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Acupuncture Malpractice Insurance – Hyaluronic Acid: The Key to Hydrated Youthful Skin

 

Acupuncture Malpractice Insurance – Hyaluronic Acid: The Key to Hydrated Youthful Skin

Hyaluronic acid is a natural. Substance found in the body. It’s present in large concentrations in the skin where it helps keep complexion hydrated. And plumped, we hear about hyaluronic acid a lot in our social media and regular world today.

Click here to download the transcript.

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

Hi, my name is Dr. Shellie Goldstein. I am here today from Florida. We are going to talk about hyaluronic acid and I wanna thank the American Acupuncture Council for allowing me to give this very exciting presentation today. So let’s go to the slides. Hyaluronic acid, the KE to hydrated youthful skin.

And for those of us in Florida, this is very important, but it’s also important for everybody as you’re about to see, what is hyaluronic acid? Hyaluronic acid is a natural. Substance found in the body. It’s present in large concentrations in the skin where it helps keep complexion hydrated. And plumped, we hear about hyaluronic acid a lot in our social media and regular world today.

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What you may or may not know about hyaluronic acid is it’s a humectant. And what is a humectant hum? A humectant is a protein or a substance that actually draws moisture from the environment, whether it’s from the air or from the water or wherever you are. So it takes it in from the environment and through the skin into the deeper layers of the tissue, what we call the dermal layer and below.

And a , like I said, is a substance that has the ability to attract and retain moisture. Similar to a sponge. Just you put a sponge in water, it just soaks it up and it holds onto it, and that’s what hyaluronic acid does. As we age our body, like other substances in our body, we begin to produce less and less of it.

So what happens? We start to dry out. Our skin looks dry, our tissues get dry. We get fine lines and we can get skin wrinkles. When we think of the body, let’s start with the anatomy of the face. You have the bone, which is your solid core structure of your face, layered and horizontally. On top of that is our layer of muscles.

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Then we have fat and we have skin, and what keeps everything together, it both separates, but it also joins all of the horizontal tissues of the face and the rest of the body is connective tissue or fascia. It’s like a web, as you can see in, in the image. It’s just this woven web that holds everything together in place, but it also holds the individual tissues in place as well.

The primary components of fascia are collagen. So collagen is the integrity and the support system of this tissue. It’s like the mattress. It’s gives you the support, gives you the volume of that you need and see in your skin tissue. Whereas the next in protein is elastin. Elastin isn’t so much volume, but.

It allows that snapback. So if you take your skin and you lift it, and you drop it, elastin is what you need in order like that rubber to snap back into place once you lift and let it go. And then there are fibroblast cells, or small protein. That when stimulated is what produces collagen or what stimulates the production of collagen in the fascia.

It also affects many immune and inflammatory responses, and it’s very important for wound healing as we’re gonna learn in a few minutes. And then there’s hyaluronic acid. It’s the moisture this . Substance that bathes all of the other proteins, the collagen, the elastin, the fibroblasts, and other cells that are in this area, what we call the extracellular matrix.

Hyaluronic acid is in the image, is this a little red line and it has a surrounding it, what we call protio glycans and protio gly cancer. What attracted those water molecules to the hyaluronic acid? It is so effective that hyaluronic acid molecule can hold up to 10 a thousand times of its molecular weight and water, which makes it responsible for th up to 30% of the skin’s national natural moisture retaining ability it has.

So here’s . Hyaluronic acid strand and then attached to what are bound to the hyaluronic acid are protio, glycans, and protio. Glycans are what the water molecules attach to, and you can see it in this area. In the lower image, you can see the hyaluronic acid and green, the protio glycans are those little

Feathers that stick out from the hyaluronic acid. In red, elastin and collagen that woven matrix of different colors of blue. So all of these are in fascia and in the what we call the extra cellular. Matrix in the face, hyaluronic acid is primarily located in the dermal layer of the skin, which is the second layer of the skin.

And we’ll look at this for a minute, and it’s found throughout. This matrix is found throughout loose connective tissue of the superficial layer of the skin. Below the deep layer of fascia, and it’s generally found in places aside from the skin, in places that are moist, like the oral cavity, the cartilage of the nasal structure and blood vessels, and in the mucosa membranes of the face here, although the structure of fascia layers varies across different areas of the phase.

Here we see it where the stars are. So the very top layer of skin is the epidermis. It’s what we see when we look at someone else, when we look in the mirror. And then just below the epidermis is the derma layer, and this is the true health of the skin. So the surface is the surface layer, the epidermis, and just below it is what we call the dermis.

And this is where we see most of the hyaluronic acid, the extracellular matrix, and all of the nutrients and proteins that keep cells nice and healthy. And then underneath that we have the superficial Retin Macular Cuts fibrous. And those are not horizontal. They’re vertical structures like ligaments that hold those horizontal structures in place.

I. Below that, we have a fat layer, which gives our skin plumpness. And then below that we have the superficial fascial membrane. And this membrane actually attaches the above layers to the below layers, another layer of ligaments. And then we have another layer of fascial membranes, which don’t have as much hyaluronic acid, but because of that, underneath it as an entire layer of hyaluronic acid or extracellular matrix.

And then we have the lining of the muscles epimysium and then the muscles themselves. So this is lining, you can see multiple layers of hyaluronic acid, which keeps this entire tissue layering nice and hydrated, nice and wet, so that things slip around and slide more effectively. So in acids, the benefits of hyaluronic acid are that keeps skin nice and plump.

When skin is nice and plump and hydrated, it minimizes wrinkles and fine lines. There are many different types of wrinkles. I’m talking about wrinkles at this. Moment that are related to skin dehydration, it increases skin elasticity and slide remembering that the elasticity is the elastin or the snap back in our skin tissue, and that all of those, that proteins need to stay wet.

In order to work effectively. And then also remembering that wetness allows those horizontal planes to slide back and forth. When we don’t have enough hyaluronic acid in our skin, we get dry. It gets irritated and then you start to see facial redness, irritation, even to the point where you have skin breakouts and dryness.

Like eczema and psoriasis. And then also remembering that we have fibroblasts in that extracellular matrix. And so without that wetness or moisture we have difficulty having our wounds heal. So hyaluronic acid and providing that moist environment helps the fibroblasts development and assisting assist in wound healing.

And here’s an example of this. So in terms of the integrity of hyaluronic acid, you see the image on top. You have tissues that need hyaluronic acid to lubricate and enhance the movement of those adjacent cells. That slide that we were talking about and then without. Hyaluronic acids are changes in that production from either age or other trauma, that type of thing.

We start to lose the production of hyaluronic acid, which leads to skin dehydration, loss of firmness and elasticity, wrinkling, and then again those horizontal planes. What happens if . You don’t have moisture. They get sticky and tight and so things, the lows, layers just can’t move independently of one another.

And that’s when you start to get fascial binding. And there are many ways to improve hyaluronic acid. One is acupuncture. When we are needling to improve the skin layer, so it’s very superficial layers of the tissue we’re not gonna place the needle perpendicular. Why? Because then you go towards the bone area.

We need to go into that superficial tissue. So we’re gonna angle the needles at a 15 to 20 degrees. Relative to the surface of the skin. So for us as facial acupuncturists, we tend to use intramurals more because you can slide them at an angle as opposed to going deeper in, into the tissue and missing it heading into the muscle layers.

So we will use very superficial needling to stimulate the skin to produce more collagen, in which case the, and the hyaluronic acid elastin all of the proteins that are found in that extracellular matrix in order to improve skin elasticity, plumpness, and texture. And then also we use needling.

Anytime you roll or create a, an, and a little channel by puncturing the skin. It allows product or whatever it is on top of the skin to move into those deeper layers of the skin. So we use it. Same microneedling is a very popular treatment that we use. And facial acupuncture. So it’s a number, like a plum blossom, a lot of superficial needles in one small area, and then you rub product into the surface of the skin.

So by superficial needling, we’re creating tiny little channels in the skin that make it easier for topical products, including hyaluronic acid, serums, or creams. To penetrate into the deeper layers through the epidermis, into the germal layer and below, and this will enhance the absorption and the effectiveness of whatever product we’re using.

And then that combination of superficial needling and hyaluronic acid, whether it’s in the form of a serum or a cream, can enhance the skin, make nice and plumb, make it smoother, more even toned with reduced fine lines, wrinkles, and even scarring it at ate layers. When we think about hyaluronic acid and topical products we think of it either as a serum or a cream or a mask. Another conversation, at another time, which I promise I will deliver here. And so we’ll use these products that contain dosages of hyaluronic acid and they go into the surface of the skin and directly moisturize the, those deeper layers and superficial layers.

Their job is to retain water. So again, the protio glycans on the hyaluronic acid proteins bring water into the tissue or wherever the hyaluronic acid sits to improve the skin plumpness and reduce the appearance of fine line and wrinkles. So it’s immediate hydration. You put the product on the moisture, it attracts the moisture and plumps the surface of the skin.

Depending upon the product and depending upon the depth of penetration, if it’s sitting on the surface of the skin, this product, then it’s gonna bring moisture to the surface of the skin, and if you can press it through the deeper layers. Say with the addition of superficial needling, then it actually goes into the tissue below the germal layer, and then it has longer lasting results.

Hyaluronic acid, because it’s naturally produced in the body, in its pure form, it’s very safe to use. Sometimes people will get a reaction to a product and any product which could result in irritation or redness or itching. In most cases, it’s not the hyaluronic acid that’s actually causing the irritation.

I. But it’s other ingredients in the product. Products are made of multiple ingredients. Sometimes an ingredient doesn’t agree with your skin, particularly if you have very sensitive or sensitized skin, and so you may develop some redness. It’s usually not the hyaluronic acid, although if you discontinue it and try a different product with a different formation, it may or not.

When we think of derivatives of hyaluronic acid, we think of them in terms of molecular weight. So all proteins, all ingredients, particularly in the skincare world, are have a certain weight and that’s measured in dass. So a compound. So in its raw form, say hyaluronic acid in its raw form, because it’s raw, it has a very high molecular weight.

Which means that it has difficulty pressing into the surface of the skin. So it remains on the surface to pre and remembering that the hyaluronic acid is, and the proteoglycans are actually gonna pull the water to the place of the hyaluronic acid. So if it’s a high molecular weight, it’s just gonna sit on top of the skin.

It can’t get through the skin, so it’s gonna remain on the surface. And where does the water go on the surface? So it’s going to create a protective film that prevents water from actually evaporating. So it’s gonna keep the moisture that’s in the skin in, and it’s going to put water on the top. So it’s actually going to give you a tightening effect because it’s a locking moisture in.

So it’s gonna look plump, but it’s gonna feel a little tight. For deeper penetration, particularly in skincare world, we look at different forms, say the hydrolyzed, which actually breaks it down a little bit and allows the hyaluronic acid to split into smaller fragments, and that’s usually less than a thousand to 1800.

Das. And so this allows that product to penetrate a little bit deeper into the surface of the skin. So again, drawing that water a little deeper through those tissues. There’s another form, sodium hyaluronic, and this is the salt of the hyaluronic acid that’s used and it’s good for stability when you think of cells.

And molecules that penetrate through the cell wall. Salt is one that actually go, is small enough to go back and forth and back and forth through the cell walls, which is where you want the moisture. And so another form the form of the alkaline foreign sodium hyaluronate is oftentimes used in cosmetic formulas, allowing it to penetrate a little bit deeper into and through the epidermis into this.

Skin area, the deeper layers. And this is actually a, gives you a visible effect of plumpness from underneath the skin surface as opposed to on top of the surface. There are two new forms of hyaluronic acid that are being used right now, sodium hyaluronic cross polymer, and this is even a lower molecular weight than the salt version, and it’s crosslinked to form.

A molecule that is a little bit higher molecular weight, but passes through that barrier quickly. And it’s it’s very interesting because it’s gives you the stability of a hyaluronic salt acid but also the humectant properties of a more superficial, so it’s covering both the surface and a little bit deeper and then to go most deeply or the deepest into the skin.

Is the the new sodium ated Hyaluronate and acetyl hyaluronate is it’s new. And what’s fascinating about this form is that this ingredient or this formulation of hyaluronic acid actually can penetrate into the skin three times. Much deeper, which allows for three times more water and absorption than ordinary hyaluronic acid.

And it keeps it in, it locks it in so that it stays longer. So it’s great for aging skin, dehydrated skin, or people say who live in the desert or in dry climates or even in the winter when you tend to lose a lot of moisture on the surface over your skin from cold. It also inhibits the release of MMP one, which is a degradation of collagen, immature skin.

Skin and it’s also used to help protect the skin from the UV rays and environmental pollution. So it’s lookout for that one. It’s new. It’s coming up and I think it’s gonna. Be really popular. It’s used to reduce crows free and the nasal labial fold of the skin, the wrinkles that run from the corner of the nose to the corner of the mouth.

And keep an eye out. I think it’s gonna be very popular in upcoming formulations of skincare. What’s interesting is this research study, it’s a randomized control trial of the efficacy of cream-based hyaluronic acid at different molecular weights. And this. They’re using water bound hyaluronic acid at a weight, a molecular weight.

So three different weights, 51, 3300, 802,000. That’s more than three, isn’t it? It’s five. And so they applied it around the eyes. 76 female patients between the ages of 30 and 60 years for 60 days. So they measured at 30 and 60 days. And what they, so one eye, they used this cream and then the other at different molecular weights.

And they used placebo on the other side. And then they were taking objective measurements. So they used a semi-automatic morph photometry meter in order to demonstrate the changes, the objective changes. What they did is the measurements were wrinkled depth. They, and then they also compared the size or the amount of change that occurred at 360 days.

And the 60 day measurement, what they concluded was the application of a 0.1% hyaluronic formulation was made significant changes in both skin hydration and elasticity, but they also found that the lower the molecular weight. The more effective it was. So again, going back to those cross pollinations or breakdowns of combined hyaluronic acid products that are coming up, they’re designed to both break down the acid, the hyaluronic acid, into very small, low molecular weights in order for it to penetrate through the skin more effect effectively and efficiently.

The other, another very important way to get hyaluronic acid into your skin is through your diet. So a diet rich in nutrients that support hyaluronic acid production can help improve the health and appearance of your skin. Key factors related to improving hyaluronic acid or getting hyaluronic acid through your food and diet.

A water. Drink as much water as you can. And that will help keep hyaluronic acid functioning properly. And then nutrients to consume are foods high in vitamin c, e, and magnesium to help produce and support the synthesis of hyaluronic acid. So these vitamins help synthesize it, water helps to keep it functioning.

And then antioxidants, such as fruits and vegetables. They actually protect that hyaluronic acid from breaking down. And then collagen rich foods and supplements can support hyaluronic acid by promoting skin elasticity and hydration. So you will need to have nutrients like vitamins C and magnesium to build or synthesize it.

You need antioxidants to help it from breaking down. And then drink plenty of water in order to support or maintain the functioning properties of hyaluronic acid. And then you want to promote, help, promote and support that hyaluronic acid by promoting skin elasticity and hydration by taking collagen rich foods or supplements.

And then here’s a research study. This is a 12 week double blinded placebo study, and 12 weeks is about right because when we talked about the epidermis and the dermis, skin cells start at the base of the dermis and make their way up to the epidermis so that you, what you visibly see. It takes about 30 days to, to migrate up from the cells, from the base of the dermis all the way up to the surface.

So 12 weeks is three rounds of improved production of hyaluronic acid in that germal layer in order to visibly see a difference in the epidermis. After 12. So in this study, this double-blind placebo controlled study, they were using daily hyaluronic acid, 120 milligrams, and it was from High Best.

It’s a company in Tokyo. Taken daily for 12 weeks in 40 healthy Asian men and women ranging in the age of 35 to 64, and they evaluated objective measurements of wrinkles and the stratum cornea water content. That’s the surface of the skin. The amount of transepidermal water loss, that’s through the tissues.

Elasticity and they looked at imaging analysis so that they were objective measurements rather than just asking the people. How do you feel? So this was actually a measurable controlled study. I. After 12 weeks, they noted that skin condition was significantly improved in terms of wrinkle assessment, stratum, cornium, water contact, transepidermal, water loss, and elasticity.

So they concluded that. It makes a difference. What’s very interesting is remembering that when you were applying hyaluronic acid to the surface of the skin, you wanted a low molecular weight. In this one, what’s interesting is another 12 week period they were looking at the benefits of hyaluronic acid.

Applied orally. They did a similar study, 60 Japanese male and females aging, 22 to 59 years old, presenting with crows free and wrinkles. And then they were assigned hyaluronic acid at a me molecular weight of two 300 and 300. Again, 120 milligrams of hyaluronic acid. Now what was so interesting about this.

Is again measuring the skin wrinkling by imaging analysis and skin condition, and that was from a questionnaire survey. Here’s what they found is during that study period, what they found is that the higher molecular weight at 300 K group showed significant, a higher significant. Change in terms of diminishing wrinkles and compared with the placebo group.

So both worked at two and at 300, but the conclusion is that the 300, the higher molecular weight. Worked better. Why? Now? This is a good question. So think about this. If you are applying it to your skin, then those molecular, then the hyaluronic acid molecules have to get through the skin. However, if you’re eating them or ingesting them orally, it has to get through the digestive tract and get absorbed in the digestive.

To track. So when you break them down, a higher molecular weight has more of it. So you actually get a higher delivery of the product as opposed to topically when you can’t a higher molecular weight, it’s not gonna get through. So it’s just gonna sit on the top. So situation, you want a lower one. So I hyaluronic acid is great and.

It just depends how you do it. Whether you stimulate it with acupuncture, you ingest it, or you apply it topically. And so the benefits are really not just the hyaluronic acid but the delivery system. Low molecular weight for application on the surface of the skin topical application, and a higher molecular weight.

When you ingest it, so read your ingredients, read the package you want around a 300 molecular weight of 300 k if you’re gonna consume it, and you’re gonna want a smaller, safe five to 50 if you are going to apply it topically. So if you want more information about hyaluronic acid, I actually will be giving a presentation about tissue and DA fascia at the upcoming Pacific Symposium.

Here’s more information about it, and that’s it. So thank you very much. I appreciate your time here, and I hope you enjoyed this and learned a lot. Again. Thank you American Acupuncture Council for allowing me to present today. .

 

 

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Acupuncture Malpractice Insurance – Safety Misconceptions: Are You At Risk For a Claim?

 

Acupuncture Malpractice Insurance – Safety Misconceptions: Are You At Risk For a Claim?

We have certain misconceptions around safety that we’re gonna go over today and really what puts us at risk. And I wanna be sure to hit on some things that will not only help keep you safe in practice, but are gonna help you build your business as well.

Click here to download the transcript.

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

Hi everyone. I’m Dr. Nell with American Acupuncture Council. Thanks so much for joining me for another episode of To The Point. Let’s go to the slides. Today we’re gonna be talking about something that. I don’t always go over in such a straightforward way. A lot of times this topic is interwoven into some of the the themes that we have throughout our different broadcasts, but it’s something that has been coming up a lot for me lately.

Not just in my own practice, but in things I handle in my day-to-Day work at AAC, and I think it’s really important to note that. We have certain misconceptions around safety that we’re gonna go over today and really what puts us at risk. And I wanna be sure to hit on some things that will not only help keep you safe in practice, but are gonna help you build your business as well.

All about that efficiency. So when we’re looking at this, I think there’s a few reasons why we miss the mark when it comes to safety sometimes. So I think when you hear the word safety, it’s very easy, particularly in our industry to think, oh, that’s OSHA related. Or that’s clean needle technique.

And I think that buzzword of safety makes us think more about occupational hazards when it comes to keeping safe with our needles, with our cupping supply. All of those things that of course we’re running into in our day-to-day when it comes to practice. But there’s a whole other aspect to keeping ourselves safe, not just the materials we use or the patients we use those materials on.

But also how we’re operating in our day-to-Day, and how do we keep our practices safe as we’re growing them. And I think part of this is due to another myth, this misconception that acupuncturists don’t really get in trouble, that we have such a safe medicine, which we do. And compared to other healthcare providers it is very safe.

We focus a lot on preventative health. We have obviously a more holistic and natural approach. So there is going to be some built-in safety to the way that we practice. . However, there’s also built-in risk. And so I think sometimes we focus in on these ideas of clean needle technique or osha because we think this idea of managing risk outside of those very straightforward things feels maybe too overwhelming.

Or like we don’t have a how something to really latch onto with that. And so I wanna demystify a little bit of that today and just give you one really easy takeaway, the main thing that you could take away from this to potentially avoid a claim coming through your office. So when we look at this misconception around safety first and we think about the occupational safety that we need to take care of, I think.

That makes us forget about all these other aspects of risk. So a big thing board complaints, for example. That’s something that could happen even if you are a hundred percent with your OSHA standards, your clean needle technique. That’s something that we don’t even think about when it comes to just the safety of protecting our practice.

If we hear the word malpractice, we’re thinking that’s okay. Yes. Directly related to patient care. Nothing on the periphery. So we really need to reevaluate what’s coming to mind when we think about safety. And that other piece about, oh, our medicine’s really safe. This is a problem for . Other healthcare providers?

No. There, there’s a real truth here that acupuncturists can have claims coming in. And even though our medicine is very safe and it might be obviously more risky to be a surgeon, we still have to look at what our normal is, what our risk tolerance is the things that we’re gonna encounter in our day to day.

When we look at what a patient experience looks like for us specifically, there’s a lot of risk that’s just baked into our normal day-to-day. We have a one-on-one relationship with our patients. There’s not a scribe. A lot of times there’s not office staff. There’s not. Witnesses to things that could potentially happen.

So that puts us at a little bit of increased risk. And because of nuances like that, that are not cut and dry, it’s not like we’re performing a surgical procedure and there’s either a favorable outcome or not. There’s either a complication or there isn’t. There is nuance to how we need to think about safety in our practice.

So the number one thing that we can do, and I want you to see this stat, over 90%. I am wondering if you have any idea what comes to mind or what comes to mind for you individually when you hear this over 90% with regard to claims. So this is actually, a colleague of mine uses the stat when we speak in the different acupuncture schools that over 90% of claims in acupuncture could be avoided if there was proper communication on the front end.

And that sounds really scary because it’s scary to even think about claims in our practice or something going wrong, especially because most acupuncturists are very well-intentioned and wanna do really right by our patients. But to think that I. The claims that do come through that, a lot of times there’s a breakdown in communication that should actually feel really empowering.

That’s something that we can get better at. That’s something that can help protect us in practice as well as help us grow our businesses. So just like when people say things, it’s very cliche, oh, if you invest in yourself, you can never go wrong. If you invest in your communication, your ability to manage expectations on the front end, that is a great way to bridge that gap between thinking about safety from a, how do I protect myself, my practice, my patients.

Managing expectations is a huge part of lowering that risk. And so this 90% plus for you to think about how powerful you could be and how safe you could be in practice with that effective communication for you from a business building perspective is going to help with patient acquisition.

It’s gonna help with patient retention because you’re managing expectations better. It will absolutely help with referrals because if we’re effectively communicating the value that we provide, so if you’re. Invested in becoming a stellar communicator. Not only are you gonna lower that risk but you’re gonna bring your business to a new level as well.

To wrap this up, I wanna bring all of these together focused on what we talked about at the beginning. So if you take anything away from this, just know that there’s more to safety, so don’t hear that safety buzzword and think, oh, I just need to get my N-C-C-O-M PDAs and knock out that one class. I already did clean needle technique.

I don’t need to think about that. No. Safety is something we need to think about every single day in our businesses, and we need to expand beyond that, that safety net of just checking the box that we’re doing clean needle technique or effective OSHA practices or even effective HIPAA practices. We need to think about how

Every little bit of communication that we have, every action that we make absolutely falls into that safety category. And the reality is we’re licensed providers. So licensed providers, regardless of what your day-to-Day looks like, there’s an increased risk because you have a license, it’s. Stake and you have certain standards that need to be met to maintain that license to help the public be protected to be a fiduciary.

And so we need to think about safety a little bit differently within the context of being licensed. And the last thing is. Safety doesn’t need to be a boring thing or a check the box thing. It can be a really interesting thing. It can be a really exciting thing because it does help you manage risk, but also build your practice.

We have another previous show where we went over the fear of, in a discussing informed consent. Informed consent is my favorite business building tool. So there’s a lot of overlap here between keeping yourself safe and making sure your business is going to continue to grow. Thrive. I appreciate you all listening today.

If you have more questions, always feel free to reach out to me at aac and don’t forget to tune in next week. We’re gonna have, of course, another episode of To The Point. So thank you so much and see you then.

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Building Bridges Between Classical Chinese Medicine, Biofield Science and Consciousness

 

 

And we’re gonna be talking about building bridges between classical Chinese medicine. Biofield science and consciousness. And it just seems that’s where the paradigm shift is going. Impact-Site-Verification: 938298511

Click here to download the transcript.

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

So again, welcome back to another episode and happy to be here as one of your hosts. And today I have a guest with me and a colleague, Todd Luger. And we’re gonna be talking about building bridges between classical Chinese medicine. Biofield science and consciousness. And it just seems that’s where the paradigm shift is going.

And Todd has become the co-chair of a collection of presentations and lectures that’s available online that we call the Healthy Horizon Symposium. And I wanted him to come on to really talk about . This topic about this building the bridge. So rather than me ramble here, let’s bring Todd on and I’m gonna ask him some questions and we’re gonna geek out a bit ’cause that’s what Todd and I like to do when we meet in person, when we get on the phone.

Todd, nice to see you again. Nice to see you Lorne. . Our topic today is building bridges, classical Chinese medicine, biofield sciences, and Consciousness. And I’d love to hear your side of this story of what was the original inspiration for you? Wanting to organize this group of speakers and talks on building bridging or not building, but bridging classical Chinese medicine, biofield sciences, and consciousness.

I was working on a project a couple of years ago and I was doing some research on speakers that I was recruiting for that project. And I stumbled by chance onto just an explosion in research on biofield science that had taken place in the past 20 years and had really escaped my notice because I had been.

More focused on things like functional medicine and Chinese herbs from a pharmacological perspective. And I had missed out on this really amazing new area of study and. The thing that really excited me when I came across this research on biofield science was that I felt it had significant implications for understanding how Chinese medicine works from a modern scientific perspective.

When I think about this, Todd and this is what got me interested when we connected on this, is so much we seem to be wanting to fit Chinese medicine into the Western paradigm. And in that talk that you and I, I. On and with Dr. Ed Neal, and he’s one of the people that have put the presentation together for this.

He said it’s actually the other way around and he’s trained as Chinese medicine and he’s a medical doctor, a physician. It’s the other way around. Western medicine fits into classical Chinese medicine and so much of the research . Is on such a material level trying to understand the mechanism of acupuncture.

And part of this stuff that I think when we geeked out is there something else happening that we’re not looking at, we’re not measuring properly or looking to measure? And I think that was also part of this process, right? Because maybe something’s happening on a biofield level, and then what we’re seeing is the trickle down effect.

We’re measuring what’s happening in the body when we look at . Hormones and gene expression. And this was where I think also got we got intrigued, right? Is what are we working on? And if we stay on that Newtonian materialistic level, we may miss out on things. ’cause that’s what we seem to be. I don’t know if you’re still thinking this, but it seems like we’re trying so hard to justify our medicine, validate it through the Western model, but maybe the western model is incomplete and it seems the Western model going to quantum physics. The new science seems to be understanding the world from maybe a different perspective, not just the five senses. And to me it seems like classical Chinese medicine fits more into that model, and it can explain why people benefit from it, even though it’s been hard to research from the current Western model.

Do you have any thoughts on that? Yeah, I couldn’t agree more with what you’re saying, Lorne. I’ll give you an example of one of the lines of research that I thought was incredibly exciting when I became aware of it. There’s there’s a researcher at Tufts University named Michael Levin, who has doctoral degrees in biology and computer science.

And when he in his biological research that he’s been doing for the past 20 years, he was really inspired by a pioneer of. Bioelectrical research from decades ago named Dr. Robert Becker. And Robert Becker toward the end of his career, also did a lot of research in the area of acupuncture and bioelectricity.

But that research fizzled out. For a long time, I think it was in part because there was a lot of excitement about the Human Genome Project and that was finally going to reveal the underlying code of the way everything worked in the body. But a lot of people feel that. What happened at the end of the Human Genome project was they didn’t quite get to the finish line, and there was still a missing piece of the puzzle.

And Dr. Levin took his background in both biology and computer science and started thinking I. The genes seem to code for the, the bits and pieces of the body, the various proteins and enzymes, but the hu that the genome doesn’t seem to explain how all of these things function harmoniously to create.

That the body working in a very seamless way. Just because what enzymes and what proteins are there and you’ve mapped out what the biological pathways are, it’s really hard to understand how everything works together. I. In such an amazing and intricate fashion. Following on the work of Dr.

Becker and also early researchers from earlier in the 20th century Dr. Levin started doing research where he was, I. Manipulating bioelectrical patterns in the body. He refers to them as the bioelectric blueprints of the body. And in manipulating these bioelectrical blueprints, he was able to demonstrate some really amazing things.

For example, . He was doing stu studies on mice where you take these mice that have a gene where the mice will always get cancer because of this oncogene that they have, and he was able to show that by modulating bioelectric patterns in the cells, he was able to prevent the cancer from developing, even though this death sentence of an oncogene was there.

Ano another exciting area was he was very interested in limb regeneration. This was also an area of focus of Dr. Robert Becker back in the day. He’s famous for his experiments with salamander limb regeneration where he demonstrated that there was aspects of bioelectricity that were a major factor in the limb regeneration.

Dr. Levin hypothesized that maybe you could leverage . That thing that happens in salamanders you, salamanders regenerate. I think most people are aware of that. If you cut off a limb, it’ll grow back. But once you get up the chain of evolution, that functionality is lost. Dr.

Levin wondered if it would be possible to get what happens in the salamander, which is bio electrically mediated to happen in higher animals, and he’s shown that it actually can, in fact, recently, They’ve regenerated the leg, the amputated leg of a frog, which does not normally regenerate. So when I realized that Dr.

Levin was, and he specifically refers to these as , the bioelectric blueprints and that they are these global blueprints that guide the formation of the body from the fertilized egg and guide it to form all of the tissues that develop from that fertilized egg. I thought that’s really conceptually similar to the concept of qi in Chinese medicine because QI.

Is generally thought to be this very mysterious thing and often dismissed by . Western scientist is having no grounding in Western science. But chi in Chinese medicine is responsible for everything that goes on in the body. And for years, western scientists who would look at acupuncture, they would measure things like endorphins or neuropeptides see molecular changes that were taking place.

Map brain imaging to show changes taking place in the brain. But in, in all of those cases, I. You have to set aside the classical Chinese understanding of how the body works and say the Chinese discovered something cool, but it doesn’t work for the reason that they thought it did. When I start seeing research like Dr.

Levins, all of a sudden it seems like I. Maybe there is something to the classical Chinese understanding, and I’m not saying that QI is bioelectricity, but I’m saying that there clearly is an energetic, a holistic, energetic layer to the body that is upstream from matter and. And that got me thinking wouldn’t it be really cool to bring together people from the biofield research community and also people from the classical Chinese medicine community so they could cross-fertilize each other with their ideas?

The biofield people could share the amazing research that they’re doing, and the people from the classical Chinese medicine community could share what they’ve discovered in the classical Chinese medicine texts that maybe could provide insight into. Some of this research that’s been done in recent years and ideally provide inspiration for future directions.

And I’m gonna repeat what you just said. ’cause that was the idea of creating, of putting together a collection of presenters from the biofield sciences, from consciousness and from classical Chinese medicine. Because when we started talking, I had this dream of putting together an event which focuses on the role of.

Which focuses on the role of consciousness, mind, and healing. And you had this idea about the biofield sciences and we thought the two part processes. The biofield science research actually will give validation to what we observe and witness in our clinics and also . It shares with us that the classical texts are not just stories, there’s actually science that is validating, confirming what they wrote in the classical text.

So that was part of the excitement of, let’s bring these two groups together, as you said, let’s cross pollinate. And then on the other side, they’re doing this research. The biofield experts are doing this research almost in the dark. And the classical text can give them so much direction to, to research as in.

Validate this. ’cause they’ve already said, this is what, how worth, this is how the world works, . Can you validate it? And so we thought, looking at the world, and most of you are aware that we see a lot of suffering, a lot of mob . Hate and fear and to heal the planet. We think classical Chinese medicine has a role in it.

And this new science of biofield science and consciousness letting each other know that we’re more together than separate may be the way to, to heal. And and so we can enjoy our peace and freedom. That’s my lofty spiritual side of it. And . I kind of love to have you tell us a little bit about this collection of speakers and talks that we have labeled The Healthy Horizon Symposium that’s available online at Healthy Seminars.

We’re putting together a collection of speakers with a goal that to weave together insights from clinical practice, research, scholarship, and personal experience. Before I go on, I should say that I wanna, I. Include a piece that we haven’t discussed quite yet. I’ve been talking about biofield science research and I’ve been talking about classical Chinese medical literature that seems to provide a lot of clues to what’s going on in the biofield research, but I don’t wanna leave out all of the practitioners

Who have been bringing these ideas from either one or the other into their clinics for decades now, because a big emphasis in our talks is going to be on the practical level. Even if some of us like to geek out, as you said on these subjects, which I clearly do, We also mo most importantly, we want to take this information and use it to really ramp up the ability to heal people, heal society heal the environment.

Because this concept of the biofield. It’s there a lot of the research has focused on what’s going on in the human body, but this concept of the biofield actually extends beyond the human body into the relationships that we have with other people, and also the environment. The, the natural world around us being an aspect of the biofield and all of it is Also connected to consciousness, because consciousness is also an aspect of the biofield.

So we’re weaving together people who come from clinical practice, research, scholarship and personal experience. And our goal is to begin to tell a new story. The old story is one of. Materialism and reductionism and scarcity and the new story we want to tell is one of holism complexity and abundance.

There’s a new paradigm coming and this new paradigm can help, as you alluded to, Lorne bring us all together and begin to heal the rifts within our own body and also . Within society and between humans and nature. There our speakers are gonna be coming from the biofield research world.

They we’re gonna hear about some really amazing research that I think is gonna be really inspiring to people. And we’re also going to hear from scholars who’ve spent years digging around in classical texts and seem to be reaching the, coming to the same place from a different angle.

But. Perhaps most importantly, we’re gonna be hearing from the clinicians who are gonna be showing the people who attend these presentations, how they can actually really amp up their work with their patients and create really exceptional healing experiences for them. And I guess before we close here of this collection of talks and speakers that we have now available, can you share some of the examples of these different types of presentations and how they fit into this vision?

Yeah. Speaker who’s gonna be upcoming in the near future, and somebody who’s been on your platform many times and will be on it many times again, is a woman named Yvonne Farrell. Yvonne has been focusing on the treatment of trauma using the eight extraordinary vessels for many years.

And the eight extraordinary channels have sometimes been referred to as the embryological blueprint of the body. And when I, when I first , Was learning about Michael Levin’s research and he was talking about the bioelectric blueprint of the body and specifically talking about embryology.

I thought to myself that sounds really familiar. And I cracked open a few books that I had on my shelves on the eight Extraordinary Vessels. One from Giovanni Maia, the late Late Great master of Chinese Medicine and another man named Hamid Monte Kab. And sure enough, they were also both referring to the eight extraordinary vessels as the embryological blueprint of the body.

And that was actually one of the things that got me thinking, that the Chinese Chinese medicine has actually been using similar terms, and I know Michael Levin. Wasn’t studying Chinese medicine or the eight extraordinary vessels. He came up with this term himself. And yet people in the Chinese medicine world have been using the same term.

And that’s what really got me thinking. There’s something in classical Chinese medicine that’s gonna really help understand all of these things. So they, the eight extraordinary vessels, as all the acupuncturists in the audience know are the carriers of essence or Jing in, in the body. And the.

Jing is in inherited from your parents, some from your mother and some from your father. In, in the past it’s often been said that the essence was very similar to the concept of. Genes in western medicine. But I think now as we’ve moved past a more simplistic understanding of genes into the world of epigenetics and now the biofield and because Chinese medicine comes from a less.

Material perspective. I’ve be beginning to think that it’s more appropriate to think of the essence as maybe the carrier of not just the genes, but also the epigenome and the bioelectric code. Bioelectric code is another term that’s been used by Michael Levin. According to Yvonne.

When you experience any type of trauma in the body, the eight extraordinary vessels are a primary part of the body that’s affected. And that’s whether that trauma happens, personally in this life or is societal trauma from, systemic racism. War which is something that is really on everybody’s minds recently and also intergenerational trauma.

I think a lot of people are aware of research that’s been done showing some really unfortunate effects that happen when people go through the trauma of war and the marks that are put on your. Biofield or epigenome actually pass through and affect the future generations.

Yvonne has discovered that focusing on the eight extraordinary vessels is actually a way to alter Restore this blueprint of the body to where it would be prior to having experienced all of this trauma. And again, like I said, there’s so much synchronicity and conceptually, at least between the way I hear these classical practitioners speaking.

And what I’m also finding in the biofield research area, and I thought was particularly interesting when I had a recent conversation with Yvonne about this is, like I said, Dr. Levin is not familiar with what people are doing in Chinese medicine, and Yvonne wasn’t really familiar with. What was going on in the biofield research either.

And yet they had landed in a similar place using similar terminology which I thought was very striking. That’s that’s one example. From the from the biofield perspective, there’s what are called biofield therapies and biofield therapies. Fit into two general categories. They can be manual therapies where people are, using their hands either actually touching the body to modulate the energy of the body or even hands-off therapies.

And they can also be technology mediated therapies. We have one speaker at the conference prana, who’s an Ayurvedic practitioner, who’s also a licensed acupuncturist with a background in electronic engineering, and Prana has developed some exciting new technology, . That uses very precisely designed combinations of frequencies that are based upon his deep understanding of both Chinese medicine and ancient Ayurvedic texts to generate various types of.

Sound, various types of frequencies that can be output in various forms. If you connect his system to a set of headphones, you can take in the frequencies in the form of sound. But if you connect his device to a pulse electromagnetic field generator, you can take in the frequencies, in the form of pulse electromagnetic fields.

And and his whole model is based upon . An understanding of Chinese medical patterns and from his Ayurvedic background chakras and the various systems of channels in Ayurvedic medicine. So very fascinating stuff that’s going on right now. And what we’ve done to he Todd just gave two examples.

So to build the bridges between classical Chinese medicine, biofield science and consciousness, and to help with this paradigm shift healing on a individual level, on a global level, on an environmental planetary level. We’ve brought together 27 . Inspirational presenters at the top of their game to bring this information to us.

’cause that’s the idea we need to understand and how to bring this into our lives and into our practice. And so this information’s all available if you go to the healthy seminars. You should be able to find it there. Just ask us about this, what we’re calling the Health Horizon symposiums.

Symposium and we’ll be able to direct you where you can find a collection of these talks from these 27 presenters. Todd, I’m glad that we connected and that we had that opportunity to chat and geek out. You shared this idea about the biofield sciences. And others other materials. And I was sharing how I was in this frame of mind getting into personal development and spiritual evolution for our profession and our society.

And then we just kinda merged the ideas and it grew and expanded it and I. All I gotta share with everybody, everybody that we connected with the presenters are very well known and busy. And they all pretty much said that they were gonna say no, ’cause they’re too busy to prepare this material for us to make available to you.

And when we shared our vision But I think one, based on their schedule put other things aside and came together to create this content for our community, which we’re grateful for. And Todd, I’m grateful for you for really being the co-chair of this this material , I call it the event, the material.

’cause you really storyboarded and really worked with the presenters to tell this story. So it has meaning for the acupuncture community. So thank you for that as well. You’re welcome, Lorne. I’m excited to be part of this project. I just wanted to add one, one more thing before we go that I, I feel that I glossed over.

We have a lot of practical presentations that we have planned in the year ahead. But rather than focusing on protocols for disease treatment I mentioned one where we were talking about trauma. There’s really gonna be a strong psychospiritual emphasis in the presentations that we’re planning with the idea.

That the ultimate root of ill health according to Chinese medicine the internal cause of disease is the mind and the emotions. And so we’re really having a big focus on healing the mind, working with the emotions, and helping people in their psychological and spiritual development in the practical presentations.

Perfect. Again, thank you Todd, and again, thank you guys for tuning in to another episode here. We much appreciate it. .

 

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Medicare and Acupuncture Updates

 

 

Most of you’re gonna hear something starting now because the Medicare enrollment period begins October 15th and goes all the way through, I believe, December 7th.

Click here to download the transcript.

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

Hey, greetings everyone. It’s Sam Collins, your coding and billing expert for acupuncture, the American Acupuncture Council, and really to make sure you’re getting paid. What I wanna go over now is Medicare. There is still so much confusion. I do seminars. I travel the world for on behalf of acupuncture. I deal with so many different groups throughout the United States, and I get so many calls from network members that are asking.

Sam, my patient called me and says they have direct Medicare or what’s going on, what’s changed? And what I wanna do is hopefully clear up a lot of the confusion ’cause in fact, Most of you’re gonna hear something starting now because the Medicare enrollment period begins October 15th and goes all the way through, I believe, December 7th.

So you’re gonna see probably a lot of television ads and other things talking about acupuncture and Medicare Part C plans where I find they’re actually using the profession to help promote their own insurance. But then what is the difference of these? What is Medicare? How does it cover acupuncture? Is it different from when it started in 2020?

So let’s get into that. Let’s go to the slides, everyone. You’ll see here. I wanna talk about Medicare and acupuncture update Medicare, part B and C. Do not be confused. A lot of people hear the term Medicare and it realize it encompasses a lot of things. The two areas that focus for acupuncture though are part B and C.

Part A is for hospitals, nothing to do with us. Part D is for drugs. And then supplement policies don’t affect US either, so it’s part B and C, and most commonly people get part B automatically. When you turn Medicare age, but many people now are trading for these part C policy. So I wanna make sure we understand the differences.

’cause part B has not changed when it comes to what type of acupuncture coverage there is. Part B coverage is still limited to chronic low back pain and so forth. So the problem is though, this is the type of thing are your patients are seeing the public, they’re seeing ads like this that says Medicare now will cover acupuncture for chronic low back pain.

They call Medicare and they say, oh yes, you can get acupuncture. Not understanding the differences with regular Medicare Part B. Yes, there’s coverage, but there’s some obstacles or some hurdles to cover to make sure it’s covered. The one that’s a little bit simpler, of course, are the Medicare Advantage plans.

These are the Part C. In fact, I like to use this one ’cause this is taken off of an ad from television for a Medicare advantage plan for UnitedHealthcare. In this particular plan I look at this and I thought, wow, this insurance company is using acupuncture to promote the sell of their service.

They’re letting people know, Hey, come and join us. Don’t have regular Medicare and you can get acupuncture for a zero copay. Is that gonna be attractive to some people? I think so. So certainly wanna look at that. And just to keep in mind, part B is what people automatically get. But many people are trading for the Part C policies.

In fact, you can tell that because look it, there’s ads all over the tv. Here’s one for Clever Care, Medicare Advantage. It doesn’t even talk about acupuncture in this part of it, but it’s showing someone talking about dentists and see your doctor, but showing someone getting needle. And obviously there’s a big push.

A lot of people are recognizing, Hey, acupuncture can be helpful for me. Where do I go? How can I go and does my insurance pay for it? ’cause particularly a Medicare patient, generally gonna be on a fixed income though, could, some can be wealthy, they’re still fixed. They’re joining, they’re, they’ve got pensions, they’ve got retirement plans, they have social security.

So they’re certainly gonna pay with their pocketbook, meaning they’re gonna look to see if they have any coverage. So the confusion comes in when someone comes in. How do we identify them as a Medicare patient? I’ll make a real simple statement. You’ll know they’re a Medicare patient. If we’re over 65, everyone in the United States that is over 65 gets Medicare.

Whether you want it or not, you get it. Now, the part A is the automatic, the Part B you pay a little bit for, but everyone does it. And that’s the card on the left. This one here, you’ll see that’s regular standard Medicare Part B. Notice it’s A and B. The one on the right, this is an actual card from someone that is a Medicare Advantage plan, and you’ll know it as such because you’ll notice right on the card it indicates.

United Medicare, silver. There’s golds and so forth, but you’ll see that, but this one takes over. Don’t be confused when a person trades their policy for a Medicare advantage plan. They’re not gonna make them give back their regular Medicare card. So when someone comes in, always ask them If using, let me see all of your cards.

Because if they have one of these advantage cards, this regular Medicare is gone. They’ve traded for this, and I believe this year is gonna be the first year. Last year, about 48% of people I. Change to a Medicare advantage, Part C, whereas 52% were regular. I think this year is gonna be the tipping point.

’cause these plans just offer generally a little bit more generous benefit and frankly better for us. So let’s talk about regular original Medicare part B, regular Medicare Part B. As far as acupuncture coverage covers only chronic low back pain, which is defined as. Back pain over 90 days. That’s not too hard with an older person, certainly, but still something we have to have.

The bigger issue though, is this. The chronic low back pain can be treated by an acupuncturist, but it must be what they’ll say is under the adequate supervision of a medical provider. Now, I want to take back here, you’ll hear some people say direct supervision, and in many instances it will be direct, meaning you have to be in the same office.

However, adequate could mean . If the medical provider feels comfortable enough working with you, they may not be in the office at the time you’re delivering the acupuncture. The problem’s gonna be, it’s not a simple referral. They can’t just refer to you at another office. You have to be working in the same facility, whether they work in your office and make your office part of theirs, or you go to their office.

So this one makes it a little bit more complicated. It’s probably a little bit easier in this way because it can also be a nurse practitioner. Or a physician assistant who are a little bit more traveling, but you have to be working with them because they’re who are billing it. You’re not billing directly.

You’re gonna be working for them, whether as an employee or an independent contractor. Now, the good news is adequate supervision means you might be able to have an arrangement where maybe they’re in the office two days a week. And on days they’re not there with the prescription, you’re doing the acupuncture and they’re supervising remotely, if you will.

That can be allowed. So keep that in mind. But it is not a simple referral, so don’t get confused. The other thing is they require very specific diagnosis, and I apologize for the typo here. I did redo this short just a moment ago, but the diagnosis codes you’re required to have are M 54 51. Which is vertebral genetic back pain or M 54 59, which is other specified meaning specifying is chronic.

If you use M 54 50, it’s gonna be denied. So I have a lot of people going wait a minute. My claim was denied. The simple reason didn’t have the right code. They do not accept M 54 50. But again, that part B one’s a little more complicated. I do have several offices doing it now that have done quite well.

But you really have to get someone that’s a medical person that you can work with. Remember, it must be medical doctor. Physician assistant nurse practitioner. It can also be a certified nurse specialist. Those three, it cannot be a chiropractor or physical therapist. Now Medicare Advantage Plans. Part C plans are ones that people trade for and frankly, this is the one you can bill directly.

So don’t be confused. Part B, no direct billing by an acupuncturist. Part C. Plans advantage plans will allow you, in most instances that you can, they do have the same parameters of coverage. They cover for chronic low back pain, but many of them offer what we call routine acupuncture, which means they pay for pain management, and these you can directly bill.

In fact, in many instances, you don’t have to be in network. But just willing to provide the service. The one thing to keep in mind though, you will be subject to their fee schedule. If you choose to bill a Medicare advantage, you cannot balance bill your full fee, but the amount they allow, frankly, it’s gonna be a little bit more than Medicare, however, so that part I will say is good.

Now remember, not all Part C policies necessarily will have the additional routine acupuncture, which means direct billing. Most will, but always verify. What I can guarantee is they will all have the chronic low back pain supervised, but you’ll see that coming up. When I show you a little more direct policy.

Now what does Medicare actually pay? And I think this is where a lot of confusion Medicare will pay for three sets of acupuncture. I. The initial set, and this is gonna vary, this is why I have the variation in fees. This is gonna vary depending on where you’re located. Different states, different counties all have different fees, kinda like house prices.

But you can say on average the first set’s probably gonna be 40, though I’m putting 40 to 55 ’cause some states are higher, depending if it’s elector, acupuncture as well. And then the additional set is 30, but it can be as much as 40, again, depending on the area. So I’m gonna highlight that for three sets.

It’s roughly a hundred dollars a visit. Now that does indicate about a 40 minute visit, of course, but nonetheless, a hundred dollars. I think for a hundred dollars visit. I can make that work. It is not great. I’m not saying you’re getting paid thousands, but that’s not bad. Assuming 20 visits, that’s $2,000 per Medicare patient of reimbursement.

Not to mention the medical provider gets to bill for an exam or other services they may do for that patient, but your services would be paid at about a hundred per visit. Now, Medicare part C policy, and I apologize, this is a little bit small. This is UnitedHealthcare one and up here talking about what is covered.

They’re letting you know the same as Medicare. What’s the same 12 visits to start? Eight visits if it’s showing improvement for up to 20 for chronic low back pain. However, many of these plans don’t require and or direct referral because they’ll have, as you’ll see here, acupuncture, Medicare covered, and then they’ll talk about routine acupuncture, which means.

They cover for pain management, and I’m gonna say to you, the majority of these Medicare Advantage plans usually have that benefit. So you’re not gonna be limited to just low back pain only, but just about any condition so long as it’s painful. Keep in mind, however, for back pain though, they too will still require M 54 51.

M 54 59 to give you a good feel for it. Take a look here. It talks about acupuncture C P T codes that it covers, and you’ll see here, even dry needling, if you felt so inclined to do it, I wouldn’t. Dry needling doesn’t pay very well and I don’t think you’re doing that. You do an acupuncture, but the four acupuncture codes, and then it says here, common routine acupuncture codes, not a complete list.

So what I wanna highlight, this plan is noting that they’re not just gonna pay for the acupuncture, but they’re gonna pay for exams. The acupuncture codes. But then notice they’re listing several therapy codes. In other words, they’re gonna pay you within the scope of practice for common services that are payable under the plan.

On these plans, you can see sometimes some pretty generous reimbursements. I’m not gonna bring some of those up because it’s way beyond what you may are be billing, and I don’t want to entice that. But I’d say on average some pretty good pay. So take a look here for an Aetna patient, this is for three visits.

Three visits with two sets. They’re getting paid $234. It’s not bad. I would take that and the patient only has a $9 copay. Would you think a patient might be interested in that? I would. I think a patient would certainly be interested in coming in if they only to pay a $9 copay for three visits. In other words, three bucks a visit.

Here’s another one for Humana for a single visit, you’ll notice about 67, again, two sets, if there were a third set, probably would be a little bit higher. So would I say these are ones that are viable to you and ones you can directly build? Absolutely. But just be careful. Regular Medicare Part B has not changed.

We’re working on it. When I say we, we as a profession are working on getting acupuncturists fully into the Medicare system that you can register. Then once we can do that, we’ll have direct billing that’s gonna happen that just don’t know how soon, I’ve, I could say two years, five years. I really have no idea.

We have to see if we can get Congress to get together. Vote for a speaker, , and then we can start voting on some real bills. But nonetheless, I think this is a real positive. Think of the number of people who have Medicare now realize 10,000 people per day become Medicare eligible. I would certainly wanna let people know I’m out here.

’cause when you are looking at this type of plan that’s paying you at least a hundred, maybe even as much as 200, would that be something that could boost your office? What if you got five of these per month? And keep in mind with these, you do have to bill insurance. Is that a big deal though? In my opinion, no.

If I have an insurance that I know is gonna pay me, I can figure out how to bill. That’s not that hard. But I’m not gonna accept everything, so I want people that are doing cash. Don’t be beholden thinking because you take one plan. Like for instance, what if you say, Hey Sam, I’ll accept Humana and United, but I don’t take Blue Cross Medicare Advantage.

That’s your choice. Remember your choice to what you wanna bill is there, but keep in mind, it’s your choice. If the patients come in, they probably can have zero or very little copay on these cases, and again, can pay pretty decently. I would say look at what your cash price is. Anything that gets me up equivalent to that, that billing is simple and easy.

I’m all in. ’cause realize all of these plans will have portals where you’ll be able to bill electronically and so long as you do it through their company, it is going to be free. So I say, why not? So be aware. You’re gonna see a lot of this coming up because we’re in the enrollment period. Take a look at the commercials coming up.

They’re promoting your business. Let’s make sure we’re saying, Hey, you know what, we’re here and available here would be the thing though. How does someone know they even have benefits? Have you ever put anything out in your office that says, we accept Medicare or Medicare Advantage? Because otherwise they’re not gonna know.

I still think a lot of people don’t understand there’s even the benefit, so we wanted to start to do things to promotes that people know there’s access, and particularly for the plans, we know that are the good plans. As always, I’m here to help. We do seminars. By the way, what year is it right now?

It’s 2023 Sam, but what updated this month? Diagnosis codes. If you’ve not been to a seminar with me, you have a few coming up. You may want to get there to understand there’s been some coding changes, particularly for migraine headaches. Where will you know how, what fees to charge, the Medicare rates? All of that stuff is something we cover.

We do our network services. Just go over our website. We’re always there to help and I’ll bid you a due. Until next time, everyone, thanks so much. This is Sam Collins and I’m out. . .

 

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Memory and Cognition : Special Points for Treating Chemo Brain

 

 

Click here to download the transcript.

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

Hi everybody. Today I would like to lecture on the very interesting topic related to memory and cognition, and especially the effect of acupuncture in reduction of memory and cognition in patients with cancer or patients who are undergoing chemotherapy. And I would like to thank the American Acupuncture Consult, putting up this presentation.

This phenomena of cancer related cognition, impairment, or chemotherapy related cognition impairment are quite known. Sometimes patient describe it as chemo brain or chemo fog, which means they are, have difficulty in concentrating. So different normal tasks, even like reading a newspaper or having memorizing, simple tasks.

Are becoming a chore and becoming a really difficult situation. And it is very, the prevalence is very high. If we see three out of four breast cancer, survivals will say that they had some kind of memory impairment or cognition impairment, and it ranges from 16% to 75. And even more depends on the cancer, depends on the chemotherapy and the length and strength of the chemotherapy.

There’s been few acupuncture studies which are very promising in the result, and they’re very innovative. In the way they look at how acupuncture affects this cognition, one of them look at the effect of acupuncture in breast cancer patients undergoing chemotherapy. It took 80 patients, 40 received acupuncture, 40 were in the control group, and it looked at two parameters.

One was a biomarkers, which is neurochemical peptides, which are released in the brain. The more you have them, they’re called B D N F. The higher the B D N F level in the serum level of the patient, the better cognition, the lower. The worst cognition. So it’s actually looked at the biomarker that you can see objectively the effect of acupuncture versus the control group.

And it took a battery of different tests like assessment of cognition test that the patient had to feel and looked the difference between the patient in the real group comparing to the . patients who were just in the control group and the results were very promising. There’s different things that were different that you could see that statistically are different between the group.

First of all, in the all the tests, the patients who had the acupuncturist scored my higher than the patients in the control group, but also the serum level of B D N F. This biomarkers were much higher in the patients who receive acupuncture comparing . To the control group and when you compare both, there was a good kind of relationship between the higher B D N F level and the higher score in the tests.

So this is showing that this biomarker has significance and potentially it’s another way to understand, or later on to research how acupuncture is affecting the brain and affecting condition cognition. Not just in this group of cancer patients and then going chemotherapy, but generally within the general population and in the control group, there was no significance different on both, not on the B D N F and not on the scoring for the tests.

So the conclusion was that acupuncture therapies an effective treatment for . Chemotherapy related cognition impairment in breast cancer patients, although we need to look deeper into the mechanism and look how the B D N F has affected in this group. When we look at the acupuncture point, it’s quite interesting.

You’ve seen that the group of acupuncture points are concentrated in the head and there is additional points on the leg, like stomach 36. So it affects more in Chinese medicine, we’ll say the spleen, the E. The ability to digest information. Gallbladder 39 will affect the gallbladder, which also and nourishes the brain, but it’s also a point for the marrow, which is reduced during chemotherapy and kidney point and kidney as we know.

And the disease of the kidney is especially important for a long-term memory. So the design was quite interesting. Some point on the head that the fact . Memory and points that affect the postnatal and prenatal chi. Another interesting study was on it’s a very small it’s a kind of very pilot study or initial study, but it was very interesting in the way it was designed and it was in cancer related cognition, impairment in Chinese group gynecological cancer patient.

But the reason I want to bring this study, because they looked already at three parameters. So they look at the assessment like patient has to fill in the forms. They looked also at the micro structural of the white matter in the brain because there is a certain reduction in a certain area in the brain.

When cognition is lowered. So they look at the difference and also in the wide matter itself, in the brain and look at the different neurochemical peptides in the brain, the n a and also in the small group, there was a big difference between control group and between the real, these are the different points, all of them on the head, as you can see.

So it has its advantage and this advantage. And the patient can determine which points he’s choosing according to the patient’s condition. This is example for Tang Point on the head, which can also used for other headaches and other problems in the head when we use it normally in acupuncture. And the results were very interesting because again, there was a better scoring on the test, although the group was very small.

But also there was a difference in this micro structural Side of the brain that is related to cognition, especially the apo colonus and the bdnf. The n a level was also higher, so also this peptide, which you can isolate from the serum was higher. So we are moving into kind of a new era of research, and first, let me say a word about acupuncture and cognition and memory.

In acupuncture, we look at the body, mind, spirit approach. So in the body we, it very much relates to the kidney and to the gene and the strength of the body and the vitality of the body. The stronger the vitality of the body, the better the memory on the mind level. We’ll look at the E, we’ll look at the spleen, we’ll look at the different aspects of ability to think and to assimilate memory and bring things from memory.

But additionally, in Chinese medicine, which is not , Difficult to put in research. We also look at the spirit and Duchenne and the heart, which gives this kind of coherence of cell up awareness and general coherence. Although, we can, when we look into chemotherapy, we need to look also in other aspects of phlegm and toxins.

We can, which we, I will touch on in a minute, a little bit more. So now we are looking at a different paradigm of research. When actually the researchers look at the body of, like in functional MRIs, we look at brain fractures, biomarker pathways, and different neurological system, which are affected by acupuncture.

On the mind. Patients will do the cognition tests and can be compared, but still, hopefully in the future we’ll also give space to something which is more in Chinese medicine, we’ll say, the spirits, the presence, the ability of . Self awareness and being in, in a good awareness, not just in a, for cognition, for tests.

So this integration of Chinese medicine into especially oncology, has a very promising future. I would like to mention that we are doing looking at the, very much at the skills. That acupuncturist needs in order to treat cancer patients. And in the T C M Academy, we’ve developed a very unique and international course, very deep course that looks into the core competence that ones need in order to treat cancer patients.

And as you can see, like cognition and memories is just one aspect. Chinese medicine, especially acupuncture, has been shown . With evidence to help in many other conditions. And when we are looking at teaching the core competence, we are looking at the Western medicine understanding and research. We are looking at the Chinese medicine understanding and also generally we can look at the evidence that are available there and see how we can conclude for evidence.

So in this International Oncology Acupuncture certificate course, We go deeper into understanding this and covering many conditions, especially many conditions, that there is already evidence for them, helping acupuncturists to become a well equipped to treat cancer patients. So we look at different conditions such as pain, nausea, vomiting, fatigue, dry mouth.

And a big list of others in order to equip acupuncturists with the best knowledge and the core best core competence to treat cancer patients. So I hope you enjoyed this presentation. I would like to thank you very much. If you have further questions, you can write to me and all the very best. Be healthy and well.

Thank you very much. . . .

 

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Microneedling for Aging Hands

 

 

Today’s lecture is about microneedling the hands, because one of the things that happens as we age, our hands can develop age spots. And the skin itself can lose its elasticity.

Click here to download the transcript.

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

Hi, my name’s Michelle Gellis and I am an acupuncture physician. Today I will be speaking to you about microneedling for aging hands. So just a little bit about me before we get started. I am a former faculty member and clinic supervisor at the Maryland University of Integrative Health, and I am currently on faculty at Yoan University in California.

And I’ve been teaching facial and cosmetic acupuncture classes since 2005. I have been published several times in the Journal of Chinese Medicine, acupuncture today, and also the acupuncture desk reference. So here are some pictures of me teaching. This was in Sydney and in Sydney, Australia, and in California.

So I do travel and teach internationally.

The first thing I wanna speak to you about is microneedling. I mentioned that I teach cosmetic. . And facial acupuncture classes. Neuromuscular conditions. Cosmetic conditions. So why would you want to, might, why might you want to think about adding microneedling into your. Cosmetic acupuncture practice or into your practice at all?

Microneedling is an alternative to surgery and it can address things skin level conditions such as fine lines, acne scars, loose skin, enlarged pores crow’s feet, lip wrinkles. Dark spots and even stretch marks on the body and can be very beneficial for hair restoration. And that can be head hair eyebrow hair, even empty spots if you have a beard.

So how does this work? What does it do? It helps to stimulate your body’s own collagen production and any products that you put on your skin like serum, it will help to increase the absorption of those products by up to a thousand percent. And all of this is clinically . Proven there have been hundreds and hundreds of studies on microneedling and its effectiveness for hair growth, stimulating collagen, treating scars, and increasing product absorption.

The benefits of microneedling are that there is very little downtime, unlike some other . Cosmetic procedures like lasers or surgery, there’s very little downtime. There’s very low risk. It is extremely effective and it can, as I mentioned, help to boost the natural collagen production in the body. It’s very comfortable.

Most people don’t need any numbing cream. But it, the process itself is quick, it’s comfortable, and the results can last up to five years. So here is a cross-section of skin. So this is what a piece of skin looks like, and here we have the epidermis, and then we have the dermal layer. And then below that we have the subcutaneous later layers.

So when you’re doing microneedling, you’re only affecting, all you need to affect is the epidermis. And here is a cross-section of the epidermis. And this very top layer is called the stratum corneum. And this is . The way that skin reproduces is, it starts at the bottom and then all the new good cells work their way up.

And this top layer flakes off. So microneedling when you’re microneedling, you have two different types of tips you can use on the pen. And I’ll talk about those in a minute. But one type just sloughs off the sh stratum corneum. And then the other type will go a little deeper down into the epidermis and we’ll get right into the base layer of the epidermis, which is this stratum based saw layer.

And that is where the new . Healthy skin cells get produced and by needling down through these upper layers, you will create new healthy skin cells more quickly. And this helps with wrinkles, the dark spots, and can even tighten the skin up a little bit. If your skin is . Sagging. It used to be believed that you had to go down into the dermal layer here and this can be very painful and there can be a lot of bleeding.

But what they have found in the past couple of years is you really don’t need to go that deep in order to . Affect these new fibroblasts, these new skin cells to be created. So this is what a cross-section might look like of the microneedles going down into that epidermis. And when these very sharp needles just puncture the epidermis, they go up and down very quickly and they create

They stimulate new stem cells and also fibroblasts. And this helps with things like scars and wrinkles, discoloration, and the other things that we. Mentioned, so it looks like this. You have your piece of skin, maybe this is a wrinkle or a scar, and you poke little holes into the epidermis.

You get new arterial and venous capillaries and the fibroblasts, and they all come together to form these new collagen fibers, which makes your skin look smooth and healthy and youthful. Another benefit of microneedling is it helps with the endothelial cells inside your capillaries and blood vessels, so this can help with things.

Like spider veins, it can increase the blood supply to the scalp. So this helps your scalp to be more healthy. And in addition to your products getting absorbed and exfoliating the all of the old sebum that can build up on your scalp, it helps the blood supply to the hair follicles, which helps your hair follicles to stay healthy, and it helps the little hairs to poke out.

So this is a picture of a microneedle pen, and we have a little bird joining us for today’s webinar. So I have a microneedle pen here and I’m gonna show this to you really quickly. If we can go to meet. Thank you. We can go to me. They are . Package like this, and then this end, you can plug in if you want to, or you can screw the plugin end off.

And it comes with two batteries and the batteries screw on like this, and then you would put the tip. So this is a needle tip. . And if you just, if you press, let’s see, where am I going? If you press on the end, you could see the little needles poking out. So what happens when you put the tip on the pen?

You click it on nice and tight, and then you turn the pen on

and it will. You see the numbers changing and the higher the number, the faster the little needles will go up and down. They’re moving in and out. And then you can also adjust the height right here. That’s my little adjustment. You can height you can adjust the height of the needles, and this determines how deep the needles will go in.

And the other type of tip I’m just gonna show you while you have me on full screen is called a nano needle. And as you can see, the needles are very tiny. You can hardly see them. They are like little tiny cones. And those are used for the red part of the lip. Inside the orbital rim areas that you normally would not want to needle.

Okay. We can go back to the slides. Today’s lecture is about microneedling the hands, because one of the things that happens as we age, our hands can develop age spots. And the skin itself can lose its elasticity. So when you pull on the skin on the back of the hands, it doesn’t snap back and it can look saggy.

And also the veins on the back of the hand can become very prominent. And I noticed this on myself as I was getting older. I’m 62 now and I was really becoming conscious of what the back of my hands looked like. And I used to derma roll them. But once I started microneedling and the microneedle pen that I showed you is made by AccuLift and there are a lot of great

Microneedle pens out there. So I strongly recommend we don’t have time today to talk about microneedle pens, but I strongly recommend doing your research about pens. But I started microneedling the back of my hands and it really helped with any dark spots and veins. And I was very happy that Really faded out the dark spots and helped my hands to look really youthful because most people focus on their face or their neck, but they’re not thinking so much back of their about their hands.

Now there are special concerns though when you are talking about the hands, and that is the hands are very bony. The veins can be very close to the surface. They can be very sensitive, especially when you’re microneedling on bone and because the fingers and the hands do not have as much blood circulation as other parts of the body.

especially in the elderly, the healing capacity can be reduced. So these are things you have to think about when you’re going to be microneedling the hands.

Also you, even if you’re just microneedling someone’s hands, let’s say they’re coming for cosmetic acupuncture, you do the cosmetic acupuncture on their face, and you wanna do some microneedling on the back of their hands, you want to make certain that you inquire about all of your usual contraindications, things like steroids.

Blood thinners, any prescriptions they might be on. And then after they have their . Procedure, their treatment that they use sunscreen on the back of their hands because our hands, we always think, oh, sunscreen, I’m gonna put sunscreen on my face. But we don’t always think about the back of our hands.

And then we’re driving, we’re biking, we’re golfing, we’re playing tennis, and our hands can be exposed to the sun just as often as our face. So the protocol. And again, this is just an overview. This is by no means in-depth training. If you want an in-depth training, you can go to my website facial acupuncture classes.com, and I go through a full microneedling training.

But just as an overview, the patient would wash their hands. You need to wear gloves. You can apply numbing cream if they’d like it, and that it needs to stay for about 20 minutes. Then the numbing cream comes off. You can use a cotton pad with alcohol on it or even some makeup remover with alcohol on it.

And, Definitely wipe the back of their hands with alcohol. Then you’re going to apply your treatment serum, usually a hyaluronic acid, and then you are going to adjust the pen height and needle depth according to the directions. And normally the technique with the pen is just up and down. You’re not gonna wanna go left to because you’ll be going over.

You’d be going over tendons and you don’t wanna do that. So it’s up and down when you’re on the hands. And then you might use a stamping motion if they have any spots, and you might get a little pinpoint bleeding, but that’s okay. It’s perfectly fine. You just. Go through that. And then if there’s any prominent veins, you want to go gently over those if they have any veins on the back of their hands.

So here’s an example of someone that I did. I. Just a couple of treatments on and you can see that hopefully you can see better there. This one spot in particular really faded tremendously and this had bothered her quite a bit. And little bit more collagen starting to form after just a couple of treatments.

So the treatments are spread out once a month. And normally four to six treatments is what is required. And if you want more information about microneedling training, I do live classes. And my schedule is at fa facial acupuncture classes.com. And you can also follow me on my social. It’s . You can just find me at Michelle Gillis and I have a facial acupuncture Facebook group as well.

I’m on all forms of social media under Michelle Gillis. Thank you so much and thank you to the American Acupuncture Council for hosting this. .