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Proving Medical Necessity Dr. Sam Collins & HJ Ross

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Thank you, Virginia.

Sure.

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

Well, you have a lot of credentials.

Thanks for that.

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

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

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

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

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

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

I’m fine. I can’t hear anything.

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

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

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

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

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

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

You can’t see them.

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

I see the title but not the content.

What’s up with the slide?

It says stopped sharing.

Okay.

All right, good.

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

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

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

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

Really?

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

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

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

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

Absolutely.

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

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

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

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

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

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

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

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

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

Great.

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

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

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

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

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

Mm-hmm (affirmative).

So that’s good news.

Yeah. Definitely.

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

Mm-hmm (affirmative).

Yeah.

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

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

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

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

Yeah.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Thanks so much for having me.

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

No, DrGilTCM is the easiest way to find it.

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

Consider This Criteria When Looking For An Acupuncture Business Insurance Policy Provider

Not all acupuncture business insurance policy providers are created equal. Although there are many of them that claim they are the best in the industry, this should not easily convince you. What you need to do is to carefully scrutinize their portfolio. Doing so will make a big difference in terms of the quality of service that you will get.

The question then becomes: What should be your deciding factors when looking for an acupuncture business insurance policy provider? You should include the following in your list of criteria:

Industry experience. No question about it, this should be on top of your list. Some have been providing insurance coverage for acupuncture companies for a year or two, but there are those that have been in this profession for decades. And that can make a significant difference. Note that industry experience refines service expertise. An acupuncture business insurance provider that has been in a decades-long service is way better most of the time, if not all the time, than the newly-established ones. With that said, it makes sense to take into account industry experience as one of your criteria in picking an insurance provider.

Reviews. Your prospects might be claiming they are the best acupuncture business insurance providers in town, but try to checkout the reviews they have received in the past. Are they getting positive reviews? If negative reviews are way more than the positive ones, then that is rather telling. That means you have a compelling reason to cross these prospects out of your list.

Insurance coverage. What are the insurance package inclusions? The best way to answer that is to compare quotes from different prospective acupuncture business insurance providers. That means you need to request quotations from at least three top recommended companies. Then, carefully examine their offers. Ask follow-up questions as much as possible.

The charges. Of course, last but not least are the fees. Try to do some research about the average cost of acupuncture business insurance policy in your area, and then make a comparison. If your prospects are charging way higher than the average market price, consider crossing them out from your prospects list.

Looking for a reputable company that offers acupuncture business insurance policy? Contact American Acupuncture Council today.

Call us at (800) 838-0383.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Right.

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

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

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

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

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

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

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

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

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

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

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

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

Thank you Lorne.

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Top Reasons To Get Acupuncturist Insurance

Although acupuncture treatments have the reputation to be very safe, an acupuncturist can still be vulnerable to several issues, including legal suits. For this reason, it makes sense to get acupuncturist insurance to protect your professional reputation and your business. It might cost you some amount, but the benefits far outweigh the spending.

Whether you are just starting or have been in the acupuncture business for quite some time, acupuncturist insurance can serve as your first line of defense from legal complaints that anyone might lodge against you.

Here are the top reasons to buy acupuncturist insurance:

A way to protect your license – Even in the absence of professional error, an acupuncturist in his/her practice is vulnerable to damaging complaints and should take preventative action. Acupuncturist liability insurance is the way to go.

Protection from allegations of malpractice – The controversial nature of acupuncture treatments puts professional acupuncturists to some level of vulnerability to an allegation of malpractice. This is most especially true in the US where eastern alternative treatments are not yet fully embraced in the medical industry. Thankfully, insurance providers such as the American Acupuncture Council are available to protect individuals running an acupuncture business.

Protection from a lawsuit – If a professional acupuncturist makes an error in procedure, which is rare, an insurance provider can offer protection for the practitioner’s best interest. Without protection from insurers, one could suffer extensive damages – both in financial loss due to a lawsuit and a professional career.

The importance of finding a reputable insurance provider

While there are lots of insurers you can find around, the fact remains that not all of them are created equal. Some are just way better than others based on service quality and insurance package inclusions. Make the best effort to find the most qualified insurer available in your area.

Are you looking for the best acupuncturist insurance provider in the California area? Contact American Acupuncture Council today at (800) 838-0383.

Acupuncture Malpractice Insurance Protection

If you are putting up an acupuncture business, one of the things that you will need to decide upon is whether or not to get an acupuncture malpractice insurance. If you are still in doubt about its importance, the following might convince you to get one.

Higher risks from lawsuits. The fact that your profession covers daily appointments that include inserting needles into patients’ skins, it opens the door to significant risk, which could compromise your professional reputation and your business. Acupuncture insurance will help protect you from a stressful scenario by alleviating costs, time, as well as the legal burden brought about by a filed complaint.

Protection from lawsuits. The truth is, like any other type of business, an acupuncture business can be at risk from lawsuits. These lawsuits might be filed by patients – those who get injured, and even those who just get skin rashes. When faced with this situation, isn’t it good if you have something that can protect your business and reputation? Should someone lodge a complaint, you can rest assured that you are covered financially, legally.

Protection from disasters. An acupuncture malpractice insurance can also be designed in such a way that it protects your business from possible disasters such as fire and natural calamities. The protection you get from your insurance provider can help secure finances. This can help in rebuilding or replacing your business without having to spend the money from your pocket.

Coverage for premises liability. An acupuncture malpractice insurance can also be designed so that you can protect your business from premises liability. What does it mean? This inclusion means protecting from lawsuits that stem from bodily injuries that a patient gets inside your clinic or acupuncture facility.

Looking for the best acupuncture malpractice insurance? Call us today at (800) 838-0383.