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Evidence-Informed Acupuncture Practice

 

 

And so today we’re going to be talking about the importance of evidence-based practice. Or evidence-informed practice, which means it’s coming out of a lot of the research, which the exciting part about that is that we’re getting from the other aspect, the more Western scientific model.

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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 welcome today’s episode of the American Acupuncture Council live stream. My name is Tsao-Lin Moy. I am a licensed acupuncturist and herbalist with a brick and mortar practice in union square in New York city. I’m very excited. Today to be welcoming Sandro Graca and very grateful to the American Acupuncture Council for putting these livestreams on now a quick Al Sandro is a licensed acupuncturist and lecture and research.

Is he’s done. He’s writing lots of papers about in particular women’s reproductive health, which is extremely important because not enough is done for women’s health. And he is also an avid speaker. And he is the director of evidence-based acupuncture and a fellow at the American board of Oriental reproductive medicine, and S and also the society for acupuncture research.

And so today we’re going to be talking about the importance of evidence-based practice. Or evidence informed practice, which means it’s coming out of a lot of the research, which the exciting part about that is that we’re getting from the other aspect, the more Western scientific model. Is now really recognizing, the benefits there’s like more concrete evidence and information.

And so we’re really looking at integrative medicine, or this is the, this is what we’ll be bridging that helps to bridge, understanding and better practice. So thank you so much, Sandra, for being. Thank you so much for asking me, inviting me to be here and asking me to do this talk. It’s always a pleasure to talk about.

I love research, but more so, it’s a pleasure because I get to contribute towards the future of our profession. Absolutely. We really need, we really and this is for the, for the public. Because we’re looking at what’s happening is, Medicare is going to be covering a lot of insurance companies are covering or not covering because there is, where’s the evidence.

And this is an area that it just benefits everyone. And if somebody is on the fence, About I don’t know if it works that here. We’ve got some great studies. And again, we were talking before the break about the one with carpal tunnel and I’m so very excited to see your presentation Sandro.

Yeah, thank you so much. I think that’s a really good point. And one of the things that I would mention is that there are actually different ways of using this information and different ways of using research. So one of them is, as you said, just having that you know the language to be able to talk to other people about what we do because not everyone knows what we know or loves acupuncture and Chinese medicine as much as we do.

So they might not have that language. But if we have another language to be able to communicate with them, then it just becomes a little bit easier to have that interaction and to get the ball rolling in terms of communication. And also, as you said, with the policymakers, obviously, But another aspect that I will bring up on my presentation as well is going to be that fact of the more you write about what you do in your clinic, because that’s research too, reporting, what do you do?

And the results you’re getting in your clinic. You’re contributing to the literature and you’re leaving something there for not just the people around us now, but also for the future for others to read what we’re doing in the clinic and taking that a step further. Absolutely mean, what would we be doing? What would we do without the sew-in aging or the link shoe, or, the golden cabinet or all of those things where this is very traditional practitioners, we’re recording all of their cases.

And then from that, tome of information gathered. That they were getting results that then ended up being prescriptions and points to use that they could pass down. This is thousands of years, so there’s no reason why, we shouldn’t be continuing to contribute. And then with modern science to take advantage of, that aspect of.

Yeah, absolutely. Yeah. Yeah, I’ll talk a little bit about those different aspects during my presentation. So if we’re okay to go and then I’ll obviously I’ll leave a little bit at the end as well for us to talk about it, but I’ll show you how I try to put those together. Hopefully what do you will take from this and thinking about my main role, in terms of research with evidence-based acupuncture and being that idea of ancient medicine, modern research, and the evolutionary thinking that hopefully for all of us to continue to carry our perfection forward, this is almost like a little bit of a disclosure as well.

So what I do, as you said, I’m on the board of directors of evidence-based acupuncture, I’m a fellow of the born. And on my, for full disclosure to pay jobs. I am a lecturer at the Northern college of acupuncture, and I’m also a researcher on the Cochrane review group for acupuncture, for IVF. My main work is and research and passion is on PCLs polycystic ovary syndrome.

And I am a member of the SRM of Astra and the androgen excess society for PCLs. So that’s really the. My passion lies. And I want to say big, thank you. And this is not just a, a token of gratitude. This is really a big, thank you for you inviting me to be here because I’m a doer. I like to put the M get my feet down and could do some work.

And this is a paper that came out only. Last month was the end of March that was finally published. And this is a survey of clinical practice. And this is really asking the practitioners what they’re doing, how they are doing. Really proud of this is my first author paper as well. And working with such a great, an amazing group of people that are, really motivates me and to do more.

So what this says, and this is why I’m really saying a big, thank you, is that practitioners that were in the survey actually said that they favored knowledge obtained from webinars and conferences. Ah, nice webinar talking about research. So I hope that this reaches as many people as possible and the message for our side, because as I was talking just before we started, I don’t spend as much time in the clinic anymore.

The message for academics and clinician researchers is to hear what the practitioners are saying and saying that they still want this dissemination of knowledge. They want to know about this, but beyond those traditional publications on the journals and stuff like. They do want to know more about research literacy and special interest groups, like for example, da Borum or the obstetrical acupuncture association that I’m connected with as well and the AAC as well.

Like it’s the associations needing to link with the practice. Just a quick acknowledgement, because again, we like doing this and TCM and here I am saying that I would not be here if it wasn’t for the passion for research from professor Ian McPherson, who unfortunately is no longer with us.

And he’s there with the person who was my supervisor for my MSC. That’s Dr. Lara McClair. And I just want to say that yeah, Lara was spot on when she wrote that for Hughes retirement. When she said that he inspired thousands of us to become researchers, that I’m really proud to be one of those and to continue that work.

And obviously Dr. Mike Armour, who we saw the name on that publication there, who’s really helping me. And in this new career, for as a researcher. So I’ll start this with a little story and. Because my granddad was a great storyteller and I always look at Dr. Leon hammer and think about the great stories that he always shares with us.

And this really connects and links for me in terms of research and why we’re doing this rather than just being in clinic and keep doing the same thing over and over again. So he wrote this paper in 2002. So that’s 20 years ago. And look at how relevant that is. He started with the paper could be some not, but a small story.

And he said a little girl once asked her mother why she cut off the end of the roast before putting in the oven. And the mom said because that’s the way that my mother, your grandmother used to do it. We’ll have to ask her. So off they go to grandma’s house and only to find out that grandma actually did it because her mother had.

So the three generations are to go over to great-grandma’s house. And I love his wording was there to seek the wisdom of the ages. And when they posed the question to the great grammar and the great grammar just said, why? Dear the pan was too small. So that story just continues and it’s a great article.

If you have the time to read it, it’s amazing. And he just talks about that. Chinese medicine needs a new pond for a roast that has grown since ancient times in size and in shape and what we can talk about now, he says then at the end there about the. Pulse is no longer a sign of internal cold in our time is a sign of overworking nervous system.

And I always think about this and going, this was written in 2002. How would this tide pools will be described in 20, 22 after all that has happened recently? So it’s really interesting to see that sometimes. And this is no disrespect to our practice, but some is there. More cases that we’re just doing things because that’s what we were told.

And then when we asked the people who told us they were doing it as well, because that’s what they were told. So that’s what really motivates me. And at the time when I was getting this information together, I would, as I was at a webinar, there you go with Elizabeth and she said this is word by word, what she said, Chinese classical medicine is not yet finished.

We have to continue to edit it. And I thought, huh, that’s really interesting. And bearing in mind like me. So I’m Portuguese. I speak English. I know a little bit of Chinese from learning. Elizabeth Tasha is French. So she’s speaking in English and she’s talking about Chinese medicine as well. So for me, the language is very important and she said that it’s not to invent, but to discover new ways to express, it’s not because it’s not in the classics that it’s not interest.

And then this was the sentence that really, I was talking to her, like emailing back and forth after this webinar, because I thought this was really interesting. There are a lot of things that we are yet to develop. If we want to continue to practice a living medicine and not a dead. And again, I really liked language and that really stayed with me.

And this is the work that I was already doing, and that I’m really passionate about doing now, because it depends on how we see things, order and chaos could be different in different ways that when they are in front of you, So I do love the classics. I read them when I was studying and I still do when I have the time, you always go back to them, but now I just do more work in research and I love research.

And I think that it’s really important for the continuity of our medicine. And just like Elizabeth Kasha said to continue to practice this Olivia. So you might be wondering, and if you’re one of those purists that would say that, no, this is, ancient medicine. We need to stick with the ancient medicine.

I thought that too, and I was able to see things from a different perspective and I always bring up this study because it, I came across this just by pure accident. And again, it’s just one of those things Dr. June mouse was involved in this, as you can see in the name. And it just really caught my eye because when considering barriers for occupants to use.

And bearing in mind, this is a hot topic, right? Like it’s breast cancer survivors. So it’s really, it’s charged and it’s emotional. And I would always think that the main thing would be because I don’t use acupuncture because it interferes with the treatment that’s that was my perception would be, that would be the top thing.

So when I started reading the paper and realizing that lack of knowledge about acupuncture was actually the main reason why these people weren’t getting acupuncture was just mind blowing. And knowing that interfering with the treatment, not based on science, the side effects, painful, difficult time finding an acupuncturist.

I thought, I always thought those were going to be way up higher. I did not think that lack of knowledge was going to be an issue. And since it is, then we need to get this information and try to make sure that people know about acupuncture, but that they know about it from reliable sources. And if we can’t communicate with them in terms of the classics and old language that is harder for them to understand, let’s bring a language that it’s easier for them.

So that’s I want to like interrupt you just for a second about the cancer research, because I mean our the information okay. That is one of the very, if I remember correctly, the th the evidence and the efficacy of acupuncture for nausea. From chemotherapy, that was one of the burbs studies for nausea, for pregnancy and chemotherapy.

That was really validating okay, this is why acupuncture works. So the surprise that in the area among, breast cancer, that is still not this is a great thing to do that, it’s a, non-drug, it’s, easy to. Very it’s not going to injure you in any way.

That’s the surprising is that it can really help simple, very simple thing to be doing to help somebody. But so you can see how important it is that to language is, so this is going to be teamwork, right? So it’s going to be the patient needs to know the clinicians that are already looking after that patient.

They need to know as well. Practice. I think that we all have to be ambassadors for our medicine, for sure. Yeah. Yeah. And we need to, and once we are called up to be on that team, we need to be able to talk to them because if they ask us, what did you just do? What treatment was that for that particular patient, we need to use a language that they can understand this.

Otherwise, they still won’t know what, when damn cheap Schwab, they won’t know what that means. So how would you want to work with someone that you can’t understand? So it’s being part of the team and what language you’re using to make sure that people can go actually allowed something here.

I always say this on my presentations in we do the. Practitioners graduated and they start going into their own practice. And what they do. I always say that do not ever let any patient leave your clinic without them knowing a little bit about what you did, because you don’t want them to go and talk to someone else and go, Hey, I went for acupuncture and it was brilliant.

And that person is going to ask him, oh, acupuncture, I’ve heard about that. What did they do? Oh, I don’t know. I was just lying there and they put in some needles. I don’t know what kind of advertising. It’s not really, that’s not really great word of mouth. Is it? I was lying there at then. It’s, people, patients that are informed make better decisions about their health, right?

Yeah, absolutely. Yeah. So that’s really good. And thanks for bringing that up because that’s one of the aspects. So that was a little bit of about. How it relates to our practice and to the people around us. So more specifically now I’ll give you an example of B for me, how it’s start. Was I looking at points or IVF?

So I was getting people into the,

and Nick and they were going, and I remember clearly the very first time of looking at a re what’s, this thing, all about this, Paul, all those protocols. Points are to use this right? So it helped us. And it was interesting for me, need to go. It wasn’t available in the classics in this detailed way for this specific issue that is so recent.

And this kind of gotten me thinking and from then on, it was like, okay, so what else is actually been written and in research and what else can I, what other information can I get from these papers as well? And to take that con the continuous from the policy protocol and how things changed here we are.

Now, all these nipples protocol was published in 2002. Here we are now in 2019 with a systematic review and meta now. Telling us more about three or more treatments, the use of a modified protocol. We know the C MoPTA credenda migraine. The acupuncture protocol is even more used now and how we’d adjust to the changes on the IVF procedures as well, because the IVF procedures now are not the same as they were when the policy protocol was designed.

So again, it’s a living medicine, so we’re all learning from it. Yes, exactly. Am I just want to point out that, protocols are. So really a guide. They’re not because of course each we’re still practicing patient centered medicine. And, radically personalized. And so this two ideas about the idea of improving blood circulation, calming the nervous system down, right?

So those are these points elections, but they’re not the only thing. And then there are many practitioners that do, assist with reproductive, with the IVF protocols, et cetera, et cetera that are going to tail. To their patients and use some, maybe all maybe less. But yeah.

So with protocols, I like, okay, it’s not with everyone. It’s got it. We still have to personalize treatments. Absolutely. Yeah. And I’ll show you a good example of that then towards the end. Cause I have one again, because I have more experienced with the IVF side of things and how important it is to have, as you said, like that protocol, that set of ideas, but then how.

Also work with that and add more related to that person in front of you. So just to summarize, and I will talk a little bit more about these points, just more specifically, but research literacy. So knowing about research, why is it important if anyone was to ask you. Through the main points that I would say to someone best practice.

So we spoke about this just now, knowing what is being done, what has changed, what are other peoples in other parts of the world doing and how is it working for them? So in other words, is it informing my practices? Professional credibility. When you’re talking to someone, if you’re able to talk to them in a language that they understand, it’s easier to have a conversation.

So it’s not taking anything down from the classics or from Chinese medicine. Language is just adopting that if I was speaking Portuguese only because I was in Portugal, we wouldn’t be able to have this conversation. If the classics weren’t translated from Chinese into English. We wouldn’t be able to read them when we were in college and we wouldn’t be having this conversation.

So it’s the credibility of, oh, I understand what you’re saying. And we’re having a conversation and then linked with that is engaging with other healthcare practitioners, because we want to be part of that team that is looking after the patients. And that is pretty much how evidence-based acupuncture was born.

By the way evidence-based acupuncture was something that was set up by a medical doctor who did acupuncture. And in his own words, it was just getting the same question all the time when he told people to in his office and they say, oh, I think you should get acupuncture. People who go but you’re a medical doctor and you’re telling me to go and get acupuncture.

Do you believe in that? I knew would always say the same thing. It’s nothing to do with belief. It’s to do with it works. So I’m telling you to go learn. Belief has nothing to do with this conversation. So the EBA has this one sentence thing that you see on the website and on our forum. It’s the goal is to construct a successful evidence-based explanation, and that will help us to communicate.

Acupuncturist evidence effectively and support the public clinicians and healthcare policy makers. And that’s really important because those people are the ones that will decide what type of medicine and who gets to work, where, and that is using the language of science. The healthcare policy makers was something that we added more recently in the last few years.

And it’s been really interesting for me to look at that group specifically because. They might not have any medical background at all. They might be coming from a law background or, anything else, not necessarily a medical background. So not only they wouldn’t know about what we would call biomedicine or Western medicine, they definitely would not know from Chinese medicine eater.

So really important to have a language that we can talk to them about. And that’s because the public. And these, everyone is reading stuff from all the way from, as you were saying, these great papers coming out in terms of acupuncture for cancer. But the other side of the spectrum has stuff that is not accurate at all.

And we just can’t change it because it is the way it is. So there’s a big wide spectrum of information that these people are accessing. And I would prefer them to get this information from us. I added a slide because he asked me to, because he wants to talk about this one. And I really liked this one and seeing the stuff that came out of acupuncture research that is so much part of our day-to-day life.

And that’s sometimes we might not even realize that it came about because of acupuncture, research, neuro imaging research, you were talking about the. The paper and talking about how MRIs have been used and gave us so much information about what’s happening inside our brain, when we’re getting acupuncture biomedical knowledge of connective tissue, Penn level Lily Helaine Lowe’s event, like a it’s all, acupuncture is definitely so fascinating that as it looking to see how it works, they find so much more and it actually does advance.

The Western medical model. It’s yeah. So you see it adds onto it. Yeah. Insights into therapeutic encounters. Again, professor you McPherson wrote a lot about this as well and how, and even, yeah, Vitaly not, but I’ll put this out there as well, how the encounter actually matters. And that should account for when you’re doing the research tens machines, the anti-nausea wristbands, all of this stuff is there because of this work that is being done.

Hooray to us, and the new thing that you seeing more and more the comparative effectiveness research in terms of really trying to get that pragmatic approach to what we do in clinic and trying to put that into what is happening in research as well, and the amount of stuff that is out there.

And again, I won’t go on too much about this because we all know about this. John puts this amazing stuff together, compiles all this information. There’s almost 16, probably. Now this was in February 16,000 of Cochran’s central register of controlled trials. We should not discard this information.

We should use it. And that information is of good quality. This is something that we hear every once in a while about there’s a lot of research, but is it of good quality? We now have information showing that it is it’s the last 20 years. Yeah. Twice to fold higher rate than biomedical research.

The quality of that research is better as well. It has improved on journals and we have the papers to prove it as well. So this is good information to have on your website and to have on under your belt when you’re talking to other people. If they say, oh, there is stuff written, but it’s not a good quality.

Actually let me show you. And this is, I always go back to this amazing sentence that John said when we had our conference about the research is out there, but who’s reading it. And I guess that this is why I’m here doing this with you. And this is why we have our goal with EBA to get people, to talk with different languages and understand different languages and ultimately whatever floats your boat acupuncture.

So I’m asking you to be the change, you all listening to this, you and I say this, that you spend more time in clinic than I do. So you matter. And here’s the example that I was saying to you about the IVF work. So we’re looking at this from 2012, the Delfi consensus put together. So this is asking practitioners about information, about what you’re doing in the clinic for your IVF treat.

That information is, can even see that Shane Littleton was involved in this professor. Carline Smith’s name is Derek says on grant. Anyway, the names you’ll recognize the names anyway, but this was asking to practitioners, tell us what you do in the clinic. All that information goes towards an RCT. It doesn’t always have to be an RCT, this group is really reliable and really good at putting this research together.

They were able to put it in RCT together. That goes into a secondary outcomes of that RCT. So more information from that in terms of anxiety and quality of life for women undergoing IVF. And sometimes the clinics are really interested in this quality of life, anxiety for those people going through IVF.

Then all that information that started with the clinic remember goes into a systematic review and meta analysts. That gives us a lot of information. All of that goes into information for the Cochrane review, which is more likely to be something that, again, healthcare policymakers and medical people will be reading about that.

Remember how it started with that email in your inbox. Hey, do you have five minutes? Do you have 10 minutes to help us out with this? So what I want to say is that, if acupuncture is helping with anxiety over IVF, then. It’s obviously going to also help with anxiety over climate change, anxiety, over whatever anxiety.

And we see, move that there is this opioid crisis for pain. Acupuncture is great for pain. It’s great for helping people get off of addiction. But also if it’s great for anxiety, then we’re also gonna be looking at the future where so many people are on anxiety medication. Which are also very addictive.

And so just by, I’m just like adding into this. Just because one research area is about they’re a little more granular. The information then, gets applied in other areas as well, which is a very easy bridge, especially when it’s addressing those biomed those Mo biological mechanisms, that are showing up for things like anxiety, depression, and all of that. So this is a really big. And a good add on to that would be also to say that if you are, which I’m going to go into now auditing your clinic and showing and putting out there what’s happening in your clinic, you might actually be finding new trends you are now seeing in clinic a lot more patients complaining with X condition compared to what you were before.

And once you write about that, maybe someone in. Austria is going to go. Oh, actually it’s funny. You mentioned that because I’ve been noticing that too. And then someone in New Zealand is going to go, oh wow. It’s not just me. These guys also noticed that, right? Oh, there’s definitely, I’ll tell you in my practice over the last couple of years, anxiety and sleep problems.

And then looking at other research, there was, increase in writing of prescriptions for anxiety medication. Like even looking outside of. Who’s coming in your office, you start to see other, trends that are in the media and being reported, you start to look at, oh, cause I look at it when a patient comes in, I’m having a sleep pro and I’m like, wow, it’s all happening.

And then all of a sudden you see so many people. Are experiencing having these things. And once it that’s what I was saying. Once you start, if you keep this in your clinic only no one will know. Then you’re going to beat the best, kept secret. If you find a prescription that is really good for that particular condition, and you don’t tell anyone again, let’s go back to the beginning and think, is this a living medicine?

Is that going to, is that going to be the secret from your practice? And no one will ever know. So I know I’m exaggerating, but I’m just giving the example of why it’s important to audit your clinic. Just show what you’re doing and how you’re doing it. And then when you look at the outcomes, you might be helping practitioners all over the world to access.

Improve the type of treatment that they’re giving to their patients. So on-screen now there’s just a few examples of how you can do it. My mom, a lot of people know about it and a lot of people use it, which is great. There’s one which is online now in the U S you might’ve heard about it because I can track are actually involved in the study going on in the Northwest as well.

So yeah, you will hear more. About them because they’re online. So it’s just a little bit easier to collect this information from the patients as well. So that would be my thing. And for those who are interested in getting to know more about how to collect that information, then write it down in a case report.

And here’s what you have to do. Basically just look up. Care, which is case reports and then start collecting the data from your clinic. There’s actually more specific into Chinese medicine. It’s called Karch. And a lot of people will know about it even for N of one trial. So when you have just a one person this information is out there, but I would go back to what John Weeks would always say, it’s out there, but who’s reading this right.

I’m always in there. I’m in there. Yeah. Yeah, jumping in and I go if this herb is doing that, I’m going to look in the other categories. And I also look at the foods, what’s in the food medicine, there’s so much there. So this is really, I’m really excited about, you talking about.

Big point of interest for me, because it’s important that, a lot of practitioners may not do continuing education or, they may get a little bit I don’t know, stale with their treatments. And so I think this is important, very important to be up to date on what’s out there and also really again, to be in back.

For our medicine to be able to talk about it intelligently. Now, when I was in school, we didn’t have as much, I was in school, graduated 20 2002. So over 20 years ago there wasn’t a lot that was out there. There was the IVF study coming out of Germany. There was the study for the nausea and I think there were still working on the.

Down at NIH, right? So there wasn’t really a lot. And then you’d have to have things well, actually coming out of Japan, there were things, but they’d have to be translated. So what we have now, and also the internet was, very much in its infancy. This is, it’s so accessible for practitioners to do that and good good clinical practice.

To double check. Yeah. And this is we didn’t, people are going to be watching this and thinking that we arrange this, but we didn’t, and this is a great segue into this because what’s on screen now. It’s only part of the slide and I, this is actually a sentence from the paper itself that I’m going to show you.

And it’s something that adds on to exactly what you’re saying and what still to this day. And I hope that this will help to change that. Turns people against acupuncture research a little bit while clinical trials provide valuable data about if efficacy of interventions, findings often do not translate into clinical.

That’s something that you see and you hear, I would say that too, like maybe 10, 15 years ago, but then after learning and after doing my MSC and getting more into research, I don’t anymore. And talking about the timescale that you are giving this sentence is out of this paper that has just been published recently by a good friend of mine.

Beverly Devela. She collected information over 15 years. 15 years of information. Now, anyone can come from anywhere saying that, oh, there’s not enough evidence about acupuncture, or there’s not enough for us to base our decisions. That’s 15 years of information right there and published for everyone to see.

So in looking at this and saying these are sentences from the paper itself and that key punchline on, in day-to-day clinical. Practice not appears to be a safe, effective intervention for breast cancer survivor. This is really important for us to know and to have this, to be able to say straight away.

Actually, and what I’m going to emphasize too, is the beauty of doing the research is we also have thousands of years of, knowledge about the, how it was used. So we’re not, it’s not just being made on. We’ve got these, it’s not made up something it’s really based on, okay, this is what they say, this is what was going on.

And this is why they continued to do these practices. Now we can take that and look at it. So this is the point. So it’s the only 15 years ago, 15 years. Thousands of years of evidence that’s in, in these records and then really looking at them. So it is actually like we’re doing like a little bit of a retrospective, right?

Look at everything that’s been done and then designing. Different kinds of research based on what’s showing up in, in health for us and how, and like how we can actually use this and integrated with what I consider like the traditional model, right? Like where that fails.

There are these other things, and there’s no reason why we can’t do both. It’s not an either or and it’s and again, as you, we see that a lot of the acupuncture then informs better practices in a Western medicine model, like areas for growth. Yeah. Yeah. And this is again very timely for you to say this because I’m going to give you the two examples, just because we spoke about a discount at the end of the presentation.

This is just out in the last couple of weeks. Good friend of mine. Good colleague, Dr. Mathias, zoom or Martinez works. Mathias is a medical doctor who was also trained in TCM. He works in oncology and. And he wrote this case report about what are the patients? So this is like debunking a bunch of stuff against occupants in one paper right there, right?

Is a medical doctor trained in TCM who uses it in the oncology setting. And as now published a case report, which I’m asking you to do more and more showing the difference in one patient between getting acupuncture. This is one treatment, just one treatment. The difference between getting one treatment of acupuncture and the oncologist.

Like amazing stuff. And I just put another one because again, to link it back to the states as well and see, cause people would be familiar with this they’re obscene and Valerie, Valerie actually sent me a message before this. So if she’s watching hi and yeah, just publishing a case report and showing what’s happening in your own setting.

Again, hospital setting, acupuncture being used and how it’s helping the patients, but it needs to come from you. It doesn’t have to be a big, huge RCT a case report will do with. So here’s my plea and my punchline and my please. And then you can stop and you don’t have to listen to me anymore begging you to write research.

So here’s a time I’m V I’m more visual. So I like this and this makes sense to me. So I hope it makes sense to you as well. We started with the classics. All of this was written. Back in the day we read them. We learned about them in school. The first book that I read about Chinese medicine when I started studying in Portugal was Giovanni’s book translated from Chinese, some Chinese terminology there as well.

It all starts to make sense. Then you go into what brought me into research occupants or research the book. And again, the names they’re amazing. Rosa Schneider just, really inspirational for everyone. That’s how I started. And that’s what I read about. And it becomes the classical book now in terms of where it all started.

Now we have all this information going into Cochrane reviews and going into research and starting to be part of the research literature. My question then is who is writing tomorrow’s classics because yesterday’s classics have been. But in 200 years, in 2000 years, when they look back, what are they going to say?

That those guys in 2022, what were they writing about? What were they doing in their clinics? So this is why I’m asking you. To do it and to please make it your turn now of writing the stuff that you’re doing in the clinic and telling more and more people so that we can adjust and adapt the trials as well into being more like what you do in your own.

So that’s the end of my presentation and my begging for you to write what you’re doing. Oh yeah. I, and I have to say, I love that book. I actually have four different copies of Sue and aging and link shoe because each translation is slightly different. And I also had the pleasure of studying some with Elizabeth shot, the LA she’s amazing sense of humor.

And what I would say is that it’s also important to reread the classics, especially after you’ve been practicing, because then when you read it again, you go, oh, so a lot of this is you need to read over and over because and research and read papers because you’re at one level as a practitioner and then you get some experience and then you go back and then you can catch the deeper meaning and then also apply it.

So it’s always, so this is not, it’s like review, do that retrospect review again. Go back and you’re like, oh, wow. I didn’t know this before. And our information comes from many different places. I find my patients are fantastic for reporting stuff back to me which is also important.

So what I want to ask you Sandra, how what can we do to help you? Can we where can we find you? How can we follow you? Listen to more of the stuff that I have to say. Ah, yeah, I wasn’t expecting that. Yeah. Okay. So look as an individual, obviously it’s my pleasure. And it’s my passion to to the research side of things.

It’s just how I get to write. So some people would write books for example, which are very valuable. I, that my passion is that, writing these papers and putting it out. Sharing this information with people. So on a personal level I’m working in research. I’m I love lecturing. I love teaching.

I love learning from the students as well. So people can find me, Sandra grass online that they will be able to find more information about me. And the main work that I would do that would be more visible than for people would be through evidence-based occupants. And. Thankfully, we have a lot of people helping and supporting it’s a nonprofit organization.

So evidence-based acupuncture.org is where people can go and check it out. We have a forum as well, so we don’t do discussions on social media anymore. And we just take that to a private place where we can all talk as practitioners and as colleagues and outside of the eyes. Are there any. Censorship of social media type thing.

And without any distracting voices, either from the outside, so just for us to talk on the farm and share ideas and yeah, EBA connect is the way that people help and support the work that we do with EBA. Awesome. Awesome. Fantastic. Thank you so much. For coming on and sharing all this great information and also really helping people to really keep their practice from going stale.

And then also, be better practitioners, better, clinical practice. And then, this is how we bridge to other professions and become part of the team. And keep keep us professional, right? Yeah. Share what you’re doing in the clinic. Like it’s amazing.

I really appreciate the opportunity of coming here and being able to talk about this. I know I speak a bit too fast when I get excited about it. But it is really I’m learning so much every time. To find out from other people in their clinics, what they are doing and how can that influence? You said it yourself.

The study was from Germany and then you were reading it and then someone else, the paper I showed you, the survey of practice was actually in Australia and New Zealand, and now it’s everybody else in the world is reading it. Mathias wrote that paper from the hospital, the oncology. In Austria and now everyone is reading it.

So I think that it’s really important for us to stand proud of what we do and, have it on our websites. Haven’t, especially have it published and be able to talk about it in terms that other people can understand. And as I said, like the case reports would be, as you can see, the example would be the best way to put it out there and publish it for everyone.

Awesome. Thank you so much. Okay, so here we go. Hopefully you will join us next week. We are going to be having Jeffrey Grossman will be coming on and presenting for the American acupuncture council. And all right. And again, thank you for the American Acupuncture Council for putting this production on.