Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Hi, my name is Michelle Gellis and I want to thank all of you for coming today to my facebook live presentation and thank you to the American Acupuncture Council for giving me this opportunity to talk about my favorite acupuncture points for the face.
I have been teaching cosmetic acupuncture for almost 20 years now. And during that time, I frequently get asked what are my all time favorite points for either lifting the face or enabling more movement, more fluidity and the facial expressions and. So I have put together my top seven and I’m going to start out with points that I use in my protocol that are mandatory for my students.
And they are what I call steps. 3.5 or stomach three and a half. It’s almost like stomach three and three quarters because it’s pretty low down. So normally when we find stomach three, we get in line with the center of the pupil and we come down. Over the cheek and that is stomach three, but for stomach 3.5, you want to come down until you’re all the way over the cheek area.
And you are going to needle straight up into either the fatty part of the cheek, or if you’re a. Patient is very thin. You can even get underneath the cheek bone and right into the foramen in the orbital rim. And so that stomach three and a half, and the next point is small and test an 18, which is found on the outer canthus of the eye you come down and the same thing, you’re going to needle straight up.
And in some individuals you’ll be into the fatty part of the cheek, maybe into the Fatia or to what we call the mass layer, which is the superficial muscular aponeurotic system, which is what enables the muscles to control the movements on the. And for some individuals, you’ll actually be able to get underneath that cheekbone.
But when you needle both of these in an upward direction, it can really provide a lifting effect to the face. And I have a picture of that in a second. The next is Sanjay 17 for the gels and the lower face. Stomach nine for the neck and balancing the hormones. You yeah, for the, I’m sorry, you yell for the brow area and yin Tom for the frown lines and stomach for the mouth.
So let me go through each one of these individually. So here is a photo of. Of someone where I have needled stomach three and a half, and you can see it’s almost down into that stomach four area and then small intestine 18, which is way over the cheekbone and you needle straight up. And you can see how this could have a lifting effect on the cheeks, on the mid cheek area.
The next is San Joe 17, which is behind the ear. It’s in that space that really deep divot behind your ear. And. When I needle this point, I needle it towards the nose. You want to be careful. There’s a lot of glands back there and, but this point is wonderful. Is great for the lymphatic system.
It affects the whole lower part of the face that we call the gels. I always joke when I’m teaching and I say there’s two types of people that have gels and people that are going to get them because as we age all of the. Fat and muscles and ligaments that used to be up here, the ligaments loosen and the fat kind of slides down.
And we ended up with a less defined jawline. So by noodling this point, And then whenever I do facial cupping, I always cut this point and I do wash Shaw back there. It really has a very lifting effect on the lower part of the face. And also on the neck area.
Stomach nine is. Definitely one of my all time favorite points. This is a picture of yours truly, and thought it was a great example of a neck. So I went ahead and marked stomach nine on it. And so stomach nine can be found. It is inline with the prominence of the laryngeal prominence and the way you find it is you ask your patient to swallow.
And when they swallow, you will feel the prominence, the laryngeal prominence, you put your finger on it and you slide right over into the empty space between the larynx and the S. And if you’re having trouble finding the SCM, you can ask your patient to just press against your hand and the SCM will pop out and.
Once you found the SCM and the larynx, then you put your finger in between the two and you feel for a pulse and wherever you feel a pulse don’t needle there you can push against where you’re feeling the pulse with your finger and then needle straight in. I use a half an inch needle. You don’t have to needle very deeply, but this point is.
Wonderful for a lot of reasons, it helps with hormones, right? It’s right by the thyroid. It also helps to open the energy up to the face is a local treatment for the neck and. I’m a classically trained five element acupuncturist. This point is called people. Welcome. It can really people who have shut down, maybe they’re a little shy or they’re.
Pushing people out of their life. Maybe they have things they want to say, but they weren’t saying them this point can help to open people back up. It’s especially important. Since the pandemic where people were in and not getting out. So this stomach nine is definitely one of my favorite points.
Next is you. Yeah. Now when I needle this, I don’t needle it in the traditional way, which the traditional definition is at the center of the brow you needle straight. And the way that I needle it is I take a half an inch needle, a two, I put the two underneath the eyebrow. I go to the center of the pupil and the center of the pupil lines with the levator muscle.
So you want to get above the orbital rim. You don’t want to be noodling on the eyelid inside the. You get above the orbital rim. Sometimes you have to lift your patient’s brow up a little bit and you take that tube and you get it right underneath the brow. And then you, once the tube is right underneath the brow, you can just push the needle right up.
And so you can see in this picture that I have. Where I’ve needled underneath the brow. And then I have followed this up with bladder two and Sanchez 23, all three lifted a needle in a kind of lifted direction in order to really pull that brow. So you, yeah. Now is a real heavy hitter when it comes to lifting the brow and it can even help, not just with the brow, but with the lid.
next are those frown lines. And some people we have just the one line in the center. And if that is the case, I will thread in Tom right through the wrinkle. I needle it in an upward direction, right through the wrinkle. And again, I’ll use a half inch. Needle. And this serves two, three purposes. One is it relaxes this whole area and relaxes your patient.
And it also works right on the procerus muscle, which is this little triangular muscle here, which pulls this whole area together. And You can also needle with little intradermal needles, if someone, so you can have just the one wrinkle or you can have the two wrinkles, which they call the Eleven’s and this woman has those.
And then some people, they get the, what they call the a hundred and Eleven’s where they’ll have a wrinkle. Medial to each eyebrow, plus they’ll also have a wrinkle right in the center here. So you can use yin tongue needled and you can also use some intradermal needles and get into those other little wrinkles right there.
And this will. Both relax, your patient lacks the procerus muscle. And locally, any time you take an acupuncture needle and you thread it through a wrinkle, you’re stimulating collagen locally in the scan, fibroblasts are created and it helps to Create a collagen in the area. So the wrinkle itself can fill in because even if you just relax the muscle, there can still be a resultant, a wrinkle in the area.
And the last point. Which is another favorite of mine, and this is a real powerhouse for the whole mouth area. And the mouth area can be difficult to treat because there are a lot of different issues or concerns that individuals have with their mouth, not just cosmetic, but also with issues with movement.
And I’m going to back up real quick, a step. This can be the same with, I was talking about using you yell for the brow. If someone has had Bell’s palsy, you can use the point noodle, the way that I said, and this can help get movement back into the brow area, lift their lid. If they still have drooping, or if they’ve had a stroke.
Stomach four is right in this area called the Modi OLIS and it is just lateral to the corner of the map. And the reason why this is such a powerhouse and why it’s one of my favorite points is the muscle around. It’s not shown in this picture, but there’s a muscle that goes all the way around the outside of the mouth.
So this is the or us and people get wrinkles all around their lips. So by treating pretty much any of the acupuncture points, like run 24 or stomach for any of the acupuncture points that light around them. You are going to treat the whole obicularis Oris, which really plays into these wrinkles around the lips.
So that’s one reason. And the other reason is people can get these frown lines that go they’re called marionette lines, but it looks like the person is frowning, even when they’re not. And the wrinkles go from the corner of the mouth, down to the jaw line. And by treating stomach four, you can see all the different muscles that stomach four is attached to.
So the Buka Nadir, which is very deep here, the resorts, which pulls the mouth this way. And you have your zygomaticus major and that helps to pull the sides of the mouth up. You have your , which runs, it hooks onto your jaw and then goes all the way down over your clap. You have your levator angulate Orus your depressor anguli Oris.
And your what we call the D a O is the depressor anguli Oris, which is this muscle right here. And this muscle right here attaches right onto your platoon. So you can see all these different muscles. 1, 2, 3, 4, 5, 6. I think there’s a muscles that are attached to this modal list, which is our stomach four.
So by treating stomach four, you’re treating all of these muscles. You’re helping the wrinkles. You’re helping the drooping that can go on. And also laxity since the Dao is attached to the . When you treat the Dao, you help to reduce any pulling on the platoon FISMA, which can cause those SMA bands that can happen.
I love stomach four and I highly recommend it. You can needle it straight in. And it’s one, it’s actually a motor point for treating the whole mouth area. And so those are my favorite points for treating the face. There are many more, there are many muscles on the face, but those are my top.
And if you want to learn more about. Cosmetic acupuncture or acupuncture for treating neuromuscular facial conditions. You can go to my website, facial acupuncture, classes.com, and learn more about I’ve got a lot of free videos. I have a lot of free information handouts and plus my class informing.
So thank you for showing up today. And I look forward to seeing you again, next time.
Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Hi everyone, and welcome to another episode of, to the point. I am Dr. Nell with the American Acupuncture Council, and I’d like to thank AAC for the opportunity to present today. We are going to be talking about a sticky topic that as practitioners I’m sure some of us try to shy away from, but it’s extremely important.
And that is removing the fear of discussing informed consent. As usual, I’m going to make sure that you all have tools at the end of this, that you can implement in your practice. Immediately. With that being said, let’s go to the.
Okay. So here’s how today’s going to get broken down. In, a short value-driven time period. We’re going to start with how you’re currently using informed consent. What does that look like? How patients actually feel about informed consent versus how we might feel about informed consent.
So some key element. Of informed consent, what needs to be in there for it to be effective. And then do’s, and don’ts because there are some things that we naturally want to do as practitioners that don’t necessarily align with what we need to be doing when having this important discussion. And then of course, those very tangible takeaways that we need for you all, to be able to say, Hey, I did this 15 minute live and now I’m going to implement in my practice.
So let’s dive right in. How are you currently using this? So when I say. We’re discussing informed consent. What does that first thought look like? Is it, oh, that’s that form? That’s in my electronic health records and it’s a quick sign off that patients do before they come in. Is that something that even gets discussed?
Is it part of your new patient packet when you’re coming in, your patients coming into the office and you have a stack of paperwork for them to fill out. They’re running late and you still want to get them in and they’re going through everything and just signing as quickly as possible. Do you actually use this as a counseling tool?
Do you go through it? Is it a written and verbal way to educate your patient on what their treatment plan is going to look like and what they should anticipate? Are some of you feeling unsure? I know I’ve been in this place before, when I was new to practice. Yes. I believe informed consent is a forum.
How am I utilizing that beyond a quick signature? And if we’re being honest, it might be this last one. Is it something you just get someone to sign as quickly as possible? Hoping that they won’t ask questions like, oh gosh, I don’t want them to ask about bruising or pneumothorax because that’s going to be an uncomfortable conversation.
We’re going to go through these and actually flip it. So you see what an incredible opportunity we do have. I truly believe that informed consent and discuss. Discussions around. It is probably one of the most underutilized patient retention tools. And usually we don’t think of it in that way. So that’s what I’m hoping you all are going to get out of this today.
So let’s keep going. So perception versus reality. So that last note that I had on. Slide about, are you just racing through it, hoping that they sign it in your electronic health records forms. And then we don’t have to really have a discussion around it because there are things like pneumothorax, bruising, potential bleeding burns from moxa or cupping.
Those are things that are actually in an informed consent. And so that can feel a little intimidating and a little scary to have to talk somebody through because our medicine is very safe. The good news is patients are very accustomed to signing informed consent. A lot of times it’s a very passive process.
Half the time they don’t even read it. But when we dive into those elements of informed consent, we’re going to see that. Not only them reading, but also understanding is a key part of that. And we want to make sure that we’re doing that. So with that being said, we are going to dial down our fear because patients are used to this.
If they go into any other medical practice, they’re accustomed to signing an informed consent form. And also. No those drug commercials or when you get a prescription and that long, long sheet of paper that lists all of the potential side effects of what they’re entering into with that prescription.
This is something that is so common nowadays, and it’s not unusual to go to a doctor’s office and have to sign an informed consent. And part of that is our legitimacy as medical providers, right? So we want to be doing things that align us with the healthcare delivery system. So we can provide that integrative care that is really patient centered.
That being. This looks intimidating, especially as a practitioner. We like to spend time with our patients. We have a very personalized medicine. We want to get to know them. And some of this can feel a little impersonal at first glance, but I want to briefly break this down for you because when you look at these elements of an informed consent form, You realize this is actually about patient centered care and this opens up true opportunities to dive into conversations that will actually help your patients come back into your practice.
So converting from new patients to overturning patient, so this whole form am definitely not reading it through. If you want a copy of this form. We do have one through the American acupuncture council and I am happy to send it to you. And my email is posted on this. So Nell at acupuncture, council.com.
I’d be more than happy to send you this because it’s a good, solid, informed consent form. But what does this actually say paragraph by paragraph? The first paragraph is just saying. As a patient, I understand that I’m signing this agreement and these are the things that are going to be included in this agreement.
Then we get into. That they are actually requesting the treatment. It’s not something that’s being forced upon them. It’s something that they are saying, yes. I would like acupuncture and I’m ready to enter into this treatment space. Different methods of treatment. So is it acupuncture? Is it ? Is it cupping?
Moxa. Those are the different methods that they could encounter herbal medicine when seeing a practitioner such as ourselves and then getting into the benefits and risks. Quite frankly, we should probably flip that. It’s a little more risks than benefits. Hopefully you are throughout the entire process of bringing a prospective patient into your practice and then retaining them as a patient you’re of course, going to be going over benefits in this form, though, there is more of a focus on the risks because patients need to be informed about what those potential risks may be.
And this is where I actually think that opportunity comes in for a discussion, which we’re going to go over in a few minutes. Something also very important results are not guaranteed and there’s no promise to cure. Now with this, that is standard across all medical practices, you are not going to go to a doctor’s office that tells you their results are guaranteed.
It’s not a spa experience. It’s not Walmart. It’s not, McDonald’s where you have it, your way. You’re a medical provider. And so we can’t make those promises. And especially in our medicine, we know. How individuals bodies respond very differently to treatment and those expectations have to be managed appropriately.
And again, that levels us up to being on par with other medical providers, because of course, we’re not going to promise to cure someone or guarantee results. And then going over the patient has responsibilities with this as well. It’s not just about you informing the patient. This is what they should anticipate, but it’s also the patient accepting responsibility for their part in this treatment.
What gets focused on in the informed consent when it comes to the patient’s responsibility is to inform the practitioner. So let’s say you have a patient who is not pregnant when they initially come into your practice. They should be letting you know if they become pregnant later on. If they stopped taking a medication.
If they start taking a medication, how would you know that unless you are in active communication with their MD or the patient tells you. And so we want to be really clear that there is a patient responsibility aspect to this informed consent. It’s not just about you as a practitioner, laying all these things out there for them.
And then alternatives to the care that you are recommending. And, in this particular form, might list and sides might list massage. What are things that people may be doing through the standard of care? Or could be doing other options that are out there for whatever ailment that they have, that they’re coming to you for treatment.
And it’s important because again, that’s informing the patient and that is true patient centered care. You want people to know what their options are and then an opportunity for questions. This is actually a requirement that. They’re signing off as the patient saying, I was given an opportunity to ask questions with this form.
And I think this is important because how do we remedy that with, the standard way that electronic health records and patient intakes are set up? A lot of times people are filling out this form before they come into your practice. And that’s not really the design of informed consent, and we are going to go a little bit into.
How this is so much more than a form and how you can incorporate this in every patient treatment that you give and that you need to be incorporating it in every patient treatment that.
Let’s look at the do’s and don’ts, so let’s not set it and forget it. So what do I mean by that? There are things that you do want to set it and forget it. Your business license, you want to make sure you take care of that. And that’s not really something that you might need to be thinking about on a day to day, your malpractice insurance, it protects you.
You’re paying for it every year. You know that you’re covered, you’re reading your policy. Should be reading your policy. But unless something arises, it’s not something that you have to actively engage with on a day-to-day basis. Informed consent is different. It is not something that you just have someone sign on that very first visit and then never have another conversation around it.
And I’ll tell you exactly how we implement that. We don’t want to limit that informed consent to the first visit. Okay. Every time you go into a patient room to check them when they have needles in, if you are taking needles out, if you are reinserting needles, that’s an informed consent conversation that communication that you have with your patient telling them that you’re going to be inserting a needle into GB 30, which is in a sensitive area.
That’s informed consent, asking the patient, if that’s okay, asking that they understand the purpose of that part of your treatment. So it’s something that you will engage in constantly. And we don’t want to shy away from discussing these key points of the informed consent, particularly those potential adverse events.
This is actually an opportunity to educate your patient because. If they are used to standard of care, if they’re used to integrative care, they’ve run into horrific potential side effects from treatment, whether it’s from pharmaceutical medication surgery, a lot of things that people with chronic illness.
Which is what we see in this country run into. And it’s actually an opportunity to get into those potential risks of treatment and educate the patient on how truly safe this medicine is. And you’ll be able to come up with your own ways. I can give you some examples in a minute of how to talk about bruising.
How to talk about how bruising from cupping is different than an injury bruise and. It’s the same thing. When people are doing sales, like to address the objections, you want to make sure you get in front of that because you don’t know where your patient’s mind is going to wander to. And how scary potential side effects could look for them.
And maybe they’re just mulling over that in their head. This gives you an opportunity to educate them on how unlikely some of the risks are and how common some of them are things to definitely do. And we, I just alluded to this a little bit, engage the patient in a collaborative conversation. When you’re making sure that they have time for their questions when you are welcoming those questions and actually going out of your way to elicit those questions by diving into them informed consent, that creates a bond with your patient that helps build trust.
That allows them to understand like, Hey. This person, this practitioner is truly engaged in helping me with my long-term health goals. This isn’t them just trying to get through paperwork, which unfortunately is something that patients are used to that will set you apart, engaging in that conversation and remain confident.
Because again, you are a medical provider, just like other medical providers that patients have seen in the past. You have this patient centered approach they’re already used to informed consent. So you taking the time to really dive into that with them, you should be confident. You are an expert in your field.
You’re more of an expert, even if you’re right out of school, more of an expert than the patient who’s coming to see you. So you deserve to have that. And realizing that patients are not, they’re just not intimidated by informed consent. They may have questions. I hope they have questions. I hope they’re engaged in their care.
That’s good for you as a provider. If someone is committed to their health and reaching their health. But just know that they’re not intimidated by this questions do not mean they’re against signing this form or engaging in this process now. All right. So like I told you, your tangible things, your action items for informed consent.
So I always tell students and practitioners, there is huge opportunity here. When you look at it as an opportunity to educate, and I am all about managing expectations. I think it is something that unfortunately, how many of you have had that patient who says, oh, I tried acupuncture before it doesn’t work.
Oh, how many times did you try it once? Did anyone tell them that it takes more than one treatment to receive sustained results for a chronic condition? No. So you get to be the provider who does educate that patient. So things that you can have a really engaged discussion on that actually turn your new patients into compliant followup patients who can become a life patients, because you’re building that trust and you’re managing the expectations on the front end.
Let’s talk about the results, not being guaranteed. Again, very standard across medical practices to have something in there saying results are not guaranteed. The way that I like to discuss this beyond just saying, in the form, we don’t guarantee results. Engage that patient in a discussion around how everyone’s body is.
How this medicine focuses on individualized, personalized, comprehensive care, which means that the patient that’s sitting in front of you, that’s suffering from insomnia and their friend who was suffering from insomnia and got this one point in time. Doesn’t mean it’s appropriate for the patient sitting in front of you.
That’s an opportunity to educate them on how treatment plans look different on how you are going to be putting your time, your energy, your commitment as a provider towards their personalized treatment plan. What a great way to discuss results, not being guaranteed. It’s about them. It’s about how their body responds.
That also engages the patient in this space where they realize, oh, I have. In my treatment plan as well. It’s not just about this doctor telling me what to do and I lay there on the table and get needles and it’s magically going to change my life. I have things that I can be doing outside of here. And that’s the same thing with no promise to cure.
It’s that personalized care we have to see how your body responds, knowing this medicine, this is what I anticipate. As you’re talking through your report of findings, you’re talking through your treatment plan. You get to utilize your expertise, but also make sure that the patient has some ownership in that.
This is an important one. There may be discomfort before relief. How many of you check in with your patient after that first? See how they’re doing, particularly if they’ve never had acupuncture before they’re coming in for pain, they feel great walking out the door. And then they go home to the stress of their kids or to the stress of work.
They are, physically moving things in a way where they don’t have proper biomechanics. They can do outside of your treatment. So many things to either promote your treatment and the good work that you did or completely tear it apart. And again, because of the individualized nature of our medicines, You don’t know which way that’s going to go for somebody.
And so knowing that there may be to some discomfort and that, we’re retraining the body, we’re reminding the body, what it feels like to be balanced, to have homeostasis that takes some time to stick. This is the managing expectations piece. And this all comes from a proper conversation around informed consent.
Okay. There’s no one size fits all approach. You are a wonderful, special individual. Who doesn’t want to feel special, making that patient feel special. And that you’re curating something just for them and knowing that they’re not going to be fixed after just one visit, you have to understand it’s not a no brainer for patients who haven’t experienced this medicine.
They are used to taking a pill and having symptoms go away. The problem isn’t necessarily solved, but that is the quick turnaround that immediate gratification that patients are accustomed to. And so we need to be able to recognize that, address it and explain that, it’s like a lot of things you could go to the gym.
You’re not going to get into shape or lose 10 pounds. It depends on what your goals are, how many treatments you’re going to need, how your body responds, but managing those expectations on the front end so that your patient doesn’t turn into somebody who goes to another acupuncturist, say it didn’t work for me.
And then I like to consider using more than one informed consent form. And I’ll tell you how I do this in my practice. And we have a. Host next week Michelle Gallas, who will be talking about cosmetic acupuncture. She is an expert in that field. And so she, might agree with this as well when you’re doing certain procedures like cosmetic acupuncture or micro-needling, there’s a higher risk involved with that.
It’s a little bit different than a general acupuncture treatment. Then cupping then Quasha. So I utilize AACS informed consent form, which has a very comprehensive, the form that we went over today. Very comprehensive list and you’re well covered. But I use an additional form for cosmetic acupuncture and microneedling.
The reason I do this is because it opens up yet another conversation. It doesn’t scare people off who are not getting cosmetic acupuncture and microneedling. If you have microneedle, you need to be listing bleeding. The face obviously is much more likely to bruise than other areas of the body.
You want people to stay out of the sun after microneedling depending on, what you use topically and. Depth all of that. So those are things you might not have to talk about with someone for a general acupuncture treatment. And so to keep the conversation really focused and make sure you are reaching the goal of having a patient who understands who is requesting the treatment excited about the treatment.
I like to use those separately. So if I have someone who comes in initially for a regular treatment, they’re being onboarded as a new patient, I will use the general informed consent because let’s say six months later, they’re like, wow, my GI issues are gone. My insomnia is better. I heard you do cosmetic work.
Can we do some of that? I want that new form coming in for a new discussion so that it’s fresh in their mind. And we have an opportunity to have that collaboration together, and the patient really understands what the expectations are. So I recommend always look for ways to discuss informed consent rather than shying away from it.
This is going to boost patient engagement, those referrals. You want patients who are excited and enthusiastic about the care that they received from you and something that makes us so different from other providers, patients usually see it’s not only that individualized approach, but that true connection that you have with your patients.
They want to feel that people want to feel heard. They want to feel validated, understood, and like you’re making a plan, especially for them. And so when we focus on that and look for ways that we can incorporate informed consent, whether it’s when you go in five minutes after the treatment is started, just to check on the patient, to stimulate the needle.
Let them know what you’re doing, ask them if it’s okay. Ask them how they’re feeling, how they’re responding. You get so much valuable feedback from that. And each touch point like that helps build trust with your patients who are then more likely to continue in your care and are more likely to refer other people to your practice.
So this is what we got through today. I hope that we’ve shifted some minds and hearts how we’re currently using the informed consent, how patients really feel about it. We went through those key elements do’s and don’ts, and then of course your tangible takeaways. So thank you all so much. For joining today I’m very excited about our next speaker next week on to the point, like I said, we have Michelle Gellis.
She is an expert in the cosmetic acupuncture field. I think, yeah, I might need to tune in and get some tips from her. So thank you all again for joining and be sure to share.
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 folks Jeffrey Grossman here. And thank you so much for joining me. The American Acupuncture Council, meet up here. Thanks for taking the time out of your busy day to join me, to learn more about business and marketing. So today is going to be a little bit off the cuff. And I’m going to be answering several questions that have come in over the years from practitioners who are trying to grow their practice.
And I’ve got a series of questions here that I’m going to go through and provide as detailed of answers that I can for those. And if there are any other questions that come up later on, feel free to reach out to me or post something below here. So my name is Jeffrey Grossman. I am the owner and founder.
Acupuncture MediaWorks, Accu Perfect Websites and Accu Downloads. And I’ve been helping acupuncturists since 2002 build their practice and educate their patients and market and do all the things that are necessary for us in order to bring in new patients and remain viable. Now, acupuncture school gave you all the amazing tools to be an excellent diagnostician pulse finder, tongue reader.
Point prescriber and guash Shaw Dewar, but it neglected to give you all the tools that you need to run a business and be the entrepreneur that you need to be as far as in order to, grow your practice because I’m sure some of you are out there looking to be successful and make money that is gives you, earns you a reasonable salary.
I’m here to provide some insight into some questions that maybe you have, or have had in the past. And also if you ever need any help at the end of this training, you can feel free to reach out to me. Send me an email at Jeffrey, J E F F R E Y. @ acupuncture. Media works.com. I’d love to chat with you and help figure out some of these concerns issues.
Questions that you yourself might have. So let me just jump right into this here. One of the questions that I get often from practitioners is why should I use social media in my practice? And how would I even get started if I choose to do that? Social media. These days is something that you really can’t avoid.
We’ve got Instagram, we’ve got Facebook, we’ve got Twitter. And I’m not saying that you need to be part of all of those. Social media portals, but you need to have an online presence. And these days when people are looking for you, they are going to the internet in order to check you out and read about you and learn about you.
So it’s important to have a social media presence. And my suggestion is that you have. A Facebook business page for your practice. It’s really important to do because most of your clients are probably on Facebook and it would be important for you to have different posts on there different just, different ways to interact different questions that you’re going to be answering for them.
Couple of things that you can be doing is creating a marketing calendar and a marketing calendar could be something really simple. Like every Monday you could do Meridian Monday, where you talk about a specific Meridian every Tuesday. Testimonial Tuesday, we use share an insight and some information for, on success of one of your patients.
Wednesdays could be wisdom, Wednesdays where you share some. Wisdom and some knowledge bombs that you’ve learned over the years that could be helpful for self care or home remedies or just some really great quotes that you’ve come across that add insight and inspiration to your patients.
Thursdays could be about technique Thursdays, where you offer a specific different technique wash up. Yeah, electric stem and then Fridays could be free for all where you would do whatever it is that you want. So that’s a really simple strategy to use and post on your Facebook pages. Now, one of the things that I’ve heard that.
Rough for a patient for practitioners is developing the content. There are several ways you can go about this one. There you can go to, you can hire that out and outsource that. You can hire writers. You could hire designers for you. And you can have people create, marketing social media graphics.
As for you. You could go to a online website called Canva and create your own portals. Or you can go to an online website called Acue downloads.com where they provide done for you content for practitioners specifically for the acupuncture industry social media graphics, research updates, clinic forums.
Everything that you need to establish an online presence. So that can really simplify what it is that you need to do and how to get it done for you when you use social media. But I really do think it is important to have that presence because. The more that you are in top of mind awareness with your patients.
The more familiar they will become a view. And therefore when something comes up with them an injury or a friend needs a referral, they will remember that you posted something on Facebook about migraines or infertility or sprained ankles or whatever it is. So curating that awareness will be helpful for you.
Develop that online following. Okay. Hopefully that helps. So another question that comes up from practitioners often is what’s the difference between a core message and an elevator pitch. Okay. So this is something that I’ve talked about on the AAC in the past is developing your core message. And it’s an incredible piece to.
Creating your practice and creating your message. So a core message is really important. The core message is it’s a positioning statement telling people why you do what you do and why they should choose you over the competition. Whereas an elevator pitch just tells people what you do. So let me talk with you a little bit about some of the core principles that create a corpsman.
Part of a core message is coming up with three aspects. What the person’s problem is in this case, your patients have a particular problem that they want solved what your particular solutions are to solve that problem and what their life will look like after you solve their problems. So for instance, acupuncture, media work.
Our court, what are the core messages that we use is that acupuncturists, the problem is an acupuncturist. I’m just speaking to you. Now, the problem is that acupuncturist don’t like marketing their practice, right? They don’t know what to do. They don’t know how to grow their business and so on. So the core, our core message reflects that and our core message would go something like this acupuncture.
Struggle with growing their practice and developing marketing tools to attract new patients here at acupuncture, MediaWorks, and Accu downloads. We provide high quality cost-effective and powerful marketing and patient education tools for the acupuncture profession so that acupuncturists can spend less.
Developing those tools and more time to helping their patients so they can ultimately reprieve the rewards and increase their profit. So that is a simple core message that we use for Acura doubt for acupuncture. Media works. Okay. Simple core message for you. As a practitioner could go something like this.
Let’s say for instance, you are working with patients who have sports injuries and they want to really do well on their next marathon. So the problem would be that many patients, many of my patients suffer from injuries and strains and sprains are due to overexertion here at Jeffrey’s acupuncture.
We provide state-of-the-art high and Telecare and telehealth and and acupuncture techniques to help alleviate pain, improve for four minutes so that our patients can go out and win their next race. And and and and be injury free, something as simple as that would be great for that particular type of conversation.
A core message is an important piece. And I feel like it’s one of those things that is often overlooked and squashed in with creating an elevator pitch, an elevator pitches. Hi, my name’s Jeffrey Grossman. I’m an acupuncturist. I help people get well and stay healthy. And my practice is over, down the street over here.
Whereas your core message really defines the problem, the solution and what their life will look like afterwards. Okay. Hopefully that’s helpful. Another question that I often get from PE from practitioners is I have people fall out of care all the time. What can I do to keep them scheduled? So my first comment on that, and my first question would be to you is what are you doing on a regular basis to stay in top of mind awareness?
So your patients won’t fall out of care. Do you have regular emails that go out? Do you have regular communications that you’re sending? Do you have. Texting policies. Do you have a social media presence is your website are updated and current and you’re are you often sending leads and patients to your website to find new information?
And when patients fall out of. What kind of particular protocols do you have in place to get them back on the books? All right. So oftentimes we spent a lot of energy getting patient, doing a marketing and doing a health fair or whatever it is that we’re doing to pull patients in. We get them in, we treat them, they stick around for three or four visits and then boom, they’re gone, they fall out of care. So the important thing first off is to do is to review. Series of a treatment plan with them. And I call that a report of findings. When a patient comes in, it’s important for you to review what you found, what’s wrong, what they can expect and how long it’s going to take with them.
And you do that when you deliver the report of findings and what this. It sets down this particular protocol and it sets down this timeline of treatments that you’ll be requesting or suggesting that they receive with you. Lot of practitioners go from treatment to treatment.
They don’t necessarily say. I want to see you once a week for the next 12 weeks, and then we’ll reevaluate, which is what you should be doing. Maybe you’re not saying 12 weeks, maybe eight weeks or six weeks or whatever it is, but it’s important for you as a practice to lay down the grounding and that foundation for them when they first, when the first visit or within the second visit of what they’re, what your expectations and what their expectations of care are, and then recommend that to them.
Okay. Patients have a clear understanding that’s going on. X amount of visits and then you’re going to come back and reevaluate then it’s, it like sets these precedent in their mind that this is what’s expected and this is what they will or won’t do. And therefore they will, most likely continue their treatment plan with you.
And then once that initial treatment, Continue to follow it up. They’ll have a regular tuneup visits, but that’s what you need to communicate to your patients in the best time to do that is between the first and the second visit using report of findings. So patients will fall out of care. It’s inevitable, but the way.
Communicate to them throughout the process from when they first become a new patient. You’ve got to always be in top of mind with them. You ought to always be sending them communications and always be sharing things with them. One of the things that I find that’s interesting with the Accu download software is that when a patient comes in off the treatment table, what do you send them home with?
Right there. So a patient comes in, they’ve got migraines. Do you send them home with something that you can literally print handout and send them for self care? When a patient comes in and they’ve got back pain, what do you send them home with to help them alleviate their back pain further? What kind of self-care tips do you provide them?
If they got suici deficiency, what are you sending them home with? Awesome that you’re doing moxa or cupping or even the, or the acupuncture, but what kind of self care, what kind of protocols are you sharing with them that they go home with and furthers their care? So when you send them home with something, it does a couple things.
One. Makes you look awesome because you’re sending them home with some really cool tools to further support their care. And they’re like, wow, this guy must really care about me. Every time I go in, I get a new piece of information that helps me get better. Helps me get well, he’s really committed to my care.
That’s one thing that it does. The other thing that it provides is it provides you with constant tools of communication that you’re already. Sending and sharing with your patients. Okay. So when you do that, it makes patients less likely to fall out of care. All right. All right. So let’s see another question that comes in that I asked for that I get frequently.
No, of course, right? How do I get new patients? Okay. Everyone wants to know that one. That’s the million dollar question. So when I work with my coaching clients, Then needing to get new patients. The first thing I asked him is what’s your core message. Okay. Then I’ll ask them what happens when I hit your website.
Is your core message on your website. When I go to your website, do I know exactly? What it is that you do within a few seconds. Do I know that you are a sports injury doctor? Do I know that you helped with infertility patients? Do I know that you help that you’re the migraine expert in the community? I need to know these things, the moment I hit your website.
Okay. And so when people hear about you, when they get a referral, For from you, the first place they go is your website. So that needs to be dialed in a way that expresses what your core message is. And that offers them strong calls to action, like schedule an appointment, download this form to come in for a a an free or low cost evaluation or whatever it is that.
Wanting to use to motivate those people to come in. It needs to be front and centered and present on your website. It shouldn’t be just schedule your appointment with me. There should be something. Prior to that gets them introduced to you. That gets them to test the waters, so to speak, to see if so they can be assured that you’re the right person for them.
And so you could rest assured that you want to actually work with them with care. All right. And so the first things to think about when you get new patients are what’s your messaging. What’s your website and then what is your followup, your nurturing that happens after patients get on board.
Okay. How do you stay in communications with them? All right. So let me just give you a couple of cool things about attracting new patients. First thing I tell all of my students, when I teach at the practice management class. Join Toastmasters. Okay. Toastmasters international, go to it, putting your zip code, Google it.
And you’ll see tons of Toastmaster organizations with where you are now. Toastmasters changed my life. It gave me the confidence to speak more efficiently. It gave me the stage at which I would present my topics about acupuncture. And it also gave me referrals. And from those referrals, I got other referrals.
All right. So Toastmasters is not only. Powerful to help me get new patients, but it’s also an incredible way for me to build my confidence as a practitioner. Step one way in getting new patients. Another way is reaching out to local MDs, NDS, chiropractors, LMPs, and, introducing yourself, getting connected with them, reaching out to them, asking them how you can refer to them.
And in turn. I was telling them how they can refer to you. And what I mean by that is when you develop this relationship, this rapport, and you reach out to them with the idea that, Hey, I’m looking to refer people to chiropractor. I want to know the best route at which how I can send people to you. I want to know what kind of chiropractic you do.
I want to know what kind of, what your success rate is with particular conditions. Do you focus on anything? Do you specialize in anything and so on? And you can do that in different different medical arenas. And then with that, you would ask them if they want to establish a referral relationship, you’d give them, tell them, what you specialize in, what your current message is and how.
Best for them to refer people to you. Do you have certificates that you can hand out? Do you have business cards with calls to action on them? Do you want them to go to a specific pages unique to that doctor in, on your website, in that respect? Okay. Also health fairs are an amazing way to get new patients on board.
I love health fairs. One of the books that I found most intriguing. And most effective for me to get a PA patients from the event into the clinic was Giovanni’s book on tongue diagnosis. I literally opened that book up to the ugliest tongue pictures, put it on this front and center on my table and people would walk over and they’d be like, Hey.
Gross look, what are those tongues doing over there? And then that would be my segue and opening into talking with them about, that tongues are a barometer of inner health. And as an acupuncturist, we take the tongues and all these other diagnostic procedures into consideration to come up with a an in-depth unique treatment plan for every individual that comes into the clinic.
No two people are treated the same and so on. That would bring the people from the health fair into my room. And then from there you need to have a strong call to action to get them from that event into the practice, what I’ve used in the past for two things, inviting them in for a stress reduction treatment where I just use 0.0 and Shen men of the ear.
And then also and then also inviting them in for a low cost evaluation. Okay. Great ways to get new patients on board. That’s about all I have for you today. So if you have any questions, any comments feel free to reach out to me again. jeffrey@acupuncturemediaworks.com or info@accudownloads.com.
Either those you can reach me at and. The world needs more healers. Like you guys are conscious, you’re aware you’ve got powerful healing abilities with this medicine changes lives. Be scared about getting out there and grow your practice. These lectures that the AAC brings you are powerful and deep.
And even if you walk away with just one little nugget from today’s lesson that potentially could change your practice. So I apologize for wearing my headphones and looking like a pilot here today, but that’s how we had to go with with the recording. So you guys stay beautiful. Stay. Awesome. And until next time remember change the world one needle, one person at a time.
Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
So, What is the number one way? What’s the update on inspiring MD referrals into your practice? This is Chen Yen, six and seven figure practice make-over mentor at introverted visionary. Your host for the American Acupuncture Council live show today. Attracting new patients is a. It’s a so nice to be able to have referrals coming into the practice because it just feels good.
And you could focus on helping your patients instead of worrying about where to find them. And when it comes to medical doctor referrals, Ma many medical doctors have a lot of patients within their practices and we’d be willing to refer if they knew about you and also understood how you can help, but what would be the best way to develop those relationships and then be able to actually inspire those referrals.
So the first thing to think about is what is the trifecta. So when we look at the trifecta, I want you to think about. Either a particular provider you would like to be getting referrals from, and that way you don’t have to be doing as much marketing in your practice. So it could be a medical doctor.
It could be a nurse practitioner. It doesn’t have to be limited to medical. Doctors could be PA. PTs. We just had an acupuncturist. Client of ours get quite a few referrals from a PT office just the other week. And so think about what holistic practitioners also conventional practitioners could medical practitioners could be good sources of referrals for you then consider.
The trifecta. So what is the trifecta? So once you’ve decided on who you would like to be sending you referrals, then we need to think about how can we inspire them in these three Trifacta areas. Number one is what. How is their level of connection with you as a person, because have you ever thought about this?
The people you tend to refer to, they’re probably people you have some kind of a connection with, it’s probably not someone you don’t really like. So that level of connection with the person can also determine the frequency and whether they refer. Or not that’s one aspect of the Trek trifecta.
You can think about this by drawing a triangle by the way. Or just thinking about it in your head. So the second key area trifecta is what. Is there trust and understanding of your modality. Now you might think of this first as oh, okay. So they need to trust in acupuncture, working for their patients, but it’s not just limited to that.
It’s also about. Are they clear about what situations are good are most helpful to be sending their patients to you for it, because they’re not going to send all their patients to you, but in what particular situations would be good to send it to you for acupuncture. And do they feel comfortable with it?
Because a lot, the truth is a lot of medical doctors and conventional medical practitioners are concerned about loss exceeds. They don’t want to refer someone, a patient to someone and then really don’t know what they’re doing with them. And then there’s some issues with the patient and a lawsuit comes up, like they’re concerned about that.
So how can you help them be able to feel comfortable with safety and efficacy? If they don’t feel like it’s going to be safe and effective, they’re not going to refer. So that’s a second aspect.
So the third chat trifecta. Is the third trifecta is what is the how are you staying in top of mind awareness for them? Because just because they have, you have a good conversation with them and it feels good and you think, oh God, I’ve got a connection now and they’re going to refer. It doesn’t mean that they’ll even remember you.
A few weeks from now, because many times doctors are approached by different people, whether it’s nurses, different vendors drug reps, all kinds of things and new people coming at them. And so if you’re not top of mind awareness that even if you do develop a relationship with them and they do know about you and they trust in you, if you’re not top of mind awareness, then.
They’re not going to refer as much, for example, why do you think that drug companies hire drug reps to go and talk to the doctors? Why not just hire them to do it once because, and I’ve worked at HR company before I’ve seen the insides of a drug company, and I know there’s statistics about every single time when a drug rep goes and talks to a medical doctor, there’s a prescription.
For that particular medication. Why? Because that doctor was reminded of that. So when you are top of mind awareness for the doctor, then they’re going to be more likely to refer. So those are the three key aspects of the trifecta. So then if you have decided who you would like to be getting more referrals from, or getting new referrals from a medical doctor or a provider, then consider rate yourself on a scale.
One through 10 for each of the aspects of the trifecta and with 10 being the highest that you’re, really solid on that with one being, being the. Then we could see how we can move you up closer to 10 for each aspect of the trifecta. That’s going to help you with inspiring more medical doctor referrals.
Now, another common question I get is what is the the best way? So what is the best approach to getting their attention and in such a way that they would refer. Now I will say low-hanging fruit for many of you is not. Cause one thing I hear is oh, I don’t like to just reach out to random doctor’s offices and cold call them.
That just feels really intimidating. And I think so one thing that low-hanging fruits is you could reach out to people for whom you have. And then I, but just because they’re pressed with how well you treated their one patient, it doesn’t mean that they’re going to refer and constantly refer either.
So one very important thing is. Circling back to the trifecta about trust in your modality and really understanding how it can help their patients and what’s particular situation. So it’s about how to educate them in such a way that they will end up trusting you enough to refer. That is going to be so key, and this can happen one-on-one with a provider.
It can happen where you educate them in their office. So for example, the acupuncture session is telling you. Client of ours. She ended up educating a PT office and I helped her with what to say and also what to bring. And she started getting referrals from that PT office. So having a good way, an effective way of doing that.
And then what. Also needs to happen if you would like to continue to get referrals without having to always be marketing, is, do you have a system in place that supports inspiring those referrals on an ongoing basis? It’s interesting because I have heard of practice management companies talking about oh, this is how to get doctor referrals.
You’ve got to write out your list of 75 or a hundred doctors in the area. Oh my gosh. As an introvert, that just sounds so like tiring, doesn’t it. And when our approach of it, because a lot of our clients are introverted, visionary acupuncturist who don’t really want to be. So outwardly and spending their energy that way, they like to be just, they would like to have relationships with fewer people and more in-depth relationships.
You don’t have to, the good news is you don’t have to be extending your energy out in an exhausting way. And to a lot of people, you just need to be very Like effective with a handful of providers. So having a, an approach that works with that, and then having a a, also a way of inspiring referrals beyond that initial connection.
Have, do you have a system in place that supports that? Do you have. Because when you do, then you will find yourself starting to get referrals from medical doctors and other providers. You will notice yourself that while you, for one, you’ll notice that the patients who come in through those relationships, it’s like they have listened to they’ll listen to you more than just because their doctor told them to see you.
Their provider told them to see you. So it’s very different than someone calling up and then saying, oh how much do you charge? And that’s the, in the conversation. Great. So it’s often at least our clients have shared with us. It’s so much nicer of a relationship. When you are getting referrals from medical doctors.
So one way of doing this in terms of getting a medical doctor’s attention is that our clients have been doing lately is to reach out to them through LinkedIn. Is one avenue. And but what do you say w what would get their interests? So I’m going to pop this in the chat and that way, or in the comment section.
So then that way you could click on the link and get, download the script and also get additional step-by-step training on how to attract more medical doctors referrals into your practice. So you can go. I’ll just give this to you out loud too. Is that at www dot? Get more MD referrals.com www dot.
Get more MD referrals.com forward slash linked in script. So www.getmoremdreferrals.com. Forward slash linked in scripts. I’ll pop the link below and you can click on it and get that exact script you could copy and paste and use to, to start developing relationships with providers. And for those of you who are in a place where you feel like you’re at a plateau, or you would just like help with this, because a lot of our clients tell us, oh my gosh, I’m so glad I ended up getting help with this from you, because I wouldn’t have thought of half these things.
And now I can just literally swipe. Paste or or just having an approach that works and starting to get those referrals, because we imagine if you actually had two providers sending you two patients a week, what would that do for your practice? It totally adds up. Doesn’t it. If you would like help with, as you can go to introverted visionary.com and request a chat with us and happy to see how we can help you grow faster with less stress.
So next week stay tuned for Jeffrey Grossman host of your show. And till next time and click on the link and I get your free LinkedIn script, download and start getting more doctor referrals.
Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Hi everyone. This is Sam Collins, your coding and billing expert for acupuncture, not only the acupuncture profession, but of course the American Acupuncture Council and the Network as well. Welcome you to another edition. And today we’re going to discuss. How do you grow a practice? What are we doing? And what’s going on out there.
And I get this question quite a bit from teaching so many seminars over the years in dealing with so many acupuncturists, one of the common questions are, how do I grow? What do I do to get better? What do I do to get more people? And so I want to address that really from both ends of the patients, you’ll get, whether it’s going to be a cash practice and insurance practice.
Com combination of both. It’s going to be a matter of how do you attract the patients that you’re looking for. And let’s give you some ideas and some things to chew on and think about to see how your practice is going to change. Because one thing I will say is you always have to be willing to admit.
And to make changes. If you think of it, when you first started practice, you probably don’t treat this the same way you did when you first left school or five years ago or 10 years ago, if it’s been a long time and that’s because you learn and grow, it’s one of the reasons we have continued education.
And in fact, I would say, it’s why we call it a practice. And not a perfect, so let’s go to the slides. Let’s talk about what we want to do to grow our practice if you will. So here you go. We just look at how we change from that little bud to something that moves a little bit more. Let’s talk first on what do we consider success?
And this is something I think sometimes is going to be defined differently by different people. And where I have a concern is often too many people try to define what someone else should do, as opposed to just define on your own. So I would say define your own practice success for some of you. It could be, I need to make a million dollars for others.
I just want to help patients. And obviously I think everyone wants to do a little bit of both. I’m not sure I want a million dollar practice. That’s probably a million headaches, but think of how are you going to define what you’re doing? What does a successful. I would say it’s a combination of certainly there has to be a monetary success.
You have to stay open, but at the same token, the satisfaction, this is the part that I’m not sure patients always know what we do or how we do it and the results of care. And I want you to think of it in these terms. How often has you have someone that’s coming to your office? Not feeling good and literally left feeling better.
When does that ever happen? Outside of an acupuncture practice, frankly. Has anyone ever went to a medical doctor with a headache and left with it better? And I’m not saying that as a negative towards the medicine, but that’s not how they treat. So I want to think of what we have to define it, but then if we’re defining it, what are the barriers?
What are the things preventing us from really moving forward and doing a little bit more? How are we getting more people are not getting more people, where’s it going to come from? What things are we looking for? Is it a matter of changing styles and techniques to get better results? So start thinking of what are some of the barriers I’ve set up internally, meaning among yourself, but also among the patients.
I think for patients, you always have to think of how they value our service. And I think this is going to be the number one way to think of it is that people value a service. And when they value. They’ll get it. They’ll pay for it. If they don’t value it, they won’t. So we’ve got to set up that value and think of what is that barrier will barrier as often.
So we have to think of if I’m going to grow a practice and money’s the barrier, how do I change that? How do I make it work? So think along the lines of what is the model I have, like currently, what is your model? Have you really set forward a business plan. It’s something that you set for and say, here’s what I want to do this year.
And literally write down some ideas because until you write it down and then really follow through, it’s going to be too esoteric. So I think it starts with people in. So you’ve got to think of first off the barrier is people just knowing what we do, why we do. So I want to ask you, what does acupuncture do once you think of what you think it does, but I also want to think along the lines of what does the average person understand about acupuncture?
What is defined what’s out in the field that lets them know what we do, what message have we gotten and what message has the profession or others set up for us? I know a lot of what we have to deal with this kind of. Healthcare in the U S is very medical oriented, obviously. And it seems that people like to line up for pills and surgery, but when it comes to making changes in their life, having a better lifestyle to stay healthy, they want to be lied to, it’s okay. In other words, it’s interesting when people think of insurance, we often use the term health insurance, but I would ask you, is it really, is it actually health insurance, or is it sick? In other words, we have a model that we say health care, but is it really, I get there’s some preventative things.
We do cancer screenings and so on, but really is there anything to set up a person to be healthy? So that’s one way to think of there’s a portion of people that are understanding that no, I need to stay healthy and not get sick. So what role are we there and how do people know that they can even access with access that with us?
But I want you to think along these lines here, there’s an interesting meme. Someone had sent to me and I think it fits. How do you think people view acupuncture? Here’s one where it shows what your friends think. Think of, particularly for many of you who went later in life to become an acupuncturist, some of your friends are like, what.
And then of course your mom thinks you’re driving a big needle into someone. Of course that’s not the case. And then let’s face it. This Western medicine have a downside to acupuncture, to an extent. Yes, I will certainly say that’s not as bad as it was, but I’m not going to say there are proponent per se there, we’re not throwing money down the toilet, but that’s often what they’ll say.
What we think we’re doing is so much bigger than that, but let’s take it. There were two realities. What people still do take medications. Don’t do well. Face it, the VA has a problem with suicides and deaths because of the way that. But what do we really do think of this? A patient often feels when they come for acupuncture, but do people know that?
So what is our message? What information is out there? We’re, here’s two examples. The Mayo clinic and Cleveland clinic, this is something they have on their website about what acupuncture does. And though there’s some similarities there’s differences between the two, which you can see here, chemotherapy induced, nausea, dental, pain, fibromyalgia headaches, labor pain, low back pain, neck pain, osteoarthritis.
And so on, on that side. But notice here it says differently. And stroke cramps, sports injuries, cancer, and cancer treatment for side effects, face pain. I think of Justin Bieber recently had that issue. I hope he’s going to an acupuncturist, immune problems, infertility irritable bowel. So this is a pretty broad scope of things that acupuncture does, but yet, how does the average person know this?
Now? I just searched this at their website. So if you think of it, when someone’s searching for what acupuncture. This is going to be the first things that popped up. And I did that because I wanted to see what does come up. So we want to start to think of, if people are seeing this, how are we communicating the message or do we want to communicate a different message?
Here’s something interesting from the company, Kaiser Permanente, a big health insurer and the doctor all in one, it’s an HMO and this is from their head acupuncturist at the Kaiser. And it says, what does acupuncture treatment says in China? Acupuncture is used to treat. It’s not thought of as alternative medicine, which is very true for most people.
It’s a common part of their medical care in China. Acupuncture is often used as complimentary treatment for all types of health conditions. And that’s one of the things that through my work with Maryland and Ellen and others at WHS. The world is beginning to recognize that acupuncture is way more than just pain relief.
We know that acupuncture speeds recovery. I would suggest every person w having any care post-surgery should have acupuncture. However, again, are people aware of it and have they had a chance to try it. And I think this is going to be our issue. So when we talk about growing your practice, we have to attract people that know that what we can do can help.
By example, we leave it up to the other companies. I just showed you what comes up on the Mayo clinic. So if you typed in, what does acupuncture do? The number one is going to come from those areas, but you’ll notice this here companies like United health care use acupuncture as a medic. To advertise people to buy their product.
So do you think that they’re using acupuncture as a tool for people they are, which means there’s access? What if someone says what do you mean? I get acupuncture visits with zero copay. I think I want to go in now realize that this is a plan that I’m not going to say it pays a lot of money, but it pays it above a hundred dollars a visit.
So certainly something that might be viable for some, for others, they may say, Nope, I want to do all cash. What my point is. If a patient comes in with this and you are not available to it, they going to go and, or can you sell them an alternative? Look at this particular company for a Medicare advantage plan, literally they’re talking about acupuncture, but showing it.
So I’m seeing a lot more people now becoming a little bit more attuned to say, Hey, maybe I want to try it because we’re seeing it out there more. I want to start to change the narrative and attract people to what I do by example, here’s the company Evercore. Now, sir. 20 years ago, would insurance coverage was different, but Evercore, which manages a lot of plans, you’ll notice here, the things that talks about adjunct cancer care and mental health.
Now mental health is more than PTSD and anxiety, but even anorexia bulemia. Let’s face it a little bit of everything, including menopause. So we’ve got to start to realize that there’s a message out there. Are we directing that message? What is our message? What is your message? If you’re growing your practice, if someone’s going to find you, how are they finding.
Why are they going to come to you? What is the messages like if someone were to look you up on your website or your blog page or anything like that, what would they know? What if they drove by your office? Would they know anything about what you do and the why I should come? And I will tell you, we’ve got to set up that people have to have not so much a need, and I’m not saying there isn’t a need, but a want, and this is something that my mom taught me early on.
She said, people will buy what they want. And big for what they need. And this is part of the reason I think acupuncturists can do very well with cash. Partly because insurance is traditionally not covered as well. So therefore we’ve not relied on it. In fact, the American physical therapy association noted that if patients have a $30 copay, they won’t go into Acupac or go to a PT, or at least a third of them, they don’t find that same thing for Acura.
And I think because we set that message of someone wants the care. It doesn’t just feel like I need it. And we’ve not realized. So in other words, we have to set up and create a value. So if you’re going to grow, you have to grow by expanding some way either you are going to see more people or less people, more visits one way or the other, which means there’s some out of value set up.
So you’re going to think of, as someone drove by your office, What would be the message. Here’s a couple of examples of offices that put up things like, what did they treat? Think of how often someone might have something like fibromyalgia and they’ve never heard that acupuncture can help it. So why would they think you can help it?
What about Bell’s palsy or weight control? We have to set the narrative because think of when someone passes by, they see acupuncture, I don’t even think about it. I’m going to suggest we want to start creating that. Outside your office. What do you do? Do you do fertility? If so, let people know because why would someone come to you if you don’t, they don’t know what you do because you don’t tell them.
In addition to that, I want to think of, what about does your website say about you? Here’s an interesting, I just did a quick search to. Acupuncture and insurance coverage and acupuncture treatment. And this is one of the things that popped up. And I thought this was interesting. What types of health insurance covered?
I, this is actually someone’s website. I didn’t put their information at the top, but notice they’re indicating if someone says, Hey, I have this particular plan. I know what it can do. Aetna banner blue, cross blue shield plans that they take, if you’re going to, except some, I would certainly let people know.
Cause if someone has, But you don’t list it. Why would they come in now? Good news. Do you have to accept insurance? No. In fact, even have to bill insurance. No, that’s a courtesy. My suggestion is always to have a diversified practice. And what I mean by that is diversified in this way. I’m going to take people who can pay for my service, what I prefer, all cash.
You bet I would. But what about the people who have insurance? Would I turn them away now? Certainly if I have a plan that doesn’t pay very well, not too many. But plans that do, I certainly would want to be part of that or at least accept them. Keep in mind if there’s an insurance, you don’t want to build don’t bill.
When you do want to build, you would, but if you’re accepting any, does anyone know? Think of it. What if someone says, Hey, I have Aetna and they were looking for a provider. Would your name pop up? Remember if you don’t have a search engine that does it, it’s going to be a problem. Here’s one that as another website that I did, and those are the things that.
Bell’s palsy, difficult diseases, natural pregnancies, skin conditions, pediatric and geriatric care, migraine headaches, severe and chronic pain. What are they sending that message towards? Who are they trying to attract? Why are people will come into that office? What about veterans? If any of your treating the VA I would ask you, does anyone know that you treat it and in other words, think about it.
When someone sees you, what do they know about. The message we get and sometimes that message we’re letting someone else determine it. So I want you to think of a model situation. You are a business. So think of the show shark tank a little bit. If you were to take your business model onto the show shark tank with someone invest.
Now, I’m not saying in reality, but the idea is that a solid business model. So you’ve got to think of businesses. How do businesses change and grow or close by example, the company series. Was the biggest retailer in fact, had a complete catalog and shipped everything. What did Sears not do? They didn’t adapt.
I think of it. Amazon took their idea. What if someone at serious said, Hey, wait a minute. This company is, we’re going to go back to that. We already have a catalog. Why didn’t they do that? Because I felt there were too big. And so they wouldn’t integrate, they wouldn’t adapt. So what happened to Sears? But it’s interesting when you take other stores, take the store target.
I find that interesting from a business standpoint, if you go into target, you’ll notice when you first walk in there’s a little 99 cents store items in that place. They, they got three, four hours, not a lot, but what is that doing? It’s attracting the nine instance. ’cause people like that stuff.
Why not offer a little bit of it? So think of in your practice, do you offer a diversified way for people to come in there? Is it one way or the highway? I’ll give an example. I have a very good health insurance. I literally have no deductible. I pretty much have no copays. That sounds crazy, but let me have you understand something for that plan.
It costs me and again, you’re going to think. I’m kidding. Okay. About $3,000 a month just under that. So when I say I have no doubt. What does that really mean? Yeah, I don’t, but I’m paying $36,000 for no deductible. So the reality is it’s expensive. So does everyone have that type of policy? No. So if I walked in, I would certainly say, you’d go, yeah, I’m going to take your policy because it’s a really good one, but not everyone’s is, and that’s something you have to learn that there’s nothing wrong with cherry picking.
You can say, oh, I’ll accept this plan, but won’t accept that one. We do the same with any patient. So think about what is your diversification here? Have you seen modern acupuncture? That’s very. That’s an all cash. How do they make that work? Part of how they do it is they make their visits very inexpensive.
So you have to learn how to make volume work. Now, the difficulty is that we can’t have multiple fees for the same service. Now, if you were in a completely cash practice, you can set your fees anywhere you want. But as soon as you bill insurance, now we have to have a balance because you can’t appreciate the ability to insurance patient more than a cash patient, makes sense.
Same price. Now, keep in mind though, this model does work well. It’s a very popular one. Now, how does it work though? People don’t buy a single visit? You can, but it costs a hundred dollars. If you buy packages of visits, it changes to as little as 60 or maybe 40 or even $20 a visit. It’s just a matter of making sure we have done it right now.
I’m going to say to you, is there any reason you couldn’t offer that in your office? In other words, you’re like targeting you offer that cause are there going to be patients interested in it? I have a couple of practices that their whole practice is based on prepaid. Liberal. The in fact, they don’t do anything but prepays.
And she says that they sell about 25 to 30 every month. Her cheapest one is about 600, most expensive, about 5,000. No kidding. Now she will tell you she doesn’t sell that many of the 5,000, maybe one or two a month. Still not bad. The idea being though she set that up. Now the difficulty with that though, was this, when you have that type of practice, if the economy.
Is low. Does that start to dry up? So I’m going to suggest yes, but why do it? And I offer both, in other words, I will take some good insurance, but I’m not taking all of it. And I would prefer to do more cash, get people interested in health care. Remember insurance only covers so much. What about your true health care?
So you want to think along the lines of what about doing that, but here’s the part I want you to see? What does someone see? How is your office viewed? What do they know that you do? What do they know that your costs. How do you come across on a personal level? When people see you, do they see someone professional?
Do they see someone when they meet oh, this is the person I want to go to. This is a person that gave me some writing formation. What is the community around you think? How are you in the city or the community you’re in? How are you viewed? We set that narrative. What is your web presence? What if someone were to search acupuncture to treat whatever and your city, would your name pop up?
Here’s something I’ll guarantee you the American acupuncture council, the network, our education division. If you were to type in acupuncture seminars, guess who’s going to pop up first. We do. We do it by design. It’s not by happenstance. We make sure we put out a lot of information too, about how to run your practice.
And it’s not about all insurance. But that way, people know that you need continuing education in heck we teach a heck of a seminar that deals with just cash. But again, will you show up? What if someone says, man, I have migraines. Have you ever written anything up about it? Is there any information they might find?
Is there any blogs or any written video? Because you remember for a search engine is going to look for people who have put. If you’ve not put any information, you’re not going to come up. So start to think of where do we show up? Remember the old days of a yellow pages. No one does that anymore. So how did they find you?
What are we creating for referrals within our own patients? Is there any newsletters you send? Let’s go old school, send them out via email or even mailing. What do people know? I have an office that what they do is they work with. And every time they sold one of those welcome packets they’re included in there.
Cause I know I get some periodically in my neighborhood and it’s always a dentist or two chiropractor, a few medical doctors, but have you ever thought, Ooh, is that a way for you to go in? Hey, I’m looking for an acupuncturist and then think about what about groups that you might work with? Have you ever thought of any civic groups that might need someone to come do a lecture now?
I’m not saying that’s going to be as prominent now that’s probably coming back, but start to think of how am I adding. Have I worked with any sports teams and I’m talking not professional, but what about being the person for a high school team that helps deal with pain? I’ll give an example. The I coach high school kids.
And one of the things they know is if coach Collins is talking to him about treatment, I’m always wanting them to get acupuncture because I have found a person with acupuncture gets well faster, simple as that. And once they see it work, it becomes a thing. And quite frankly, I coach at the most prominent sports high school in the U S and everyone knows what’s going to happen when you’re one of my athletes.
My goal though is that, do people know that you do that? So where are your patients? There’s lots of patients. Everybody’s account. Technically even some insurance. So start to think of how am I getting my cash? Am I advertising? If you are all cash, how are you using that to your advantage? Is it on your site that your price is cheaper, it’s more affordable or is that the right?
We don’t want to go. We want to talk about the quality of care. Here’s one thing I’m always concerned with is cheaper. Always better. I don’t think so. I’ve never picked a doctor because it’s cheap. No. Now, I’m not saying there isn’t times that many of us do, but I want to think along those lines, but realize there are things you can do.
What about a prompt payment? What about a pre-pay and then of course all the different types of insurance. Now, what you’ll see here as well, there’s nine different ways of insurance. I will point out not all of these are good. And I think this is where people go wrong. You are going to have a practice that’s diverse and accept the things that are welcome to you.
And the ones that aren’t the medical doctor I go to, which is very rare. He doesn’t take PPO and HMO insurance. If you don’t have a plan like I do, he doesn’t accept you. You can pay. But if you’re going to use insurance, he doesn’t accept those lesser ones. Now his practice is busy cause he’s built that you’ve got to be able to stick with it.
Know what you’re looking for? What are the patients looking for? Cause here’s what it comes down to. If your practice is going to grow it’s about patients, it’s about how do we attract them? Start to think of what have I done to attract patients and then start tracking, do things and see, Hey, did that work?
Did it help? Did you create something where you tried to create a referral based within your own. Maybe something you let them know, Hey, have your patients come in or have your friend come in, we’ll give them a free consult. Things of that nature. Does it work? Does it not work? If you do a cash discount, you do a group on, does it work?
Here’s what I’ll say, deliver what you do best, which is to make people feel better and your good care. But we’ve got to make sure people will know that we do that. And are we setting that narrative? If you’re not looking to grow. And even grow a little, you’re going to shrink, which means you won’t be around.
Here’s one of my concerns and this sounds awful, but it’s true. Approximately half of the people who graduated from acupuncture school within five years, no longer practice. And I think that’s mostly from bad management of the business. And I think partly because this is something that’s the hard thing to deal with it and know it doesn’t work.
You can make anything work. If you stick with it, there are practices that do all cash and do very well. I’ll tell you what though, by a tee, they all have really good communication skills. They also generally are in higher than average areas of income and have built that in. But if your practice is about in that type of area, maybe a bit difficult, maybe you want to be a little bit diversified.
I said, deliver what you do best. This is what I want people to feel when they go to an acupuncturist, how do they feel after? And sometimes that’s going to be your best way. Do you have anything on your site that gives patient testimonials about, I can’t believe it. That’s usually going to be the best way to commute.
I help a lot of people, everyday acupuncture offices deal with problems from billing and coding, to collecting, dealing with cash and all those things. And some of the best ways I can communicate is just simply give examples of offices I’ve helped and how we’ve helped them. And that’s how you continue for the rest.
So I’m going to say, go out and start to think if you’re not thinking of growth, if you’re not implementing it. And there’s several ways to go. There’s not only one. We’re here to help you. The American acupuncture council is always going to be your resource. We have a network service where I become part of your office.
Call me, email me. We deal with everything on a day-to-day basis, no limits. And it’s not about insurance. It’s about everything can include insurance. We are a resource go to our. Take a look, we have a lot of free things out there along obviously with these types of programs. But what I will say to all of you is think in your own practice, what am I doing to make my practice better, to make my self better?
I think we’re always doing that, but how do we communicate it? So I’m going to say thanks for the time everyone in next week is going to be Chen Yen. So again, go out, be successful. Hope to see you at a future seminar. Take care, everybody.
Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Hello, everyone. Thank you very much for attending our lecture on the sacred iliac joint. My name is Matt Callison. I’m here with my colleague, Brian Lau. Hi, thank you very much to the American acupuncture council for having. Brian. And I were talking about the upcoming module two low back hip and groin for this sports medicine acupuncture certification program.
That’s in September. And we’re thinking about different ideas of what we could be able to present. Because sacred iliac joint pain that would be presented at September and November is so prevalent with many people with different lifestyles. And we thought it would be a good idea to share with you some of our experiences.
As experiences at different points and different things that we can be able to use for releasing sacroiliac joint pain and dysfunction. What we’re doing is actually just going to be providing you in this short period of time, just a slice of the pie of things that can be used to help to reduce pain and the sacred early, actually, there is quite a few more things that you have to take a look at, but that would end up taking quite a few days to be able to go through all of that.
So let’s go ahead and get that. Pearls these nuggets these wonderful protocols to be able to use for sacred iliac, joint pain and dysfunction. So the next slide there, if we could. Go to is it’s such a crazy common injury for people and it can be able to come and go can actually really be recalcitrant for a number of different people as well is sacred iliac, joint pain, and the sacroiliac joint and the tissue surrounding that is usually the innocent bystander.
If from the different postural and muscle imbalances that are causing a total. Our torsion, a strain within the post here, sacred iliac ligaments, and also the that are just over that sacred iliac joint. So the sacroiliac joint does have a very small amount of motion, but again, it’s the innocent bystander from different pelvic imbalances and muscle.
And with those muscle imbalances come channel imbalances. And with that then comes challenge bounces within the associated channels. So this is something for us to be able to take a look at as an acupuncturist. Let’s go ahead and present some real gems here that we can be able to instantly take pain away from the sacroiliac joint and not just needling local.
So the next slide, please.
This is a bit of an overview, so we could use the innovations of L four L five at the Wachovia, Josh G points as well as you be 31 and 32. You be 33 would also be a choice. That’s just easier to find. You’d be 31 at 32 Bali out points. So this would be where we could actually affect the. We’ll also talk about points along the internal pathway of the call bladder that can be used as its own separate treatment protocol as well.
And of course, local needling in the sacred iliac joint region. And the reason why I say not into the sacroiliac joint is because it’s very difficult to get an acupuncture needle into that small little crevice of the sacred iliac joint. It’s something that I think as professionals, we should never say.
To anyone that were actually neatly into that joint, we would actually need some kind of digital imaging in order to guide us to go in there. So it’s just important that we have our language straight, especially if we’re going to be discussing to medical doctors or chiropractors or physical therapists, we’re stimulating the tissue around the Secor iliac joint, helping to decrease pain.
Then after that, we’ll get into some important motor points and also some tissues like the sacred tuberous ligament that are associated with the urinary bladder and kidney. So let’s go ahead and start right off. I think the next slide, please. This is a repaid. This is some, these are some points that you can use consider when you are needling locally underneath that PSIS for the sacred iliac joint pain is the innervation site to that joint.
So walk to a jig points at L four L five needle, those bilaterally as usually for the past. For needling, those points also, you be 31 and 32. I don’t really need all those bilaterals, but you could normally I would be needling just the side of the effected SSI joint. So you’d be 31 and 32 good combinations with local needling that you can use that in addition to, let’s go to the next slide point combination here of gallbladder 29, which is. Motorpoint or the superior motor point for the tensor fascia Lata. You can also use gallbladder 30, or I prefer the piriformis motor entry point. And I’ll discuss why in just a second. That would be with your SIJ needle technique and then also do one.
So why are we using this point combination? Let’s take a look at the internal pathway. So that image on the right, this is from Royston Lowe’s book of secondary or ordinary. I think it’s called secondary to. Printed in the 1980s, you can see from gallbladder 29, Brian, I don’t know if you’re have a cursor, if you could be able to point that out.
So gallbladder 29 on the hip there, we can see from that primary branch 29 will then go to gallbladder 30. That’s as we know into the buttock region, there’s an internal pathway that goes from gallbladder 29 down deep across the PSIS and communicate. Seemingly with the steak really act joint and its tissues, because the next point is that it communicates with, as you be 31 30, 2 33 and 34, the Bali alpha points, then that internal pathway goes down to two one, which is really quite interesting when we look at the pelvic floor.
So we’ll have a quick discussion on that, which is a very quick from that do one. Then the internal pathway arises and goes back up to the surface at gallbladder 30. This is the reason why we could use gallbladder 29, where the internal pathway begins before it goes to the sacroiliac joint. We could also use do one would be a good choice because of the ligament that had a cost to Jill ligament is the seam of the left and right pelvic floor.
So it has a lot of communication within that region. We could also use gallbladder 30 there because that’s where the internal pathway comes up and arises at gallbladder 30 personally, I prefer to use the piriformis motor entry point in this case, the reason why is because of its influence within that region has a really strong stabilizing effect for the sacrum itself.
When I’m using gallbladder 38, I’m actually thinking about trying to stimulate that sciatic nerve when there is true. SIADH. So I’m using that for a little different purpose or also with ease and gallbladder 30, just on a side note, it’s an excellent point for tonifying chia. Something to be able to mock up, you can use that with 36.
So back to the sacroiliac joint pain, gobbler 29, where the internal pathway exits from gallbladder 30 is where it comes from the deep, after going to the Bali Al points and the secretary iliac joint region to do one resurfaces at gallbladder 30. So you could use that point or the piriformis motor entry point.
That’s a nice combination. And you would tie in those needs. Those local needles around that area with gallbladder 41 is sad. Job five being the master income fluent points for the diamond mine young way has a strong effect on the civic really act joint that we demonstrate quite a bit with Gillette’s test in the smack pro.
All right. So that’s a standalone. However, you could use that with the L four and L five watch OCI points, or you’d be one and you to help tie in that internal pathway and also the innovation. It’s a solid treatment. So let’s go into, I think the next one, Brian is going to take over and start talking about the urinary bladder and kidney.
Yeah. So this would just be a, something to consider an add into the treatment. If we just get an overview of the urinary bladder and kidneys and new channels, translation for the sinew channels. We have a partial list on the left for the urinary bladder. So a new channel and a partial list on the right for the kidney sinew channel.
I say partial, cause it’s only taking us up to the lumbar spine. These channels would continue. But I’m just glancing at that image. We can notice a couple things. First of all, the urinary bladder sinew channel is going to go posterior region through the glute max hamstring tendons. We’ll talk about a couple other structures, but they’re going to form and unite at the posterior.
Part of the sacrum with the posterior sacred iliac ligaments. So that’s something right there. So it’s going to have an influence on the sacred iliac joint. Through the posterior second is really act ligaments, the kidneys, send new channels, going to dive deeper, anterior to the sacrum, to form the ligaments on the anterior portion of the sacred.
So those channels run fairly close to each other, running up the leg and thigh, and then diverged at the pelvis. Kidney channel can be sending a channel going into the pelvic floor, anterior to the sacrum urinary bladder, posterior to the sacrum. And they’re going to have quite an influence on the balance of the sacrum.
So we’re not going to necessarily have to treat every structure listed in. But we’ll highlight a few specific ones and we can look right now and notice on the left, we have the sacred tuberous ligament as part of the urinary bladder sinew new channel. This is the ligament that goes from the issue of tuberosity to the sacrum, a major structure that supports the sacrum.
So if I’m bending forward, that’s going to prevent my sacrum from basically popping out of the joint. It’s a very supportive structure on the sacrum, the piriformis part of the urinary bladder send you to. Blue max, which would be important. We’re not going to talk about it as much today, but we’ll highlight that line from the hamstrings, especially the biceps for Morris into the sacred tuberous ligament, and influenced also by the piriformis.
And then one last structure on the urinary bladder is one that would not be super obvious for a lot of people is Fronius long in the prone in general, the peroneal group, it’s very lateral. It looks like it’s on the gallbladder channel. It’s a lateral branch of the urinary bladder sinew channel. I’m going to put my cursor on it and run up through here.
The gallbladder channel would run just anterior to this. So this is a lateral bland branch of the. Urinary bladder channel. It’s going to go up to the fibular head and then link very strongly with the biceps for Morris. And then up through there and to the sacred tuberous ligament and the posterior sake really act ligaments.
That’s a key structure that we’re going to be working on that whole line in this. And we’ll talk about that in this presentation. And then the kidney send new channel. Just isolate one structure and that’s part of the pelvic floor, which has a big influence on the sacred iliac joint. That’s the issue of Cox.
So let’s move forward and look at those. Brian, yeah. Can you go back to that slide? I just want to offer one thing. I remember something that you and I have taught in the past when we’re talking about acupuncture as an assessment. So when the patient is laying prone and you can palpate underneath that PSIS and they have a certain amount of pain when you’re palpating in that region.
It’s usually the peroneus long as sometimes it’s the biceps for Morris, but it’s also the protein as long as it’s a real go-to muscle to go ahead and treat that motor entry point and see if that’ll decrease. The SSI joint pain usually does by a good 50%. So remember that combination, the Proteus longest the biceps femoris, and of course, going into this particular tuberculous.
But the peroneus longus is one point that can really take a lot of pain away from the sacred iliac joint, which is wonderful to be able to do so you can see patients have a lot of confidence. You as a practitioner, when you use one needle and you decrease their pain substantially. Thanks, Brian.
Yeah, sure. Yeah. This would functionally would really help support the SSI joint during gait, cause as you’re walking in heel strike, those muscles would start firing and help help. Whole mechanism that supports and pulls down and blocks, maybe that’s the right term, but supports stabilizes.
That’s sort. I was looking for help stabilize the sacred iliac joint, especially in running and walking type activities. So it’s really tied into the balance of the sacroiliac joint closure of the joint. That’s awesome. That’s great. Performance and sacred tubers ligaments are are ones that we’ll look at a lot.
And this slide This is a complex topic. When we get into the movement of the sacroiliac joint, I’m not going to go into super detail with it. Cause you have to, if you’re interested, you can look up nutation and counter nutation. It’s a long process to describe it and it can get very bogged down in the mechanics.
But simply speaking as you’re walking and running, you have one leg going forward and one leg going back in the innominate bones follow that there’s going to be a rotary rotation type motion in the denominator. You can picture the leg that’s swinging back is going to influence one that side. Let’s say, it’s my right leg.
That’s swinging back. This is going to influence that right side into an anterior tilt the pelvis. Whereas the leg that moves forward the forward leg is going to influence the innominate bone on that side of a D my left side in this case is going to go into a posterior tilt. And then as the gait changes in the leg switch, that’s going to go back the other way.
There’s going to be this kind of rotational type aspect through the innominate bone. That’s going back and forth. And even just from the get-go, you’ll notice with people that there is going to be a cemeteries in that. And maybe one side, it goes really easily. And the other side, not so well. So that’s going to set up the potential for things like say curly act, joint pain.
The sacrum has a particular movement in that rotation that is helped and supported by the guy wires of the parapharmacy and sacred or tumors. That’s going to prevent the sacrum from just being locked to that innominate bone movement. And it’s going to create this nutation and counter nutation motion this swaying and nodding of the sacrum.
And that’s what kind of creates the sacred joint movement. It’s a very small movement, but it’s an important movement. So we’re there to help support and guide the sacrum and its movement within that rotary movement of walking and. So it’s very important in the balance and stability and movement of the sacroiliac joint.
Because these are such key structures that holding onto the sacrum and supporting the sacrum and guiding the sacrum, it makes sense to make those part of the treatment. Paraform MIS via treating via the pair of farmers, motor entry point and the sacred tuberous ligament are very key structures that you can just include in treatment for Sacre iliac joint pain, but.
Ways you can use assessment to help determine when they’re going to be most effective manual muscle test postural findings. There’s a test for the sacred tuberous ligament that we use that we help feel for when it’s over bound and preventing and locking the movement. So those can help guide it, but they’re really key structures for this whole dynamic.
So let’s talk about piriformis motor point. This is from from Matt’s book the motor point, you actually having both the sports medicine acupuncture book, but also the Motorpoint index for the location. That point is halfway between you’d be 53 and you’d be 54. That’s how it’s described in the motor point index.
But easier to teach when we’re teaching this motor point for location is to find the PSIS. Let me get the cursor there. Find the borders of the PSIS lower border, upper border medial lateral get right in the middle of the PSIS. That’s going to be one of your points. Next point is going to be where’d my cursor go.
There we go. It’s a little hard to move on this due to, we know we’re due to his and draw a line between middle Brian. Yeah. Do we have a video for this next? It might be easier just to watch that video because the cursor is having a harder. Okay. Yeah, we can do that. Yeah. It’s hard to control the cursor cause it’s a kind of a small window, so yeah.
And it just describes it in the video. So let’s just go for that. Okay. We’ll do so I think it’s the next slide. Yeah,
we’re looking at the lateral side of the hip and identify the piriformis and loader entry. So first let’s go ahead and feel for due to then also for PSI. So we’ll take three fingers. I feel for that PSIS superior Porter, inferior border medial Porter, lateral border. And I just arrived for the middle of that.
PSIS I feel duty. Yeah, from the middle of the PSIS to do too, we’re going to divide that in half. So there’s a line drawn from the middle of the PSIS to due to being the hiatus of the sacrum. Divide that in half on that line. Okay. So then now this point, the halfway point, you’re now going to go perpendicular to the line until you feel the edge of the sacrum from the edge of the sacrum.
We’re now going to follow that line, just continue. One more SU identifying the PSIS inferior border fingers, medial border superior border, and lateral border go right into the middle. Take the other hand to the sacral Cox show injunction, which would be due to the hiatus of the sacred and the PSIS the highest of sacrum.
Divide that in half. There’s going to be a line here. So divide that. From that line now drop perpendicular line paid out till you feel the edge of the sacrum from the edge of the sacrum. Just one more soon out and you’ll then locate the piriformis. Motorpoint approximately one sort away from the lateral border around the sacred.
This was soon.
Next slide. Alright, so you guys, the continuation of that video actually does show the needle going in, but it’s just it’s a perpendicular needle with a three-inch, going into the depth about two inches. For those people that have studied with us before, that this is also the piriformis motor point is an empirical motor point that softens the urinary bladder 10 region.
So it’s really quite useful with a cervicogenic headaches when needling for sacred iliac, joint pain, and dysfunction. So always a good idea to needle bilaterally the period before. When you’re using manual muscle testing, it’s very common to have one piriformis be weak, and then the other one would actually be strong or a locked short position.
So it’s always good idea to be able to needle both piriformis. Brian, you wanna just keep going on the secretary of this ligament or do you want to keep take over.
All right. So in combination, as Brian was talking about earlier is the guy wires for the sacrum would be your sacred tuberous ligament. And also by that a performance, we just covered now with the sacred tuberous ligaments, a very prominent, dense tissue, easy to find just off of do to. So if you divided due to, and the issue of tuberosity in half and did a cross fibers for your cross fibering, where that ligament is, it’s a very.
Ligaments about the size of your pinky. Very dense. However, it does have some flexibility. So when you find some Oscher points within that region, you can see it. The red arrow that’s on the left is going to perpendicular with the sacred tuberous ligament. That’s how you want to palpate it. That’s how you want to needle it.
Usually in the middle sections where you’re going to find some Osher points I’m using an inch and half. You might need three and she knows depending on the size of the person’s bum but it shouldn’t happen to two or two and she will usually go right in that area. Needling that bilateral late is usually a good idea with sacred iliac joint pain as well.
Now there’s going to be another muscle, the next slide part of the pelvic floor being the issue of Cox and GS muscle, the issue of Cox GS Brian, let’s see if we can get the cursor. I know it’s really channel. To do that, that right-hand side, that issue is going to be located under the sacred tuberous ligament.
So you can see the cutaway on the right hand side of the image. And the cutaways, you can see the sacred tuberous ligament and also the sacred spinus ligament and where the pointer is right now is the underlying issue of Cox a G as part of that pelvic floor. So the same way that you would needle the sacred tuberous ligament going right into that dense ligament, if you took a three inch needle and threaded that up underneath the sacred tuberous ligament scraping, basically the.
Of it. The needle would probably be brushing against the sacred spinus ligament as well. The next tissue is going to be an issue of Cox and GS. This is a game changer for sake, really act joint pain. And there’s a number of different reasons why we need them in this muscle as well for the lower ciao complaints.
But for right now, let’s just keep on the sacred iliac joint. You can consider the issue of Cox, of GS as part of the pelvic floor and also Guidewire to help to stabilize. So needling the district Cox, a gas is very safe. However you can see that caution is advised on the left-hand side there. This technique really should be needled by experienced practitioners with excellent knowledge of anatomy.
You need to have really good command of your needle technique and know where the point of the needle is going at all times with this. Inadvertently go too far internal, you could affect internal organs. And that would not be a good idea whatsoever because of the risk of infection. This is a wonderful point to be able to use for just for experienced practitioners only.
All right. What do we have next? We’ve got now the local needling, right? The local needling for the sacroiliac joint pain in the secure sacroiliac joint region has been around for decades. There’s different ways of going about needling it, the way that we teach it in the smack program is to get the upper two thirds of that sacred iliac joint, where mostly where the pain is and divide that into four quarters.
From that PSIS the medial border. You move out just medial, just about once someone may be three quarters of a stone in order to take a finger to press underneath the PSIS, which is the roof of the sacroiliac joint. So that finger is going to go just underneath that. PSIS toward the secretary iliac joint, and you’ll divide that into four different vectors or four different angles.
So it always good to ask the patient does vector. How does that feel? That better be as you move down a little bit, how does that feel? Vector? See, it should move down just a little bit more. How does that feel? And of course, vector D and they’ll tell you let’s see, they’re going to be, what’s common.
It’s usually a and C could be B and D. So whatever those are you go ahead and take your inch and half needle and start threading that underneath the PSIS in the direction of the CIC. Really? Actually, there’s a great local. Technique to be able to use in combination with the other points that we have used, or at least some selection of different points that we’ve have talked about.
Great to be able to combine these needle techniques. After all the needles have been pulled out with the following myofascial release technique. This is something that we teach in our sinew channel myofascial techniques, class. This is also another game-changer to help, to reduce the tension within the tissues of the sacred early actuate and also the glute Maximus.
Brian, do you want to take it away? Now? We have a video for this one. It’s a pretty simple technique. I’ll let the video show it, but it’s, I’m working on the boundaries, the borders and attachment sites at the sacrum. It’s an easy technique just as loosen that a lateral border of the sacrum and help free the sacroiliac joint.
And you can modify it based on somebody in a posterior tilt or an anterior tilt. You can basically. Bring the leg up and you’ll see this in the video. It can like a crawl position to help bring that more anterior tilted pelvis into a posterior tilt and influence it out of that position pretty well.
Or you can move in the other direction for somebody in a posterior tilt to influence that and take it more into an anterior position. We’ll see that in the video.
so we’ll be working on the attachment. So the glute Maximus, especially the sacral attachments and just the spreading and moving softening the attachments along this. Very nice technique. We can adapt the technique to somebody who has a posterior and anterior tilt. This model. We have an anterior tilt, but I’m an exaggerate.
The anterior tilt. You can imagine with that, that it’s going to be much more effective if I move that tissue away from the sacrum. Yes. But also downward and help encourage more posterior. Or they took the pelvis. Conversely, if somebody has posterior tilt your pelvis under. And in that case, if you were working in that same direction, it’s going to encourage them more into a posterior tilt than the RDR.
So it would make more sense to come from a different angle and help lift the tissue to help encourage more anteriority to the pelvis. So we can adapt that general direction, but in both cases are moving the tissue away from the sacrum, either away and down lateral and down or lateral enough. So we’ll start with.
Lateral and downward, is that a little bit at the edge of the table? My side is towards her, so I can gently let my body sink in for them tissue using the elbow. Also a little bit of the proximal hole. Now I go right to the sacral attachments, think perpendicular and then spreads slightly lateral just to distract the tissue away from the sacrum and inferior.
I might have the. Gently and slowly tuck the pelvis under just the small movements, adequate
relax, slightly downward, another area of the tissue and under move, that movement that you’re doing, you can help them talk, but all of us under.
They generally talk under
pass.
I’m from instances you might, especially with an anterior tilt, you might add to the technique I put in the patient into sort of a crawl position. And you can see in this position, that’s going to encourage even more of a posterior tilt the pelvis so it can do similar technique. You’re comfortable.
Cellular technique with them in this position. And the position itself is going to encourage more of a posterior tilt
and I might hold a little longer in this particular position.
All right.
We have a QR code here for the new program that just started. We’ve the sports medicine acupuncture has been going on. This is jeez, what cycle is this mat now? 13, 14, but this is a updated version of it where we’ve added significantly to the. So for more information you can access the QR code.
That class has just started. I just actually returned from San Diego two days ago. So I’m still on California time. But that was for not for this, but the class just started this past month for module one module two will be in. You can start at any time, low back hip and pelvis. It’s a really pocket one.
It’s great. Yeah. It’s starting in September.
And Matt, why don’t you talk about this? Sure. Yes. So we are crazy enough to be able to put on a symposium because the field needs it. So ACA sport education we’ve gotten together, we’ve decided that the field really needs to be able to have a sports orthopedic acupuncture type of supposedly. So it’s something that should be happening hopefully every single year.
We’ve got a great speakers. This is going to be coming up in March 30th, April 1st in 2023. I’m here in San Diego. If you want any information there, just go to sew as education.com. So app as is the acronym for the title of the simple. The civic sports and orthopedic acupuncture symposium or so, so as education.com the next slide, I’m not going to get into all these introductions.
You guys can go ahead and check that out. Check that out. That’s also going to be on. So as education.com, theme is going to be mild fascial assessment and treatment. We’ve got some great people here. I can’t wait for this symposium. This is going to be a lot of fun. We also have recordings through loss of OMS.
That’s going to be available. Under the online CE use 75% of the smack program is going to be online, is online. And Brian and I are also working on an acupuncture anatomy series. You see there on the upper left. So as major and quadrant slump, And then if you want, if you like the way our education is, then you know, this get connected, we’ve got Facebook, we’ve got YouTube, our sports acupuncture Facebook page is really quite popular.
That’s a great one. To be able to ask some questions, you get a lot of knowledgeable people that are trying their best to be able to give their experiences with it. It’s a good Facebook feed as for sure. Brian, is there anything you want to add to that? Nope. I think. Okay, so next week, Sam Collins for me here.
Oh, that’s right next week. Sam’s going to be here. That’s awesome. Thank you so much to the American acupuncture council for having us, it’s really wonderful. Brian, it’s always a pleasure to be able to be hanging out with you and talking about medicine. It’s great. Thanks very much. So then we’ll see you next time.
Thanks everybody right. Bye. Bye.
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