American Acupuncture Council: Elite Versus Preferred Program
Is there a difference between the Elite and Preferred programs offered by the American Acupuncture Council?
The answer is YES!
The Elite program is a special program that provides you a discounted coverage costs for incorporating an Arbitration Agreement and Informed Consent into your standard office intake documentation.
The Elite program is widely accepted, and very effective at eliminating false claims that might be brought against you.
The Preferred program is the American Acupuncture Council standard program and requires no special changes to your normal office procedures.
Remember, the American Acupuncture Council (AAC) offers an unparalleled track record in acupuncture risk management.
There is a reason acupuncturists have trusted AAC with their business for 50 years.
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Does the American Acupuncture Council fight for its members?
The answer is YES!
No one expects a problem, but if a claim occurs, the American Acupuncture Council is the fighter you want in your corner.
The American Acupuncture Council’s reputation for being tough on claims is top-notch!
Every year, the American Acupuncture Council defends its members, produces dozens of malpractice dismissals, and commands thousands of dollars in court-ordered sanctions against abusive plaintiffs.
Remember, the American Acupuncture Council (AAC) offers an unparalleled track record in acupuncture risk management.
There is a reason acupuncturists have trusted AAC with their business for 50 years.
Not an American Acupuncture Council member? Get a Quick Quote and find out how much you will save! Click here!
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, and welcome. I’m Dr. Kristal Lynn Couture, the Pelvic Accu. My passion is sharing pelvic care with acupuncturists. Around the globe really diving into the sacred medicine of the pelvis and using our unique viewpoints as acupuncturists to treat the pelvis in a holistic manner. This is why I’m so excited that my entire series on the pelvic floor,
and Women’s Health is brought to you by the AAC, the American Acupuncture Council. I just want to take a moment to thank them and share my appreciation and gratitude for the American Acupuncture Council for sponsoring yet another video. In today’s vlog, what we’re going to be chatting about is the pelvic floor and its connection to fertility.
So let’s get into it.
The table of contents for today’s workshop includes chatting about fertility in Western medicine. In order for us to have an interplay with Western medicine as Eastern practitioners, it’s super important for us to have an understanding of what’s happening physiologically in the body. And that means understanding the male and female feedback loops that occur with the body.
the reproductive hormone system. We’re also going to chat about fertility in Chinese medicine, of course. We’re going to get deep into our chat about Tian Gui today, as well as revisit Yin and Yang. We’ll have a look into the differences between Eastern and Western philosophy when it comes to looking at fertility.
within our clients. We’ll also look at the connections or potential connections between the pelvic floor and fertility. And we’ll look at a couple of studies and perhaps ask some questions that could infuse energy into future studies. And then finally, we’ll chat about how to provide support to your clients that are coming in now with potential pelvic floor and fertility issues.
So here we go. Let’s begin with fertility in Western medicine. As I mentioned, in Western medicine, we’re really dealing with the hormone reproductive physiology, which is really determined by the hypothalamic pituitary gonadular axis and the reproductive hormones, of course. There are both positive and negative feedback loops in females and in males.
The stages of conception include the healthy sperm production, high quality egg production, and high quantity egg production, successful transport during ovulation of the egg to the fallopian tubes, transportation of the sperm to the fallopian tubes, and then of course the sperm penetration of the egg, which would yield fertilization, and then finally that implantation of the fertilized egg.
into the thickened uterine lining. Okay. So let’s begin with these feedback loops. They might be a little confusing when we first have a look at them, but the key is to remember that whether a female or a male body, we are looking at this relationship and interplay between positive negati positive feedback loops, which encourage stimulation, and then negative feedback loops, which are the inhibition.
So let’s get our bearings around us. First off, GnRH is gonadotropin releasing hormone. This is released by the hypothalamus to stimulate the anterior pituitary gland. So you’ll see in green on your screen, the hypothalamus followed by the anterior pituitary gland. What happens here? in the first phase is that the pituitary hormone, inter pituitary is going to release luteinizing hormone and follicle stimulating hormone to stimulate spermatogenesis and testosterone secretion by the testes.
Great. Everything is in balance, right? But the body has a natural system. The body is always seeking homeostasis. And this is actually something I learned in school in Western medicine before I learned it in Eastern medicine. The body always wants balance, right? If your ankle is off on one side, your hip eventually is going to go off or your knee in the opposite side, because the body is seeking homeostasis.
Balance. The same is true of hormones. So the body in males has a natural negative feedback loop which halts the overproduction of testosterone and the overstimulation of spermatogenesis. So in this negative feedback loop, what we can see, so that’s marked by the red on the side of your screen, is that we have inhibin and we have testosterone, which are going to inhibit the secretion of GNRH to hypothalamus.
And then the, that will then, of course, inhibit LH and FSH by the pituitary gland. We also do have a little micro, feedback loop, which is that the Leydig cells will also stimulate spermatogenesis within the testes. So this is the basis of what the male feedback loop looks like in relation to hormones.
And we’re really looking here at a quantity game. We’re looking at the perfect quantity and that’s why we’ve got positive in the negative feedback loop. In females, the feedback loop looks similar, but it is slightly more complicated in that we’re not just looking at a perfect quantity, we’re also looking at the cyclical nature and that’s based on what the uterus is doing, right?
So again we have our hypothalamus, we have gonadotropin releasing hormone Then we have the anterior pituitary and then of course in this case we have the ovaries and the follicles and the uterus and endometrium. All are part of this hormone feedback loop, right? The endocrine system. The pituitary, the Gland is going to release LH and FSH, so luteinizing hormone and follicle stimulating hormone, to stimulate several follicles to grow during that follicular phase, right?
Pretty, it’s named pretty aptly actually. So luteinizing hormone, follicle stimulating hormone, several follicles begin to develop within the ovaries. Check. That’s our positive feedback loop in this phase. of the menstrual cycle. The negative feedback loop in this phase is that the dominant follicle is going to begin to produce estradiol, which is the most common type of estrogen in the body.
This can inhibit the GnRH, FSH, and LH production and this is going to cause the endometrium to begin to thicken. So we can start to see how this process is very unique and Very complex interplay of hormones. A lot of things can go awry here. In our next phase, we have ovulation. During the ovulation phase, we’re going to see that we have two positive feedback loops.
Same system is set up, and and in this phase, what happens is that luteinizing hormone and follicle stimulating hormone actually just stimulate that one follicle That is primary to mature. On the other side of the equation, we have the growing follicle continuing to produce that estradiol. And at this phase it begins to stimulate the G-N-R-H-F-S-H and LH production, and then the LH will serve to promote the.
to trigger the ovulation, right? So we can see that this is an overall negative feedback loop becomes a positive feedback loop. In phase three, we’re going back to a positive feedback loop and a negative feedback loop. So luteinizing hormone in this phase is going to stimulate the formation of a corpus luteum from the follicular tissue that is left behind after ovulation.
Okay, so that occurs within the ovaries. The corpus luteum is going to secrete progesterone, so now we have another hormone in play, and we see, if we look at my last presentation, or any of the hormone graphs that are out there, we can see that progesterone peaks at this time in the cycle, right?
When we have progesterone peaking, this is going to then inhibit GNRH, it’s going to inhibit follicle stimulating hormone and luteinizing hormone production. This maintains the endometrium. As the corpus luteum degrades and progesterone declines, this initiates the sloughing of the stratum functionalis.
So we have a basic understanding of these feedback loops. The key that I want you to remember here, even if you don’t have a total understanding of it or can’t remember it throughout the entirety of the cycle, is that This interplay can easily be jostled, right? We can impact the hormones in the body, we know, by stress, by lack of activity, by lack of proper nutrition, right?
So there are so many factors that can impact any of the phases of the body. this cycle and these feedback loops. Excuse me. Sorry about that. So that’s the key and that’s where Chinese medicine comes in to really have an impact because we come in with our needles and they’re like in our herbs and they’re like little lasers to target the exact parts of the body that need extra support.
So let’s just look for one sec at ovulation to implantation, and we can really see in this image, if we look at the ovary and then into the uterus, we can actually really see that this is about an eight to nine day process from the oocyte being produced to fertilization occurring and then migrating through the phases of cell development.
So we go from that first cleavage to the two cell stage, four cell stage, and we develop over time into the eight cell stage. And then we start to see the formation. of the inner cell mass, and we start to see how that blastocyte is immigrated into the wall of the uterus, right? And that, of course, is the implantation.
So again, this is another complex part of what’s happening in the total picture for female fertility. Now, if we have a look at Chinese medicine we’re looking through a whole different lens here, a whole different world. And perhaps the two uniting is the key to creating successful fertility in women and in men.
Ching Hsu, who’s a gynecologist during the Qing Dynasty, emphasized the unique difference between the blood And the menstrual blood. Blood is traditionally known to Ho House the Hun, and to nourish, of course, the tendons, the sinew, the skin, the eyes, and the hair, the Ian Gu or Heavenly Water. is considered to be the menstrual blood, which is derived from the kidney water and the female hormones of estrogen and progesterone.
The liver is the link between the two. Thus, the tonification of the kidneys is what is one of the most important things to consider when we’re working with fertility in Chinese medicine. Now I made a little bit of a graph here to help explain what we have going on. So if we look at this graph, we can see that we have kidney water and the impact of minister fire activates kidney water to become tian gui.
And then we have the link between tian gui and blood with the liver as the communicator between the two and the connection between the two. So let’s talk about minister fire first. Prenatal fire formed at conception on the du and the ren access. So minister fire actually exists before menstruation commences.
Some texts say that it is the kidney yang that turns the tian gui red. It’s just something to play with there. At 14, the ren opens and the chang flourishes, and this is what matures that tian gui. So the minister fire also serves to worm the uterus and balance the yin. which yields potentially conception.
It’s a pretty exciting process when we really look at it from this viewpoint, right? The Ming Men is the root of the Yuan Qi and the residence of both water and fire. The Yin of the five Zhang cannot nourish without it, and their Yang cannot develop without it. Without it. So what we’re saying here is we have this interplay.
Once again, I’m using that term. We have an interplay of water and fire where fire is not trying to overcome water and water is not Extinguishing the fire. And this is really existing within that role of the kidneys. So our system from Chinese medicine and Western medicine, we see some harmonization here, and we also see different and unique viewpoints.
And these different and unique viewpoints play to the physiology and the energy or the nature of the system. And that’s important to consider as we move forth with our chat here. So in my last presentation on menstruation, I shared this slide of yin and yang, and I’m going to share it again here so that we can remind ourselves of how important the yin and yang water and fire balance is within the body as we look at fertility.
So during the menstrual cycle phase, we have yang at its peak and yin at its minimum, then yang and yin cross, they intersect and the follicular phase begins where yin becomes yin becomes prominent Yang starts to become less prominent. And here we have the ovulation phase when each of these is at its maximum.
Then the yin becomes yang, right? And we start to see again, cross or intersect during the luteal phase. The yang begins to rise and the yin begins to fall. When we look at this and blow this up, blow up menstruation, we have During the menstrual phase, we have menstruation. The yang is going to peak and then drop in the qi and blood are going to be moving downward.
We know that, right? Because we have the discharge of menstrual blood or tian guai. The heart is going to be the one who is discharging During this phase, the invigoration of blood is going to be important to move all of the Tiangui out of the system. Next we have the follicular phase. During the follicular phase, the yin and blood in the system, are relatively empty.
Yin grows and crosses yang. And in this phase, the kidney tonification and blood nourishment is really important since we know that we’ve got this emptiness within the system, right? Building back, right? This is a constant Building and releasing. Building and releasing. We have, and there’s two builds and releases.
There’s the release of blood or Tian Gui, and there’s the release of the ovum, Yang and Yin, right? So the, these are really cool to play with this interplay with. So in ovulation, the Chong and the Ren and the Du are going to be fully activated. They’re going to be online. The Yin is going to be at its maximum.
The Qi and the blood are moving upward. In this phase, tifying the spleen to hold the blood is important when we’re thinking about fertility and also strengthening the Chung in the run. Now in the luteal phase, the yang is ra rising relatively rapidly and it’s warming the uterus needs to warm the uterus to prepare for that implantation.
Of the egg, of the follicle, right? The qi moves during this phase, so it’s important to both invigorate qi and blood. Now, what are the differences between western medicine viewpoints and Chinese medicine viewpoints when we’re talking specifically about fertility? In western medicine, we are looking at that endocrine function.
We are looking at the Hypothalamus, GNRH, and those feedback loops into the anterior pituitary and then those feedback loops to the reproductive organs. We’re looking at hormone balance. We are looking, hopefully, at organ function. And then we are looking predominantly at egg function. Quantity and sperm quantity and many of the interventions that western medical fertility doctors provide are to specifically increase quantity of egg and quantity of sperm.
This is a mechanical approach and it is a numbers game. If you’ve worked with clients for fertility, you are commonly seeing labs being run and they’ll look at the numbers being measured. A huge part of this. In Eastern medicine, we have a different viewpoint. We are looking at patterns. We’re looking at that yin and yang balance.
We’re looking at excess and deficiency. We’re looking at heat and cold. We’re looking at interior and exterior factors, right? We’re also looking at system function within the collaboration of the elements and the meridians. Then finally, we start to look at the systems in more specific ways. So we’re looking at the kidney water, the tian gui.
We’re looking at the liver blood. We’re looking through a cumulative and holistic lens. At the whole body and the patterns of the whole body, the entire symptom profile, the entire presentation of the client on the level of body, mind, spirit, and emotions is part of what we’re looking at when we’re trying to establish fertility.
We’re looking at the quality of the foods and the quality of the prenatal gene. So there are some significant differences here. Again, when the two are combined, is the collaboration going to be a unique solution to creating fertility in our modern world? And I think there’s a lot to be said for that. I think that collaboration is the key.
If, and here’s the if we don’t start talking to and educating our clients and our children as a collaborative, not just as acupuncturists, as a collaborative sooner about how they’re taking care of their bodies, what’s happening in their bodies, helping them to understand their own menstrual cycle and their own fertility.
If we are building health before the age of 14, before menstruation even arrives, before the maturation of sperm arrives, then isn’t fertility going to be easier in the first place? I don’t know, just a thought I have. Okay, so our unique perspective in Chinese medicine. The TCM approach to infertility treatment integrates the menstrual cycle as a simple, non invasive, sensitive, motivational, diagnostic tool to understanding a woman’s fertility status.
So that’s the nature that I talk about. It’s the nature of the body is what guides us to determine fertility, which is really about overall health in the system. Let’s chat here about the pelvic floor and fertility. While the pelvic floor And there’s a few studies that indicate this. While the pelvic floor is not likely a cause of infertility, there are seriously a few factors to consider.
One is that if there is pain in the pelvis and tension in the pelvis, One may be less willing to engage in sexual intercourse because of that pain and dysfunction. That pain or dysfunction may put them into strange body positions throughout the day, throughout, their life, but also throughout intercourse.
So again, that can really limit sexual intercourse. the ability for the body to conceive. If there’s pelvic floor dysfunction and dysfunction, I left it broad here because we could think about pelvic floor dysfunction as incontinence for example of bowel or bladder. If someone is experiencing incontinence, it’s going to be very difficult for them to be comfortable with engagement in intercourse, which can make it very difficult to conceive, right?
So there’s an indirect implication of how the pelvic floor can impact fertility here. But now we get a little bit deeper. If there’s congestion or there’s emptiness within the pelvic bowl, I think that can directly impact. Conception, right? There’s blood, which could be stagnation. It could be that the blood is not holding.
It could be that the blood has no motility. If the blood is, if the tiangui, or the blood itself, has stagnation, it’s not holding, or there’s no motility, I think it’s going to be very difficult for one to conceive. If there’s dampness or dryness, again, those fluids are not moving the way that they need to.
And if the fluids are not of high quality and they’re not moving the way that they need to then that can create potentially a block with pelvic floor which can impact fertility. There can be some physiological blocks as well such as accumulations like fibroids, endometriosis, we can have prolapses, there can be Altered spinal segment positioning, or SI joint positioning, and certainly these physiological blocks can also prevent one from being comfortable in the phase of connecting to themselves, connecting to what’s happening in their body, and being open to conception.
When we are in pain, and maybe this is a great research study, I hadn’t thought about that until now. When we are in pain. We are releasing different hormones, right? We are releasing a different set of hormones. So does the body have enough energy to then be at peak while it’s releasing peak reproductive hormone release while it’s working through the release of substance P?
I don’t know. That’s a good one. Injuries to the pelvic bowl are going to be another region. If there’s a trauma, if someone had a fracture, a ski accident, something like that car accident that impacted the pelvis in some way, or the sacrum in some way, that can definitely be a factor that’s going to at least contribute to fertility.
And then of course, energetic blocks. I think energetic blocks are definitely a contribution to fertility and many of those exist within the pelvic floor because the pelvic floor has many sinew connections. It has all of the meridians, most of the meridians running through it. The conception vessel and the governing vessel, which if the CVGV is blocked in general, I think it’s very hard to achieve conception through that state.
And I’ve really found that in my practice. And then finally, the spirit or the emotions. The pelvis is the root of the body. If the root of the body is holding emotions of trauma again, do we have enough energy to then conceive within the body? What does it take? So there’s a couple of studies out there that are sorting, starting to touch upon a connection directly between the pelvic floor, and fertility.
So in this study in BMC Women’s Health in 2024, this is like one of my favorite studies because it’s the first one that really starts to investigate this relationship. So this study for the first time investigates the causal relationship between reproductive factors and pelvic floor dysfunction.
The results suggested a causal relationship between some reproductive factors, but there were significant differences between female genital prolapse and stress urinary incontinence. So we’re starting to see that these physiological factors are impacting reproduction. In another study in alternative therapy health medicine in 2015, there were 13 192 female participants treated in a clinic between 2002 and 2011.
So this was almost a 10 year study, which is pretty amazing. And they had various diagnoses of infertility, including blockages of occluded fallopian tubes, hormone dysfunction, endometriosis. And some of the women were actually going to the hospital. through IVF. So the study was not specific. It was very general.
So we have to keep that in mind as we look at the results. In the intervention in this case, the clients underwent whole body patient centered treatments using protocols of manual PT which focused on restoring the Mobility and motility of the structures that affect the reproductive system. So specifically they worked on those concomitant tissues around the pelvis including, the back, the gluteals, the abdomen, etc.
The manual therapy represented an effective, conservative treatment for women diagnosed as infertile due to mechanical causes, independent of specific etiology. This is another big, important study. Basically, it’s saying that with a very minimally invasive approach, utilizing manual therapy, and no other interventions, utilizing manual therapy, we can impact what’s happening in the structure of the body, which can positively impact fertility.
So that’s an important correlation to consider. But is there some missing data? And I think there is. Unfortunately, there are really no data. Just few studies that link the pelvic floor to fertility, and until this one in 2024, there were almost none that were done on fertility as a whole. Some on interventions, specifically like PT or exercise or acupuncture, but none in direct connection between what is that correlation of pelvic floor dysfunction and fertility or infertility, right?
I think there are some questions. What types of pelvic floor dysfunction are correlated with infertility? What percentage of both males and females with pelvic floor dysfunction are also struggling with their fertility? Does a weak pelvic floor contribute to miscarriage? Likewise, does a tight pelvic floor contribute to miscarriage?
So is pelvic floor muscular dysfunction going to be contributing to one’s ability to hold conception? And are there specific gestational stages during miscarriage that are more likely to be associated with pelvic floor issues? I think these are important parts when we look at fertility and the pelvic floor as a whole.
So what can we do? Here are some pillars of pelvic patency, keeping the pelvic floor in an optimal state of nourishment and function. One is client education, and that is all encompassing. That can include helping the client to understand their body, to understand a little bit about what’s happening to their body.
During the phases of menstruation to help male clients understand what is happening physiologically during ejaculation, educating our clients on conception is really important. This is something that is missing in their childhood, but if they’re coming to see us in their fertile ages and they’re trying to conceive, this is the first line that we can start with is education.
We can also begin to educate them on patterns that we see within their body. If they are drinking smoothies and eating salads every day and they have a cold and damp uterus that’s a contributing factor, right? We understand those patterns. So helping the client to understand the patterns that are going on in their body and alter their nutrition or other factors, lifestyle factors, to help their body, give their body the optimal chance of success.
For healing, that’s a great way to start. Can also begin to educate our clients on posture as well. If we’re talking about mechanical issues within the pelvis that lead to pelvic floor dysfunction, educating clients on posture. And this could be as simple as if they have a desk job that every 20 minutes they stand up Do a little stretch and then sit back down right so that they can be in a place where their spine load is changed and they’re not stuck in a sitting position.
That anterior posterior tilt of the pelvis that they’re stuck sitting in is going to contribute to what’s happening within the pelvic bowl. Breathing. Breathing is so important. Encouraging our clients to get into the diaphragm with their breath, to take intentional breathing, to take intentional breaths is super duper important for the vagus nerve.
And the vagus nerve has fibers that go all the way down. to the pelvic floor. So it’s really important to work in breathing. And the pelvic breath is specific to recognizing that so often when our clients are experiencing leakage in particular, generally speaking, this is true as well. But if we think about leakage as our example, If they’re having leakage, very often it’s on the exhale.
So they are sneezing, coughing, or laughing, and then that produces leakage. Those are in exhale, right? So the pelvic floor is actually functioning in that state, in the reverse pattern of what we want. On the exhale, we want the abdomen, we know this if we’re yogis or therapists in general, we want the abdomen to be coming in.
We also want the pelvic floor to be coming in and out on the exhale. That’s the excretion of air. That’s sending the air into the world, right? That’s the excretion. On the inhale, we want to fill and we want to relax the abdomen. We want to relax the pelvic floor. So encouraging our clients to understand the pelvic breath is very important.
Finally, movement. Movement of qi and blood is particularly important to the health of the pelvis, right? Staying out of phases of stagnation is key and also encouraging our clients to move according to their cycles is really important. At the beginning of one cycle during, the menstrual bleeding phase, the tian gui release phase, it’s important to consider that clients might be a little bit more tired.
They’re not going to be at their peak of exercise during ovulation. They might feel great. They might feel like they can handle more exercise, more weight in the gym, a longer endurance activity, whatever it might be. And that’s okay. And it’s important for them to understand that their body feels different throughout these phases.
And that’s okay. as long as they find some way to move their body. Acupuncture. We are master technicians at working through patterns and helping to resolve the pain. imbalances. So acupuncture can really support our clients in treating those sinews, in opening blocks, and in nourishing the reproductive system in the exact way that it needs based on that presentation.
And of course, dissolving Accumulations is key too. And finally, if you’re into manual therapy, which I am, I love manual therapy. It’s a big part of my practice. Utilizing that manual therapy to help restore balance and establish embodiment. And this, if you’re not trained in pelvic floor work, it doesn’t have to be specific to the pelvic floor.
It can be within those concomitant structures. Don’t downplay working on the abdomen, working on the back, working on the butt, working on the anterior hips. in order to support our clients going through fertility.
Okay, so here’s a little bit about my series with the AAC, the American Acupuncture Council. If you’ve seen me before, you’ve probably seen my pelvic floor intro, as well as my pelvic floor and menstruation workshop coming up soon. We have a workshop on pregnancy. on postpartum and on menopause all in relation to the pelvic floor.
Again, I want to thank you for being with me today and I want to thank the AAC, the American Acupuncture Council, for hosting me through this series and sharing these blogs so that acupuncturists around the globe can get into the sacred medicine of the pelvis. Thank you so much for being with me and I really look forward To seeing you soon, take care.
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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Greetings, my friends, members of the network, and all of you. It’s Sam Collins, your coding and billing expert for acupuncture, really, and for you in the profession. I always want to make sure you’re successful, because quite frankly, you’re not. We have a vested interest as a company. The American Acupuncture Council not only does malpractice and all that, but we do continuing education and do services to support you because we’ve learned.
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If you’re not well supported and it’s successful, you don’t need what we’re selling. So we want to make sure that we’re symbiotic. I want to begin starting for next year, getting to be proactive. So let’s go to these slides. Let’s talk about what do we need to do for 2025. And I’m saying it’s going to be proactive 2025.
And the reason I’m indicating that it’s got to be proactive is because too often acupuncturists are simply reactive. Something happened. What we’re going to do as a network director, if you will, I get a lot of information well before often you may see it. So one of the things I would encourage you to do is always be around AAC network to know what’s happening, what’s changing.
So let’s talk about what’s going to change for next year, but how do we really become proactive to keep our practices successful and the things you want to do with that in mind, what I want you to think, start to think of is for 2025, what is going to be my practice success? How am I defining it? What does that mean?
Is it a certain number of patients I want to help? Is it a certain monetary figure I want to hit? Is it going to be getting to just simply more people? There’s lots of ways to define it. I don’t want it to always be about money, but part of me says that. I’ve learned that you really have to make sure that this is a business.
And you do have to have a business mindset. Certainly you want to care for your patients. That’s primary, but there’s got to be payment for it. My goodness, everyone can treat someone. But what if you’re not getting paid for it? How do you continue doing that? So I want you to think of how do you define your success?
What does that really mean? And when you get there, tell me what you start to realize are some of the barriers if you look at how did I define success last year? Was it going to be for this coming year? What things stopped me from getting there? What are the barriers? What can I do a little bit better?
Because if you are not growing even a little bit, your practice is failing. Because if you grow a little bit, you’re just keeping your head above water. You have to grow just to keep your head above water. Remember economy, 3%, 4%. If we’re saying inflation may be higher, so you’ve got to probably do at least 5 percent better just to be at where you were this past year.
In fact, I’ll say maybe you’re sinking a little bit. So what are these barriers? How are people coming to the office? Is the barrier one that people just are getting to you? Is the barrier because people can’t afford it? There’s all types of things, but you want us to think of how do I. One of the barriers I think often is people are not sure what you do.
So have you created something that people know if they looked at your office, what you actually treat? Too often acupuncturists will go, I do acupuncture. What does that mean to most people? Nothing. Define to them what it means for you. I can help you with headaches or sciatica or anxiety or depression or whatever it is.
Because that barrier is often they’re just not knowing. Of course, a big barrier is always going to be money. www. circlelineartschool. com So we got to start to think of how do I make sure that I create value to what I do. Notice I didn’t say cheaper. Cheaper is not always necessarily the way people choose a doctor.
I’ve never chosen a doctor because it was cheap. I’ve chosen it because I felt there was enough value. If it’s too expensive, of course, no, but be careful. Always follow something I’ve always held true. People buy. what they want and beg for what they need. You’ve got to put yourself in a portion where, yes, they need it, but they want the care.
You’ve got to make sure that you’re creating that type of value. So what is your model? Have we set up a model that where if people are looking online, they can find me? If they’re needing to, what’s my cost? Is there a way of figuring that out? Oh, that’s affordable. That seems reasonable. Are there, pay plans and things I can do?
So start to really lay down that pattern for yourself to say, how do I want to start to make this work for next year? It shouldn’t be by hook or crook. Write some things down because at the end of the day, it really makes a practice successful no matter how you think of it. Even if it isn’t money, it’s about patience.
Helping people. But when they come in, how do they come in? Are they cash patients? There’s three types. Someone pays straight cash. How about a person that gets a discount if they pay cash? Or how about you offer so called prepaid plans? That kind of modern acupuncture style where it’s Multiple visits bought at a cheaper rate.
Realize that’s one of the ways that you can help it more affordable Is by doing that. If you’ve ever attended a continuing education seminar with me, we’ve talked about that. But how about members that are with me one on one? We have a network where, as you’re a member, we can get into it. How does it work for your office?
What’s specific to your state? By example, what if you’re in Montana? We have to have a escrow account. Other states, you may not. Is there any limits? But I think it’s something that we should all explore because always I think a barrier is money. Are there some ways we can help that? I think so. One of the ways and barriers is when people have insurance, let’s face it, do people go to the doctor more often?
Here’s a good thing for all of you to do. You may sit back and say, I don’t want to take any insurance. I agree. I don’t want to take any bad insurance, but I’m not going to turn away insurance that pays me. And I think that’s where you’ve got to start to think differently. Realize and ask your friends.
How many of your friends, how about yourself, have gone to the doctor and pay cash? And then, your answer is no. But then you expect everyone else to do it. Now, I’m not saying there isn’t a part of that, but I want you to realize, when you ask most people if they’ve been to the doctor and used insurance, it’s going to be 99 percent of them saying yes.
So you want to start to think of what some of these are better. Obviously people who have the good, standard, high level insurance with small deductibles, those are great. For But those aren’t common. What about PPOs? That’s the very common one, but here’s one thing to keep in mind. A PPO, do you have to join?
By example, and I’ll give you three. UnitedHealthcare through Optum Health, Cigna through a SH, and Aetna, often used through a SH or sometimes secure, don’t require an acupuncturist to be in network to be paid. You may not be aware, but when you’re out of network on these plans, even though it’s a PPO, oh wait, preferred provider, that means they can still go where they want.
Do you know they get paid more? So before you join something, check to see whether or not it’s exclusive. Non exclusive plans, I won’t join unless somehow it’s much more attractive because can you live off of a 40 visit? Maybe you can’t. What about an HMO? That’s the ones that are strict. They only can go there.
That’s that strong ASH, but is it worth it? My general rule is an insurance has got to pay at least what would be my cash rate. And if it doesn’t, I don’t think it’s worth the work. So if you belong to these, know that, okay, I can make it work because I can be efficient. It’s difficult for acupuncturists though, because unlike a physical therapist or a chiro that can use an assistant, you can’t.
Everything that’s billed you have to do. So all of a sudden now that makes that barrier tougher. So maybe that is one you shy away from. But what about health savings accounts? How many of your patients are even aware they can use their health savings accounts in an acupuncture office? Many aren’t.
And they’re going to go, oh, I didn’t know, because you didn’t tell them. Same would apply with, have you ever thought of, could I treat people in an auto accident? Outside of Florida, you can. These are great patients, they’re hurt, need your help. It pays really well, it pays the real fee schedule. By the way, have you ever thought of working with other providers, like an M.
D.? That you become their pain management person. Do you know they’re looking for you, because what do M. D. ‘s do? They refer. What about auto cases? What about workers comp? In many cases, you can be the primary provider. Have you ever checked into people being aware that they can see you? My goodness, in California, an acupuncturist is considered a physician in the work comp world.
But how about the VA? Have you ever thought could I be part of that? Is it worth it? I think so. It doesn’t cost anything to join and you get well over a hundred dollars a visit. That sounds like a really good patient with no co pays, but have you ever ventured? And even if you belong to the VA, how do people even know you treat the VA?
You see where I’m going with that? Often people go I treat VA patients. How do I know? I drive by your offices that says acupuncture. Are you doing anything on your social media? Any way of marketing? So when someone looks up, I’m hurting and I need to, care for pain and I’m in the VA, does your name pop up?
Is there anything on your site that would direct them there? Remember how Google works. It takes information and scrubs from different sites. And if your site has that information, your name is going to come up. By the way, if you were to Google acupuncture, coding and billing seminars and programs, I’m first.
My company is first. You know why? We don’t pay for it. But we have so much data out there because we want you to be successful. So make sure people are aware. Now, what if you treat Medicaid? I’m not a big fan because it doesn’t pay well in many States pays horrible, but some areas can pay better. So it’s something that’s worth looking into.
There’s some areas in New York, quite good. What about Medicare? And you’re going, oh regular Medicare Part B, still the same thing, chronic low back pain only with MD supervision, so not great. But what about Medicare Advantage policies or plans? Now, I’ve heard some people going, I heard all the plans aren’t going to have that new or the routine acupuncture.
Not true. It’s no longer automatic. You want to start to check. I will tell you what the plans are doing. I can tell you UnitedHealthcare is still going to have routine acupuncture. The only difference. is it’s going to limit it to 30 visits per year. So it will still be available, but you do always want to check.
Does a person have that benefit? So at the end of the day, it’s about patients getting in your office. And what is it? That’s the bottom line. Have you ever thought of if I join ASH, I’m getting 40 a visit. Does it make sense to me? In many instances, it may not because I want you to start to think of what does it cost to treat a patient in your office?
Have you ever actually thought of that? What does it actually cost me? I want you to do this by taking your overhead, all your related costs. By the way, I would include your student loan payments as part of that. I really would. And then you divide that by the average patient visits you get per month.
So let’s say you add up everything your rent, your, cost for gowns, needles, and so on. And that total is 4, 000. And you see about 25 patient visits a week or 100 visits per month. That means you’re getting 40 per visit. So if that were the case, let’s think of that for a second. If I’m treating an ASH patient and it’s one of this 100, you’re making 2 for that visit.
I don’t think that’s worth it. I don’t think you could survive on that. Now, if all of a sudden you go Sam, because I’m seeing ASH patients. I can see 200 patients a month. That drops to 20. Okay. But here’s the difficulty. How do I increase it 200 or double it? Keep it in mind that most acupuncturists are treating most people for 30 minutes, sometimes more.
There’s a limit to how much you can do. So you got to be careful of devaluing your service and falling into the trap of some of these plans by looking at really what you’re getting. Now, if you told me, Hey, Sam, I joined because I get 10 extra patients per month. Which means, Hey, I’m getting, 10 visits.
Maybe that’s going to be about four or 500 extra or more. Okay. I like that. It can’t be the bulk though. It’s got to be a value add, like taking up a spot that wasn’t already filled, but I’m not going to trade a high paying patient for a lower paying patient. So you really got to start to look at doing a fee schedule review.
This is 2025 proactive. When was the last time you made an increase in your rates or for that matter, have you ever looked at. Having your rates make sense. Understanding what is the actual value. What is the cost in my area? What resources do you have to figure out what is in my zip code? This is what I do for my network members.
Members of the American Acupuncture Council network service directly with me. It’s one of the things we do. We do a fee schedule review and we talk about, let’s talk about what’s going on in your zip code. I don’t care what your friends charge. Because they probably don’t know what they’re doing either.
I want to look at real charges. I want to start to look at what we call relative values to understand true fees. Because I find often acupuncturists devalue probably three quarters of the services they bill just getting less money. Because I want you to think of when was the last time an insurance company raised rates they allowed?
ASH has it in years, but what about other plans? I don’t think it’s so much worrying about how much have they raised. Some don’t, and it may stay stagnant for a while. But how many of you are aware that you’re billing below what they allow? I’ve seen this happen. An office bills something for 30.
The plan allows 50. Now, if you call them and say, do you allow 50? They won’t tell you, but there’s ways of figuring that out. But anyway, if you bill 30 and they allow 50, what are they going to pay you? 30. So I’d like you to start to take a look at understanding relative values. Have you ever reviewed your rates based on that?
This is federal government. This is not made up. This is what a service costs based on something else. So what you can do is start to tell me what some one thing cost and i’ll tell you what other things would cost based on the relative price of that one. So by example, this is how you would use relative values.
Let’s say by example, you said, Hey, Sam, I charged 60 for a 9 you know, for a set of acupuncture manual. Great. I’d say that’s fair. Is that very high? No, that’s probably about 170 percent of Medicare, give or take. So needless to say, if I charge 60 for that, what’s going to be my fee for my second set, third set?
Or what about other therapies? And this is where I find a lot of discrepancy. Okay. I’ve seen people charge the same amount for first and second set. Makes no sense. The additional set should be 50%, 15%, or excuse me, 30 percent lower than the primary set. So let’s give this example. If I bill 60 and insurance pays me 60 for the first and the second, you know what this tells me?
I’ve way undervalued the primary. Because if you bill below, they pay it to you. But if you bill above, they’ll reduce. So by example, let’s use this. If I take 60 as my fee. And again, this is if you’re saying, Hey, Sam, I know 60 is fair. It’s what I charge. Good. Let’s base everything on that. The value of a 97810 is 1.
15 relative value. So I take 60 divide by its relative value and it gives me 52. 17. Now this multiplier is what insurances do. And they take that number. And then they multiply it by the RVU of every other code. So by example, to give you a way to look at this, Medicare allows about 33 to 37, depending on your region for this.
So what we’re going to do is take 5217 multiplied by the RVU of the additional set of 0. 85 gives me 44. So notice 60. And then I would round this up, by the way, make it 45. But you’ll notice, oh yeah, Sam, that is about 30 percent different. In fact, it’s exactly 30 percent different. But here’s where I find it’s often the biggest misnomer.
Notice the exam price. Relative value is 1. 15 for 97810. Notice the relative value for 97, or excuse me, 99203, new patient mid level exam, 3. 35. Will we all agree that’s approximately three times the rate? Not quite, but close. So if it’s three times the rate, notice it’s 60 here, 174 here. Notice three times the rate.
I can’t tell you, at an office last week, that was charging 75 for this. That literally meant, yeah, you’re losing 100 when it comes to this. What about things like massage? Massage actually has a higher value than does an additional set. Not by much, but notice the value is 0. 91. So that means massage is 47 compared to the additional set of 44.
Please make your fee schedule make sense. If you’re a network member with me, it’s time to get ahold of me. Let’s do our one on one Zoom. It’s part of your service. Let’s take care of that because you weigh under value. If you’re not a member, it may be time to join and start to go, wow, I’ve really messed this up.
And I find that to be often true. Start to really look at a fee. Now, I’m not going to be against you saying, Sam, I chose this fee for a specific, if you’ve got a reason, of course, but is the reason when that’s bad business. Remember, there’s a time for you to put your business on Shark Tank. Is this really viable?
Here’s an unfortunate statistic for a lot of acupuncturists. Generally, close to 50 percent of acupuncturists within five years of graduation no longer practice. Now, I don’t think it’s for lack of understanding the business of acupuncture as far as how to treat someone, but not how to make a business out of it and create value.
Some people do that really well. My goal for any acupuncturist, by your third or fourth year of practice, you better be making 250, 000. You’re going to go, Oh, that’s not that complicated. If you start to understand where patient values are. So I want you to do these things for 2025. Please take a look at any plan changes of anything that you normally have billed out.
Start looking now. Don’t wait. Start to look now. A lot of things can be done online. What’s changing? As I mentioned, a lot of people said, I heard there’s change to the Part C plans. Please read more. Please make sure, make your patients aware that if the existing plan they have doesn’t have it, there’s probably choices for them to have a new one help them do that.
Realize that time is coming up. December, I believe, 7th is the last day for them to change, so make sure your patients are made aware. What about deductibles for next year? I know Medicare is going up to 254, and you’ll say big deal. But that means other plans may do that, but keep in mind, what about deductibles?
Sometimes deductibles, if the patient has used their insurance in the last three months, That may fall into the next year. What about Assignment of Benefits? Many of you have contacted me saying, Hey Sam, I had an Assignment of Benefits thing came from OptumHealth and TriWest regarding my VA patients.
What is an Assignment of Benefits? I don’t understand. Or they’ll use the term AOB. The Assignment of Benefits is something that you need to have current on file. It’s what directs the insurance company to pay us. It’s block 13 of the 1500 where it says please pay the undersigned provider of services. By doing that, you get the check.
If the patient’s already paid you in full, leave it blank. Why I’m bringing this up is that VA wants a new one every year. So get in the habit, new year starts, patients sign a new form. That way there’s no confusion. They understand, yes, payment’s coming to you. They should, of course, because they’re not paying directly.
But that applies, I think, to other consent forms. I know you may have had the patient sign a consent to treat, but what if it’s two years ago, a year ago, and it’s a new plan of care? Have them sign a new one. Don’t leave any risk there by not having a patient saying I didn’t sign a current one. Have it re signed for the new year.
Same would apply with financial agreements. When the new year comes, make sure people know, here’s what the cost is, here’s how we plan to do it, and here’s what we do. If you want to, we also offer a prepay plan. Or we offer some other type of discount for time of service. It’s not very large, but something that can be there.
Make sure patients are aware because that’s the barrier. What does it cost? How about credit card fees? Have you reviewed that? Look at your credit card fees. They’re often higher than people realize. Now, what can we do about that? It’s part of doing business. However, businesses are allowed. to disclose there’s going to be an additional fee for use of a credit card.
You just have to do it before you do it and tell the patient, if you choose to pay with a credit card, there’s an additional 3, 4, 5, whatever the fee you charge. That fee can’t be based upon the amount of purchase, by the way, but it simply comes down to a credit card transaction fee. I think that makes sense.
And of course, the other thing, please review your fee schedules. I’m going to suggest you may want to do it with an expert like me, but at least do it with some level of semblance of information. Realize in many states, what they’ll do is they look at the Medicare fee schedule, which by the way, will update in early 2025.
By the way, network members get in touch with me. I’ll keep you updated there. And start to look at a percentage of that. Realize that many major health insurances, such as Anthem, use 1. 75 of Medicare. And I will guarantee most of you, you might have one or two services, 1. 75 of Medicare, the rest are probably not.
So keep in mind, often I find for offices, they’re losing 10, 20, maybe 40 a visit by not understanding the value. Now you might say Sam, I belong to this plan and they cut the fee. I get that. But that’s something you signed up for. And that’s what I want you to start to think of in that review. Is it worth it?
Realize the American Acupuncture Council is here to help. This is our website, our phone number. We’re the resource to help you get paid and understand the coding and billing. We do lots of courses for continuing education and network members get those for free. So I’m going to suggest let’s make a good 2025 by having a proactive plan.
I hope to see you all soon. Take care of my friends.
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Today I am going to be doing part two of a two part lecture. on how to choose safe and effective cosmetic tools for your treatment space. So last time I did an overview of some tools and I went through some safety.
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. I am an acupuncture physician and I teach facial and cosmetic acupuncture classes internationally. Before I get started with today’s lecture, I wanted to talk really quickly about book that I’ve just written and the name of the book is Treating the Face and it is a 500 page hardcover book with over 350 color illustrations all about treating the face Everything from neurological conditions to some five element and also cosmetic.
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So, if you can go to the first slide.
Today I am going to be doing part two of a two part lecture. on how to choose safe and effective cosmetic tools for your treatment space. So last time I did an overview of some tools and I went through some safety. And today I am going to talk about some Practical considerations, things like ease of use and functionality, how to match tools to different skin types, and then how to set treatment goals, and also how to integrate different technologies using these different tools into your treatment space in order to get the best results.
So the first thing I’m going to talk about are microneedle pens. And I have a microneedle pen here. And the microneedle pens when you’re thinking about ease of use microneedle pens are great. They typically you want to look for ones that have both a, like a Battery that you can use or a plug that you can use.
And also you want to be able to adjust the depth of the needles. So you might wanna go to me for this. So these needle cartridges click on and then there is a little adjustment ring here where you can adjust. The depth, these numbers signify the depth of the needles on the, how deep the needles will go.
And then on this particular model, this is an AccuLift micro pen. On this one, the This end shows you how fast. It says number four. Sorry, trying to catch the light here. You just adjust, you push the, whoops, this way, you push the button on the top, and then it lets you know how fast The needles are going up and down.
You can go back to the slides. So you want a pen that has an easy to use dial for your depth adjustment. And that way, when you’re working in different areas of the face, neck, chest, hands, back any parts of the body. You can adjust the needle depth and then having it either recorded or cordless gives you some versatility and lightweight pens.
If you’re doing a lot of microneedling, you don’t want something that’s too heavy in your hand and a really simple cartridge adjustment. So the needle cartridge, you should be able to click it in, snap it on and make sure that it’s something that will stay securely attached. And replacement parts should be easy to get as well.
Just like with any. electronic device batteries can wear out on these over time, over years, and being able to get replacement batteries, cords, things of that nature is very helpful. So derma rollers, you can go to me again. This is a derma roller and they have this head. You want to get one with a smaller head that’ll fit in smaller areas.
And I like the ones that have needles that are shaped like little pyramids. They tend to not bend as easily. And these are actually integrated right into the head of the Dermaroller. And the handle has a design that makes it easy and comfortable to grip, to get a good grip on it and to hold in your hand.
And these have 540 microneedles on them, and they come in different lengths. These are also made by AccuLift. You want to make sure that any microneedle device that you have comes in a nice case to keep it clean, and that it’s protected. Pre sterilized. You can go back to the slide. The nice thing about derma rollers is they perform a lot of the same functions as a microneedle pen, but they don’t require any batteries.
You just take it out of its case and you don’t require any numbing cream. You just roll it on the face and you can rinse it after you use it. They are for single person use. But you can use them over and over again, and then you can sanitize them once a week just to make sure there’s no bacteria or anything on them.
Go to the next slide. Let’s see. I can do that. Hydra needles and Hydra rollers are very similar. Can you go back to me again? And these are great because, so this is a hydra needle, you can see, let me see if I can get those needles up here, tiny little needles right in the tip. and it has a plunger and when the plunger is depressed, serum comes out of this glass vial.
So you press it on the skin and it’s infused into the skin, whereas the HydroRoller, which is very similar, has these gold needles on it also, but this one you roll onto the skin. So these are great. They’re very versatile. You can build them. They cap, keep the contents from evaporating and you can travel with them, which is really nice.
Okay, go back to the slide. Just make certain whichever products you choose have steps and instructions. And again they don’t require a lot of pressure. The needles are very short. And they travel well.
Facial cupping sets are also wonderful. Oh, I’m using mine to hold my computer up. Hold on one second. Let me let me grab the cups. This is funny. I’m just gonna grab these out. And so this particular set comes with two cups. of two different sizes and two, so two cups and a large one and a smaller one and then two jade gua sha tools and the facial cups are really I like the ones that are glass and They’re easy to use.
They’re easy to clean because they’re glass. They glide well. And so these are things you want to look for. Also, they should be easy to squeeze. You don’t want to get facial cups that are too stiff or too hard to squeeze. And these smaller glass cups fit well on the face. With the Gua Sha tools jade is certainly preferable to a lot of times they’ll be plastic or synthetic or I’ve even seen metal ones.
Really not designed to be used on the face. They can cause injury. You don’t want to cause any redness. or Payne when you’re working on the face. You don’t want to leave any cupping marks when you’re working with the cups and that’s where the glass is really unique because it will collide and it will work well.
You can go back to the slide. Instructions are important. The the set that I used has instructions in the box and on the box and it really makes it wonderful because you can refer to it yourself and you can also sell them to your patients and they can do some self care at home, which is nice.
So the shape you can see here in the slide, the shape of these Gua Sha tools is very versatile, has notches for around the jawline. These flat sides work underneath the jaw, around the temporalis, across the forehead. And then these rounded edges are really nice for stimulating acupuncture points, for massaging the temples, and for working in between the eyebrows.
And Fosha is wonderful for releasing any fascial adhesions, stimulating blood flow, really getting that Qi moving into the face, and it’s very calming and relaxing at the end of a treatment.
Red light devices tend to come in two general categories. There are the tabletop ones which are nice. You can easily just move them from room to room and they typically have an easy setup. They’re lightweight, easy to store, Get them out of the way. They do have some limitations though over the floor models.
Of course, the floor models, you can easily move them all around a patient and depending on the size of your treatment room would determine whether or not it makes sense for you to have one of these. They Usually are the same power. They come in different powers. Some of them will go as far as a pain setting.
Some of them are really just for cosmetic. But when you’re looking, you want to get one that has really simple controls, a built in timer, that has an automatic shutoff. So if you can’t get back in the room to shut the lamp off, it’ll shut itself off and it should come with some sort of eye protection. So microneedle pens are best for really aging skin deeper scars, discoloration, also for fine lines.
They’re good for normal skin combination oily skin. You certainly don’t want to use it over any inflamed or pustule acne, a very sensitive skin, and it’s great for stimulating collagen in the long term. Dermarollers are better for not quite as severe signs of aging, home maintenance, and again, if someone has very sensitive skin, they’re probably not the best choice.
You don’t want to use them over active acne as well. And that’s it. So more advanced signs of aging, the micro and scarring microneedle pens, derma rollers for less. The hydro rollers are like the hydro roller and hydro needle. are just like a dermaroller, but they will infuse serum right into the skin, and again, you don’t want to use those with very sensitive skin.
So the HydroRoller, you can work quickly over a larger area, whereas with the HydroNeedle, it’s better for spot treatments. fine lines, dark spots just little areas. You certainly can use it all over. And it’s, you can actually take a hydroneedle and put, if you have a hair loss product that you’re using, you can put it right into the hydroneedle and use it for that.
Facial cups are great for puffiness, tension contouring the face. Pretty good with any skin type, but you want to stay away from any broken capitals. capillaries, or any active raised, inflamed, or pustule skin conditions, really good for enhancing the circulation, lymphatic drainage, and giving that healthy glow.
The facial gua sha tools will help with any tension in the face. Relaxes your patient, improves the skin texture, and it’s pretty much good for any skin type, except for any active wounds or infections. The red light device is wonderful for almost every type of skin, anti aging, redness, acne, and the only, there are some contraindications if someone is on a medication that’s sensitive to the light.
And you can use it with some of the other tools, but I don’t usually recommend using red light before or after microneedling just because I like the skin, unless you’re using just the white light, the blue light to clear the bacteria.
So for microneedle pens, you want to optimize your results. You want to clean the skin, disinfect the skin, adjust, adjust the depth of the needles, use good high quality serums, keep the speed and the movement consistent, and then the cartridges. have got to be discarded in your sharps container every time.
For the microneedle derma rollers, you want to choose the right length for your patient’s particular skin. You can either, this should say or before or after, but you can either use the serum before or after. I guess you could do both, but If you put serum on first and then you roll, you’re really going to have to be diligent about cleaning that roller and make sure that when you’re rolling, you work in multiple directions, gentle, consistent pressure, and you’re going to be replacing those rollers about every three as much as six months, depending on how often you use them.
And with the HydroRollers and the HydroNeedles, you’re going to want to use good quality serum and pretty much the same as a DermaRollers. You’re going to work in sections. You don’t want to press too hard. And if you’re doing a deeper treatment, you don’t want to treat more than every two to four weeks weeks.
The same thing with the hydroneedles, and you do want to keep them clean. You clean the head of the device after you use it. With the cups, make sure you’re using a high quality oil and Be careful not to use too much suction. You’re going to follow the lymphatic system and you can do cupping as much as three times a week and you want to choose the right cup size for the person’s face.
With the gua sha tools, again, make sure there’s Good high quality oil and use proper techniques. You’re going to be doing more of an upward and outward movement and you can work on different acupuncture points. I always tell my students you can go for the Gua but not the Sha. And red light devices, you’re going to choose the right wavelength depending on your patient, make sure their skin doesn’t have any product on it, and you can use it as three to five times a week, um, for the best effectiveness.
Bringing these, this all together you really want to tailor combinations of treatments. Depending on your patient you can layer your treatments. So you could do some dermarolling and then some red light. What I do is I sit down with my patient and I am going to adjust my treatment plan depending on their needs.
I might do acupuncture and put the red light over it. I always do. cupping and gua sha after a facial acupuncture treatment. And I educate my patient about what it is I’m going to be doing and A lot of these tools, not the microneedle pen, a lot of these other tools you can sell to your patients for at home care in between treatments and make sure that you take before pictures and really track their care.
progress, speak to them about their goals ahead of time, and then check in with them and see how they’re doing. Again, my name is Michelle Gellis. If you would like to reach me, you can go to my website. FacialAcupunctureClasses. com. You can learn about my classes and any of the products that I spoke about today.
And you can also find me on social media under my name. And I want to thank the American Acupuncture Council for this opportunity today.
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