’re going to be at the edge of the rectus abdominis. The spleen channel travels along that edge, but when the muscle gets closer to the pubic bone attachment, it narrows quite a bit.

The line of the stomach channel falls on the edge of the rectus abdominis there. So it’d be more of a lateral kind of edge of the muscle very frequent area of trigger point formation for low back pain. So that’s going to create this sort of horizontal band of pain into the sacrum and along the iliac crest, oftentimes bilateral, just like this.

It can be a very similar pain to lumbar facet joint pain. And sometimes those two go hand in hand, that it could be a little bit of both. contributing to that horizontal band. But easy to think about the lumbar facets for that and do tests for the lumbar facets. Maybe not quite as apparent to consider the rectus abdominis muscle.

So definitely when you have this type of pain distribution in including palpation and orthopedic evaluation for the lumbar spine, I would encourage you to look at the rectus abdominis if you’re not already. All right, and here’s just an image. You can see what I’m talking about. Spleen channel follows along that lateral edge, stomach channel right in the middle.

But as the muscle becomes narrower and I get down to stomach 30, then I’m on the lateral edge. So trigger points form on that lateral edge, sometimes in the belly of the muscle. It’s a little trickier to distinguish. between the kidney channel and the stomach channel there. But to be honest, I think it’s more often the kidney channel.

So this is another one we’ll come back to in just a bit. All right. So last thing I’m going to come back up to the stomach region up to that upper part of the erectus abdominis and notice underneath that the stomach organ is there. In this area, if there’s a lot of restriction in the rectus abdominis it can impair just normal, good, healthy stomach motility.

So as you take a deep breath in, that stomach has a various ranges of motion. It does rotation in the transverse plane. It kind of moves in the sagittal plane, rolling forward. And it creates sort of a rotation in a diagonal aspect also. So I don’t know if you need to memorize all of the different ranges of motion unless you do visceral based osteopathic type techniques or Tui Na techniques that work with the organ motility, but just having an appreciation for that motility is really very important because as we open up the organ.

The rectus abdominis create more space, create more potential for movement here. That’s going to encourage a little better stomach movement with the breath. It’s going to allow for a deeper breath and really help that healthy motion that kind of massages and mobilizes the stomach organ. So let’s take the PowerPoint away.

We’ll look at a couple manual techniques. And then we’ll look at an exercise to work with this anatomy, especially that upper part of the channel for this class. All right, so we’ll look at an exercise, but let’s first talk about a manual technique. Obviously, this would be done with a patient prone, but it’s easy enough to do on yourself, even standing or seated.

Xiphoid, I need to be careful of the xiphoid process, not putting a lot of pressure on the xiphoid. I’m actually over the rib cage. So just lateral to the xiphoid process, I want to hook into that fascia and mobilize and move that fascia like I’m pulling open the ribcage, moving it lateral, spreading along that lower portion of the ribcage, pretty sensitive area on a lot of people, but I’m not putting a ton of pressure, just sinking to the level of depth to the ribcage, angling, spreading, opening.

So really nice technique that I teach. Very simple to create more space and more openness there. I could also find that tendinous inscription. I can feel the muscle. If I’m careful, I can notice a little dip into that tendinous inscription at stomach 20. Same thing at stomach 25 would be the same technique.

And I just want to press Soften that tissue. It almost feels like I’m pulling that tissue away from the costal margin, creating space. So just some holding pressure there or I could also spread laterally in that same way if I wanted to. Very easy techniques that you can follow up with after needling, and they can give a lot of assistance with creating space, more movement, freeing the tissue after the needling.

So the last thing, we’ll look at a corrective exercise to move and stretch the rectus abdominis, but especially this upper portion. This is from eight pieces of brocade. It’s called Separate Heaven and Earth. I want to start. With my rectus abdominis slightly contracted, pulling up on the pubic bone attachment, that’ll take me into a slight posterior tilt.

Rib cage is slightly pulled down, so I’m bringing my upper and lower attachments closer together. Bottom hand facing up, top hand facing down. My hands change, but think that the hands are moving because I’m opening the front of the body up. Pelvis goes to neutral. Rib cage lifts. and push. My hands are on the midline.

Hands come together because I engage the rectus abdominis. That’s going to start to tuck the pelvis under slightly, bring the ribcage down. Hands separate because my ribcage is lifting away from my pelvis.

Exhale, everything comes together. Inside, inhale, everything comes apart. So the main thing with this exercise is I don’t want my hands to get too much to the side. I want them to be on the midline so that I can encourage that movement in the stomach region, mobilize the stomach organ, stretch the rectus abdominis upper fibers.

So I displace that to the side, I lose that stretch in that midsection. I need to also lift the chest so that everything separates. Everything comes together,

inhale, separate, exhale. Ten times would be a nice nice amount for patients just to open that structure up. Last one is the first move of eight pieces of brocade. Two hands hold up the heavens. I’m going to clasp my fingers, turn my palms up, reach the hands, lift the chest, same thing. Opening of the front of the body helps lift the hands.

If somebody has decent enough balance, they can follow it up on their toes.

Hands come in, spines coming together, lift, press, lift,

and back down. Easy exercises. Patients usually are able to do those quite well. They can really supplement the treatment. Fun to, to go into the abdominal fibers, like I said, we’ll look at a little bit more on that lateral edge and medial edge, looking at the kidney channel and spleen channel.

Difference in the anatomy, we’ll look at that in the next webinar. So thanks again for American Acupuncture Council, and I look forward to the next time.