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Facial Cupping & GuaSha for Cosmetic and Neuromuscular Concerns

And I would like to thank the American Acupuncture Council for this opportunity to speak to you today about facial cupping and GuaSha for neuromuscular facial conditions.

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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.

Hi, my name’s Michelle Gellis and I am a board certified acupuncture physician. And I would like to thank the American Acupuncture Council for this opportunity to speak to you today about facial cupping and GuaSha for neuromuscular facial conditions. Can you go to the first slide please?

So a little bit about me. I am a former faculty member and clinic supervisor at the Maryland University of Integrative Health, and I was there for almost 20 years. And I’m currently on faculty, on the doctoral faculty at Yoan University in Los Angeles, California. And I teach facial and cosmetic

Acupuncture continuing education classes and have been for almost 20 years as well. So the, I wanna start out today by giving a definition for a neuromuscular facial condition. So what a neuromuscular facial condition refers. To is any group of disorders that affects the nerves and the muscles that are responsible for moving the face, our facial expressions, and also any sort of pain or neuropathy, any sort of dysfunction or abnormality that affects the neuromuscular system.

Which involves the communication between the facial nerves and the muscles that control the face. And our face is the only place on our body where the. Muscles are directly connected to the skin and as a result, we can move the skin on our face without having to move a joint or any other part of the body.

And this brings with it some very unique . Issues such as particular conditions, which can affect either one or both sides of our face and some of the more common . Common neuromuscular facial conditions that I’ve seen in my practice over the years are Bell’s Palsy and also any sort of facial nerve paralysis.

You’ll see this frequently, people who’ve had facial surgery or an injury, myasthenia gravis, which is a degenerative condition. Involving the muscles and it is almost always noticeable on the face as well. Hemi facial spasm, which is any sort of twitching or spasming of part of the face, T M J, which involves the temporal mandibular joint.

Trigeminal neuralgia, which is a very painful neurological condition involving the trigeminal nerve and posis, which when we’re talking about the face, typically involves one or both of the eyelids. So today I’m not going to go into depth about . Different modalities for treating these diseases or about the diseases themselves.

But I am going to talk about facial cupping and gua and how and why these two modalities can be a wonderful compliment to other . Things that you might be doing, your body points, perhaps some facial motor points, submuscular needling, scalp acupuncture, things that you might be doing to help the face to get back to normal functioning.

So here is just a couple of photos from some of my classes me teaching facial gu Shaw and facial cupping. So first I’m gonna talk about facial cupping and the benefits of facial cupping. Facial cupping helps to bring blood just like . Cupping on the body helps to bring blood and cheese circulation to the muscles.

Facial cupping helps to bring blood and cheese circulation to the muscles and therefore to the skin, which means that when the extra blood circulation comes up to the skin, it . Increases the fibroblast activity, and this will stimulate collagen and elastin production. So this is more of a cosmetic benefit.

I. But having that extra collagen can be beneficial. Also, if someone has had long-term paralysis and they’ve lost collagen in their skin and their wrinkling of the skin, doing the cupping can help with that. It also relaxes any tight fascial. . Fascia fascial tissue that is on the face. And by releasing and relaxing the fascia, the face can move more smoothly and function better.

Facial cupping and gua can release nerves that have become entrapped on the face sometimes. . Wi woven within the nerve, the muscle sometimes within the fascia. Cupping helps to move stagnant lymph out of the face, which can take toxins with it and helps the. Reduce inflammation, which can help the nervous system of the face.

It also helps with inflammation on the exterior of the skin. If your patient has redness, heat signs, rosacea, eczema can help with that. And also, just like with any cupping that you would do on a patient facial cupping helps to strengthen the vascular integrity of the face.

So this is a cross section of the cheek. And you can see here we have the skin and then some subcutaneous fat. And then below that is this . S what is called the SMA layer. It is the superficial muscular aporetic system, and this mimetic muscle helps to get the signals from the nerve into the muscle, out to the skin, and it is what allows the skin on our face to move below that.

We have and it’s invested in various tissue and surrounded by fat, and then below that we have a facial nerve. Then in some areas of the face, on the fattier parts of the face, we’re gonna have more fat and then more muscle. This is a picture of a fass of fascia. If you’ve ever taken let’s say chicken and you’ve pulled it apart, that really tough fibrous stuff that you have to cut with a scissor to get the meat off of.

That is fascia and what can happen, especially if there’s paralysis. But sometimes just with aging, the fascia can become very stiff. It can get moved into a place where it really shouldn’t be. It can pull down and . Nerves can get trapped in there by doing facial cupping and facial guha. You can help to break up some of these adhesions and allow for more free movement in the face.

The cups, when you’re doing facial cupping there’s certainly a lot of options for cups out there. The ones that I like are glass cups. They’re much smaller. You could see the size. I use these two sizes depending on where I’m working on the face. But the cups are . Glass. And the reason why I like glass over silicone or any of the other materials, plastic is one of the most important things when you’re doing cupping, is that the cups can glide.

You don’t wanna leave marks on the person’s face. You don’t wanna leave cupping marks. So it’s not like cupping other places in the body where the person is gonna be left with cupping marks. The cups have gotta be able to move and they have to be able to grab enough of the tissue to make a difference.

So they have to be large enough to actually get in there and get that blood and tissue moving, but not so big that they’re too big for the face. So these are the two sizes that I like. And then the rubber part of these . Cups. It fits well in a hand and is easy to squeeze if you’re doing a lot of facial cupping during the day.

If the cup is too hard to squeeze, then it could be very difficult. Your hands can get sore and no one wants an acupuncturist with sore hands, . The Guha tools that I like are made out of Jade and they have different edges on ’em. And when I talk about Guha in a second, I’ll go over that, but there’s like a use shaped section.

There’s a little nobby section on the tops, and then the sides are flat for working on other parts of the face. , there are some contraindications with facial cupping and gua. You do wanna be cautious if your patient has very high blood pressure that’s not controlled well. It can bring a lot of blood and she and energy up to the face and the head.

If the person is on anticoagulants or just has a condition where they. Bruise easily. This could be an issue because even though you’re trying not to make any marks on the face, I. When you’re dealing with the face, the skin is thinner, the tissues are more delicate, the vessels are thinner and more delicate.

So this is something you need to note. If the patient suffers from frequent severe migraines, then facial cupping and gu. Again, brings a lot of energy up to the face and head. It can be an issue if they have a pustule acne. You don’t wanna be running the cups over that. If they’ve had any sort, I. Of treatment done on their face, microdermabrasion, lace, or Botox fillers.

This is a big conversation and I go through, in, in my classes, I go through all the contraindications and all the different types of fillers, but basically in a nutshell, for the purposes of today, if they’ve had any sort of treatment done on their face. , their skin and their face has to be healed.

And in order for you to start doing cupping and you never wanna do cupping over an area where there’s been a neurotoxin like Botox ’cause it can make it wear off or move it. The, for facial herpes, I have never personally had . A person breakout, but it’s certainly a possibility. And then if they’ve had recent dental work or any sort of facial surgery, you want to be gentle maybe some light cupping, but definitely not using guha tools over the area.

So the symbols that I use in my cupping instruction for the slides that you’ll see, I have an X that I use for suction and release, and O if you’re just suctioning and then a line if you’re dragging the cup. So in this example, when you start out, and I’m not going to go through all the steps of facial cupping, but I’m going to give a few examples.

So the first thing you do is you’re going to do a lymphatic drainage. So you would take the cup and you would suction and release down the neck. When you get to around kidney 27 under the clavicle, then you’re gonna drag the cup. Over to the lymph node, which is right around lung two, and you would do this like three times and then you would move to the next area.

I always work on one side of the face and then the other when I’m doing facial cupping. The next would be a suctioning, and then dragging the cup over different parts of the face that have been affected by the paralysis. Now, if the person is having facial pain, like trigeminal neuralgia, you would not want to be doing cupping over the areas that are tender.

In this example, , If the person had Bell’s Palsy, you would be working the cups along the stomach line to help with any facial movement in those areas. In this picture I’m showing you can suction and release and you can drag the cups around the lips, stopping at different acupuncture points and stimulating them, and this is good.

For patients who have any sort of disharmony around the mouth, whether it’s neuropathy or any sort of tension in the mouth, and this can help to release. The orbicularis oris muscle for issues with the eye, things like ptosis, any sort of drooping with the eye, or any sort of inability to open or close the eyes.

You can work gently inside the orbital rim. You don’t wanna point the cup at the eyeball, but gently working around. The orbital rim in order to bring energy into this part of the face. And the orbicularis oculi if the person can’t raise their eyebrows or if the person has a lot of tension in their eyebrow, in their forehead, if they’re having any sort of

Twitching in this area. Then you can go to yin to and suction and then drag the cup up to do 24. Do the same with you Y up to gallbladder 15 and then San Joo 23 up to stomach ache. Next is facial gu sha for facial Gu Shaw. The benefits are that by doing the gu sha on the face, it helps to clear wind, which is part of the metal element and can help with the skin metal and skin, and can also clear the wind, which

Is involved with facial ticks. Also, it helps to expel fire and invigorates the blood. Harmonizes the blood. The Jade gu sha tools are wonderful. They are very much a part of Chinese medicine. I. Only use Jade on the face for this reason. Works with stagnant blood and also helps with microcirculation and does this by causing some microtrauma, which again helps with collagen production.

So here is that tool I was talking about. This is a Jade guha tool and has different corners, this U shape and then flat sides, and then these massage corners. For specific acupuncture points, the technique that you’re going to use are very large scraping strokes, so you’re going to do it gently, evenly, and steady.

I tell my students, you go for the gu, but not the Shah. You don’t wanna bring up all that redness. They’re not going to look like they’ve had Guha, but it will . If you work in one direction other than in between the eyebrows, you can go a little more vigorously, but you are going to release some of those fascial adhesions, really get into the muscles, stimulate acupuncture points, and this is wonderful for young.

Younger patients, needle phobic patients, people who really need to be treated on their face, but are a little reluctant to have needles put in their face. So here’s an example of what it might look like if you were doing gu guha. Now, when I do facial guha, I use two tools and you’re going to put, for the cupping and guha, you’re going to put

Oil. The oil that I use that I like is all organic and vegan. It has C, B, D and Arnica in it, and it allows the tools to glide well without clogging pores. So you’re going to start at l i 20 and you can. Massage there, and then you’re going to move the tools along the sides of the face, and this will break up any sort of stagnation or disharmony that’s going on within the muscles.

And really invigorate the blood and the chi in that area. Same for the eyes. You can massage a bladder two and then use the U part of the tool around the orbital rim and around the braille. I really like, especially for wrinkles between the eyebrows, but . Even if your patient is just having a lot of tension in between their eyebrows, really getting in there with the in tongue, can I.

Relax, the corrugator muscle, the procerus muscle. It allows everything to ease up. It’s great for your patient’s mental health and my patients that have come to me with various sorts of neuromuscular facial conditions from Ms. Myasthenia gravis Bells. Even ptosis, this really can allow the face to relax and when the face is relaxed, it can function better.

I. One of the last steps that I do is I take the flat sides of the Guha tools and I work all along the temporalis muscle and the trigeminal nerve, the facial nerve they can all . Have some disharmony and dysfunction if the temporalis muscle is tight or tense, if someone has T M J or if they have trigeminal neuralgia and you really can’t get in there and work on their face, you can still work on the temporalis.

Relax the temporalis and this will relax their face and their jaw. The very last step that I do is I turn my patient’s head to the side. I start at the base of the Oput and I work all the way down right to the shoulder, right down the trapezius, pressing fairly hard in one direction, and this will release the back of the neck, which releases the occipital frontals, releases the face, and it really is a very relaxing way.

To end treatment for your patients.

If you have any questions about anything that I talked about today, you can put them below and you can also go to facial acupuncture classes.com. My classes are listed there and there’s also a Contact us button, which you can use. So I want to thank the American Acupuncture Council again today, and if you missed any part of today’s recording, you can go to the link and catch us there. .

Treating Digestive Disorders in Children

I’d like to first thank the American Acupuncture Council to that for hosting me today, and I will be speaking about treating digestive disorders in children.

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Hello and welcome. I’d like to first thank the American Acupuncture Council to that for hosting me today, and I will be speaking about treating digestive disorders in children. So I think we can . Dive right in. Can you turn on the first slide? Yes, I’m Moshe Heller and I’m from Moshen Herbs.

And I’d like to discuss today treating digestive disorders in children because it is actually summertime, a fire phase. And a lot of times we don’t think about . Necessarily connecting the digestive disorders with the fire element. But there is a very strong connection, which we’ll see in a little bit, other than the fact that of course the the digestive fire right is associated with that kind of element, the fire element.

I wanted to point out that. Digestive disorders are actually extremely common in children and sometimes they don’t manifest as the main complaint, but they’re associated with many disorders that range from even cognitive issues of difficulty focusing to allergies, to various other things.

And I will point out as we go how this, what are the connections? But the first thing I want to make sure that everybody is clear on is that children are born with a weak digestive se system, meaning that that their spleen is often very deficient. And that’s very obvious. Babies have difficulty digestion di digesting and have a very soft yellowish

Bowel movements, which are all signs of some spleen, va acuity. As we see that the patterns of digestive dysfunction are easy to notice when we put the earth in the center, the spleen in the center, so there’s. Starting with wind affecting stress and in infections and anger, all can affect the spleen.

The, in the fire element we have heat and over overstimulation, overheating. Creates can affect the spleen in the center. And then the, in, in the metal element, we have dryness and frequent colds or invasions of. Pathogenic influences that can affect the the digestive system as well as affecting the large intestine if they they affect the younging causing constipation as well as the emotional state of the lung can when there’s loss or grief.

It can affect the spleen function a lot in the water element. Cold, raw, cold, eating, raw, cold foods, the use of antibiotics and some prenatal, like a, some kids are born with even weaker spleen, so the digestive system is even more sensitive to . The the foods that we introduced to them, even sometimes the breast milk itself and also prematurity affects the kidney and fear and fright.

All these factors can also influence the spleen. And there’s an interesting saying in pediatric, in Chinese medical pediatrics that actually all children disorders arise from fear and frighten and indigestion, meaning that fear is a causing factor for many disorders and also issues with digestion.

Those are the two main issues. . That children present with with disorders. As we can see here all these influences eventually can cause spleen G deficiency that affects the spleen’s ability, trans to transform and transport and therefore damp can be produced and and accumulations.

These are the sort of the digestive dysfunction issues that can arise. I also wanted to point out that we, there’s this really strong connection between our digestive system, our immune system, and our neurological system as an as . I call the neuro gastro immune system. They’re all connected and connected, as one system.

We know that the the immune system and our digestive system are very much connected through the microbiome and the microbiome health, meaning that the mini minute R microbiome is imbalanced then. It can lead to immune issues. So we can feel, see that the, there’s a lot of gassiness and bloating and discomfort in the belly, abdominal pain from this kind of mis the microbiome dysbiosis.

And that can affect our immune system and also . Through the the effect of the vagus nerve. Our neurological system affects both the immune system and the gastrointestinal system, meaning that there’s feedback back and forth between them. And so if there’s neurological dysfunction, it can affect our or vagus nerve dysfunction.

It can affect our gastrointestinal system and our immune system. And vice versa. If there are disorders, if there’s issues with our gastrointestinal system and our immune system, it can affect our neurological system through the vagus nerve. So this is a very important . Connection to always remember that aligns our immune system and our neurological system in in the same in affected by our gastrointestinal.

And there’s like a triangle that are very closely related. Anything that happens in one can affect the other.

So I wanted to say to point out that there are five common patterns of illness in children according to Julian Scott. This is his idea. And actually I found it very very true in my office, in my clinic. I always can probably . 90% of my pediatric patients will fall into one of these categories of disorders or as at least as, as a part of their diagnosis.

We’ll have one of these five. So these are very common patterns and I just wanna go through them really quickly so that we can remember. The first pattern that I want to mention is called an accumulation disorder. And accumulation disorders are very common in, in the early years. So somewhere between six months when new food is introduced to the baby.

And up to about two years at two years, I would say that is the point where the the digestive system matures. So at this point of time the digestive system is very delicate. And and therefore if some wrong food is introduced or some cold is affecting the digestive system accumulation can result.

And this accumulation is similar to the concept of. Food stagnation in adults, but it has a more of a, another aspect to it. It could be the beginning of of or the pre the precursor for For digestive, for food allergies later on in life. The symptoms are very similar. There are very clear sets of diagnostic symptoms that point towards accumulation.

And I’ll just point the most significant one is that there is a constant redding of the cheeks look red. Most of the time in those children, they it’s not like a healthy red cheeks that you would expect from newborns or, or babies or toddlers. But it’s it’s almost like a real strong red.

Kind of coming out from the skin. And it’s very typical of those those kids that have that accumulation disorder. And of course it comes with a lot of digestive issues and tendency to have colic and gassy and issues with with digestion and bowel movements. The next pattern is a regular spleen, chief acuity, which we can expect this is a more of a deficient condition.

You’ll see a child will be more flabby floppy, not flabby floppy. The muscles are not strong. Sometimes . Associated with low muscle tone and also issues with digesting food, with eating patterns are very, usually very difficult. And so it’s more of a deficient type of pattern.

The hyperactive spleen, chief acuity follows a similar pattern where there’s this kind of digestive deficiency. But the energy of the child, the emotional state of the child, is very hyper, very difficult to sit still and very manipulative and and not able to sit quietly.

There’s another type of deficiency with a mixture of hyperactivity, and that’s called the kidney chi deficiency Hyperactivity. The only difference between the. Spleen chi hyperactivity and the kidney chi hyperactivity is that the kids show some kidney vacuity on top of the spleen vacuity.

And a lot of times they’ll be very fearful. You’ll see them, they’ll be very hyperactive. They’re very curious. They’re, they’ll have issues sleeping, but their digestive system will definitely, they’ll have food issues also associated with that. And the fifth one is the lingering pathogenic factor.

I see a lot of that. The most important way you, there’s a few very strong clues towards lingering pathogenic factors, but I always palpate for the lymph glands and see if they’re swollen. There’s a suspicion. That and the child is not actively sick at that moment, that there’s something lingering.

A lingering pathogenic factor is involved. So I always check for that too. So these are the five common patterns, as you can see. Except for the lingering pathogenic factor, which also always almost involves digestive sys system issues. All the other four are clearly digestive dysfunction as at the core of those fi five patterns.

When we see that spleen sheet deficiency in kids, it’s really simple. That’s why I really thought it would be a very important to remember that. Because it’s actually very simple to treat them. There’s, these are very basic points. Stomach 36, CV 12, and I also sometimes might help.

I’m I, I. Didn’t write it down here, but UB 20 as the back shoe of the of the spleen is really important and helpful. You can use it with needles, you can use it with tiger Warmers. You can use moa, but it is really easy to treat children to strengthen their spleen with these points and so effective that is definitely worth stressing.

So useful points for accumulation and indigestion and colic issues. Again, we have . CV 12 and stomach 36 as the basic combination the use of CEN points in babies. I use them up to even up to two years old. I use cen very, I know traditionally there’s this idea that you need to prick it and express this kind of yellow fluid.

I find that even using a shone hin tool to press on these points until I get a little bit of a reaction then that’s all that’s needed or a quick in and out with a siren. Ear, needle. And sometimes I am able to . Put all all eight points ’cause only I don’t use the thumb eight points before the child actually realizes that I did that.

That means it’s really great. I also wanted to point out this combination of using CV 10. CV 13 and CV 12, all three. Because that helps to regulate the stomach function. CV three I call the upper sphincter of the stomach. The CV 10 represents the lowest sphincter of the stomach and CV 12 representing the stomach itself.

This, the use of those three points, whether it’s by massaging or ENA or by . Using po the needles or magnets. Sometimes it can help regulate the stomach chi, which is really important to make sure stomach chi is functioning well. As well as spleen cheer and the heart the relationship between the stomach chi and and the spleen chi is balanced.

We also I I like to use gallbladder I stomach 34 for calming stomach pain. That’s a a different point that’s usually used, but sometimes it helps to actually come if stomach 36 doesn’t and stomach 40 for transforming phlegm. If there is phlegm that needs to be transformed.

I, I frequently use when there is constipation, I use a combination of triple burner six and bladder 25. And and when I work on eliminating damp heat from the intestines, I use stomach 25, 37, and 39, the lower C point of the large intestine and small intestine. Here’s some tuna recommendations.

Of course massaging the around the belly button. Just remembering that if we are wanting to promote paralysis, we use it clockwise. And if we want to stop her stasis, we use it counterclockwise. So if there’s constipation, you would use it clockwise. If there’s diarrhea, you would use it counterclockwise.

The spleen is represented at the tip of the tongue thumb. Generally if I want to strengthen the spleen in pediatric patients, I would do rotations. On the thumb area. Basically in pediatric Trina rotations will create more ification, whereas linear or spreading outwards like this, Is more dispersing if you have a damp accumulation from spleen.

In the spleen. An excess spleen, not very common, but sometimes there is, you can disperse and the stomach area is just underneath, underneath the spleen in this area. So you can disperse the stomach by pulling outwards, or you can tonify the stomach chi by doing rotations.

So I wanna point out one of the formulas from Moshen Herbs that I use for a variety of digestive disorders. It is called Digest. Interestingly enough, it’s based on, I. BHA one. And it harmonizes the spleen and stomach and resolves de phlegm and regulates the liver chi. So it is, as I said, based on bha one from the Yin Nourishing School of Ju Chi.

This formula actually reduces food stagnation and preserves proper functions of the digestive organs. So it’s a great formula for supporting the digestive system and that’s what I like about digestive ’cause you can use it as a tonic to support a weak digestive system. Especially if there’s concerns about this weakness and it can also be a treatment.

So I modified it and her and and added herbs that support digestion. Clear some wind, heat and regulate the cheese. I’ll talk a little bit about these. Of these herbs, gin, , and . Both are actually considered great summer teas to prevent pathogenic influences in the winter.

There are cooling herb, cooling herbs. They’re both flowers representing summer and affect the head. But they are really great. Digestive regulators. I. We don’t think of them as such, but they are, and that’s why they’re really recommended to be in China it’s a known what would call summer tea.

You drink, you can drink in warm or. Cool. With and . And so I added that because it actually supports the digestive system. Again, another herb that relieves the exterior. But it is also a great digestive regulator. And it’s it’s really important herb for helping the digestive system.

And Tchen helps in the production of fluids, which is another important, very important concept that the EA is manufactured and distributed well. And that’s all in relationship to good spleen chi. So Tchen is an amazing, important herb for supporting the digestive system. So we added this herb to the formula digest and we can quickly break it down.

Di Digestive again based on . Preserve Baan Preserve harmony. Tchen and re are the main herbs. Sanja, Zu and Sharon. And Gya, and are all food transforming, helping the digestive system transform or breakdown proteins fats and carbohydrates. Excuse me. As well as a combination of Chen CIA urchin tongue, basically to transform d dampness.

And I’ve added these accurate, windy herbs used to regulate the digestive chi in them. So this is the format I wanted to really present today. I wanted to just mention another couple of formulas that are not . Focused on the digestive system, but affect it in, in, one of them actually does work on the digestive system.

The one the first one is called shield, and it is based on ing Pang. Yan is mostly Xi, which is strengthening to the spleen and Baiju. Which actually helps of course strengthen the spleen and work on the digestive system as the basis for a good immune system. As I mentioned before that relationship is extremely important.

The, this is a shield that if you have a child that has digestive system and tends to get colds very easily, shield is the formula even better than digest. And the last one has is called react. It’s based on one, but it is actually my food allergy formula. To support children who have who have this kind of accumulation disorder at the beginning.

And then it develops into these really food allergies that cause a lot of digestive issues and manifest with many other complaints. So that’s react. So these, this is all these formulas are, there are many more formulas that can affect the digestive system, but these are my points that I wanted to bring today.

I like to thank you for your time and thank the, again. . For hosting me and thank you for listening and hope you visit my MoshenHerbs.com for more information. .

Prepay Plans – Are They A Barrier to Care?

What about prepay plans? Let’s go to the slides, let’s talk about that. What are or. Prepay acupuncture plans. What is possible for us? What can we do with it? How do we make sure it’s legal?

Click here to download the transcript.

Hey, greetings everyone. This is Sam Collins, your coding and billing expert for acupuncture and the American Acupuncture Council, the network, as well as the insurer. And as always, we’re here to try to help you fortify your practice, make things better. It’s a great time to be an acupuncturist. It really is.

There’s never been a better time. However, we have to figure out how do we make all these things work? How do we meet it up? How do we start to decide that we run the business end? This is the difficulty, I think, for many acupuncturists because you get through school. You do a good job to become the best acupuncturist possible, help people.

But then you have the reality of uhoh. I’ve gotta run the business end. That’s where my specialty comes in cuz we deal with the coding, the billing, but also all ends of it. And I wanna talk a little bit today about running parts of your practice as a cash practice, not just insurance. And how do we deal with that?

What about prepay plans? Let’s go to the slides, let’s talk about that. What are or. Prepay acupuncture plans. What is possible for us? What can we do with it? How do we make sure it’s legal? I think you’ve seen things like this. Here’s what I always think of. We have to provide a way that allows people access to our care.

And I think this is often where we run into problems, is not always understanding why aren’t people coming to us? So let’s look at it. Why do people not get acupuncture? Let’s think of that. Think of that and solve and think even your friends, what do they even know that you do? Some people will say, I hate needles.

Some could be, ah, it’s not gonna work for me. Oh, they’re not real doctors. But let’s base on what’s really changed. The Cleveland Clinic, one of the most renowned places for healthcare in the US recently published that says this, what type of pain does it? Acupuncture treatment. It says, many people use acupuncture to relieve pain throughout their body.

Including for migraines now, notice pain throughout the body, including migraines, back pain, arthritis. Studies have also shown that acupuncture may be his successful treatment option for a variety of conditions, including immune system issues, infertility, and the effects of menopause and so much more.

You are now able to access people in ways that I think 20 years ago, acupuncturists probably could never. Have thought of because the people now understand it. You gotta wonder, do people really know what you do? And this is something I’d like you to ask yourself and your family. What do I do?

Because I want you to think of what does the average person think? Now notice I said ask your family. Your family who’s, who loves you. I bet many of them don’t really understand what you do. And I’m not blaming anybody, but saying we have to do a better job of making sure people understand the why of acupunctures, the things you can do.

So think of it if someone went by your office. Would they know what you even treat? If it says acupuncture, you’re assuming they know. Notice these two offices I use as an example that talk about what they treat. Fatigue, stress, tension, anxiety, depression, mood swings, migraines, tension, headaches, digestive disorders, indige.

Congestion. Allergies, asthma, cough, women’s issues, neck, back and knee pain, arthritis, autoimmune, chronic, even va. What about personal injury? What about for that matter, Medicare. Medicare Advantage. Look at this other one. Neck and shoulder pain. What my point is, Why are people choosing acupuncture?

Partly because they’re not sure it can help cause they’re not aware that it could help ’em with menopause and frankly, whether an insurance covers it and some will. If you can help a person having issues with hot flashes and other issues. Is there a value enough to pay for that? I believe so.

But realize the barrier to care for most people, as we’re well aware in the us. Cuz my goodness, we have a diagnosis code. This is an actual ICD 10 code. It’s a P, it’s a code that indicates patients noncompliance with other medical treatment and regimen due to financial hardship. How many of us know someone that needs to go to the doctor?

We, we know they do, but they don’t. Why can’t afford it? Don’t have insurance. So that puts a dilemma here that realize a lot of times people aren’t choosing care because it’s just a factor of affordability. That’s what a capitalistic society does. I’m not blaming it, I’m just saying that’s a reality. So you think what about if they have insurance?

Insurance can be good. There are some plans that pay very well. There’s some plans that are horrible, meaning they pay, but very little. But keep in mind, there’s still gonna be sometimes no or limited benefits. Maybe the plan has a super high deductible. Okay. Or maybe there’s just no insurance out.

Patient doesn’t have anything. They don’t have a job that gives them insurance, if you will. While many people do, even when they do they have a coverage? Think of a Walmart worker. Do they have insurance coverage? Oh, sure they do. But do they have acupuncture benefits? Sure they don’t. Unfortunately. So here’s where I think we need to bridge is acupuncture, I think has always done a good job of not relying on insurance.

Not to say you don’t take some insurance. The good stuff. Sure. But you don’t rely on it because we know coverage patterns for what you do is not as well covered. That’s gotten a lot better, particularly in some states, but data suggests people are more willing to pay out of pocket for acupuncture than just about any of their service, cuz they’re used to it.

But there’s also a cause and effect I think. I want you to think of, if you’ve ever been to a medical doctor, have you ever left going, God, I feel so much better. And I’m not saying that is a putdown, that’s not how they treat. How many people come to you in a day that have a pretty severe amount of pain, a headache or something, and when they leave they’re like, oh my God, it’s 75% gone.

I’m not saying we’ve cured them in one visit, but you get my point. There’s value to that. So you gotta think someone’s coming in. How do I offer that in a way that they can afford it? What about discounts? And I think you’ve all talked about I’m gonna offer a cash discount. You can certainly have a, just a cash fee.

That’s whatever you want it to be. I. Unfortunately, if you’re billing insurance, it really can’t be much different. Remember, when you are billing insurance, your cash fee can’t be any lesser or any greater, excuse me, than would be five to 15% according to the Office of Inspector General. So that’s under federal rule.

So you give a small discount, but not much. So does that really help? What if you’re charging $150 and all of a sudden the patient goes do I get a cash discount? Yeah, sure. We make it 1 35. That still may not be affordable for them. So is there anything else we might do? That’s where pre-pay plans will come in.

Let me give one exception because obviously I’m gonna have providers from all over. Remember, California has an exception to cash discounts business and professions code 6 57. So in California, yes, you can offer a substantial cash discount as long as they’re not using insurance. But California’s unique in that no other state has that.

But here’s what I’m thinking of. You’re a business. You gotta think of it like a business, and this is where prepay comes in. Sears made a major mistake 20 years ago or so. Sears, someone at Sears should have looked and go, wow, this Amazon business is really booming and all they’ve done is copied us.

Amazon has nothing more than a copycat Sears. Sears was a catalog company and you ship things. They moved away from it when City Center started, but why didn’t someone at Sears go, Hey, let’s digitize this catalog, because at Sears done that. Do you think Sears would still be around? I think so. Because would you still buy from Sears if they could ship it right away?

Of course we would. In fact, what’s funny is all those big Sears stores, many of them are turning into Amazon warehouses, which I think is funny, but it just means they did not adapt. I want you to think of adaptation in your practice. What have you done that could be helpful to a patient to get more access to care?

I give a cash discount, eh, but I want you to think of, there’s a very popular group right now. That is probably the biggest growth of acupuncture for any place, and that’s the company, modern Acupuncture. How does modern acupuncture work? Excuse me. Modern acupuncture sells packages. Now I, how do they do this?

You wonder, is it legal? Excuse me. The discount is greater than the cash discount, and the reason why is a package. It is not one visit. So unlike doing a single visit, like what is billed to insurance, you’re billing multiple. So think of it, excuse me, the company Target. Have you been in there recently?

When you first walk in, do you notice. There’s a little 99 cents store there. Now, why did Target do that? People like the 99 cents store, so that doesn’t mean, pardon. That does not mean that you cannot still buy expensive things at Target, but it means they’ve also realized people like the 99 cents store, so they’ve adapted a little bit to satisfy that.

You can go in there and still buy a thousand dollars of other stuff. But by fi, but by a few 99 cents Store items. My apologies. I’ve been a little sick recently. Maybe I should get to an acupuncturist. Nonetheless. Think of modern acupuncture. Why are we allowing them to do that model without us maybe adapting it a little bit?

Why are they the only ones? And I will tell you pretty much in any state, You can offer what they do, which is a prepay. So your practice to continue to grow has gotta get access to people. And this is popular. How does modern acupuncture work? They don’t sell single visits. I’ll take that back. They do.

You can buy one visit, but it’s very expensive. If you buy multiple visits, it’s a lot cheaper. If you buy multiples, they can be as cheap as $20, but what it means is you buy them all at once. So here might be something you can offer someone. You have a cash patient who maybe your visit is 75 or a hundred dollars, and for them to come in three times a week, they’re like, Ooh, I don’t think I can afford that.

So you might say hey, you’re gonna need 12 visits to really clear this up. If you buy all 12 upfront, we’ll give you those visits for 500. In other words, you’re selling it as a package. Let’s say your visits are normally a hundred, but if they buy a package of 10, you sell them for 700, so they get a substantial amount off.

That’s exactly how this model works. I think it’s a way to think of another way to get a person access to care. Think of how people purchase cars. No one pretty much buys a new car for cash. And I’m not saying that never happens, but the majority of us put a down payment, make payments. Notice when they advertise the car, they don’t say the price.

No one’s gonna say it’s 75,000. They’re gonna tell you, oh, 2 99 a month. That’s affordable. So you wanna put this in chunks. I think this model is something every acupuncture should offer. It doesn’t mean it’s for every patient. But I think there are gonna be many that’ll say, you know what? I know I need the visits.

If I prepay it, I save a little money. It also makes the patient more beholden to care, cuz they’ve already bought the visit. So how do we make this legal to do this? A couple of things. It has to be a fee for service. If you’re gonna do a pre-pay plan, it cannot be for a thousand dollars come as much as you want.

It has to be for a thousand dollars. You get 20 visits. So there’s a set number because there must be a refund policy towards it. In other words, any unused funds or visits the patient get refunded. So if a patient says, Hey, I came in for, only five visits of the 10, they would give half of their money refunded.

No big deal. I would also be careful of putting a hard expiration. There should be an expiration, but meaning if there is an expiration, And they expires. You’d have to refund it. So I would just up it. In other words, you’re trying to put a person into a plan here would be my point. What if you could sell 10 of these a month for a thousand dollars or 500?

Would that be value? I think so. Realize it’s not for a patient using insurance, it’s for someone paying cash, but it’s another way of giving a discount beyond your regular 10 or 15%. That allows the patient to be better committed because you’re gonna tell them, look, you really are gonna need 10 visits to get rid of this problem.

But we know how most of us would work. If I feel better after two or three visits. I’m like I feel good enough. I don’t want to keep going, but if I buy the package, so here’s a couple of examples of states that have rules about it. Here’s one for Maryland, and it says from the board you can offer a prepaid plan, but it says, That the practitioner that chooses to offer prepayment plans must carefully explain it.

In other words, make it clear up front. This is what you’ve purchased. You’ve bought 10 visits. If you use the visits, great, we’re all good. You can buy more, but if you don’t use them, there’s a refund portion to it. And realize that swings both ways. What if halfway through the patient is unruly? Rude to staff for whatever reasons, and you don’t wanna continue their care, you can certainly discontinue it as well.

So I want you to see Maryland allows it. Here’s one even for New York. In New York, it says, may a licensed acupuncturist offer a discounted package of treatments and it says, so long as any insurer is not deceived, packages would not be contrary to New York law. Meaning it has nothing to do with insurance cuz it’s not a single visit.

Buy a package. Now, could a package be as little as three, four, or five? Sure. Modern acupuncture sells 24 cuz it’s always two per month. They’ll sell more than that, but that’s how they get you going. I like the idea of this. I think it’s another way of trying to reduce the barrier of money.

I. For a patient to come into your office, but we wanna do it in such a way that we can’t get in trouble later, that they’re saying you’re acting like an insurance. If you were to sell an unlimited visit for a set amount of money, that’s an insurance. It also means if there’s unlimited, what if the patient comes every time or every day or another patient only comes once and says, I want my money back.

You’re gonna say you bought six months. You only came once. That’s on you. It has to be a set fee. Realize some states get fairly strict and so I’m gonna implore you please verify with your state the rules. Now, if you’re in the in our network with me, certainly you can contact me, but again, that’s net members only.

American Acupuncture Council Insurance Information Network members can contact me and we can talk about your statement. I’ll give you a few examples. In Florida, they allow it, but the package can’t be more than $1,500. That’s the max. And if it’s above 500, you have to put the money in a trust account, meaning a separate bank account as they come and pull it out.

That way they know the patient’s money is there. Montana also requires an escrow account, and there’s no limit. I would say most states don’t require that, but just be sure. The key is make sure the patients get what they paid for, get the treatment, and if they don’t, they get refunded. I like this idea.

Think of it. Why do people mostly not come? Money is always a big factor. Let’s try to reduce that to make people allow to come in to pay in chunks or get a better value or discount. So here’s a few things for just basic compliance. Make sure you outline multiple appointments with a patient. I would really try to set a plan.

Don’t just make it, come in whenever, set a plan, have a recall system that you know you’re contacting the patient, Hey, you’re supposed to be in for the visit. Let’s make sure you’re coming in. Or if they haven’t been in a while, That you are allowed to discount services based on the reduced administrative’s expenses.

That’s the whole point of this. You’re discounting it cuz you’re not dealing with all the other stuff that goes along with it. And then notice here, the last thing, have a refund clause that states the patient may receive their unused prorated due to them if they wish to cancel. It’s not something they’re stuck, nor are you.

It would just be refunded. So when it comes to refunds, and these won’t happen too often, I have a lot of offices that do these. And I will generally have them tell me, Sam, I don’t get too many people ask for a refund. But what? When they do, you know what they do? They just refund it. Don’t get caught up in thinking how dare you?

If someone doesn’t like the service, they don’t like it, refund it. Move on to the patients that do. Bottom line is this, if your usual rate is a hundred dollars and when they buy the prepay, the rate drops to 50. So they get 10 visits for 500. If they wind up using only half the visits, they get half their money back, meaning $250.

It’s always prorated. You can’t say since you didn’t use all the visits, we’re gonna up the fee to our normal rate. It’s gonna be the discounted rate. The refund should be calculated on the paid rate, not your normal rate. Charging any more than the quoted amount is gonna get you in trouble and patients are would make a complaint.

So long as you’ve been fair, not an issue. In fact, you’ll find patients love these. If someone is unhappy or moving, so be it. I have one particular office and always think of her when I discuss this. She’s in California, San Francisco area. She sells packages, and I’m not kidding, that range from as little as 500.

Her most expensive package is 6,000. I kid you not, but she will admittedly tell you, Sam, I don’t sell that many $6,000 packages. She goes, I sell maybe two or three a month. I’m like, wow. Can you imagine someone buying a $6,000 package, two or three of those a month? It’s pretty good. To me, it’s just another way of having a person, getting access to, in a way that can make it affordable.

Remove the barrier of money, or at least something cheaper. Your practice is gonna thrive because you get patients. Patients come in because they need the care, they understand, and then put a value to it. Be careful. You don’t wanna overly cheapen it, but again, creating a greater way of access to it, just do it in a way that protects you.

I think this is a great offer. It’s not gonna be forever. And someone might say, oh, I don’t want it, but there’s enough of it out there. Why are modern acupuncture have so many places if it wasn’t working? Must be don’t be Blockbuster and Sears. Look and go. Why don’t I incorporate a little of that? I think that’s gonna be a safe.

An easy way for you to enhance your practice. It enhance access for your patients. Even if the doctor claims, Hey, I did extra services, just refund what they didn’t use. The American Acupuncture Council is always gonna be your place for help. I do a services I mentioned. That’s the network. So if you’re a network member with me, don’t forget, you can call me.

Zoom me. We work one-on-one. I become your in-house expert. If you’re not a member, think about joining. Go to our website, aac info network.com. Take a look at our services, but realize we’re always here to help. There’s always gonna be a place that we know. We’re gonna make sure that you’re okay because your success is ours.

Until next time, everyone, thanks so much

STOP Treating Menopause and Aging Like a Disease!

So the title of this presentation is to Stop Treating Menopause and Aging like a Disease. And so this is really about embracing the wisdom of East Asian medicine and that holistic perspective of menopause.

Click here to download the transcript.

Hi welcome. I’d like to thank the American Acupuncture Council for producing these lives. My name is Tsao-Lin Moy, and I’m a licensed acupuncturist and herbalist located in New York City union Square. Practicing now for 21 years. And today I’m gonna be talking about a hot topic, which is Menopause.

And so we can go to the slide.

By 2030, the world population of menopausal and postmenopausal women is projected to increase to 1.2 billion. This is about one fifth of the world population. So if we’re looking at menopause as a disease, this makes it look like we’re in another pandemic. What this is an opportunity to improve how you help your patients, and particularly women before they actually reach that point of menopause.

So since 2021, we’re looking at half of the US female population is age 40 and older. So this is a mark. This is a whole group of people that are gonna be looking for natural ways to heal and not just go the route of hormones. As practitioners, we really wanna be mindful of what cultural influences are affecting our own beliefs and acting out of the fear of getting old and decrepit because this is all around us.

We see it in social media, we see it on the cover of magazines. Really all the TikTok and, all of the. The Instagram, and I don’t know what else there is because I try not to personally get onto any of those platforms other than to share information. Hopefully the people who need to hear it can actually find it.

But menopause is really, it’s a complex phase that involves biology, physiology, metabolic shifts, emotional, and also social changes in life. Puberty is very similar. It’s biological changes, physiological, metabolic, emotional, neurological, and also social right. We see this in young people finding their group.

And while we don’t call a growth cycle for puberty to be considered a disease, it is often treated with hormonal birth control. And this is the first sign of, painful period or pimples or something young women are giving are given hormonal birth control. And this is very problematic in my opinion.

I don’t think that women should be and young women should be on hormones from the time they’re 14 all the way till through to their seventies. This is also something that shows up in fertility problems with fertility. So just as a review in case you’re not somebody who reads the classics chapter one, my favorite chapter of the Yellow Webber Classic, also known as the Universal Truth, discusses Female Development that follows a seven year cycle.

And while males follow an eight year cycle, So when we start to look at each one of the cycles we see, okay, around 14 years old the fertility arrives or they consider the menses flows and the woman can have can start to bear children. And then we’re also looking at, as we’re moving through to around the age of 35, there starts to be a decline face wrinkles, hair begins to fall out.

So we start to see some of those, so those signs of aging. And it also co corresponds with. The, the struggles with fertility, right? Actually the slide might be out of order, but one of the things that I wanna address is, for most of the time with women’s health, the approach is not changed.

New tools, but basically the same attitude. And that is like hormones, hysterectomies, and antidepressants. Now, what really surprised me, Was to find out that the hysterectomy is the second most common surgery for women in the US after cesarean section. These are estimated to be one in nine mil nine women are gonna undergo a hysterectomy during their lifetime, basically would only be one time, and that’s about 600,000 procedures each year in the us.

So the question is, what does that mean for that connection? The heart and the uterine connection, the bowel line also. Research has found that over a third of women, when they go to their general practitioner with symptoms of menopause, they’re often offered antidepressants and this is really considered inappropriate.

So this is an area where we as Chinese medicine practitioners as acupuncturists can really help women’s health and in fact, women’s health is quite advanced in terms of Chinese medicine. A little review. How does blood yin and yang and chi interact with menopause? We start to look at yin and yang balance becoming a little irregular.

The blood and yin, which we could look at as estrogen becomes depleted compared to the yang and the chi, progesterone, testosterone. And really, so when you start to see the hot flash fluctuations, it’s really this kind of, the way the balance starts to be flipping from one side to the next. Now, until recently in the western world, perimenopause was thought to be around 45 or 50 years of age.

Right before menses would stop because that’s when the hot flashes were occurring. Mood swings. So we look at that, liver chi, night sweats, yin leaking, palpitations, heart blood deficiency. So we, when we look at these symptoms that we can actually look at what kind of patterns are emerging and no, in a women know, women are not quite the same.

Of course there are always. Formulas and recommendations for particular things we still need to look at personalizing. Now, in reality, trans transition into menopause is more accurately beginning 10 to 15 years earlier, and as I mentioned before, around the age 35. Some hormonal fluctuations might start to happen.

Maybe a little bit of irregular hormones and can impact getting pregnant, with fertility. So in terms of, what is that fertility cliff that is talked about a lot I don’t really believe it. And at the same time, if we’re looking at the long view, we’re starting to really look at.

You know what is happening really early on, shifts are happening over time. When it comes to our awareness, that’s when the symptoms are much stronger. So the idea here is that you wanna start treating your patients, talking to them, educating them, especially early on. Also if you have younger patients or your.

Female patients have daughters to really also talk about women’s health, about periods and things that they can do, especially if they’re having painful periods or bleeding or. Other things like acne that we can do a lot for naturally with diet and meditation. Like all of those tools that we have.

So here’s interesting. Studies actually show that even before puberty, which would be around age seven to nine, that there are hormonal surges that are happening, right? It’s just not one day your pubescent and then the next day you get your period. No, actually, Shifts are happening several years beforehand and this is, gives us an opportunity to really help shift the attitude towards menopause.

So this is about this yin and yang dynamic. Really as we’re shifting, just like the season, right now we’re in the summertime, so it’s much more yang compared to, daylight compared to yin of winter. With more winter and darkness, and yet at some point it’s gonna shift again. And of course we see as there are the transitions that there’s a tendency for certain kinds of illnesses to come up for people like allergies or, some colds, winter colds.

So this is to be aware, we’re always in some kind of cycle, a yin and yang cycle. I really like this particular slide because it talk it like shows where, you know, both the hormone levels, where we’re looking at yin and yang, estrogen, progesterone actually follow together, right?

So eventually those fluctuations are going to. Even out, right? So we’re always looking at, our body’s always looking to go into balance. So when one thing looks like, oh, it’s too much yang or too much yin we’re actually really looking at how the body is trying to reach that state of homeostasis.

And so it makes corrections. And eventually though, as you see, like where the blue part is really where most, like a lot more symptoms are happening as the body is shifting and transforming. So here are some of the unwanted symptoms that we find with menopause is, brain fog, hot flashes.

Weight gain, hair thinning, skin sagging, bleeding, emotional ups and downs, palpitations, poor sleep. Really what also starts to happen is like the weaker knees foot problems may occur. This is also because the connective tissue gets affected by hormones. And so you might start to, to see some of that coming in like the and know that.

That can be also addressed with some herbal formulas and acupuncture. But it’s not a disease. Not a disease. So the question is, why? Are menopausal symptoms less prevalent in Asia and other countries, and I’m really comparing like the US and some of the Western European countries.

And, what’s happening, believe it or not, what makes a difference in how women experience menopause? And I also believe puberty, coming of age is the cultural attitude towards health. And aging. So oftentimes we talk about getting a period as the curse or the shame around it.

With young girls, they’re, oh, they don’t wanna talk about it. They get made fun of. It’s something to hide and really not something celebrated in other cultures. It’s really this. Time where you recognize that you’re moving from one stage of your life into the next, and this is a beautiful thing.

So really what studies have shown is that the collective cultural attitude towards menopause plays a major role in emotional distress and physical symptoms. So why do I bring this up? Because. We have to take into consideration, we’re living in a culture that has very negative attitudes towards women’s health reproductive health.

And so the western culture, and then they find that plays a high importance on fertility and also place value on youthfulness in these cultures. Menopause reflects this age progression and loss of youth. And also loss of sexual attractiveness and leads to this negative attitude towards menopause.

There’s so many negative words that are used to describe menopause, such as fertility failure, ovarian failure versus, this is a natural progression as we shift into the next stage, of course You’re not gonna be producing children, this is, there is a window for it, but that’s normal.

There’s, we’re not part of the Handmaid’s Tale. To tell you this, I think. In my personal opinion, that that series like really normalized abuse, that it like the, in fiction becomes real, but that’s a whole other story. But what this is, it’s implying that a natural, something is a natural part of life is really a flaw or a disease.

And when your patients are coming to you, Understanding that the holistic perspective is not going to, or I would say, should not adopt this, cultural idea that it’s bad as you start to get older and mature. KO or Conki means in Japanese renewal season and energy. So in Japan, menopause is looked upon as a natural life stage, and the very word for menopause, the conki means renewal, season and energy.

So why do we have such a negative view of a natural process? While women in Asia eat more fish, less processed and refined foods less sugars, caffeine, sodas, and they walk more, et cetera, et cetera, compared to the average American. There’s also a level of respect for elders, and this is something that I think really need to examine is how we treat older people as they get older.

And one of the things that I would say is this last week I was at a conference and there were indigenous people from the Amazon and they were talking about the experience in terms of indigenous practices, of how much wisdom that elders hold, stuff that is not in a book. And when an elder actually dies.

It’s like the equivalent of the library of Alexandria burning down, right? Because what they hold wisdom that people hold within them is not something that can be reproduced. And because it’s experiential. And I think we have to really look at, as people are aging, that they also are holding a lot of experience and information.

So studies actually show menopause and menopausal symptoms are really tied to a woman’s cultural environment. So if a woman is in unhealthy environment, they’re gonna feel guilty. Shame experience for experiencing something that’s really natural. And leading to. Heightening of their physical symptoms.

It could be like flashing. It could be like poor sleep and also mental, like really heightened anxiety, depression and other countries that positively view aging and I’m repeating. And menopause such as Sweden, Denmark, and Norway, positively, similarly experience fewer unpleasant effects.

So not only does an optimistic and positive environment allow women to feel more comfortable when their cycles come to an end, but it also correlates with an easier transition with menopause. And that is where you as practitioners come in with support and really look at a paradigm shift. Chinese medicine is a paradigm shift, however, We do live in a culture that is constantly intruding on our views and beliefs.

So what can we do? Empowering your patients to cultivate their health and wellness and longevity. So this is really like the long, a long view, which. There aren’t really the quick fixes, right? If you get into hormone therapy, there’re always, there are consequences and side effects with that, such as increased risk of cancer.

So here what I’m encouraging is, To check in with your patients and find out how they’re feeling emotionally with their overall health and really address like, Hey, this. Transition that’s happening. It’s a very, it can be jarring identity, right? Your identity is changing the way cult, the culture, your society is gonna regard you.

And really don’t underestimate the impact that stress and anxiety has on health, and especially around aging and menopause. I think it’s really important to have a, To talk about that in other countries, the viewpoint is very different and we can actually adopt that viewpoint in the way that we actually treat our patients.

So again, intensity of menopausal symptoms will indicate that there might be un underlying imbalances, right? And we call those root causes that are not being addressed. So you’re, if you’re not treating the root C, you know what I wanna say is you’re treating a root cause, not the disease. All right?

If somebody is having flashing, we know that we need to balance their nervous system, like all of that, it’s not a disease. Self-care practices I give my patients homework. Really look at, what you can empower your patients with in terms of. Food, focusing on sleep. Sleep is a huge issue, right?

Because the circadian rhythm is also gonna influence reproductive hormones and overall health. Exercise and movement. Those are things that actually will help with like brain fog, but also movement is something that helps with depression. You start moving, just move your body clear out, clear the stuck energy.

Teacher patience techniques such as breath work for calming calming the nervous system and also I. Those tools, techniques, and tools are really good for managing the vasomotor symptoms, which come with the hot flashes, right? So body flashes and then get excited or anxious about it. That really calming the nervous system is actually gonna help to regulate that part.

Focus on relieving inflammation by eating, eliminating certain foods, eating other foods. I also teach my patients a kind of a self lymphatic kind of practice to help them move the lymph from their body, help to move, swelling, inflammation out. It takes. 40 seconds.

And the patients that do it can’t believe how the swelling in their overall body goes down, right? Because of all of the inflammation weight gain. One of the side effects with hormonal fluctuations is this weight gain. And things like lowered estrogen are attributed to what’s known as non-alcoholic fatty liver disease.

Or, con like liver congestion. So really looking at eating foods that are considered, that have more phytoestrogens such as flax seeds, sesame seeds, soybeans, right? Actually dried apricots and pr. And the studies show that an increase in soy actually helps reduce fatty liver.

Now there are always these concerns around consuming soy products that maybe it’s going to affect cancer it’s gonna affect the, negatively affect hormones, but those are actually really unfounded. Just discussing possible dietary Suggestions to help with symptoms could be its own presentation.

So I’d like to just, thank everyone who’s listening and please leave your comments in the bottom. And if there are any questions, you can also leave those and contact me and I will, answer what I can. Thank you.

Formulas for the Season – Moshen Herbs

I’m gonna be speaking about formulas for this season.

Click here to download the transcript.

Hello, my name is Moshe Heller and I’m from Moshen Herbs. And I wanted to thank the American Acupuncture Council for letting me host this talk this morning. I wanted to I’m gonna be speaking about formulas for this season, and so let’s go right away and start with the first slide.

I wanted to talk about two formulas that are associated with this coming season, this spring season. So as we all know, it’s officially started. Two days ago, so we’re at the beginning of spring, and I wanted to mention or talk about or discuss two formulas. One is the the first formula is called shield.

It’s a formula, again, by Moshen herbs that I created to support and boost the immune system. And then the other formula I wanted to, I’ll be speaking about today is react, which also is another formula by Moshen herbs for that I created for allergies, which is really at beginning of the season of allergies.

As we all know, everything starts to be itchy and irritated a little bit as the pollen levels rise. I wanted to start first with the SHIELD formula. And I I th this formula I created based on NG san, which we all know as Jade Windscreen and I combined it. With WA tongue, which is cinnamon, twigg, decoction.

And together these two formulas strengthen the exterior and harmonize the functioning of the way and ying chi so that when we, when our patient encounters pathogen, the body’s able to resolve it quickly. And that’s a really important. Thing I wanted to stress is that we, it’s not about not getting sick because we, especially when we’re treating children they do encounter pathogens and also as adults we also.

Are able to, or supposed to get sick. The issue is that we need to resolve it completely and quickly and exactly that’s what this shield formula is will help. So in this encounter with this pathogen, whether it’s a pediatric patient or an adult patient, The body of our patient is learning to deal with this pathogen that they encountered.

In a sense every time we get sick, it’s a learning opportunity. And it’s important to remember that because the more we learn, the more we are able to ward off. And I think SHIELD is an extremely helpful formula for this situation. So I wanna break it down a little further and how we how I created this formula.

We, I first wanted to make sure that the CHI is strong. And also that the CH Chi transformation, or what we call sometimes chia is complete. And so on top of this two formulas I mentioned before Jade Windscreen and cinnamon Twigg Decoction, I also, and I also combined. Urchin tongue CIA and CEE mostly as the two main herbs of that formula.

And those herbs will help to transform dampness and and otherwise if the dampness accumulates, it will hinder the functioning of the spleen. And that’s why it’s important. These. Two formulas. Th this formula two cured Decoction helps in that transformation and keeping the transformation going.

And so on top of that, I added another herb Tchen, which is a really amazing herb. I really love that. And you’ll see I use it. A lot in other formulas. Also, the advantages of it is that Tchen strengthens the spleen chi, but also works on regulating the water pathways and the transformation pathways of the spleen.

It, and it helps in generating fluids, generating pure fluids, not not. Turd fluids pure fluids will help to nourish and move and will move freely in your body. Whereas turbid fluids, if the transformation is not complete, will create dampness and then fle. I really Tchen to support the, this transformation.

The, in addition, I also added wwe, which helps the formula. Consolidate the exterior, but also bringing the kidney chip support to the lung. So there’s a better relationship or communication between the lung and the kidney. That the kidney supports the lung functions in both moving fluids, transforming fluids, and keeping the way chi secure.

Finally we also added Gagan. It’s a really also another one of my favorite herbs because it works on two levels. One, it supports digestion and helps with the normal function of the spleen. And on the other hand, it really helps to support the exterior. So in harmonizing the muscle layer in our what we call the muscle layer, which is this kind of relationship or is connected to the relationship between the ying and the weight level functioning.

We also, I also added the lastly linger which is, as we know, a really good adaptogenic mushroom that cons con is considered a really potent immune system tonics. So we have All the herbs that I mentioned yeah, are structured in this way. Our main main formula is NG with the addition of Tchen.

Then we have with the audition of. Greg and also I added to help clear and clear any heat and also support exterior and and as the third layer being urchin tongue transforming that potential phlegm and making sure that cheat transformation is complete together with w weights and linker.

So this is the structure of shield. It’s as I said, it’s a really great formula. I’ve been not only using it in my office, but a lot of practitioners have been purchasing it from me with really great results on. Supporting various kinds of conditions between just as a immune tonic, especially during the pandemic.

And then also as spring, as a spring preparation. Formula because a lot of times, as we know, when we see seasonal allergies, it’s all about harmonizing the ying and the wait chi and making sure that the immune system is functioning normally and therefore will not react to the Poland as as sometimes happens.

So the next formula I wanted to discuss is react, and it’s actually a very interesting formula, I believe so at least. And it’s based on the formula, whoe one, which is an anti parasitic formula or a formula associated with the in level. It’s sometimes curious why we might use that for allergies anyway the theory and we, I’ll show you some research that’s been done on that to support it.

Is that anti parasitic herbs. Inspire. Inspire is maybe not ex the exact word, but promote the body to regulate the immune sss the immune response and specifically the allergic immune response, meaning mast cell, histamine response, et cetera. So this formula. Combines hot and cold herbs and to address the Chinese perspective of of of allergies, which is common that we have both heat and cold concurrently in in the, usually the patterns of allergies.

Classically we’ll see this kind of the nasal, let’s say discharge is usually clear which represents a cold condition, but a lot of times this kind of hyperactivity and and hyperresponsiveness is a sign of heat. So this, there’s this kind of both heat and cold symptoms that manifest in the same time.

So reacts, react takes W one as the basis of the formula, and then adds herbs that are commonly used for food environment and environmental allergies like Fei Ang, Yuin, Bechen, and gj and also Zi and fun are. Commonly used. And and then added some adaptogenic herbs like Wrenchen and Tchen, as I mentioned before in, in shield to focus the formula on recalibrating and harmonizing the way she functions.

If we look, this is the research I was referring to. It comes from Dr. Lee from Mount Sinai, but this is the the link to the article if you’re interested in reading. And you should be getting the slides. So you could. Access it. If you wanna read more about this research.

Fascinating. About the use of. WME one. And so I also put here the original formula of WME one. So if you look up WME one pills these are the ingredients. You’ll see that there’s one of the herbs I had to change it’s called a hin or her Citis. And. It, this is a herb that I had to eliminate because it’s not available.

I think FDA Rev removed it from being used or, so I had to change that. And I also, I wanted to show you that this is the finalized formula. In in that Dr. Lee used. And so the original formula fui and hin were eliminated in the in the Research formula. I kept the f the fui in the formula.

This is the React formula. That’s the breakdown. Here’s WME one. You see we have wme and instead of hin I added Sisu. Yeah. As a substitute for it. But I did keep the the aconite fu in, in, in the formula. And again, here on the right, you’ll see all the herbs that I added for known to help in regulating food and environmental allergies and as well as the adaptogenic herbs I mentioned before.

So this is the form now react is really great for seasonal and environmental and food allergies. So it, it addresses a lot of the different manifestation of aisle allergies and it’s a great formula. And I’ve used it. For many of my patients from food allergies all the way to environmental allergies and whether it manifests with eczema and or other signs and symptoms of different allergies or even gastrointestinal if it’s a food allergies.

I also mentioned mast cell activation disorder. So this is another Manifestation of an allergic or allergy syndrome. So it’s getting a lot of attention. And it’s a very interesting syn syndrome that you can look into. And react works really well. I’ve had a few mast cell, quite a few mast cell activation disorder.

Patients that were really helped by react. What I want to add is a caution. When you react, if somebody shows or manifests anaphylactic shock or anaphylactic allergic response you have to be very careful about prescribing this formula and working. And it’s really Really important that you work with the patient’s doctor for testing reduced sensitivity for those anaphylactic results and or anaphylactic causes.

And also I wanted to mention that we have a very specific dosage suggestion. This formula is not, both the both of these formulas are not formulas. You take. Necessarily symptomatically to resolve a symptom, but rather you take it long term. Both of them need a minimum phase of three months before you, before they come to their full effect.

And so there’s a three months. Minimal period. Sometimes you need longer individually, so three months is an average. Some people, some patients will respond faster and some people, some patients will respond more slowly. And it also depends on how much acupuncture is concurrently administered and how many, and how they’re responding to all the other guidelines you might give them as part of the treatment.

Excuse me, but generally speaking, it’s really important to understand that this is not a short, both of these formulas are not short term formulas. There’s an accumulating effect that happens while taking them these formulas for a few months before considering considering the results.

These were the two formulas I wanted to discuss. I I encourage you to visit our website, Moshen herbs.com and I wanted to thank you very much for listening. And I also wanted to thank again, the AAC for letting me do this presentation. Thank you very much and have a wonderful day.

Is your Practice on Fire or Burning Down?

Holly Battrum is gonna be talking to us and our topic today is on, is your practice on fire or burning down, putting resilience and power back into your practice.

Click here to download the transcript.

Welcome to another episode of the American Acupuncture Council, to the Point, I’m your host, Lauren Brown. And I’m a C P A. I’m a doctor of traditional Chinese medicine founder of Healthy Seminars and author of Missing the Point Why Acupuncturists Fail and what they Need to Know to Succeed. And today I have a colleague and friend on our episode.

It’s gonna be Holly. Holly Battrum is gonna be talking to us and our topic today is on, is your practice on fire or burning down, putting resilience and power back into your practice. So let’s bring Holly in here and I’m gonna do a brief introduction here, but just let you know that she is also a doctor of traditional Chinese medicine.

She’s been doing great in her practice since she started it back in 2015. She’s also an. N l p coach and mentor and before she did Chinese medicine she was involved in business leadership. And Holly, it’s good to have you on and I’m looking for you to share some of those practice management pearls today.

Hi Lauren. Thank you so much for the invitation to chat with you and of course, the American Acupuncture Council for hosting these conversations. Yeah, we’re gonna have some fun. We’re gonna have some fun. So, you know, your title is Practice Is Your Practice on Fire or Burning Down and Putting Resilience and Power Back into your Practice?

And you and I I have had, you and I have had this conversation that. People want this work-life balance, and I don’t know if that’s a realistic expectation, but I’ve heard you talk about not so much work-life balance to have joy and succeed in your practice, but you talk about rhythm. Can you kind of tell me what that rhythm is about and how that is different from a work-life balance?

Yeah. I think that for me particularly, rhythm makes so much more sense, right? When you talk about balance. What are you walking on a tightrope or we’ve, you know, it’s a very fine line of things that you’re trying to achieve. Even when we’re talking about harmonizing in Chinese medicine, we don’t, we are not necessarily trying to balance the system.

We’re, we’re trying to harmonize it and move things around and so, If we get sort of trapped in this balanced concept, I think we put a lot of energy into staying in this very narrow window, right? We have our boundaries and we need to keep those boundaries and, and it’s almost like those latency patterns that we have in Chinese medicine start going into kind of holding everything in place, which becomes very taxing.

So, Right. If you look at rhythm, rhythm is ebb and flow. It’s the what we talk about all the time and. In our medicines, but we don’t necessarily apply it to ourselves. And maybe that means you don’t have a daily habit, you have a weekly habit. I know for one thing in my practice it’s, it’s really hard the way I have my clinic set up for me to get every single thing I wanna get done every single day.

But for example, when Mondays are my really long day and I may not get my workout in, I may not get all of my. How stuff done that I wanna get done because I’m spending 12 hours in practice, whereas I’m not in the clinic on Thursdays. And so I’m able to allot more time on Thursdays for some of those other things.

So I, when I started to look at it from this rhythm concept, it just took a lot of pressure off and made the burnout less and made sort of this challenge of keeping all this structure together a little bit easier. So what do you see as the some of the factors or why people are burning out?

Because we do hear practitioners, colleagues say that, you know, they went into this, they went into this to help people but they find they’re struggling. They’re becoming a. Exhausted, disenfranchised. And I’m curious kind of what do you think some of the reasons are behind that? Maybe it’s that whole rhythm, work-life balance you just discussed, and then how can somebody assess where they are in their practice to know whether they’re going in that right direction?

Yeah. So I think in medicine in general, but particularly in our, our profession, one of the things that happens is we’re taught from sort of this authoritarian concept, right? We have, which is it’s all good information, but we’re taught from a lineage standpoint. And so everything that we do then becomes, this is the way somebody else did it, our masters did it, and you.

And you’re trying to almost replicate that. And so when that happens, we know you can’t think as well in your own sense. So you can’t think as deeply of bringing your own purpose and root into what we do. So though a lot of us do go into these fields trying to help people, we’ve kind of lost ourself in the process.

And so if we try to change our mindset a little bit, and I don’t even wanna say necessarily mindset, but if we start thinking outside of that box, then we can start thinking with more of an abstract concept, and that’ll leave some of that burnout. And do you have any like specific examples, like from, did you come right outta the gates and it’s, and it was all perfect?

Or did you learn through some of your own mistakes that I know that’s, that’s where I got a lot of my lessons and that’s how I share with my colleagues. So what about yourself? Do you have any personal stories that you don’t want people to repeat and then kind of what you’re doing to have this.

Rhythm. And, and I’ll just add, cuz you were sharing, we’re talking about the work life balance and then you’re talking about rhythm. You know, everybody. If you think you’re having work-life balance on a daily basis, those are probably difficult expectations. And I liked how you said you, you know, Monday’s your busy day, so you’re not getting your workout in that day.

But if you look at it over a week or a monthly period, it looks more like balance. And so going back to my, my question, I’m just curious, like what was kind of your experience and what are some of the things that you’ve learned that you’d wanna share with our listeners? Yeah. So no, mine was perfect day one.

I’m just kidding. . I’m totally kidding. I think you go into practice and you go into this sort of, I have to make this work. And that’s great. And that’s where that motivation comes from. And you use those resources where you push yourself forward and you continue to try and try and try, but then you start to reach a point, or at least I did where.

Everything looks great on paper, right? You have this successful practice. You’ve got all these things going on, and, and everyone’s getting better. Not everyone necessarily, but PE people are getting better. People are coming in and, but you maybe don’t really feel like you can take a breath. And that’s where I started to notice this concept of, of what is this rhythm looking like and how, what is my definition of success and how does that look?

Throughout so that I could then kind of almost take back and start that concept of running my practice versus allowing it to run me. Oh, I like that. Can you Talk a little bit more about that and emphasize that, that, and to me that’s a really interesting mindset going from or going to running my practice versus my practice running me.

Can you give examples of what it looks like if your practice is running you and, and what it looks like if you’re running your practice? I, I, I’ll throw it. One, tell me if you agree with this, but in the beginning, my schedule I would, whenever patients wanted to come in, I would see them. So at seven in the morning, seven at night.

And then eventually I created hours. Even though, you know, you wanted patients, you wanted to be available cause you wanted to help everybody. And also you wanted to have a busy schedule. So let’s say you wanted to see eight people in a day. You would maybe work 12 hours to get those eight people in. And then I realize if you’re using one room, this should be done in eight hours.

And if you’re using two rooms, this should be done in four or five hours. That was a good example for me. My practice was running me and then I started running my practice that way. Is that an example? And do you have any others you can share? I, I think that’s absolutely a great example. I know when we first start, we do need to kind of bend over a little bit and, and say, oh, maybe our schedule does need to be more broad.

I know when I started, I, I worked two evenings a week and I worked Friday mornings and you know, a whole four and a half days kind of thing and a couple long days and, and, and now I’ve kind of isolated that to three days a week and I only work one evening. And, and that’s a great example and you sort of.

Kind of work outside of your boundaries. And now I’ll still, I don’t put those so concrete that I have to control them. So I think that’s where this, this little bit of a shift concept works with the resiliency. I mean, resiliency is sort of an elasticity and sometimes I do need to see somebody when I wouldn’t normally see them.

But I’m a hundred percent okay with that before I might be putting all these people on my schedule and really just being frustrated by it. And so if I keep myself within my parameters of my rhythm most of the time, then I’m able to offer more compassion and understanding to my patients when I step outside of that.

So that is a one great example. And then I’m so sorry. If you can kind of repeat the question a little bit, Lauren, then I can Yeah. Add to that and I, well, I was talking about examples of you running your practice versus the practice running you, but you just said something about cuz that flexibility and elasticity a sense that I’m getting is that you really gotta get clear on who you are, what success looks.

Looks like for you. And so it’s more about this inner work as well. Cuz when you choose to work outside your schedule, where’s your mindset at? Like, are you doing it out of fear? You’ll disappoint other and they won’t like you. Are you doing it that then they won’t come back? That to me is the practice running you.

But if your mindset was, I’m feeling. I’m feeling resourced. I really want to help this person. It would bring you joy. You’re not doing it out of guilt, out of, out of neediness, out of fear. You’re doing it out of compassion, and as you shared compassion and you really want to do this and it’s an exception more than the norm, then it sounds like that keeps you in your rhythm.

And so I, I like how you shared that. And to me that’s, that’s about getting clear on who you are. What do you want? Having healthy boundaries. Healthy, well, weighty, right? Mm-hmm. . We talked about an example of, of your practice running you versus you running your practice. Cause I think that’s what a big, when you said that, that was like, that is a good reason why we have burnout.

Mm-hmm. , most people practice. Are running them and they’re not running their practices. What do you think? So I was looking for another example besides your scheduling, but if, but another question, if you don’t have another example right off the bat is just as we get closer to wrap up, what do you think practitioners can be doing to have more of that resilience and joy back into the practice and, and what they may not want to be doing so they don’t run into burnout?

Oh one thing that I would say that we wouldn’t want to be doing is sort of the constant mind chatter. So you’re talking about that inner work. If what we choose to do is you nailed it, you know, put a nail on the head of, of if our stuff comes from a place of lack or comes from a place of should.

Then that is when we start to realize that our practice is running us. If our joy comes from a place of groundedness and oh, this helps my purpose go forward, then we’re gonna be much more in charge. Of our decisions. So that’s the big thing of like, I think what we should and shouldn’t do one thing that I think we miss out a lot of is that creativity.

And so if you’re struggling, you’re listening to this conversation and you’re saying, oh yeah, duh, I know that, but what do I do about that? It, it starts to do the self-work, but come from it as a place of creativity. If we are more creative, which might be just giving ourselves time to let our mind wander.

We forget, we take all this information in, especially this day and age, we’re trying to download more and more information in our brains, and we don’t necessarily give our brains time to process that information or daydream. For one thing, and that can be a part of creativity. If we have a creative mind, then we’re more innovative.

So if you’re struggling with what does this look like for my practice and I wanna keep, you know, a lot of people wanna keep their lineages and I think that’s absolutely amazing. But what can creativity, can you bring into that where you’re bringing your purpose and a little bit of yourself into that as well.

So a couple quick things that you can do is, you know, even just simply as picking up a new hobby, it doesn’t have to be one that you go back to. A lot of times we talk about that and we’re like, well, I used to knit, or I used to play the drums. You know, maybe that was 10 years ago, Lauren, and maybe now you wanna actually pick up a new hobby.

And while you’re working on that, you’re gonna start thinking about your purpose and your life and things like that and your practice. So that’s, that’s absolutely one thing that we can do. The other things is a couple great assessments. So you can either take a top down approach and say, Hey, what is my purpose?

What is my vision? And does everything that I do come from that standpoint? Are my yeses because I’m furthering my vision and my purpose? Or am I yeses once again from that should so you can come at it from that way and just take some time and look at that. The other way that you can do, if that feels like.

Too much is a, is a more of a, you know, bottom up approach. And so you can literally work through almost every task that you do on a daily basis and write it down and say, Hey, I have to do this. Does that feel good to me? Do I wanna do that? Do I not wanna do that? And then once you take that assessment, you can start breaking down and, and using that as, as more of like a how do you wanna feel versus what do you wanna do?

And that’ll help you align as well. And I’ll, I’ll add to what you’ve shared, cuz I like that, that I find the top down that purpose vision, basically, if you really get clear on who you are and how you’re showing up in the world, and then your practice is an extension of that for whatever reason, it just seems like the universe kind of collaborates with you and.

And you find your tribe. So if you’re authentic and you’re, like you said, trying rather than trying to be your lineage or trying to be, you know, if I try to be Holly I may not get those patients cuz it’s not authentic. But if I’m me I’ll find my tribe. Mm-hmm. And so, mm-hmm. To me that’s that. I think of on a spiritual level, conscious, more of a conscious work, really getting clear on who I am and and bringing that into my practice and getting aligned and being authentic.

And then the, the bottom up part I like that I was just actually listening to re-listening to. The book by Eckhart Toley called The New Earth. And he actually said that in it that he’s talking about there’s certain things in during the day that you may not want to do, which is normal, right? He’s talking about feeling good.

And he says, but if you can look at all your tasks and some of your tasks, like you said, are just things you’re not gonna like, but check in on how you feel and if you can just become truly present. So now we’re getting a little, again, back onto consciousness on presence. Mm-hmm. . If you can just be honest with yourself.

You don’t like to do it, but it needs to get done and just focus and be present with it versus thinking, I shouldn’t do this. I don’t want to do this. Just do it with mindfulness. Then it, and, and accept and full acceptance that this is what I need to do right now, just now. Then it has less of a drain on you.

And then I’m sure we’ve talked about this off camera. If it’s something you don’t like to do, You can always find somebody who likes to do that and do that well, and that’s somebody you can hire and delegate that too. So you don’t have to do everything. But at some, some at the beginning you do, right?

Mm-hmm. , you can start to delegate that, those things off. So you’re doing more and more of the things that you, that bring you joy that you’re really good at. Mm-hmm. . Yeah. Let me just I know we need to wrap up, but couple little things along those lines. One of my friends. Said this to me a long time ago.

We were talking about paying bills. She’s like, oh, you know, my husband always tells me that I should just be super grateful that I have the money to pay the bills. And I think that is such a different frame of reference. It’s like, oh, maybe you don’t want to pay the bills, but, you know, changing it and like, oh, I’m grateful that I can do this.

And then my other friend runs sort of a, a cleaning, like a house wife blog kind of thing. And she always calls her house cleaning instead of cleaning. And I just sat. It was a huge shift for me. Cause I’m like, oh my God, I hate cleaning. And I’m like, oh wait, no, I’m cleaning. mindset’s so important in life.

Right? And, and it comes to our practice too. I, I, I agree. So Holly, if people are looking for some coaching and a mentorship how do they find you if they wanna follow up more with you? Yeah. You can absolutely just go to hollyBattrum.com and current offerings will be up there. Shoot me an email at holly@hollybattrum.com and I’d love to chat.

Perfect. Thank you very much Holly. And I wanna remind the listeners as well that we have lots of practice management courses and some with that spiritual twist on healthy seminars.com. And also, if you like the consciousness discussions we have on my website on lauren brown.com. I have lots of conscious talks on there as well.

So healthy seminars.com for those practice management talks. And you can email me if you’re looking for that link, but, The other website is lauren brown.com and you can check out my book as well called Missing the Point, why Acupunctures Fail and What They Need To Know to Succeed. And again, thank you to the AAC for this opportunity to be your host and to our guest today, Holly.