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2 Keys to Attracting New Patients & MD Referrals

 

 

So I thought I would share, two principles, keys for attracting these patient referrals, and how to communicate with medical doctors for those referrals as well.

Click here to download the transcript.

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.

I want to thank the AAC for inviting me back to host, um, to the point. And, uh, my name is Lorne Brown. I’m a doctor of traditional Chinese medicine. I have my practice in British Columbia, Canada. It’s called acrobatics wellness center. I’m also a CPA, a certified professional accountant in a past life. And I’ve written the book I’m missing the point, why acupuncturists fail, what they need to know to succeed. So I brought my clinical experience and my, um, my accounting business experience and share that with my colleagues. And I’m also the founder of healthy seminars and online platform for continued education and the chair of the integrated fertility symposium. So I love coming on here and sharing practice management tools. So you can be those prosperous healers where you’re supporting your patients. You’re experiencing abundance, you’re creating great health, and everybody’s happy for that. Um, my presentation today, and we’ll bring up that presentation now is called two keys to attracting new patients and MD referrals.

And so to build up a busy practice and to heal your communities, you need patients, they need to come and see you and want to see you. So I thought I would share, um, two principles, um, keys for attracting these patient referrals, um, and how to communicate with medical doctors for those referrals as well. So one of the keys here is being patient centric versus doctor centric in the business world. When I used to be an auditor and we’d do consulting, that would be customer centric versus company centric. And the key here is to be customer centric in our case, patient centric, creating that value for our patients being of service for our patients. And a lot of us have the right intention. We believe, we really believe that we care about our patients and we’re patient centric. Um, but I would suggest that on an unconscious level, often we are still being doctor centric.

It’s, we’re making a more about ourselves than we are about our patients. And an example of that would be our brochures and our websites. How many of us have beautiful pictures of people receiving acupuncture on our website, on our brochures make sense? We’re doing acupuncture, right? Or you think it would make sense. And it’s something that we love. Like we’re quite passionate. We love getting our acupuncture. Most of us who are practiced love, getting it and love, um, providing acupuncture. But do you ever think of what your patients see when they see your brochure? And what they see is this actually a large part of the population actually has a deep fear of needles. And so I would suggest unintentionally, a lot of us are being doctor or company centric and not customer patient centric. If we were them, we would think more about what our patient’s experiences are when they come to our website and see our brochures.

I will add that I’ve learned in my practice and I think we’re successful because we don’t really think or believe our patients are coming to us for acupuncture, what we realize. And it’s all based on your attitude and intention. We realize that our patients are coming to us for a solution. And if it happens to be requiring acupuncture needles, then, and they, and there’s research to support it, or we have case studies and competence to say that we can help them. Then they’re open to the acupuncture. If I say it’s taking Chinese herbs or receiving GWAS or cupping, um, or laser acupuncture or [inaudible] or cheek gong, they’re coming for a solution to a problem. And that’s what they’ve come to you. And it’s not necessarily that they want or need the acupuncture in their mind. They’re coming to you for a solution. And it just may happen.

That acupuncture is part of that solution. I just want to give you, so I said, I’m going to give you two key, key, um, steps for referrals. So the first one is being patient centered care and really putting yourself into your patient’s shoes, really trying to experience it from your patient’s perspective. An example in my practice at [inaudible] we’re famously known for fertility, we do a lot of reproductive health. And at the beginning, we used to have a baby pictures on our site and in our office. And we did a focus group and we learned that the patients hate seeing pictures of babies in the waiting room and on our website, we thought they would like it because it shows success and hope, right? Hey, look, look what we can do for you. But most of them say that they’re reminded of them not having a baby they’re failures.

Um, they are miscarriages that are unsuccessful ideas. And so coming into the waiting room, um, added stress and not, um, pleasure or peace to them. So again, getting into your patient’s mind and trying to understand what they want. So the focus here is B is to be patient care. And so we meant that patient centered care is about having that intention to care for your patients. However, the intention, the desire to care for your patients, or you even feeling a believe, you care for your patients is not enough. They actually need to know that you care. They have to experience it and believe it. And I’m going to suggest with you, um, I tip, can we go back to that earlier slide story? I, I that’s that too quickly. Um, I’m going to share with you, um, what I do, um, to show I care and I’m, I like to be known.

I want to be known for simple and powerful and effective tips and tools in my clinical practice and business pearls for you guys as well. So what I’m sharing with you is simple. So simple that it’s easy to be dismissed or ignored. It’s not complicated, but simple doesn’t need mean easy. Simple means anybody could do it, but it does require some discipline. And so I say here, what is easy to do is also easy not to do. And I’d like to send, check in emails or call my patients to see how they’re doing. And you can do this after our initial or after a special milestone. Um, I make a habit and using that word unconsciously, a habit of following up with my patients, um, around their pregnancy test date, um, for an IVF cycle. So I support a lot of women through their IVF.

Our clinic does not just me and we show, we go on site to the IVF clinic, the largest one here in Vancouver, BC, and provide both acupuncture, laser acupuncture on site. And I make a point to check in with them between their transfer date and the pregnancy test day, just to see how they’re doing, see if they have any questions, um, and then asking them to let me know an update when they know whether they’re pregnant or not. And so I encourage you to do that and it could be as simple as the following. I want to sh I want to give you, uh, some of the copy that you can do. It doesn’t need to be a long email. It can be tight. It could be subject line checking in, and then your copy could be hi. So-and-so I wanted to check in to see how you are doing period.

Please send me an update at your convenience and then your name and that’s it. Now the intention behind this is you want to know how they’re doing this is important because if you’re doing it, I believe intention carries some chew with it, some energy. So if you’re doing it because you want them to be your patient, I think on a subtle level, they may pick up on that. The good news is that when you do this, you create mind share. They remember you and likely often they’ll get back to you. Many of them will, and they’ll book more with you if they haven’t already. So there’s good news to doing this wherever your intention is to find out how they’re doing, because if the patient hasn’t rebooked, it could be because you resolve their issue. And so wouldn’t, you want to know that in document that in the file, you can even save the reply and they say that everything’s great.

You could ask them, um, to write a testimonial or Hey, if you know anybody else that struggling with what you struggle with, please send them. Cause as you can see, I love to treat that so simple like that. So your email is, and I’m going to show you some responses from patients that I sent this email to. I just wanted to check in to see how you’re doing. Please send me an update at your convenience. Sometimes they’ll tell you something that didn’t work. So you got to learn from their experience. So, and you may be able to correct that in that email or call them to make it right, but it’s just important to follow up with your patients. So, um, here’s an example of just two examples of what I received back from when I sent an email to patients. Now, I would say over 50% respond to my emails.

And, uh, often they’re, they’re quite nice emails, surprisingly, but good to get that feedback. And then there are those that just never respond. Um, so I sent an email checking in on this patient wanting to know, um, she had any questions and, um, I, and I asked if she could send me the results of her IVF cycle when she knows, um, she said, thank you Lauren, for the email, this is very kind of you to reach out. Remember I sit in their previous slide, they need to know you care, um, saying it or thinking it is not enough. And one way to let them know you care is by checking in via email. My blood work results came in today and it’s positive rate CG is 5 96. The nurse advised that is very good number to have at this stage. Let’s hope everything continues to go well from here.

So, you know, we’re having that relationship that trust, and this is good that she’s actually sharing this March. I appreciate your and Ryan support, Ryan and I both saw her through our clinic. Your clinic has been a tremendous part of my journey. Everyone has been so wonderful kind and professional. Thank you for providing this kind of support to women. I could follow up and say, thank you and remind you that we like to support you throughout the pregnancy. So now I can have that conversation with her. Um, so continue the acupuncture and advice about what we do during pregnancy. I could ask her if we can use her this, um, email, um, for our testimony, if it’s allowed in your, in your state or province to put it on the website. Here’s another example. I willing to respond it from her. Check-in you’re Lauren, your ears have been burning.

Your ears must have been burning because I was just talking about you and how incredibly skilled, supportive and genuinely caring you are. My hubby really enjoyed meeting you as well. And I know you really impressed him as well. So it’s showing you that we care based on their emails back. They’re showing you that little touch point, so simple to do, but again, what’s easy to do is also easy not to do. And you want to create this a habit, a lot of clinics. Um, I would recommend you doing this after the initial, if they have not rebooked. And even if they have within that week, just send in a check in email or any special milestone. It’s good to check in. And if you haven’t seen your patients for so many weeks or after two months, and you think there should be more care based on what you’re treating them for, then send in a, an email. Hi, just want to check in to see how you’re doing. Please send me an update at your convenience. So the next thing for referrals and for good medical care is, um, communicating with other health professionals. And I’m going to give examples of what we send to medical doctors. And you get a busy practice by getting referrals for word of mouth, through patients and also referrals from healthcare providers.

So the key here in anything in life to be successful, any enterprise, whether you’re a clinic, whether you’re selling widgets, whatever you’re doing is creating value for the person that’s buying your services or your products. And, um, in this case, think of, remember, we talked about patient centered care, think of the doctor as a customer of yours as well. You’re wanting them to refer to you, right? Um, so, um, think of them that way and want to create value for them because when you create value for other people, they tend to like you and want to work with you. So it’s important to find out their needs and how your relationship can benefit them. I know most of us are going to them saying, I want you to refer to me and that’s needy and that’s not creating value for them. That’s creating value for you.

And I would imagine those relationships don’t flourish or go anywhere because you started off with what can you do for me versus what can I do for you? So find out what you can do for them. I know in the Canada social system, doctors are quite busy. Um, medical doctors, um, tend not to like to treat the patients that have pharma allergy or list of symptoms. And so, you know, you can ask the doctors, what are the patients that you don’t like to see or take up a lot of your time. And so just start developing a relationship with them and finding out what kind of patients, um, you can help them with. Right? And when I say help them with in this case, um, you know, patients that, um, again, in Canada being social medicine, they don’t want to spend an hour with a patient.

They want to spend 10 minutes, maximum 15 minutes. So if a patient has a laundry list of, of, um, issues, they don’t like those. And so they would love to refer those off to people like me, where we spend an hour with them so they can see more patients. Um, I remember one doctor said, um, he doesn’t like patients that have a whole list of symptoms. And I said, well, I’m a holistic doctor. So I likes it. Patients, the whole list of symptoms. Sometimes a little humor will help as well. You want to create trust, um, and allow time to build this long-term relationship. So it is a marathon. It’s not a sprint. You don’t meet the practitioner or the medical doctor that day and then expect them to be a great referral source. It’s a relationship and over years, um, I’ve been in practice since 2000 over years, you start to develop relationships where these physicians become your champion, where they send a lot of patients to you. Um, and that could take time. But if you’re in practice today, think of yourself three years from now, what do you want? What kind of referrals do you want? And think of in three years, I want that relationship with that MD. So today start that relationship knowing that you’re going to date, you’re going to develop a relationship and over time it’s going to become a healthy relationship.

So I’m sending him a letter to the doctor. I find very beneficial and it’s good medical, um, um, medical care on your part as well. So, um, when you see a patient, send them a thank you letter for that referral. Now here’s a trick for you. Um, send them the thank you letter, even if they didn’t refer the patient to you. So when you do your initial, um, if you don’t collect it on the document, ask the patient who their primary care physician is. And so when you send a letter, um, say thank you for referring such a patient, you’re almost programming them like, oh yeah, I refer them. You know, but even if they haven’t and just let them know, you have this patient and mutual care, and I’ll share a letter that we sent to a doctor here in a moment. So I will give you a little template here that we use that you can now use.

So send them a, you know, what, they’ve come in for what your plan is, and that you’ll send them some progress report. So it’s good to send them kind of your initial findings and your treatment plan, send a revaluation, let them know, definitely refer back to the MD as well for their followup and confidently communicate with them. When you have questions or suggestions, don’t put them on a pedestal, but don’t have counterwill or make them your enemy and fight with them. Either your colleagues working mutually for this patient’s benefit. So own what you know, um, but also read the room and know who you’re talking to as well. And it’s really good medicine to have this integration. So here’s an example of a letter. I apologize, the presentation, put the bullet points there. You don’t need the bullet points, but I took out some names and some information just to preserve confidentiality, but here’s a letter to whom it may concern.

Um, Mr. X presented to our clinic AquaBounty wellness center on Wednesday, August 23rd for pain in his left knee, which he shared with related to osteoarthritis. I’m using a technique. Our clinic calls, laser acupuncture, which utilizes a class three B medical grade, low-level laser therapy in combination with electrical acupuncture. And skeeted, don’t inundate them with too much information, keep her letter short. And also it’s a good thing to remind you, at least in Canada, that when a medical doctor receives a correspondence regarding a patient, um, they’re technically supposed to put it in the file as well. So again, reminds them when they look at their file, who you are in your involvement. I give a brief education of what laser is. So education here, low-level laser therapy has been shown to relieve pain associated with main diseases and syndromes and cleaning, osteoarthritis. It implements red and infrared light to decrease pro-inflammatory cytokines promotes blood circulation and promotes tissue regeneration by increasing mitochondria ATP production through fighter, by my white fire till biomodulation.

And then I give them a two links to go to my website. If they’re really want to learn more, some doctors are going to want to know about this, and they’re going to look it up. I’ve had doctors call me after to go for lunch. Cause he wanted to know more about what we were doing. Cause they had a lot of patients that they have been trying to help with drugs, drugs, or surgery, and they still have not found relief. So they they’re looking for anything to help these patients. Um, my Mr. Patient, uh, so put your patient’s name, your Mr. Patient’s name. So whoever their name is, has received a treatment. So in this letter, just so you know, I was slow. I didn’t send it when they first came in, patient came in and I did not send the letter, but I sent it, you know, I said to the progress reports.

So sometimes you get behind. So I sent them this letter anyhow, um, after they’d been seen with seen by me for a couple of weeks, they received eight treatments, um, since August 23rd and has experienced noticeable improvement in pain reduction by his third session. So I’m showing the progress and how good this was after three treatments, they already have no pain. His current pain level is not existent. Even with strenuous activity. We have not noticed any significant reduction in swelling. So he was quite swollen, but we hadn’t seen much change in that over the past three weeks. And then I let him know. My plan is to continue to offer one or two weekly treatments until he has results from his schedule. X-ray October 2nd. Do you have any questions about our mutual care of this patient? Or if you want to communicate with me about any aspect of his care, please feel free to contact me in health. And then you give your email and name. If you’re sending it by mail, which I recommend, um, I’d say both mail and email, but put your business card in if you send it by mail.

So just remembering being successful as not doing extraordinary things, the, um, thinking about the patient centered care, sending them a check in email, writing a letter to your doctor at best, not extraordinary, right? But being successful is simply doing ordinary things extraordinary. Well, and so you want to make it as a habit and just think for the next three years, if every patient you saw, you sent in a check, an email and you sent a letter to their primary care physician, I’m just curious how many extra referrals you’ll get because the patients now know you care. And the doctors now know you exist.

Do keep in mind. It takes 20 years to become an overnight success. Really the point here is to manage your expectations and that this is a marathon, not a sprint I’m when I’ve coached my colleagues often, they’ll say I did what you said and it didn’t work. And just so you know, this response, I did what you said, didn’t work is one week after I told them what they could do. So if you’re telling me did work after a week, you’ve missed the message on building a relationship and it takes 20 years to be an overnight success. It’s a marathon, not a sprint and just create this habit and do this over time. And then after six months rafter, you’re telling me how it’s going, but definitely not after a week.

So keep this in mind. There’s two types of human suffering. This is by Jim Rowan, a nice quote. Um, look at the image on the left. You can see the fit gentleman inside this obese body drinking soda, water, it’s the pain of regret or the pain of discipline. So either way, there’s going to be some type of pain or effort. So the pain of regret or the pain of discipline. So I’m inviting you to go for the pain of discipline and write these emails. Um, I talk about what we just shared in my book as many other and many other, um, what I consider a key points in mindset and activities to help you build a successful practice. Remember as a practitioner acupuncture, you’re a business, whether you like it or not. Um, small businesses, acupuncturist are always at risk of failing because we’re small.

Just the nature of us being small businesses, lacking resources and money or people to do everything that needs to be done, puts us at risk of not succeeding and then add to it that many of us are in denial that we’re in business or don’t want to learn about business puts us even at greater risk. And so to be an effective healer, you need to have the union balance. You need to know your medicine. So constantly work on your clinical. And we do this well. We’re always putting our continued education forward and a priority. I know this from healthy seminars, seeing how many people are constantly learning. And then you have to also the other side, the young, you have to also give attention to the business side of it. And if you didn’t young or out of balance, you have disease or they separate and there’s death.

You go out of business. And so you can’t ignore the business out of your practice. And if you’re not in practice because your business is failing, unfortunately, then you’re not able to heal your community. And it’s important more than now than ever to have practitioners like you available to heal your community. So continue your healthy seminar studying on the medicine side. And I want to remind you just also study the business side so you can stay in business, have a busy practice, feel fulfilled, um, healing your communities. And if you’re interested in my book, um, there’s free shipping this month go to missing the point. book.com, make sure books in the URL. Otherwise it will go to a different website missing the point book.com. You can order a copy and have free shipping this month. And if you want to contact me, um, you can either go to healthy seminars.com.

That’s where we offer online continuing education. And I get a copy of those emails on my own, a little website called Lorne brown.com, where I interview people on conscious talks and I share, but conferences I may be involved in. So you can check me out there. There’s the website for my book, missing the missing the point book.com. And my clinic is AQI balanced.ca um, stay tuned to future AAC webinars with me. I’ll be interviewing more, um, colleagues over the, over the months and years. And I want to let you know that next week our colleague and our friend Jeffrey Grossman is going to be on to the point for this AAC webinar series. Thank you very much.

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The Stomach Sinew Channel and Low Back Pain

 

 

 We want to discuss the, uh, low back pain and the significance of the stomach channel. So let’s take a look at that first slide. Our discussion, very short discussion about this topic is going to be looking at the stomach sinew channel from above the knee and into the rib cage region and its influence on low back pain.

Click here to download the transcript.

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.

Hello everyone. My name is Matt Callison. I’m here with my colleague Brian Lau and everyone. Uh, thank you to the American Acupuncture Council so much for having us. We want to discuss the, uh, low back pain and the significance of the stomach channel. So let’s take a look at that first slide. Our discussion, very short discussion about this topic is going to be looking at the stomach sinew channel from above the knee and into the rib cage region and its influence on low back pain. Um, the techniques that we’re going to be presenting here today is just something that you can routinely check for low back pain patients to see if the stomach Sr channel is a contributing factor to this person that’s coming in with chronic low back pain. It could actually even be acute low back pain to go ahead and check that as well.

So I think we should probably get going. We’ve got plenty of, of information here. Um, the first slide or this next slide that we’re going to be getting into is going to be specifically about the lateral Rapha. Now the lateral Rapha is a very significant tissue along the stomach sinew channel. That can be a contributor to low back pain. Let’s discuss this very strong fascial connection to the lateral Rafat. Um, you can see there on that lower left-hand corner of that. Call-out if you can circle that there for us. Yeah, there we go. It’s a continuation of tissue from the abdominals, the fascia from the abdominals and the thoracolumbar fascia. Uh, for those of you that know about the thoracolumbar fascia, it’s gained a lot of popularity over this last 20 years, significantly over the last decade about its importance functionally, but also in low back pain.

So the thoracolumbar fascia, it has got three layers. You have a posterior layer that covers the erector spinae. Okay. You’ve got a middle layer that’s underneath erector spinae and above the quadratus lumborum and then you have a deep layer that’s between the quadratus lumborum and the LDO. So as each one of these layers connect laterally, it becomes the lateral Rafa, the thoracolumbar fascia specifically between the poster and the middle layers. However, if you also look at cadavers, you’ll see that that poster layer also has some contributions to the lateral Rafa. It’s a communication link. It’s a segway between the abdominal fascia and the thoracolumbar fascia, and it sits right on top of the quadratus lumborum and we can be able to pal that palpate that for Osher point. So, uh, the reason why we’re talking about the latter fr right now, before we go into an overview, just such an important tissue for us to be able to consider and then farther into this presentation and we’ll get into the assessment and the treatment of it. So let’s go into the overview of the stomach channel and Brian, do you want,

Yeah, yeah, sure. So next slide. Yeah, we have, um, just a real quick introduction or re-introduction of the stomach sinew channel, if you haven’t, uh, looked at it recently. Um, the secondary channel that includes the myofascial planes, uh, of the stomach channel, there’s really two main branches. Uh, we have one that travels up the anterior lateral leg and thigh goes around the genitalia and spreads out into the abdomen. Then from there, it travels up the chest neck and face to the lower eyelid. So this is the main channel that you’re seeing in this image and this kind of, um, 3d model image here. Um, you can see primarily that main channel coming up, the midline of the thigh are a little bit, uh, lateral on the thigh. And then up into the abdominal layers up through the chest, up into the neck and up into the face, um, that kind of follows the, the primary channel for the most part.

Uh, the second channel is another branch of this that you don’t really see from this image, but we’ll have plenty of opportunities to see it in the next few slides. Um, this other branch is on the lateral kind of starts from the lateral knee, goes to the region of gallbladder 30. Sometimes it’s in that translations, they might say it and it connects the shower young. That might be another way that it’s worded, but it kind of becomes a little bit more lateral as a sort of a segue between it and the stomach channel from there. It runs to the 12th rib and ends at the spinal column. This is kind of adapted from a Vanguard translation at the link shoe, which is a particular source that I really like. Um, but, uh, all of the sources say relatively about the same thing when you look at translations. So let’s go through each of those branches a little bit more clearly and to the next line.

So if we wanted to start at the distal part, um, from the lower extremities, we can look at the stomach DJing, Jen, how it travels along the anterolateral leg and thigh. I think actually these two branches actually, uh, start in this, uh, leg region below the knee. And you can kind of look on this image for the tibialis. Anterior tibialis. Anterior is just lateral to the tibia. This is where really the primary channel of the stomach, the stomach primary channel runs along this area. Stomach 36 would be noodling directly into the tibialis, anterior and happens to be the motor point, uh, for tibialis anterior. So that’s an actual primary channel point. That’s going right through that region. From there, we could kind of follow that up, uh, lateral to the knee, into the rectus femoris, continuing to follow that stomach primary channel. But if you look at this image, we also have the extensor digitorum, longest muscles.

Um, you know, there’s several slips of those. The two, um, create a poll extension for toes two through five and especially toes two and three are part of the stomach channel. So this in some ways is sort of the beginning of that lateral branch. It’s kind of a, between the stomach primary channel and the gallbladder primary channel. It’s part of the stomach sinew channel. You have those toe two and three slips that kind of drive up toes four and five would be gallbladder send new channel, but we’re on the stomachs in your channel. That’s going to connect into the vastus lateralis and start to become that a secondary sort of a branch that more lateral branch.

All right. So let’s go back to the main branch main branch is going to run up the rectus from Morris. You can see the rectus for Morris, this image that kind of dark line on the thigh is the kind of the fascial separation between rectus Morris and vastus lateralis. So that’s in my opinion where the stomach channel runs, but that rectus for Morris that more medial muscle in that picture is going to be the sort of primary channel branch of the stomach sinew channel that then connects to the a, I S it actually connects to the a S I S or it’s fascia. And then it runs up through the inguinal ligament up the abdominal layers up the chest, et cetera, kind of following the primary channel of the stomach. Um, so in this case, what we want to focus on for today’s lecture is the abdominal fascia in particular, because we’re going to look at how that connects and wraps around to the, um, to the thoracolumbar fascia and the lateral Rafa in the stomach channel. It’s all the fascia that lives in is found on top anterior to the M rectus for Morris. I mean, excuse me to the rectus abdominis. So it’s all the fascial layers that are on top of, or superficial to the rectus abdominis. Um, part of those fascial layers in wrap around the body, following the fascia of the abdominals into the thoracolumbar fascia, into the lateral Rapha, and then connecting all the way to the spine. So next slide.

So the lateral branch on the other hand is going to be a little bit more lateral on the thigh. It’s covering the vastus lateralis, which is a pretty big muscle. That’s the fastest part, I guess, but the vastus lateralis actually covers really a lot of real estate on the lateral thigh, really going into attaching all the way to the back of the femur. Um, so it really covers the territory of both the stomach primary channel to some degree. And the, also the gallbladder, um, primary channel, the iliotibial band would be running down on top of this structure. Um, so it would be a kind of in a pretty big area, but this is the link through that lateral branch. If you follow that fastest ladder up, you can see where it communicates the chair’s fascia. It attaches to the same region as the anterior portion of gluteus medius and minimus, especially minimis. So, uh, just that, that hip joint region, you can see where those two muscles are communicating. Then from there, it’s going to continue into the thoracolumbar fascia meeting with a lateral Rafa about anything you want to add on these are,

Yeah, that tissue with Cal patient is pretty significant when somebody has a posterior tilt or an N tilt of the anonymous bone, versus when it’s a neutral pelvis, you can really tell the difference in palpation of that fibers of the anterior fibers of the minimus and the medias, like I said, with quite a change in inclination with that.

Yep. And it’s an often, we actually had a discussion on our, uh, Facebook group on sports act, a sports, um, acupuncture group. And, um, we were talking about how often this fastest ladder Alice is ropey and rigid and dense. And I think if you palpated the thigh quite a bit, you can probably notice that you do know, you do find a lot of patients that have a ton of tension in this area. Right. So let’s move on to the next slide. All right. So we have a few, uh, three, I think, cadaver images. So just the general warning. Um, this was in the beginning, we have the warning on the bottom of the screen. We’ve already had one small image, but these are a little bit closer, a little bit, um, more obvious they fill up the screen. They’re a more obvious cadaver images. So just be aware of your surroundings, you know, if you’re at a Starbucks and there’s people looking at your screen, maybe, you know, get it into a position where they can’t see it, it’s better not to view these in public, don’t share these images, um, you know, keep, uh, it’s it’s, we have to be very respectful to the donors and make sure that we don’t do anything inappropriate.

So this is an educational settings. So we have these images, but, um, but don’t share them with the general public or be mindful where you’re watching this ad. All right. So next, uh, next slide, let’s start looking at this connection. So there’s two lines on this, uh, cadaver drawn over this cadaver, and it’s just the dissection image. And then the top one, uh, which is the shorter of the two lines that’s showing the upper border of the glute Maximus and sports medicine acupuncture. We’ve referred to this as the gluteal app and erotic line. So that’s going to be more superficial than the glute medius and minimus, but I just wanted to show that demarcation, the bottom line is traveling up from the vastus lateralis. Then as it kind of makes a curve, you see it connecting into the glute medius and minimus, and then it follows right up into that, uh, lateral border of the erector spinae, which is that top portion of the line, um, that is kind of that whole trajectory of that lateral branch of the stomach, uh, send you a channel going all the way through the lateral Rapha and a moment we’ll actually see the erector spinae lifted, um, so that we can, um, get a clear view of the lateral Rafa.

One other thing to highlight from this image, you can get your bearings straight is if you go to the very top of that, um, that line, the longer line that’s, um, from there, if you go to the midline of the spine. Yep. Right in that region, we actually have the erector spinae cut. So everything above that, you’re seeing deep to the erector spinae. That’s going to allow us to lift up that little flap of the erector spinae to see the lateral Rafa a little closer. So let’s go to the next image then. And, um, this is just the lines removed, right? So see if you can find that same territory we just discussed kind of look at that trajectory of the sort of channel, like portion going from the thigh all the way up the glute medius and minimus up into the lateral Rafa. Okay.

And now let’s look at with the rector SPI and a lifted. So that would be on the next slide. So there is that little portion of the erector spinae lifted. Then you can see deep to that, to the next fascial layer and that boundary of the lateral RFA. That’s just that little, um, band that runs just lateral to the erector spinae. So again, you can follow that line down from the thigh, from the lateral thigh, going through glute medius and minimus into that lateral Rafa all part of the stomach sinew channel, that lateral branch of the stomachs, a new channel and a pretty juicy area when you’re working with a lot of chronic back problems. Right. That’s pretty sick.

Yeah. It’s pretty significant, uh, continuation from the lower extremity into that latter Rafa, you can see that line with the erector spinae lift up and the thickness of that ladder Raffa as well.

Interesting. Yeah, for sure. Yeah. Get that image in your mind though, because you’ll see some palpation coming up in a bit. Um, and this is where actually, can we go back to the previous image with the erector spinae down? Imagine you are pressing not on a cadaver specimen necessarily, but on a person, if you were pressing and you could kind of see through the skin and, um, and see that your, your pressure is going right to that lateral edge of the erector spinae diving, just deep to it, to that, uh, that boundary of the lateral rafting, that’s going to be where we’re going to be palpating. Um, so this is a, a lot of the types of things we tried to get across. Like these images come from our, um, uh, uh, anatomy, cadaver dissection lab that is on, uh, LASA right now. So these are part of, uh, you know, we have a bunch of videos and I’m really a little more thorough presentation on this, but even just looking at these images, you can kind of get an idea of, okay, if I were to press into that tissue and try to reach the next image, go to that, the next slide and reach that tissue that’s on that boundary, just deep to the erector spinae and know that, okay, that’s the lateral Rafay, I’m palpating for tension at that region.

And knowing that that’s part of the stomachs and new channels. So we have a lot of information right there that you want to take it and kind of go over that. It kind of kind of started the process a little bit, but I wanted to highlight it on the cadaver portion. So when we see it, we know what we’re looking at.

No, that’s great. This is going to be the cadaver dissections in module two anatomy, politician, palpation cadaver lab on Los OMS. But what you said, bright for the person to really understand where that lateral Rafa is, which is going to help significantly when they’re looking for Osher points in this tissue. And also when they’re palpating for, so the lateral Rapha attention test, which is going to be coming up here in just a couple minutes. So am I next? Yep. Okay. Let’s go to the next slide please. All right, here it is Latta Rafiq tension test. So you guys hear it for your notes. Um, you have this a step-by-step, you’re going to ask the patient to designate the pain level with palpation of this tissue on a scale of one to 10. Um, many people are gonna be thinking, well, you’re just palpating. The quadratus lumborum is actually the depth of the palpation.

That is significant here. When you look at the video that’s coming up next, you’ll show it it’ll show that Brian is palpating within the first quarter inch of the superficial tissue. Just touching that lateral Rapha that covers the quadratus lumborum. If we’re looking for the quadratus lumborum trigger points or motor entry point ratchet pop hitting more from deeper into that tissue. So there’s a difference in the palpation of it. A practitioner is going to attempt to decrease the tension and the pain of the lateral Raphi by using the following acupuncture, motor points, stomach 41 works great. 43 can be used on 36 being the motor point, as Brian said of the tibialis, anterior, the vastus lateralis motor points work really, really well for reducing the tension and the latter Rafiq. Um, same with the rectus abdominis points. We’re going to be covering that because there’s four different segments of the rectus abdominis motor points.

And it’s usually going to be the lower aspect that is going to be changing significantly, the tenderness of that lateral Rafa. So let’s look at this image here. You can see how Brian was talking about the, uh, channel going all the way up the vastus lateralis, going to the anterior fibers. I’m talking about the lateral image here of the patient. So you can see going up the vastus lateralis, going up the anterior fibers of the minimus, the media’s going across that iliac crest, which you just saw on the cadaver going right into that lateral Rafa right now from that tissue, the lateral Rapha is going to be following along on the poster and the anterior aspect of the abdominal wall, going to the rectus abdominis. So there’s your connection, your significant connection of the stomach Sr channel for low back pain into the latter Rafa.

And also the abdominal aspect is contribution to low back pain as well. There’s something that we’ve been talking about for a few years now, it’s called acupuncture as an assessment. Um, this is something where you can use a couple of acupuncture points just to be able to see if they will decrease the tension of a particular orthopedic examination. In this case, what you’re going to see in this next video is Brian’s going to be using a couple of points to reduce tension in the lateral Rapha. So let’s check out the ladder off a tension test and acupuncture as an assessment, let’s go to the, into the video

[inaudible].

So we’re looking at the lateral branch of the strong stomach send new channel. So the lateral branch of the stomachs and new channel from the thigh comes up through the vastus lateralis, connects with the gluteus medius and minimus, and then to the thoracolumbar fascia. So one of the key areas we look for in this lateral branch that connects them to the lumbar spine from the stomach channel is the lateral Rafa. The lateral Rapha is the meeting point is the fascial wall. That is the boundary between the iliacus Dallas’ lumborum the erector spinning and the quadratus lumborum. So those fascial planes come together in a seam at the lateral Rafa, and we’re going to go right into that lateral Rapha at a Rambo level of L three. Doesn’t have to be exact, but L three is a good landmark, and we’re going to start to palpation following the angle. So here’s the erector spinae falling off following the angle of the erector spinae down into that valley of the lateral Rapha. And we’re just looking for tension, but also palpatory pain to that. So we can ask the patient on a scale of one to 10, how that, what that pain level is with palpation. So what does that pain level there? Three by three? Yeah, it feels denser. Doesn’t feel, it feels like it’s healthy tissue. Most likely go to a different area. How about right there?

Three. All right. So can you stop bad? But if this was a big pain producer for the patient, then we would look at reducing that with distal points for this assessment and come back and how pain and see if that changes it. So primarily we’re going to be looking down with stomach channel and we can include things like vastus, lateralis, vastus, lateralis Motorpoint would be a good one to consider. We could look at, even though it’s on the gallbladder channel, the most, uh, pasture and edge of the vastus lateralis would be a possibility. So that would be in the region of gallbladder 31, and then we could follow it down also into the stomach channel, just by palpating. It feels like tip anterior has a certain amount of tension. So I’m going to use Tim anterior. I don’t know if it’ll change much based on the fact that you didn’t have a high pain aspect with the additional palpation, but let’s go ahead and work on it anyways. So we’ll use stomach 36, 1 of the motor points for tibial anterior.

Now we’ll come back to the area. So there’s two things I can look for what my palpation tells me. Does it feel like that tissue softened? And then what does the patient report in terms of pain, quality back at the same area and scale the one from one to 10? Yeah. And it feels softer to me. She says the one now, and from a three to a one, I’m having a hard time finding the exact location where I felt that tension before. Cause it feels like it’s been reduced. So other points to consider the distal stomach channel points down towards the feet, stomach 41 would be a possibility stomach, 40 stomach, 36, just based on palpation, felt like a good starting point for me. And then also looking at points along the thigh.

All right. So let’s just talk logistically about what we just saw here. So if you’re going to be treating the patient in a lateral recumbent position like that, using acupuncture’s assessments going to be really quite simple, um, you can also check the lateral Rafiq, the tension tests when the patient’s going to be standing, which is nice because you’ll be bearing and load bearing. So therefore the tissues are going to be a little bit different. Um, in that case you can check for Osher points while the person is standing. You could still go ahead and needle stomach 36, or you can use some distal points to, to see if that was start to change the tissue. You can also do the, do the lateral Rafa tension tests when the patient’s Lang prom. Now that makes it a little bit more difficult when you’re trying to be able to needle the vastus lateralis points, but we will have more access to the distal stomach channel points using stomach 45 stomach 44 stomach 43.

Those points are going to be a lot more accessible when the patient’s link prone and they will also change the tension within the lateral Rafa. And that way you can be able to plug in those points and then continue with your treatment. Um, this is going to be, um, just kneeling some Osher points within that lateral rafting. And you could see with Brian’s angle that he is angling it more toward the belly itself. Not necessarily parallel with the table, like how you would be needling the quadratus lumborum so pressing into that ladder, I Fe looking for Osher points and just tapping on that tissue. Remember that lateral Rapha is going to be a thin tissue on top of the quadratus lumborum and you might have two or three different Oscher points within that lateral Rafa. That’s going to span the region from the 12th rib all the way to the iliac crest. So let’s remember the depth of where that lateral Rafiq is. I’m trying to be able get disperse Oscher points within that region. Bride. You wanna add anything to that before we jump into the next slide?

Yeah, just that it’s um, I think I have that needle in about L three. Um, I do find that that region of L three and the lateral Rafa tends to be, um, pretty responsive and, um, you know, it’s a, it’s a good, I, I often find that is kind of the greatest tension, but for those who followed, uh, Luigi Stecco his work, um, you know, he has these really involved system where he talks about these different points, that parallel acupuncture points to some degree, but he calls them the centers of coordination. Um, and they’re like fascial unions between certain, certain regions of Paul on the muscle. Like this would probably be, I’d have to go back and look, but it’d probably be the, uh, include like the quadratus lumborum the erectors and coordinating movement between those. Um, but it’s in the fascia itself of the lateral Rafa. So this is one of his points, one of his centers of coordination, um, is that, that, uh, L three lateral Rapha mark. So kind of interesting. And I do find that that’s, I don’t know if this works super well, but I know a little bit of it, but I do find that that L three region is usually pretty predictable predictably. Um, more of the center of, of, of tension of that lateral or FFA. Sometimes when I need a lead, I have a slight inferior angle though. Like you said that 45, but, but slightly inferior.

Yeah. So predictable Osher point within that. [inaudible] so that’s great. That’s good. All right. Let’s see what the next slide is, please. All right, let’s go over the best slash motor entry points. There’s two primary for the vastus lateralis. One of them will be extra points, team food two, which is located just one to two soon, lateral from stomach 32, which would be food too. We know that stomach 32 is located six soon up from the lateral border of the superior lateral border of the patella. Uh, so following that up, make sure that you are going to be in the vastus lateralis, not in the rectus femoris. You’re going to slide over then one to two soon, um, into sheen futu, if you cross fiber, the vastus lateralis, it will often facilitate, uh, which would also be at the definition of a trigger point. Uh, if shin futu is going to be referring somewhere, then that would end up being also location of point.

Um, so this is going to be a branch off the femoral nerve going into that vastus lateralis extra point sheen food to a pretty powerful point. So it makes sure when you are kneeling it pretty slow and methodical needling, otherwise it can be a strong cheese sensation can come up really quite quickly. Now the upper fibers of the vastus lateralis, which oftentimes, um, can atrophy on many patients where it’s not really quite used, if they’re having some mechanical problems with the extension or knee flection, those upper fibers, if you divide stomach 31 and the superior border of the patella divided by thirds, it’s the meeting point between the middle and the upper thirds. Uh, you’ll definitely find an off SharePoint within that meeting point. That’s going to be another motor entry point from the femoral nerve going into those upper fibers. Um, the needle technique, that being that should actually be a little bit deeper than that, uh, should be more like, uh, 0.75 to 1.25 inches because the innervation is actually going to be more to the medial side from that femoral nerve.

So you have to go a little bit deeper into that mass lateral, so you guys would be able to make that correction. That would be great. All right. So let’s now I believe let’s go to the next slide, our rectus abdominis motor entry points here. You can see four needles on the left and four needles on the right. It’s an old bleak angle going into the rectus abdominis. The needle is starting at the spleen channel and then directing it toward the wrench channel going. Uh, th the objective here is to try to be able to get the needle to go to the poster aspect of the rectus abdominis. That’s where the innovation side is more on the poster aspect and not necessarily on the Antar aspect. We have to be very mindful to make sure that we know where the tip of the needle is going, and it’s not going past the rectus abdominis, therefore into the peritoneal cavity.

So be very, very mindful of where that needle is going, but your goal is to cross fiber, the rectus abdominis, and angle it. So it is going to be affecting more of that poster aspect. Um, there’s a great video. That’s going to be in the motor entry-point protocol. This will be in module two part of the online recordings that we have thankfully have finished. We’re coming really close to getting them all aligned. Um, it’s been over a year endeavor and what an adventure that has been I’m sure Brian can agree to that. Um, so those are available on Lassa OMS, um, the research for the rectus abdominis motor, point’s the largest diameter of these intercostal nerves. That’s going into the rectus abdominis or the ones that’s going to be located in the lower half. So that means number three, and number four, that’s on this particular slide.

So you want to locate stomach 23, which we know is going to be too soon above stomach, 25 and needle towards stomach three from the spleen channel, right? So the rectus sheets you’ll be connecting the spleen with the stomach then. So the needle is going to be going from the spleen channel toward the stomach channel, going into the motor entry point for that particular muscular segment of the rectus abdominis. I believe that particular one is innervated by the T 10 intercostal nerve. I could be wrong. It could be T 11. Um, again, but those, the research was showing that’s more of the larger diameter, um, um, uh, nerves coming across into that motor entry point. The next one to choose here would be also just below stomach 27, which we know is going to be located to super low stomach 25. That was nice about this too, is you look at it’s pretty much at the same level as the lateral Rafa as well.

So with low back pain, many times practitioners are not needling into the abdominals. And boy, you can really great get really good results by combining treatment on the back and also treatment on the front. So if you’re not treating the abdomen with low back pain and maybe your results haven’t been as good as you want to please make sure that you are going ahead and needling into these, these points, you’ll see that it actually will help significantly. And just as a side note also, um, I’ve had many patients have actually had constipation and I’ve used this needle technique and it works really quite well, more for the excess type of constipation, not necessarily for the blood deficiency type of constipation, but it’ll change Paris dialysis pretty well. All right, Brian, I think we’ve got a myofascial release technique that you’re going to be showing that’s really a great for spreading here. So do you want to introduce that?

Sure. Uh, so Matt mentioned getting better results by including the abdominal layers, especially if you’re doing these assessments and you find that, you know, somebody reports a seven out of a scale of 10 on the palpation of the lateral Rafa on a pain scale, and you need all the rectus abdominis, uh, as a, um, assessment or the vastus lateralis. And you find that when you go back and pal plate that maybe it’s gone down to a four or a three, so that’s telling you that that’s a component, you know, part of their low back pain. Maybe it’s not the primary source, maybe it is, but a component of their low back pain has to do with that tension in the thoracolumbar fascia. So sure if that, if that assessment showing improvement and why not put those needles back again as part of the comprehensive treatment and, or, and I say, and or maybe the person doesn’t have enough, cheetah include that many more noodles, or for whatever reason, maybe you don’t do the needles that you can do the myofascial, or maybe you do the acupuncture and the myofascial.

But speaking to this tension in the abdomen and possibly on the lateral quadriceps is going to be important for these patients. So this is a technique on the rectus of the dominance and it’s working, you know, the rectus abdominis has the six-pack six-pack muscle, it’s actually an APAC, but each of those little packs are there because there’s a tendonous transcription that separates one of the four segments of the rectus abdominis. Um, you know, so that, that’s what creates the six pack, but actually there’s a, uh, pack on each rib cage that doesn’t show up when people have really developed at abdominals. So it’s a, technically, it’s an APAC, but we’re going to be working in those tendonous transcriptions to free tension in the fascia. And this would not be uncommon to refer to the back, especially in the 20, uh, stomach 25 region. But let’s go ahead and look at the video for that.

So we’ll be working now with the rectus abdominis, but specifically the tendonous inscriptions of the rectus abdominis. This would be really relevant for when there’s pain at the thoracolumbar fascia, or especially at the lateral Rafa because those abdominal layers wrap around and become part of the thoracolumbar fascia and can add tension into the lateral Rafa. So in your assessment with the thoracolumbar fascia test, if you find that it reduces palpatory pain by doing acupuncture assessment at the rec fem, these would be techniques you could do after the needling. So we’re going to start at stomach 25. I’m going to use my fingers, pads and my fingers to sort of find that tenderness inscription, I’m going to sink perpendicular. Usually I find that a little bit inferior, like I’m kind of dropping in perpendicular and a little bit inferior helps to hook into that tendonous tissue, that fascial tissue, you don’t have a bone to push again. So I can’t just go straight in and resist against the bone. So I need to find a way to hook into that tissue. And this is a good, that little kind of curving motion seems to get a good hook, a good investment on that tissue. And then I’m spreading my fingers apart. So you can’t see it much. It’s a small movement, but it’s just like you’re unzipping a zipper hook in and spread.

Sometimes patients actually will feel this refer towards the back or even into the lumbar region.

You can work up to the next one, well, into the tenderness inscription sink in and spread

You can notice that as we’re working here, she’s starting to be able to take a little bit deeper of a breath, cause it’s freeing that tissue that can clamp down and resist the breath. And we’ll be at the cost of margin. I can continue to do spreading apart, or I can go up or down. If the person has a very hold in, compressed lower rib cage, I might want to bring the tissue out if they don’t have good tone in the abdominal muscles and it’s over flared, I might want to move the tissue up or I could just bread. And either way, I’m working along that costal margin,

Mindful that I don’t want to go all the way to the xiphoid. I’m just going up towards the xiphoid

One last pass. I can be at the attachment and again, spreading at that rectus abdominis attachment where the fascia starts to meet the pec major

And then I can work at the final attachment site at the pubic bone. I want to start above the pubic bone. So there’s the pubic bone I started above so that my pressure can get deep to where the rectus abdominis dives deep today, a posterior border of the pubic bone tendon, a tender area. Is that okay? And I can do a slight minuscule across fiber, or I can try to lift the pubic bone and decompress. This is another region that might refer into the lumbar region.

Right. So you don’t need to do all of those areas. You might pick and choose one or two regions. Stomach 25 is often very frequently involved. Costa margin’s frequently involved. All of it’s going to free the breathing take tension off the thoracolumbar fascia. And you can consider this technique when there’s a stomach, send you channel relationship to pain, such as facet, joint problems,

Especially a great technique to be able to use after kneeling, because it also takes pain away or soreness away from the needles as well. Um, there’s a lot more great Mahvash release techniques that we’re showing. And that’s from the assessment and treatment of the channel, send you module two, available a loss of OMS, um, really great techniques to be able to use right after the needling that can reinforce what you’re trying to accomplish with the acupuncture.

All right. It’s a slow treatment. Yeah. Yeah. It just, it’s kind of a slow, you know, you don’t want to rush through those treatments at the same time I was talking and I was teaching. So it seems like it would take a long time, but you can actually get through those, those, uh, even if you do all passes, all four passes, you can do that pretty much quicker than I was doing it there, you know, there was teaching and discussion and where and what I was doing and all that. So it seemed like it would be a long, long time spent, but not, not so much in practice.

Hi, Brian, it’s always a pleasure to be able to hang out with you and to be able to share knowledge. Thank you very much. Thanks very much at the American Acupuncture Council. Also next we’ve got, uh, Lorne Brown is going to be coming in and discussing some great things. I’m sure Lorne has been in the field for a long, long time and a great pioneer in himself. So check out Lorne next week. Thanks again to the American Acupuncture Council. Thank you very much. You guys for attending and we’ll see you again. All right. Yep. Bye-bye.

 

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Aim For The Best Acupuncture Business Insurance Package


Getting insurance is crucial for running a business. It provides the needed protection in case an untoward event happens while in operation. With that said, you must be careful when choosing one for your acupuncture business. Getting a great deal on acupuncture business insurance is one of the non-negotiable aspects of running a business.

It is a given fact that acupuncturists are vulnerable to lawsuits, which usually come from patients claiming malpractice. Without acupuncture business insurance, such a legal predicament can bleed even the personal savings of a sued acupuncturist.

When you get acupuncture business insurance from a reputable provider, you can rest well at night, knowing that there’s an entity that protects your business and professional reputation.

Finding an insurance provider

Now, here are some tips for finding the most qualified acupuncture insurance provider:

  • Ask for recommendations from reputable individuals or entities in the industry;
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  • Go through their offers and compare them to products from other providers;
  • Find out what sort of awards or recognition they’ve got in the past that would validate the claim that they’re the best among the rest.

What to look for an acupuncture business insurance

Every business is unique. So, each acupuncture business can have different insurance protection needs. However, an insurance provider can be a good candidate if they can offer the following:

  • A business owner policy, which covers property and liability exposures, protection from natural and human-triggered calamities;
  • Workers’ compensation insurance, which covers for medical care and rehabilitation of employees injured on the job or who contracts a work-related illness;
  • Malpractice insurance, which protects acupuncturists from the risks associated with this kind of specialized treatment;
  • Professional liability insurance, specifically designed to satisfy the insurance needs of a certified acupuncture practitioner and individual acupuncturist.

Online looking for a reputable company that offers acupuncture business insurance? Contact American Acupuncture Council today at (800) 838-0383.

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Building a Chinese Medicine Kit

 

 

Click here to download the transcript.  Click here to download the PPT.

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.

Hello, welcome. My name is Tsao-Lin Moy, and I will be hosting today’s Facebook live, and I’d like to thank the American Acupuncture Council for providing these Facebook lives. And, uh, hopefully they’re going to be very interesting for you. Um, I’m very excited about today’s episode and I really want to, uh, send a shout out to, uh, a friend of mine, Josh coropol and another one Neil Gordon, because it was having a conversation with them over last week. That then prompted me to talk about, uh, Chinese medicine in a way that, uh, we can teach our, our patients and also for us to be much more creative in the way we think about what it is that we do. So, so, um, let’s go to the first slide.

All right. So the topic today is building a Chinese medicine kit and how to use something like a fast food restaurant to make medicines when you’re out on the road. Uh, and it’s something, uh, I call them MacGyvering, uh, if you’re, depending on your, uh, what generation you are, um, MacGyver was a TV show and, uh, he would find himself in these predicaments and have to be very creative about getting out of his predicaments or using whatever resources were there. Uh, so what I’m going to cover a few of those formulas, uh, and, uh, yeah. Tell us, uh, where you guys are watching from I’m from I’m in New York city, union square. Uh, so feel free to type in the chat, uh, you know, where you’re from. Uh, so the first one I’m going to talk about are some formulas, basic formulas that all of you probably know them, and, uh, you can also teach your patients.

I’m a very big advocate of, you know, giving this information so your patients can actually learn how to take care of themselves, especially early stage and acute right early stage prevention. Hello, Brooke from Hawaii, Hawaii. Oh, I love it. Yeah. And Sharon from long island. Thank you. Thank you. Um, so another part will be kind of building your kids, uh, another topic, uh, I love instant soup, which is an ancient Chinese formula, big, like, what is that? And then also some, uh, you know, what to do, you know, with fast food restaurants and how you can actually make Chinese medicine. Uh, and then, uh, you being a MacGyver, like creating your own, uh, creative hacks. Okay.

So here we are, when you wish you had your Chinese medicine cabinet and really what you have is, you know, you’re, you’re on the road, whatever you’ve packed. Okay. So this list, uh, will be available on the replay, uh, the formulas and some miscellaneous supplies. Um, I love the, you ping pong sand, the Jade windscreen, uh, that is, uh, just in case anybody kind of forgot their, um, oops. I just dropped my forgot their, uh, their verbal basics, really the very initial stages of when you think you’re getting sick, um, kind of like when you’re having a premonition and that’s what you would want to, to take right away. Uh, the BN PN for that kind of stuffy nose, uh, the arch and Tom, I love that also for congestion, uh, very famous the yin child song, which I’m going to, I mean, uh, yes, the child song, which I’m going to kind of go over a few other things with it.

Uh, the [inaudible], which is the cinnamon decoction Boothbay, Tom tonifying the lungs that’s when you have the chronic cough, uh, the peep or the bay move swallow center, which is a syrup, right. That has the Loquat in it. Uh, if you’re on the road and you’re overeating, you may need something for digestion, the bowel ho wan, you know, for the over consumption of food, you know, when you’re not home to cook those organic meals, uh, then we have also the Shandling by do, do Tom, you know, for that, he gets sick with diarrhea. Um, you really need to, especially if you’re traveling overseas, you know, something other than Immodium, the classic Yunan buy-out for internal, uh, bleeding or bruising. I mean, this is like arnica on steroids, uh, a D Dodge owl, or even like a white flour for like a bruising, topical bruising pain patches emergency, which is great for replenishing electrolytes, definitely a probiotic.

Uh, this is gonna help with your, your digestion again, when you’re traveling or you really need to make sure that you have a very healthy immune system. Uh, I love to bring Kinesio tape to have that, uh, because it can double up as a great, uh, ACE bandage, uh, magnets, the little, uh, the Korean hand magnets and, you know, a little Mylar blanket for, for heat. That’s always great. So these are like, kind of, this is like a, a basic kind of a thing I like you can pick and choose, which are gonna work for you. Um, and really like, think about like how you would be able to use them in an everyday setting. Okay. So here’s this thing, instant miso soup with the tofu and scallions. Um, and this is where I was having this conversation. Uh, and I had it with somebody else too, who was traveling to south America.

They were going to be doing acupuncture, acupuncturists without borders. And I would hear that every time someone would go on these trips, they were like getting some kind of parasite, some kind of dysentery situation, um, not a lot of available. And so I would say like, bring some instant miso soup, right? It’s got the miso in it, which is, has the probiotic a fermentation, it’s got a little bit of the tofu. Tofu is considered a complete, like a full, uh, vegetarian type of a protein, right. And then the scallion is also great for the nose and the broth a little bit of salt, because you could be losing, um, some, uh, salt and you need to retain, uh, the fluids. So this, interestingly enough, I look and I said, oh yeah, this is part of this, the, the song church, Tom, which is the scallion number, Baird, soybean decoction.

So instead, like, where would you get it? Okay. Go to the supermarket. Most supermarkets actually have, you know, this instant miso soup. Um, and some of them also will have the, uh, seaweed and seaweed is really good for detox, right. And also it has a little bit of iodine, nothing wrong with that. Um, and, and what it treats. So this is in the materia Medica. It’s the very first stage of that external wind invasion that mild fever and chills will stuffy nose or the headache, um, the thin white tongue coat, the floating poles. All right. But if you’re out, you just need to know that, Hey, if you don’t have the, uh, you pink Fung sand, this is what you would take right now. The interesting thing about this particular miso soup is the formula comes from a book it’s called the emergency formulas to keep up on sleep. This is from the Jin dynasty. And, uh, by the practitioner was the home, uh, a natural scientist, a Taoist expert, uh, and really, uh, a pharmacologist. And so when we think about Taoism, I’m going to go off on a tangent here is where they say, oh, you know, it’s like religion, but that was, we’re always also looking for how to extend life. You know, we’re always looking for immortality. So what’s gonna show up is really like things to continue to, um, help your health. Right.

Okay. Foods, we could do an entire, uh, segment or on foods. But what I would say easy is T bring with you teas, you can bring dried mushrooms again, the Meese, so soup, some ginger candy preserved plums. I was in a supermarket in Chinatown, and I’m looking at these, a traditional kind of candies, which are actually, uh, like orange drawings with a salt, sugar, a little ginger. Um, so they’re sour, they’re like sour plums, and those are great for digestion dry in my office here. Okay. So what can we find at something like a Walgreens, Chinese medicine at Walgreens? Well, the formula [inaudible], which again, combined with [inaudible], now this, we know as practitioners was part of some of the strategy for treating COVID right. If you’ve been following some of the formulas and the classic, really what we’re looking at is the two herbs, which are actually flowers are the honeysuckle and the forsythia. Now, if you, and I’ve said this to my patients, if they don’t have the in-house on, the closest thing to get is airborne and the ingredients, which I it’s very tiny on, there has a lot of the ingredients that are in [inaudible] and in particular, the honeysuckle and the forsythia, right? So this is something where you can go to a Walgreens. They’re going to have it in a supermarket now, so you can just read the label. There’s also the, [inaudible] the chasteberry I think there’s licorice in there as well.

Okay. So creative hacks and resourcefulness. So one of the things that I want to impress upon is, you know, we, in our modern society become like really complacent with our idea of what medicine is, right. What’s what’s really happened is, is a lot of pharmaceuticals. Um, but the world itself has not really changed. Right. We still get sick and we were still very much, uh, vulnerable to serious viruses and pandemics. Right. And, um, what’s happened is unless it comes from a particular place, we don’t even recognize what it is. So a lot of the things that are used in Chinese formulas, like ginger, cinnamon, um, clove, hot peppers, garlic, those things have now, uh, you can find them in the baking section, right. So if you need to like, make something like, oh, what am I going to get? Ginger? I can’t find it. There’s no sewer.

You can find it’s like freeze dried. It’s just like the package has changed. Right. And the thing about going back to gung ho, he was an expert in natural science, right. Plant medicine. And he actually intact attach more importance to experimentation. He’s the one that wrote a hundred volume tome, the Jaida case formulas. So anything that’s in a Jade case means it’s very important, right? You got a golden cabinet or a Jade Jade, uh, case. Um, but he was doing this based on his own understanding of Chinese formulas and folk medicine that he would really collect. So here we have, you know, someone who has access to all like volumes and volumes of medicine, just like us. We’ve got the internet, we’ve got Dr. Google. We’ve got a lot of it. And, but also he was looking at, Hey, what’s actually really working out in the world.

And so from there he wrote 101 formulas to keep up one sleep. I remember they had these long sleeves. Right. Then they could put stuff in. So these, that means these were important, right. In, in the ancient times, anybody that would get sick, it could be really like death. Right. If they didn’t recover. Now, one of the things that’s very interesting, the more I started, like looking into like, who is this person? I mean, Hey, we’re thinking alike. I’m telling my friend, okay, if you’re in an emergency, this is what you do. Get out your instance soup. Right. And suddenly I’m reading like, wait a second. The same formula. It comes from a book called emergency formulas to keep up on sleep or in your glove compartment, or, you know, wherever you’re going to be in your suitcase and you in your little makeup bag or right.

Um, but one thing that he noted, and this is a very interesting thing. We’re talking about Jin dynasty two hundred sixty six, three hundred and eighty, right. We’re looking at, he noted that the earth Ching, how, which is the urban Artemisia known as wormwood using that juice to treat malaria in the 1970s, Artemisia in was actually extracted from the wormwood by Chinese scientists, scientists, and this in 2015, uh, this scientist got the Nobel prize in physiology or medicine. It says it was awarded to professor you U2 for her key contribution to the discovery of artemisinin. Now this is where we’re looking at this stuff is everywhere, right? And, and we, as practitioners, we have access and understanding to what there is the thing is, is that we’re not recognizing it, that it’s still around us. The world is not changed that much in terms of the natural world. Things get packaged differently. We look so much too. If it comes in a little container in a pill or a backed by let’s say science or pharmacy, that it’s gotta be powerful. The thing is, is that we have these things that we can still do. Even if there isn’t a, a, an apothecary that’s near us, we have to be creative. And, and hopefully at the end, you’re going to like this and you’re going to see it.

Okay. So necessity leads to invention. This is really applying what, you know, by observation and resourcefulness and in case anybody was born, I know in the nineties, uh, and didn’t get to see this, uh, guy MacGyver. Uh, if you go back and you’ll see like wild stuff that he would do, uh, to get out of these, uh, situations, he’d find himself in. Um, and I look at, you know, that’s the same kind of energy and creativity that we need to be thinking about when, like, what could we, you know, what could we use? Uh, one thing, uh, that I would say the pen during the pandemic, people got really creative. They were making a grilled cheese sandwiches on using an iron, right. And, and, uh, poaching eggs, you know, like in a water kettle, right? So this was, you know, something that we need to continue to use that energy, because otherwise we’re going to get very stuck and complacent in how we’re treating people and really like recognizing and observing what is in front of us and, and, and simple solutions.

Now on the list, one of the things, uh, that was on there was the, the cinnamon decoction, right. That’s the wager. And that formula is a fantastic formula, right? Cause it’s for, you know, muscle pain, neck and shoulder, you know, when the you’re cold, you’re getting sick and you feel it like in your neck and your back, but it’s also a great formula for muscle cramping. And I’ve actually given this formula to some of my patients who do triathlons. One of their problems is as they get muscle cramping, the chief ingredient in there is the cinnamon and cinnamon is known as a vasodilator, especially to the capillaries. So how do you get, you know, blood circulation into your toes and your feet, um, sediment, that formula is also great. If you have cold in the stomach, cause cold in the stomach, it’s another formula, which is basically the wager tongue plus extra ginger and extra of the Maltese.

So here we are, the MacGyver hack making some fire cider. I know fire cider has been out all over the internet and it’s, it’s made with like horseradish, garlic, onion, uh, apple cider vinegar, um, hot peppers. So there are many different, uh, recipes for it. But if you’re out on the road and you need to make yourself like a quick little, let’s knock this thing out, you’ve got horseradish. And just so you know, I picked the most common, you know, it’s not organic horseradish, it’s not organic, honey. I just picked the ones that you most likely might see at like a Outback steak house or someplace. If you’re, you know, a, you know, a fast food place. And just as an aside, if you’re ever really looking for super clean bathrooms on the road, McDonald’s better than Starbucks, right? So a lot of these places, you’re going to find these condiments that are here.

There’s the vinegar, there’s the honey, there’s the hot sauce horseradish. If they don’t have it, you can probably find the wasabi. You find those little packets. If you want to make a little more little marmalade that has the little bits of the orange peel. Sometimes with some honey, that’s something too for settling your stomach, right? This is like the using the Chen P right. Or the chain P to help with digestion. And so this is like something, you get a bunch of these packets, you get a little hot water, you can, you know, make a little decoction yourself, drink it down, or spoon it down. And it’s going to help with like a sore throat. And then also, you know, the horseradish stuff is going to go up to the nose, right? So all of these things actually have many of these anti-microbial antiviral properties.

And the thing is, is that we, you know, there’s no, not necessarily a supermarket and you’re not going to start, you know, grading horseradish. You can just get one of these packets. And this is really, we’re talking about kind of emergency situations, but if you’ve got a patient there and there, you can just say, go to the, you know, go to the Outback steakhouse or, or go to the five guys, hamburger, joint, or someplace asked for, you know, the honey packets or the hot sauce or all of that stuff. Cause most of the time they give you too much, right. Anyway, home Depot and your backyard. So getting back to bat combination of the honeysuckle and the forsythia, right. Sometimes it’s in, it’s in your backyard. If you can’t find it home Depot or gardening center actually carries these plants. And so realistically, if you needed to stop by a home garden center and, you know, grab a, you know, grab a few branches, right.

Or the down the line down the line, there is weeds there, weeds they’re all over the place. Uh, and so these are things you might be hiking and you start having scratchy throat and just trying to figure out like, oh, where can I go? You’re like, it’s right there. Um, one thing that I have to say is dandelion is pretty distinct. So you’re not going to end up picking something that is, uh, uh, poisonous. You need to know what it looks like. Right. And honeysuckle is very, it’s, it’s obvious what it is now. Things like plants, as we know, like honeysuckle in particular and a lot of the flowers that are in our formulas that we use, you remember that there are bees that come around, right. And they pollinate now what makes a honey? So, uh, immune boosting, because they’re getting all of the properties from these plans and then it’s being, uh, combined into to make honey, right. So this is why honey is one of those substances, which is actually really good for the immune system we had. Remember where does it come from? Comes from flowers. Right?

Okay. So this is not Chinese medicine, but we’re looking at using things for multiple purposes and to keep in mind, right. We’re getting creative looking at, what can you use? What has a multiple purpose preparation H right. It’s got two key ingredients. One of them is the fenal, uh, fennel, LeBron, uh, which shrinks has a way of shrinking. So for bleeding, it’s used for, uh, hemorrhoids, right? It also has the pro McCain, which is a topical Anil analgesic, which is actually great for itching and rashes. Now there are different kinds. You’d have to look even there’s a preparation age that just has, uh, the, a little bit of hydrocortisone on it. So this is like, wow, what are you going to do? If you’ve got like, uh, a bug bite? What can you do? Well, you can also use a little bit of the preparation age, right?

It’s going to bring the swelling down. It’s going to be cooling. Um, the one that is the suppository is really just made of the, of cocoa butter, right. It’s pretty natural cocoa butter. And then the, um, the fenal Efrin which shrinks the, um, has, uh, uh, shrinking shouldn’t the blood vessels, right? So that’s something in the event of a bug bite. You could probably use it, you know, say for kids, but check, um, you can just take it. It’s like a little bit of a thing and you could just rub it on and it’s gonna like help. Um, the kids. Now, this is a multiple purpose thing. If you can, people have been using it for, you know, under their, their eyes. Um, you might, even if you have little varicoceles or spider navvies on, you know, on the, you know, swollen fee, you could probably use a little bit of that. Um, what else is it used? Yes. And bug bites. Right. So those are things just be creative. Right?

Okay. Well, this is something. And the reason I decided like preparation age, cause, uh, interesting. I remembered back in the early eighties, late eighties, that there were these headlines about preparation H being a target for cocaine addicts. So this has to do with like some of the things that are shoplifted from pharmacies and what they found was like cocaine and heroin, heroin addicts were stealing preparation age and using it for their inflamed node, their noses and the places where they were injecting, which was actually pretty interesting. But then later on, so there was like 87 later on. We started to look at, um, some, it became like the number nine in the most stolen things from retail shelves. Right. So that actually caught my attention, like preparation, H one of the number one things that shoplifted, right. And then by 2005, yeah. Ended up being on the number nine list of the most shoplifted items. And this is, you start to look at, these are people that are kind of desperate and they get creative, right. Need creative causes, you know, creativity. Right. You gotta be creative. Like what can I do to, you know, I’m in pain.

Okay. So what I would love to know are, what are your hacks? What are some of the things that you do, maybe you tell your patients to try something, do something, oftentimes a patient will come to you and say, Hey, I was doing this thing. And I was like, oh, really? Why? And, uh, find that very, very interesting, right? Like why would you do that? Uh, and, uh, so I tend to look into it. I want to know more, uh, there’s a lot of information. And another suggestion is go back into your, uh, into your books, start looking up. Some of these formulas, actually individual herbs are great. Um, I didn’t have time to talk about using things like magnets, uh, and, and stuff like that. Uh, the hand magnets, but that’s a, you know, something we can do another time, you know, as a way to, uh, treat, uh, certain conditions, especially, uh, they’re non needling, so you can teach your patients.

Right. Um, so, all right. Hopefully I want to hear your, your hacks, uh, inform, if you want any more information, you can definitely reach out to me. And, uh, let’s see, I know next week, join us next week. Uh, with Matt Callison and Brian Lau, they’re going to be your host. I have, uh, done their training with Matt twice. I did the whole sports medicine training. Uh, they do fantastic job. You’re going to learn all about anatomy and physiology. You really get a good understanding of what’s going on under the skin. Uh, you’ll be a much better practitioner treating sports injuries and really understanding needle depth and really what is there. Uh, and so I highly recommend taking their training. I highly recommend that you, um, also, uh, go and, uh, tap into next week’s, uh, uh, American Acupuncture Council broadcast. All right. Thank you.

 

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Identify and Use the New ICD10 Updates

 

 

So every year when you hear the new codes is started, always remember it begins October 1st. So it’s important to note, am I making sure I have the codes that I’m using? Have there been any types of updates? So let’s move forward and talk about those.

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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.

Welcome everyone. This is Sam Collins, the coding and billing expert for acupuncture and the American Acupuncture Council. Give you another episode of our show that keeps you up to date and what’s changing and moving forward. And as of course, I’m sure you’re aware. There has been an update to diagnosis codes. Keep in mind that diagnosis codes don’t update. At first of the year, they actually update October 1st of the year before. So every year when you hear the new codes is started, always remember it begins October 1st. So it’s important to note, am I making sure I have the codes that I’m using? Have there been any types of updates? So let’s move forward and talk about those. Let’s go to the slides. So here’s what we’re going to focus on. What are the 2022 updates, but I’m going to be pretty acupuncture centric. I want to make sure we’re focusing on the things that you code regularly because obviously each year that can be a lot of changes.

So keep in mind, October 1st is the date and it begins for this year with changes to back pain. So that’s really, what’s new, but it’s more than just back pain. And that’s what I want to kind of warn you about now. Probably not as maybe common, but the focus is we want to be certainly acupuncture centric. And as you well know, you’ve seen these updates year to year from 2017 to present every year there’s updates. And it’s confusing in a way, because often you go, well, if they’re changing 1,974 codes, do I need to know all those changes? And in fact, I would say, no, we want to know about the code you bill, the codes that are reimbursed and whether or not those have updates. So each year you’ll see these changes some years makes literally no difference. Other years can be a tremendous difference.

Beginning in 2021. Of course, there were some updates of course, that you had to work for a headache. Now you can think, okay, got headache codes update, but it was only to I’m sure you remember the [inaudible] in our 51 9. Good to note that those codes did update from our 51. And they are both reimbursable, whether you were billing like Aetna or Cigna, all the other payers. So those went right into the protocols of payment. And that to me is the focus. It’s not just knowing the changes, but what codes are payable. And I think that’s a confusing and often frustrating part for acupuncturist is not knowing what codes you get paid for. Well, for this year, there’s been updates where there’s 159 additions, 32 deletions, and you’re thinking, oh my God, what do I need to do? Well, let’s focus on what has changed for this year.

The one that’s very acupuncture specific of course is low back pain, low back pain is the most universally covered condition for acupuncture. In fact, I would say just about any insurance that covers acupuncture will cover for low back pain. So what does low back pain mean? The old code was M 54 5. Now that code is gone. Don’t use that code anymore. And the approximate synonyms for low back pain are all types. It could be acute chronic, whether it’s pregnancy related with radicular, apathy, mechanical, low back pain, you know, simple lumbago loin pain. Now the key here is that you’re just describing the pain. You’re not necessarily describing the causation. And I think that’s where often some acupuncturists get confused. Should it be better to decode like a sprain or a string? Well, potentially depends on the payer, the most ubiquitous and likely covered those to keep it simple, go with just back pain.

So what has been updated while there’s a new code? That’s M 54 50 that says low back pain unspecified. Now I want to keep in mind that this update began October 1st. So don’t be confused if you treated someone in September and you’re sending the claim. Now you’re going to use the old code. If you treated someone October 1st or later, you’re going to use the new code. So keep in mind that type of issue. But bear in mind, I’ve had a few people that go Sam I’ve built out in 54 50 and it came back as invalid. But I want you to bear to keep in mind that that was likely because of the clearing house. It wasn’t the carrier, but the clearinghouse often they’re just not updating their systems often enough. So what does low back pain unspecified really mean? Well, we’ll get into that. There’s another code and 54 51 for, for T progenic meaning related to the spine that looks promising, but we’re going to talk about that more specifics as to whether or not it’s going to fit for a typical acupuncturist.

And how about M 54 59? So here’s the update three new codes for back pain and 54 50 51 and 59. Now you may already be familiar with them, but let’s dig into what each of them mean, unspecified low back pain. And you think what does unspecified mean? It means that there’s a non-specific low back pain defined and not attributed to a specific pathology. Now often in many states, acupuncturists cannot make a quote unquote Western diagnosis or differential. So this might be your safest bet because you’re simply describing it hurts. You’re not differentiating. Why? So in other words, if there were something like pain in the low back related to a sprain or a strain or radicular apathy that potentially could be coded that way. And for like a Cigna insurance, they wouldn’t accept that, but Aetna would not. They’re going to take only the pain code. So it’s kind of knowing your carers, but this would be a good, easy code to indicate just low back pain.

And I would say this is the one that probably represents the change over from what M 54 5 was. I think this would be a safe bet or a safe bet to use, just to describe the plain symptom that you’re not differentiating it, but just that there’s a symptom of pain. Now you may be differentiated into, you know, B syndrome or cheese stagnation, but I’m talking about differentiating from a Western standpoint, like ridiculous apathy. Well, what about M 54 51? Now that’s specifying that there is specific pain from the vertebra or spine. Now I liked this because it seems like, oh goodness, I’m going to say it’s spine related, but let’s understand this really doesn’t, isn’t going to be used very much because the purpose of this code, which wasn’t well-publicized the purpose of it was to describe more specifically, what’s called vertebral endplate pain, which means actually a pathology of the bone that’s causing it.

So I would suggest this is not one you would use for like, oh, it’s something related to the spine, like a sprain strain. You would code that. So M 54 51. I’m not saying it’s not usable, but not very likely unless you have a differential of end plate pain in the vertebra of the low back. So not likely it’ll be a covered diagnosis, but make sure you have some specificity for it. The spine related conditions, such as sprain strain, radicular, apathy would not be appropriate for this. Cause simply code that. And again, I’m going to implore you. Here’s kind of the weirdness, Aetna wants only pain. However, Cigna will allow you to differentiate. So Cigna will accept back pain as well, but they allow you to differentiate to sprains and strains. So depending on the carrier, it may allow it for instance, Anthem would do the same.

Well, what about this other one? It says other low back pain. So we have unspecified and then others. So this is determined to be kind of non-specific low back pain is defined as low back pain, not attributable to a recognizable known pathology while you’re thinking, well, wait a minute. Isn’t that? What other or unspecified mean? Other means, I think you can kind of recognize that there’s some sort of causation, but just not one that you’re directly attributing it to again, pain, but not F not differentiating like spraying string. So the reality is it’s likely that you’re going to be coding M 54 50 or 59 as an acupuncture provider to replace the M 54 5. The key factor is making sure that you’re describing low back pain with the correct code. Keep in mind. They now require five characters. I know some of you are going to say, but standby have built in, has been rejected.

Remember that’s likely from the clearinghouse and potentially what you’ll need to do is just simply wait until they get an update to it. The problem here is that what about some of these plans that have a very short window to send claims? So check with your clearing house to figure out why they’re rejected because the carriers have certainly updated. What’s the best practice for this best practice. Use them 54, 50 or 59, simple 51 again, end play pain. I think gets a little bit, um, outside of probably scope. I’m not saying no, if it’s predetermined, you know, by example you could code are riotous, but it’s not going to be by you directly, but from, you know, their medical provider, they bring in the note. So again, best practice and 54 50 59, well everyone’s onto those codes, but are you aware that there was another code that updated headaches are also universally covered for acupuncture?

And there’s a new code specifically for what’s called a cervicogenic headache. Now cervicogenic means that it starts in the neck. So it’s a neck problem, but the pain is perceived in the head. So a little different from tension, but it’s usually involving some type of range of motion or other issue that’s directed into the neck. Now what’s the reason they’ve added this code is because they wanted to make it somewhat more specific, a cervicogenic headache before this code would have been coated with our 51 9. But now that there’s this specificity you could use code by example, our 51 9 would include things like, uh, I would say probably, uh, a headache where you’re saying it’s a sinus headache or some type of facial pain. Whereas this one is just a bit more specific. Would this be covered for acupuncture providers? Oh, absolutely. Again, you’ll see this one with Cigna.

I believe Aetna will adopt as well, but at this point I would hold off and stick with the R codes until we get a for sure on it. This is something that isn’t going to be a lot better to coach cervicogenic headache compared to say just a headache. Well, I will say it’s a slightly more specific and it might mean why you’re doing other things. Maybe it’s involving some neck pain. I mean, certainly you could have a headache which is playing neck pain, but again, I just liked that there’s some additional codes that you can kind of specify a bit more. I always will say medical necessity often as determined by the complexity of the condition you’re treating. So if we have simple back pain or simple headache, we’re not thinking very severe, not longterm, but in turn, if I said migraine or cervicogenic, there’s a little more severity and chronicity to that same would apply.

Let’s say you have low back pain where there’s radicular apathy. That’s certainly going to be more than simple pain, but again, it’s knowing your carriers, which carrier will and will not accept. And that’s, what’s important to know. That’s one of the reasons we do the service that American acupuncture council, the networking seminar. So make sure you stay on top of not only what the new codes are, but which ones are and are not payable. Well, what also updated now, this is when you’re going to go, well, sing them. This is, you know, I don’t cope, cough. It actually, I’ve not seen cough covered for any carrier though. I’ve seen some that do cover respiratory issues, not all, but some do well. This is a new code for cough, and I’m not sure, obviously that many of you were using these, but they did update them.

The codes now no longer are three characters. They now are four and in dictates the type of cough, but here’s why I’m bringing this up. Could this be a complication? Could this be what we call a comorbidity or adding to the complexity of the patient’s need for care? Let’s say a person has back pain, neck pain, and they’re coughing a lot. Could that irritate that so-called, Valsalva fecal pressure caused that pain to get irritated maybe. And I’m pointing out that these are things like let’s say a patient has a significant cough. Would that be something I want to document as part of their care, as part of their history and indicate anything that might increase the need for care, realize that even American specialty health and these types of carriers, when you’re requesting additional care, they’re not only wanting to know what’s going on with the patient in the sense of the primary reason for care, but all the other potential barriers to the patient responding well.

And that could be things of this nature. So always keep in mind, diagnosis is going to be the lifeblood of payment. It’s what we’re doing, but all plans have a specific code that they allow. Remember Aetna and Cigna are a bit different Evercore, a little bit different, a little bit more ubiquitous, but what about United? And now there’s a lot of similarities, but differences. So make sure you understand the codes that they are allowed. Make sure you’re using the code to the highest level of specificity, which means the new back pain codes have to add a digit, but most important, make sure it’s on their list. By example, if you were to code back pain to both Aetna and Cigna, those would be payable. But if you were to code a sprain of the lower back as 33, 5 XX, a Cigna would pay you, but Aetna would not.

So then how would I code back pain or sprain to Aetna? Well, you got it. If there’s pain well, will a sprain cause pain. Absolutely. So I simply just code the pain. So what’s allowed here is that Cigna, for instance, or Anthem allows a greater specificity in severity, but it still will be covered by sticking with the code. And that’s the part I want you to get. Don’t overcomplicate this, make sure the codes that you’re billing, which you’re probably eight to 10 on a regular basis are accurate. Correct. And up-to-date to make sure that your claims simply can be paid without the right code. We’re going to have a problem. So it’s easy to understand codes update every October 1st. Are there any other codes that have updated? Sure. But how often do you build Sjogren’s syndrome? Have you ever coded that? Probably not. They updated that code, but again, not one we would use regularly.

So I always will say, don’t be afraid to be a little acupuncture centric, just have the right code to note your claims get paid. And that’s really our role. The American acupuncture council is always here to be your help. Not only is it your malpractice carry, but also your support. Remember there are seminars and programs we do to make sure your claims get paid. Like if you’re saying, how do I get that list? Well, that’s where our network services do. And what I would ask all of you to do, take a moment to go to our Facebook page, to the American acupuncture council network, click on our Facebook page. There’s weekly updates on all types of issues, coding this week’s questions on how to do an ENM. And do you need a 25 where there’s also updates regarding vaccines and other types of issues. It’s always going to be a good source for you. So take a look. We always want to be here to help. That’s really our goal and mantra. Your success is our success. So I’m going to say thank you for being with me next week’s guest will be Dr. Taso-Lin Moy, and I’ll look forward to seeing you the next time. I hope to see it a seminar take care of everyone.

[inaudible].

 

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Growth, Hiring and Culture

 

 

Our topic today is growth hiring and culture setting your clinic apart. So everyone wants to work for you today. I’m very happy to announce that I got two other experts joining me in our expert panel today that we each will be sharing ideas on growth, hiring and culture fit.

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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.

Hello. And I want to welcome you to the AAC To The Point my name’s Lorne Brown. I’m a doctor of traditional Chinese medicine. I’m a CPA, a chartered accountant, and I’m also the author of Missing the Point- Why Acupuncturists Fail and What They Need To Know To Succeed. Our topic today is growth hiring and culture setting your clinic apart. So everyone wants to work for you today. I’m very happy to announce that I got two other experts joining me in our expert panel today that we each will be sharing ideas on growth, hiring and culture fit. And we got Mark Sklar and Aimee Raupp. let me give a little bit of a brief introduction here. Each of ’em each of our presenters, our experts today. So mark, um, he’s known as a fertility expert, um, and he has over 18 years in clinical practice, helping couples get pregnant.

Um, he’s president of the American board orient to reproductive medicine and a founder clinical director of a very successful functional medicine, Chinese medicine practice in San Diego, where he sees several hundred patients a week. He’s developed a whole online platform where he does coaching and seeing patients also, um, around the world and his YouTube channel has well over a thousand subscribers already. So welcome our Sklar to our panel. We also have Aimee Raupp with us today. She’s known as a women’s health and wellness expert and just selling author. So published a couple of books, body belief, yes, you can get pregnant and chill out and get healthy. Um, she has been in private practice for over 16 years. She’s a licensed acupuncturist, herbalists in the New York area and she has two practices with several associates. I should mention. Mark also has several, several associates, which is why there are my expert panel today.

And Aimee has appeared on the view and has also been featured in goop glamour shape alert and the red book and has received endorsements from some people you may know, Deepak Chopra, Dr. Christine Northrup, um, Ariana Huffington and Gabby Bernstein, as well as she received endorsements from me and mark as well. I don’t know for there on this graph, so we can draw in a little bit of just an overview of growth hiring culture. So I’m going to bring up, uh, a presentation and then I’m going to have mark join us for a little bit on what he’s going to share on growth hiring culture. And then Aimee is going to take us home the anchor of our panel, and she’s going to talk a lot more about, um, cultural fit. Um, so let’s get this started and talk about growth, hiring and culture fit.

So really to have, um, a busy practice, it requires continuous referrals. And in this case, referrals come from having informed admin staff, um, from having, um, informed patients, which we create. And then, um, you being an, a formed TCM practitioner. If you stay to the end, um, we’ll share some key points and where we can go into more detail, cause I’m going to do a very superficial, but big overview for you guys today. Let’s focus on the really valuable front staff. So they’re your first, uh, contact for your patient. So they make your first impression. These are the people that are answering the phones and greeting your patients and exiting when, um, uh, saying goodbye when the exit and making sure if they need to be back in your clinic for that followup appointment. And so without this valuable front staff, um, this alone compare paralyze your practice, if they’re not the right person, because they are your first impression, your staff need to be able to instill the confidence in your patients, meaning they have to know, they have to be able to communicate to the patients that you, the practitioner are the right choice.

And so in my practice of Vancouver, acupoints wellness central, we have several associates been in practice role since two year, 2000. You can do the math there for awhile. We train our admin staff to be as knowledgeable as practitioners. So basically they become like practitioners. They can’t legally treat, and this allows them to become better advocates for the medicine and also, um, to be able to communicate well with the patients and ask for answer a lot of those questions. Um, it may be beneficial to treat your staff, your admin staff, and even their family members, because if they have a positive experience, um, then they’re going to become better advocates of your medicine as well. In the hiring process, often people say, do you have benefits? Do you offer medical benefits? And your answer actually can be, yes, I know the default always is no.

And I hear some of the reasoning, um, you know, we’re small practices. We don’t have that budget for, um, external or medical benefits, but you do actually offer medical benefits. It’s the medicine you practice. So if you’re doing, um, practicing as an acupuncturist or functional medicine practitioner, um, your staff actually be probably quite happy to receive a free acupuncture from you and a discount on, on supplements, um, and free or discounted testing services that you offer. And you may want to extend that to their family as well. So you do actually offer benefits and a lot of the people that take this admin position, the salary that it’s based on often, they can’t afford your services. So even more of a value added for them wanting to join your practice. My biggest mistake was, um, in this cultural fit ideas, I’ve heard some great admin staff, but I hired admin staff that had fear of needles.

It wasn’t a question I had asked. And so, um, it was only when a patient, um, would ask if you had, have you had acupuncture before, or they’re trying to communicate the acupuncture. You could see it in their face. That there’s fear. They didn’t want it. And so that is one of the, if you’re gonna take anything away today, when you’re hiring your front end staff, you should ask the following question. Have you ever had acupuncture before and watch their face? And they’d say yes. And it’s a very uncomfortable phase. They’re probably not going to be a good fit for you. And if they smile and tell you, they love it. That’s excellent. If they say they’ve never had acupuncture, the up question is, would you like to receive acupuncture? Do you have an interest and follow that instinctual facial response. I’m telling you that if they have a fear of needles, if they don’t want acupuncture, you don’t want them being your first impression, your front end staff take it from me. I learned this the hard way with integrity. They can’t tell patients that acupuncture is for them. So let’s talk about hiring for cultural fit. And first of all, let’s talk about the common pitfalls, um, for when you hire for cultural fit.

So some of the common pitfalls are hiring nice people. I’ve done this so often, right? Looking people. I think I get along with this person, this person seems nice, but they don’t have the skillset. So don’t do that. I’ve done that. Not very good for your front end. They do actually have to do the job besides you liking them, being a fit for your practice. They must have the skill. Um, you gotta be able to clearly set out the role and the requirements of the job. So this is your job as the leader, as the owner, the owner of the clinic, um, and another pitfall is, um, keeping them on board. Um, and they’re not the right fit. And so one of my colleagues used to say, you gotta be able to pull it off like a bandaid. If you have to let somebody go. So when you notice those red flags and those first few weeks of hiring somebody, don’t ignore them. And they think it’s better to pay attention to those red flags and let go of the people quickly. If they’re not the right fit, it’s much harder to do it later than it is at the beginning. Um, you know, not delegating properly, um, and, um, not giving them proper feedback. So that’s part of that training.

So we want to hire for the right cultural fit. Um, you know, we used to hire based on resume alone, um, and who we could afford, that was an epic fail. So you really want, um, the, uh, hire for the cultural fit and make sure you know, what your culture is. So I have on this slide, what my Acumatica’s culture culture is, and it’s clear to know what yours is, and then you’re looking for that fit that they share the vision, the values that you do, and having several touch points is key for this. And I have a link there to the community library@healthyseminars.com. Um, I have a much, uh, comprehensive talk on how to hire for culture fit and how to go through the process of hiring. So you can check more out there.

And then this just outlined some of the processes that I mentioned, that’s in that community library that I’m not going to go over here. And also myself, Marc and Aimee in our coaching and mentorship program that we offer for you guys, we go into crazy amount of detail and give you documents on how to do this as well in our rise, transform impact program. And again, these are some of the steps to pay attention to. Uh, and as I mentioned, this is the rise transform impact. So I’m just going to skip this because I want to just do a breath today. So that’s at healthy seminars.com for slash RTI, where myself, Marc and Aimee are going to be putting out some more of these free little clips for you to enjoy. And then there’s also much more that we do in our mentorship program. The real question you want to ask yourself then, because so many of my, um, the people that I’ve coached and talked to, um, they’re running their man, they’re doing their front staff job and really think of it this way.

This is really how you can clarify it. Did your school train you to treat patients or be a receptionist? What is your training and where does your passion lie? Is it in treating patients or doing admin tasks, even if you’re excellent at the men task, where’s your passion. And I think for the majority of you that invested time and money into Chinese medicine and functional medicine programs, I think your passion is in treating patients, not doing the men’s side. And I’ll share with you that if you have a good admin person, you can actually see more people help more people heal because less time answering phones, scheduling, collecting money means more time that you can be, um, taking care of your patients.

Let’s talk about our associates, be clear that this is not passive income. Um, you need to bring value to your associates, but it does add or increase your income generating potential. And it gives you some flexibility with time as well. Also know that you’re changing your job role, your, your leadership role, you’re going from being the practitioner to now managing people. And so if you don’t like managing people, um, then you want to hire and you want to have associates. You may need to hire an office manager to help manage your staff because there’s the entrepreneur, there’s the manager. And then there’s take technician. And we all love being the technician being that practitioner. But once you hire on staff and associates, you now have that managerial role and all that can take away from the entrepreneurial role, the vision of the growth of your clinic.

And so once you hire associates, you now have to manage people. So please know that your role is changing. Common question that Marc and Aimee and I get is, you know, I get staff. So how do I keep them from like leaving me and compete? Um, I will let you know that the non-compete agreement is hard to enforce. And there are other ways that we do in our mentorship program where you can set up systems. So they want to stay with you. And if they leave you, you won’t be resentful. Won’t be costly as well. So there are ways to do this that has integrity, that your associates feel great about. And you feel great about, um, there is, uh, a quote by Richard Branson that says the following train people well enough so they can leave, treat them well enough. So they don’t. And so a lot of this is about, um, how to train your staff.

So, um, they are great and they couldn’t leave you, but treat them really well. And this is what we go through more in our program. Um, so they don’t want to leave you. This is key, and we’ll also give you our non-compete, um, contracts. So all the things that we have put into our agreements and contracts. So the key here though, is to invest in your people. And there’s a meme going around saying, I’m the CEO and the CFO are having this conversation. What happens if we invest in our staff and our people, our associates, and they leave us. And the response from the CFO is, well, what happens if we don’t invest in our staff, we don’t train them and they stay in our company. And so you don’t want uneducated and untrained people in your company. Um, they will, they will bury you, um, in David Pink’s book dry, um, he talks about what motivates professionals and you are professionals, if you are practicing medicine, and this is that whole motto treat them well, may, will stay, but basically the factors that lead to a better performance and personal satisfaction out of the following, having autonomy.

So you want to have the sense that you, you are in control. You don’t want to feel controlled. So autonomy is important. So when you have associates, you don’t want to have your thumb on them, but it’s also not a free for all, but they got to have autonomy to be happy, to want to stay with you. Um, second one is mastery, um, to be able to reach for their potential to constantly have growth. Well, if you’re a practicing medicine, you never arrived that, you know, enough, as we know, there’s always opportunity to learn and grow in, uh, in your medicine. Um, so if you don’t have that mastery, like your drip looking envelopes, then that can become very boring. And it’s hard to stay in that job. But again, remembering that in Chinese medicine, that is not the case, having purpose, feeling like feeling what you do matters that has value.

Um, this is important. And then the last one is recognition. Um, your staff have to feel appreciated, have to feel valued. This is where I have failed early in my career. When I hired admin staff and I, our associates, I’m a self motivator. I’m doing all this great work for myself, investing myself, but I didn’t make time to talk or connect to my associates. And they felt not appreciated, not valued. So I did lose some associates in the early days and I adored them and I loved them and I did value them, but I didn’t communicate it to them. And so regular, um, connecting with your staff is key because if they don’t feel appreciated, this is another thing in the research that shows that people won’t leave. If they don’t feel valued or appreciated by you in his book, he shares that you can pay people fair market value, or even 10% below fair market value.

And if they have autonomy mastery, purpose, and recognition, they will stay the same thing as you pay them way over from market value. So the monies is better than they could ever imagine, but they don’t have autonomy mastery, purpose recognition. They’ll still leave you. So money’s the, uh, it’s not the driving force for people to stay. So, um, I do want to let you know that there’s a lot of talk about the renumeration. So what do I do? Is it a salary? Is that hourly? Um, do I pay, do they pay rent? How do we do this? Right. Um, how many rooms do we give them? So really these things come down to how you’re going to set up your clinic, because how you pay them, how many rooms they get is going to be based on a what’s your clinics, Val, um, um, goal and mission, meaning that acupoints minor all employees, because we’re a full on team.

Like we are a unit, that’s one of the things we have. So they’re all employees and how you do this really is what’s the value you’re creating. So there is no right way to do this, but there is a right way for your clinic and your vision, which myself and marketing, when you go into more detail in our programs. And so I will share with you that these are some of the ways that people do it. The key point here is what’s the value you’re bringing to your associates and what value they’re bringing to the clinic. And that’s how you determine the hourly, the salary, whether it’s commission rent, et cetera. So I’m going to bring on our experts. I just want to let you know that we do run a mentorship program, a coaching program, the three of us, um, is called rise, transform, and impact. And, um, if you want information on that or sign up for some more of our three little chats, um, then go to healthy seminars.com for slash RTI. I would like to bring on, um, mark now. And mark, I would like you to share a little bit about how we can do this, um, the growth and the hiring, the culture fit so we can grow our practices and people set ourselves apart. So people want to, um, want to work with us.

Absolutely. Well, first and foremost, thank you, Lorne, for, uh, inviting me to be part of this. And, um, you know, I think this is such an important topic for all of us as business owners, for the very fact that you mentioned in your slides, that, you know, we are not taught these things when we are in school, right. We’re taught to be clinicians and doctors. We’re not taught to be entrepreneurs or business owners. So if that’s the direction we want to go, then we need to take a step back and evaluate things a little bit differently. And in the first place that we need to start to evaluate and really consciously think about is growth. You know, where do we want our business to go? Where do you want to take your business? And, and when do you want it to get there? And so I think it’s easier to break this down into five-year chunks.

I mean, certainly if you want to look beyond that to have this really big, big goal, that’s fine. But I always like for all of you business owners to then say to yourself, where do I want my business to be in five years time? And this sets the stage for how those five years are going to go for you. So once you decide how you want the next five years to go, like what you’re trying to accomplish in those five years, maybe you want to have multiple clinics. Maybe you just want to grow your one clinic to have, uh, you know, 10 providers. Maybe you want to have an, uh, brick and mortar and you’ll have an online presence as well, whatever it is, that’s in your dreams, wherever you want to take your, your business, your little baby. I want you to set that intention consciously of where you want that to be in five years and growth doesn’t happen just by setting that intention.

Although that’s the first step it has to happen in baby steps, but we need to break down those baby steps based on that big goal. So we’re going to work backwards, right? So if, if in five years we want to, uh, have our brick and mortar and an online presence, then what do we need to accomplish in those five years to get there? And how does that need to be broken down? So then what you’re going to do is you’re going to set out for yourself to maximum of three goals annually that you’re trying to achieve. And the easiest way to do that is to say to yourself, okay, well, if I want to achieve that in five years, what do I need to do this year to take me closer to that five-year goal. Again, it, it, we all have our to-do lists and those to-do lists can be overwhelming and daunting.

But if we break down that to-do list into two or three annual goals, then that’s much more achievable. And then we’re going to take those two to three annual goals, and we’re going to break those down into quarterly. What do you need to do quarterly? And then what do you need to do monthly? And that’s how you’re going to make your weekly and daily to do list to accomplish all that. Now, if you can just accomplish one or two things on that checklist every day, if you can just check off one or two things every day on that checklist, you will be moving very quickly, although it might not feel that way, but you will be moving very quickly towards that bigger goal that you’re, that you had set for yourself. And that’s really how we’re going to achieve our overall growth for the business is setting that five-year goal, breaking that down into annual goals, and then breaking that down into bite sized chunks that you can accomplish on a daily and weekly basis.

And if you haven’t done this, I really want to encourage you all to go ahead and do this set aside with time, uh, this weekend to consciously make a choice for where you want to be in five years, and then start to break that down for yourselves. It feels really good to cross off those things on the list you feel accomplished, you feel like you’re moving closer to your goal and you get there much faster than you would think. But again, it happens with baby steps and those baby steps start to jump and start to look like big jumps and leaps, which is how I’ve been able to accomplish all the goals that I’ve had. And I know that Aimee and Lorne also do something similar, which is why I’m talking about that part of baby steps. And part of growth is also hiring. So, you know, when you’re, you’re in your clinics, you’re, you’re in your business, whether it’s virtual or brick and mortar, at some point, you’re going to come to a point where you need to hire staff.

And I know for many of us, our first goal is when do we get to hire that associate? That’s going to work under us. That’s going to, um, you know, start to work with, uh, patients who are coming to see you. Well, I would ask you all to, uh, to question that and maybe even put hiring associates on the back burner. I believe that we all do need to hire for growth and to achieve the goals that we have, but we need to start by hiring managers. And I think managers are going to allow you as an entrepreneur, as a business owner owner, and as a doctor to accomplish much more because as Lorne had mentioned, you know, we, we, weren’t trained to be receptionists and to run a practice. So shedding those things and giving yourself the ability to focus in on one treating and two, being an entrepreneur to have to think clearly to brainstorm and to create for your business are going to be the two most productive ways that you can take your business further and that you can grow.

So instead of hiring associates, first, I want you to hire two specific managers. One is an office manager who’s going to help you run the day to day running of the business, who can also serve as a front desk reception initially, who can also help you, uh, facilitate all the admin stuff while you are dealing with the clinical side of things. And then the other person that I want you to hire in terms of a manager is, uh, a social media manager or a marketing manager. Those are the two most important pieces and hires that you’re going to make because they’re going to free up your time. And it doesn’t mean that you lose control of these things, cause you’re still have your overall vision driving those. You’re still meeting with those managers to make sure that they’re on point and that they are facilitating your overall goal and vision, and that you’re still on the same page and that they’re running the business the way you want them to, but you are giving up the day-to-day management of the minutia and the detail of those tasks, which again, will free up a lot of your time and energy and resources, um, and get your mind thinking more about growth and clinic, which is where it should be versus running the day to day business.

If your mind stays on the day to day business, you’re going to have a really difficult time getting out of that and growing to where you want to be. And then part of any growth and hiring is culture. And I know that Aimee’s going to go into this a little bit more, but I have two points that I want to mention when it comes to culture. The first one is that anyone you hire to bring on has to believe in you. They have to believe in you as an individual. They have to believe in the medicine that you are providing. And they have to believe in the mission, the goal, the vision of where you want the business and the practice to go. So part of the questioning, um, that Lorne had discussed is going to be really valuable in hiring someone who believes in what you’re doing, where you want to go and how you’re trying to support, uh, patients.

And then the second part of hiring and growth is going to be trust that obviously you have to trust in them to facilitate what, what you’re trying to achieve, but they have to trust in you, right? They have to trust that you have their best intention at heart that, and they’ll have to, and they have to trust in you that you have your patient’s best intention at heart. And if those two things are, uh, are accomplished, then you can grow. You can achieve whatever it is that your heart desires, as long as you have the right path, the right support and the right culture in place to achieve that.

Thank you, mark. And, uh, two things I want to mention it, cause it comes up to me is that I can’t afford to hire an office manager. I will share with you that 13 years into practice. I burnt out and out of desperation. I decided to hire an office manager. And in my mind I was like, I’m going to make this much less this year because I’m paying an office manager. Now I didn’t choose to do it proactively, like is suggesting I was forced to do it because of my health. I burnt out guess what happened? So I hired this office manager, pay her salary, the clinic grew and paid her salary and was even more profitable because it freed up my energy to do what I do well, and she runs the clinic better than I could. So I did bring that in. If you’re saying, how am I going to do this?

I was prepared to make less. And sometimes it’s three steps backwards, 10 steps forward. I invite you not to have to burn out to find that out, to have to our office manager. I suggest you do it in advance, mark. Great points. Thank you very much. I’m looking for looking forward to continuing our work together and RTI you just a great communicator and you’ve shown it and I’m glad you’re teaching it. All right. Next up is I consider Aimee like a celebrity cause she’s been on all these cool TV shows and magazines. Um, um, and she’s our anchor today, Emmy. Um, Aimee, can you please talk a little bit about, um, cultural fit and, and fitting in? I know you have a lot to say on this.

Well, and I think what the point you just made about, um, you hired the office manager when you burnt out is, was my experience with hiring an associate? Um, I was, my practice was so busy and I was doing everything myself as we all do. And it was probably seen about 60 patients a week. I did have an assistant who was an acupuncture student. Um, but my, the same time my father had gotten diagnosed with a pretty aggressive cancer and was not doing well. And they were in California. I was in New York and I wanted to start getting there and spending more time, but I didn’t really have any backup. I didn’t have any help. And then, you know, a crisis happened, I actually had to get there and I was cornered into hiring an associate and it worked out she’s still with me, uh, 12 years later.

Uh, but it was, it’s an experience that I don’t think you want to put yourself in. You want to be set up to, um, hire and have your people aligned up. Who’s going to be there to support you. Who knows the team of the team, they, the brand’s mission and who can represent you. Right. I was really fortunate that who came in and literally saved me and saw my patients and basically helped me generate continuing to generate money so I could pay my rent and be with my family, um, worked out and she’s not just an acupuncture associated of mine for the last 12 years, but she’s also one of my lead fertility coaches at this point in my online business. And I think for all of us, it’s it is that I was never in that position where I felt like I could give things up.

I needed everything I was taking in. I thought bringing on an associate like similar to Lorne’s perspective with hiring, um, admin was gonna cut my income. And the interesting thing was, I think I missed 30% of my work days that year that I brought on my first associate and my income went up by 30%. And, and she also, I also provided enough income for her that she could quit her second job. And it was, it was a tremendous learning experience for me. And I was really, you know, tends to be how I do things is I can get thrown in. And then I kind of learn after the fact, but, um, from that experience and really every big growth point I’ve had moving forward from that point on was an understanding in what I like to call synergy, right? So my, my team synergy, my personal synergy, my business synergy.

And I think that is, you know, mark made some really good points about growth and the brand and the mission and trust, and that all has to be there in order for us to experience the kind of growth that we want and deserve. But it must also start with our own synergy with ourselves. So, and by that, I mean like, what is our alignment with ourselves? What is our alignment with our goals and our mission? And if you hate doing all the admin stuff or writing the blog posts or doing the social media, and then you’re also in the clinic, and then you also have to do the superbills and you, you know, you start to get very spread thin and you’re not aligned with the true purpose. And that alignment is what is key for the growth to happen the way you want it to.

And I think we can often get bogged down in kind of what mark was talking about as well of the day to day to do is, and we’re missing the bigger picture. So for me, as I’ve grown and you know, now I have the luxury of looking back and I didn’t always do everything in the correct order following the right steps. But what I tend to say, what was always true for me was, was the synergy in my alignment with my passion to help and to serve. And so for you to understand that if like coming home to that first, that, okay, is my alignment in check, is my synergy in check and similar to what Lorne learned and what I learned, how am I showing up for me? How am I showing up for my business? How am I protecting my business? How am I protecting my health?

And that is what constitutes, I mean, now I feel like I can step back and say that and see that from my own experience. Um, what constitutes a good leader too, is, is the leading by example piece. But you, you can’t do that if you’re not clear on what the vision is, what the values are, what the goals are, and you need your own checks and balances to come home to on, I think a weekly, even a daily basis, what is, what is my mission for today? What is my purpose for today? And what are the things that I need to do to grow my business? I know in the beginning for me, uh, you know, I had an assistant who was an acupuncture student, who is now my other associate. She’s been with me as well for over a decade. And, um, and then I was cornered into hiring an associate.

And then I had assistants over the years. And then as my other parts of my business grows, I started to write books. I started to have there wasn’t so much of an online presence, um, with my first book coming out. But as the years went on, then there was Facebook and there was social media and everybody was writing blogs. And I did not like all of that organization. And so I had to, again, I actually hired someone more of like a coach type situation, a business coach who helped me align and get clear what, you know, similar to what mark is saying, what, what is, what is the vision, um, where do I want to see my business in five years? What are the things I love to do? What are the things I hate to do? What are the things I need to take off my plate so that I can achieve these goals and these desires.

And it wasn’t until I was able to do that and prioritize that. And it was an expense, but it really helped streamline my business, move things forward. And I could start to put things into their containers. And that’s what really started to allow more growth for me. But it was, it was rooted in the synergy that I had with myself first, the alignment with my goals, my visions, and then now, as my team has grown, you know, I now have a chief of operations and she basically, as a Jack of all trades, she does social media. She helps with my newsletters. She does all the things that I don’t really love to do. I like to go on video and talk and be live. So I’ve gotten very clear about what I like and I like to be in the clinic. And I like to coach, I like to work with clients.

I like that one-on-one time. Right. Everybody is going to figure out what, what they like and what’s their special split space to be in, in their business. And then I think you, you think about hiring on support and another thing that is, uh, you know, mark and Lorne both touched upon is everyone who’s ever worked for me actually started as a patient HIPAA compliant or not. I don’t really know don’t really care cause it’s worked out for me. Um, and they believe in the medicine. They believe in me. They trust me, they get me, they understand my message. Whenever I’ve written a book and had a big book launch. If I had a PR campaign, a public relations campaign, I always made the head of a campaign, become a patient because no one could understand me unless they were a patient of mine. That’s really what I started to see.

And again, that comes back to the synergy cause they saw me in my element. And so, um, for you to think about that too, of like what lights me up, what is my alignment? And then how can I convey that? And that’s so much a part of what you’re conveying as you’re growing your business as you’re growing your brand. Um, and also as you’re hiring, because then once you start to have this team, um, and, and Lorne touched upon it too, is a, without your synergy and alignment, the business doesn’t have that strong center, right? And it’s, it’s impossible to grow if you are wishy-washy anywhere in that sense of alignment and synergy, it can always change and adjust. But what are the, what are the core principles of, of your business? And then also you need from there, these clearly defined goals and expectations of your team, whether they’re associates, whether it’s your front, front desk person, your acupuncture, assistant your head of social media, what, what are the pillars of the business?

What are the core mission statements? What is the synergy and the alignment, and are we all on the same page? Are we speaking the same voice? And I find that the, you know, critical number one way to get there is you have to own it yourself. You have to lead by example, you have to believe in the practice that you are doing. You need a team that also believes in that practice and believes in you and you need regular meetings with your team. This was something I greatly resisted. I never was in the corporate setting. I always, um, laughed at the idea of having a meeting about a meeting. It would just drive me insane. Like I was like, this is just the most inefficient use of time ever. And I don’t want to have meetings about meetings. Like I will never be that person.

And I’ve realized I need meetings about meetings because it’s actually what keeps my team together. And I had a recent situation where my virtual assistant she’s my admin. She basically runs everything from a virtual perspective with clinic and online. She couldn’t make our regular team calls because of a, pre-pub another commitment and her internship. And I started to see the team fall apart. There started to be miscommunications. There started to be just, there was the synergy was disappearing. And so I had to get her on the phone and we talked it through and I was like, well, we have to find a time because this there’s going to be a breakdown in the system. We’re a small team. We have to find time every single week that everybody is on a video call and we’re hearing each other’s voices. We’re making sure that we’re, we’re on the same page, that synergy, we have to come back home and remember, what is our mission?

What is, what is our purpose here? What are our goals? Right. We have our monthly goals. We have our quarterly goals from a financial perspective, from a business growth perspective and also from a service perspective. And so without that convening on a regular basis weekly, you’ll start to see things get broken up and your team will lose its it’s synergy. And without that synergy, it’s, it’s very challenging for the growth to reach the next level. So to me, it’s about, you have to come back home to you and your own personal synergy, getting very clear, similar to what mark said about your goals, your plan coming back home to that as often as you can. And then when you have your team, it’s the same thing. I have weekly meetings with each of my associates where we go over cases, we’re talking Chinese medicine constantly, even though we’re both, you know, we’re all seasoned practitioners at this point.

We’re just, what’s our goal. What’s our mission talking the same talk, feeling, you know, understanding the case in the same ways. Super important. I do that with my team as well with my chief of operations and my assistant. And so, and then we also have a broader group call once a month with everybody and again for synergy. And so we can all see and hear and understand each other, have compassion for each other, know that our goals are aligned and that’s what really helps support that growth in that culture. And, um, you know, I don’t, I, at this point haven’t had, um, people leave the team because they feel very heard. They feel very purposeful. They feel a part of something and they’re, they’re seeing the results. So to really think about that when, um, in your growth vision of how aligned are you and, um, what is, what is your synergy that you’re bringing to your mission to your business? And then as your team grows to that, you have constant check-ins around that synergy.

Thank you, Aimee. And I’ll share with you guys that on the RTI page, healthy seminars.com/rti, um, sign up because we’re going to be offering some three little short webinars like this, where we’re going to go into more detail about hiring associates and staff and other things about growing your practice, because we’re in this, uh, when we talk about our practices and growth, we’re in this because we want to help you, our communities, we do this because we love it. And, um, and that’s, that’s the focus and that’s why we want to grow because, uh, in life we can’t just stay still that stagnant. You’re either shrinking or expanding. And so let’s expand and help heal our communities again, Marc and Aimee, thank you very much, uh, for participating in having you as my experts and enjoy doing the coaching and mentorship with you guys. And again, I want to thank the AAC to the point, um, for inviting me to offer these, uh, practice management, uh, seminars and webinars, and, uh, check in for next week. Um, cause we have another special guest on the AAC To The Point. So tune in and listen to that webinar as well.

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