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Brian Lau and Matt Callison

Foot Over-Pronation and the Spleen and Kidney Channels – Brian Lau and Matt Callison

Click here to download the transcript.

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.

Welcome. Thanks for attending today. So we are recording, uh, prerecording, this video, uh, I’m visiting Matt in San Diego. We’re doing some, uh, dissection and we’re doing some, uh, techniques and putting them on video for some future classes that we’re working on. So this will be prerecorded and, uh, hopefully it’ll be an enjoyable experience for everybody. Good morning, everybody. So Brian and I presenting today, a brief clinical discussion on foot overpronation and the spleen and kidney channels. This topic is in depth in a 30 minute webinars highlighting only a portion of the content. However, we felt that the information in this presentation is providing the viewer some ideas that can be integrated into your own clinical practice. And we’re going to start this presentation with three primary, uh, with three primary biomechanical components of foot pronation that also leads to foot overpronation. So, Brian, do you want to talk about the video?

Yeah, sure. So, uh, put this video together and it uses a flexible foot model. You’ll see the video in just a moment, uh, just a little bit of, um, information on the video when I’m demonstrating and I’m pushing this foot down on a hard surface so that it takes the foot into pronation so that we can look at the components of pro nation, but I really flattened that foot down to the surface to, to highlight those particular movements in real life. And there’s a disclaimer that says this in real life, this would really be more like foot over pro nation, but it helps that helps visualize those particular movements. And that’s why it’s really flattened. And you’ll see what I’m talking about in just a second. Yeah. So just so you know that it’s not going to be on your end, this video, the first five seconds there pauses just a little bit after that, it Rose really quite smooth. So here we go, Normal footprint nation occurs.

And the longest pause that we’ve had in walking and running during the impact and weight bearing phase of gait, the foot falls into pro nation. This movement helps absorb shock and builds elastic, tension and structures such as the plantar fascia, which much like a trampoline will create an elastic recoil. During the next phase of gait, normal pro nation involves a combination of foot abduction emotion in the transverse plane. E-version at the subtalar joint emotion in the frontal plane, an ankle dorsiflexion, a movement in the sagittal plane during ankle dorsiflexion. There is also a medial rotation of the tibia during these movements, the spleen and kidney channel send use become lengthened. They also help control the motion and prevent the foot from over pronating. So proper tone in these channels send use necessary for support.

All right, so the video, it can, it’s very biomechanical. It’s an important thing to understand when you’re a sports acupuncturist, then you’re working with athletes or you’re working really with anybody who has injuries that have a component of foot overpronation that’s influencing the condition. But, uh, so I would argue just understanding the biomechanics is important, but even from a channel perspective, understanding the different components of the biomechanics is important because it tells us a little something about the channel sinews, and it tells us a little something about the position of those channels and the influence and relationship of one channel to the next. So this slide is going over a little bit of that and talking about an over pronated foot, really what you saw in the video as much of a collapse as we saw on that foot arch. Um, and with that overpronation number of things happen that caused really a downward collapse in the yin channels.

We saw that on the video with the spleen and kidney channel in particular, um, where those channels are kind of collapsed and dropped down and an excess excessive upward polling from the young related channels, like the urinary bladder channel in particular. So we see this in the image that she collapses downward on the inside and the, she has pulled upwards on the young side. This can lead to a number of injuries of the foot in particular plantar fasciitis, or plant our past Geosys. It can influence things like shin splints because of the collapse and the excessive polling of the muscles that attach onto the tibia. It can be a component of medial knee pain because of the internal rotation that occurs in the tibia. And really that can transfer all the way up into the hip and back and neck and upwards. You know, I mean, it really has a global influence on the body when the foot over collapses like that.

So we have

Another image here. That’s showing this in a little bit more detail on the inside and yellow, we have the spleen and stomach cheek collapsing downward, both of those that the, um, yellow on the inside of the tibia re referencing the tip posterior is a really major influence of a particular muscle that holds up the arch. That if that muscle is weak at the spleen, she is weak in particular, there’s going to be a tendency for that muscle to be weak and not lift and hold up the arch in the proper way to, by anterior on the stomach side, it is also a big part of that, cause it crosses over and attaches to the medial arch. Both of those will really help lift the medial arch. And then you have the upward Pauline from the urinary bladder channel send you, especially through the protea, as long as the brevis, which we’ll look at

Brian, next slide. And

This is looking at it from the back. So if you look at the right side of the foot image, you can see that the calcaneum tilt. This is part of the aversion that we saw in the video, the calcaneus tilts medial, the top of it kind of falls medial, and you can see a bowing of the Achilles tendon. So we can see a dropping of the kidney sinew channel and a lifting of the urinary bladder in particular, the soleus part of the kidneys. So new channel has more fibers that attach to the medial part of the calcaneus. Whereas the gastrocnemius, the more superficial muscle, we can see that on the left, where it’s kind of splayed back, um, and kind of off to the side, the gastrocnemius attaches on the lateral side, they both form the Achilles tendon, but if you tease those fibers away, the gas track would attach to the lateral portion solely based on the medial portion, the medial portion is going to be dropped and pulled access to be long in relationship to the lateral portion.

So another influence of the channel send news, right? And this next slide, I’m sorry, go ahead, Matt. I think the next one’s going to be the navicular drop. Yes. So let’s go back. The image on the right, you can see as Brian was discussing the imbalances of the sinew channels, this particular view poster is called helping sign that we’re going to be discussing here in just a second. There’s another way of actually looking at this as well, because the tibialis posterior spleen sinew channel attaches to the navicular bone using the navicular drop test is really quite efficient and looking at the lengthening of that tendon and the spleen channel. So when the person is a non weight bearing position, which is the top image you can measure to see how high the navicular bone is that blue.is that kidney, to which we know, can you choose located just underneath inferior border of the navicular bone? The bottom image is going to be a full weight bearing position. So you can see that blue dot has dropped significantly indicating that the bones being dropped as well as the tibialis. Most tutor attended spleen sinew

Channel becoming lengthened. The medial arch is collapsing. So here we’ve got being signed. The calcaneum e-version. So the calcaneus is tilting into an every position. You’ve got a bowing of the Achilles tendon. As, as we discussed before, this can lead to a number of different injuries, tarsal tunnel syndrome, Achilles tendinopathy, et cetera. So looking at this helping sign is an indication for foot overpronation. Now there’s a lot of people in the population that are walking around like this, and they don’t have any pain whatsoever, but with overuse, eventually pain will come just because it’s such a mechanical problem. In addition to the spleen kitty channels, being lengthened. And as we’ll discuss in just a little while or momentarily, the effect that the actual organs have play into this as well.

So with this particular one, you can see this test foot abduction, or it’s also a foot flare sign. You can look at this from an anterior view, or you can look at it from a posterior view. In the anterior view, you can see how that kidney sinew channel is long. And it’s dropped going from kidney for kidney five, kidney six. You can see how kidney two has dropped is a foot flare sign, so that foot’s going into abduction, lengthening that kidney send you. So the, the tissues involved in the kidney sinew are, are lengthened, and they don’t have very much integrity here at all. They’re not supporting the arch. Whereas on the other side, the bow, the are they internal extra relationship to the kidney, urinary bladder sinew channel is in a shortened position. So we’re going to talk a bit more about how to be able to treat that.

Is there anything that you want to say that before we go to the next line? Yeah. You know, that the lines that are representing the medial and lateral side, of course, the kidney and UV, um, it’s the channel, but it’s also the channel send news, which, uh, the, on the inside of the foot as the abductor hallucis. So it really does, uh, um, kind of go along the medial side to the big toe like that. And, you know, for that matter, the primary channels also over length and like that, but, uh, but in particular, this is showing the channel send use, and then the abductor digit, I minimize for the urinary bladder channel, which attaches to the minimize the little toe. So it’s also, um, uh, you know, follows that UV channel. So in a moment, we’ll show you some needle techniques and myofascia work for these two muscles in particular.

All right. So then the intrinsic foot muscles are out of balance of the abductor. Hallucis is Brian just to discuss on the kidney channel is locked long and it fails to support the medial arch and the abductor digital Mattamy is going to be locked short. Uh, Brian, do you want to take it away? And we’ll comment on both of these, these slides. So this, uh, again, very, uh, that in and of itself is going to increase people’s ability to work with, uh, uh, with flat with flatfoot, with Pez playing this and put over pro nation and many injuries that might come from that. But, uh, bringing that back into a holistic view, that’s in Chinese medicine, we can start to look at some relationships of something called acquired. Flatfoot something that develops later in life, usually in the 40 plus age group, especially more common with women.

Um, and there’s usually relationships. This is a very Western discuss discussion, but we’re going to bring it back into the Chinese medicine discussion here in a second, but this, uh, usually is involved with a number of types of injury. I mean, uh, uh, illnesses such as hypertension, diabetes, obesity. Um, so there’s a correlation with those types of illnesses and acquired flatfoot where people start having a loss of integrity and the tip posterior muscle and a collapse of the foot. Yeah. So the unusual or prolonged stress that’s going to attack spleen cheat and kidney cheat, faulty, biomechanics, ligament laxity in particular, that’s going to be kidney churchy as well, and the normal aging process. And as we know, uh, kidney cheese on the decline, the older that we get. So let’s move on to the next slide. Go ahead and be, uh, well, uh, just, um, some, uh, information from research, actually, Matt one to take this one.

Yeah. So posterior tibial tendon dysfunction is the most common cause of adult acquired foot. So basically we’re just kind of backing this up with acquired flat foot deformity, Beals States that poster tibial tendon insufficiency. Remember that’s what attaches to the vicular bone. That drops is the most common cause of acquired adult flat foot deformity. The exact etiology of this disorder is still unknown, but for a TCM practitioner, I think it really gives a lot of credit to looking at kidney chia and spleen to you when you’re treating somebody with PEs planus, because they’re coming in with an injury.

So what we did is we looked at two different references, the clinical handbook of internal medicine by McLean, and also the treatment of modern Western medical diseases with Chinese medicine by flaws and Phillips who now, um, we just jotted these down here. You can see in the bulleted points, hypertension, yes. Liver, young rising you’ve got phlegm fire. Well, the spleen and the kidney is going to be associated with phlegm liver and kidney yin deficiency. Absolutely. You’ll see that also with hypertension. So when somebody has hypertension and flat feet, we’re looking at the kidney channel there, there’s also the pattern of Chong and Wren dysregulation, which is interesting because you see the master points of Chong being explained for, and then red being right being lung seven, kidney six, blood Stacey, this is something else with hypertension and then obesity. What these two authors with these are talking about stomach key with food stagnation will stomach, stomach being tibialis, anterior, which can be in a lengthened position in PEs, planus, phlegm, dampness.

You’ve got your spleen there. You’ve got spleen deficiency being cheat efficiency, as well as Yong deficiency. I’m allowing that collapse of the medial arts. So the strength of the organ itself being reflected within that channel primary channel and gene, Jen, I’m not giving enough cheesy to be able to support that medial arch at obesity. You’ve got liver and kidney inefficiency as well, as well as CHAM blood basis, then diabetes, there’s your stomach heat systemic channels and paying the fact that diabetes, spleen and stomach cheat efficiency. There’s your tibialis, posterior spleen tibialis, anterior not getting enough to within the channel because of the organs overall chain blood deficiency flam, again, being spleen. Liver is fleeing disharmony with heat. There’s your spleen channel again? Kidney, heart, and liver yin deficiency. There’s your kidney channel, kidney and heart yang deficiency, kidney channel again, and kidney in acuity. So there’s a lot of support with the spleen of the kidney channels here. Um, Brian brought up a really good point about this. If we were able to do some kind of, of, um, research with it. Brian, do you want me to describe your idea that you and I were talking about yesterday?

Yeah. So, you know, in the acquired flat foot discussion from Western circles, they just basically say that there’s correlation with hypertension, there’s correlation with obesity and diabetes. What would it be? Very curious and, and, uh, I think it’d be great to, to study it w it would take some time and resources. Of course, let’s say you took hypertension and you took all the people with hypertension who had acquired flatfoot, it’d be curious to see how many of those people had, if you differentiate them into patterns from a Chinese medicine standpoint, how many of those people had really more correlation with the spleen and kidney patterns? Um, based on the fact that those are going to have it,

I change in those related channels

And that my hypothesis, my guess would be that, that if you found the people with hypertension who have acquired, flatfoot, you’d have more phlegm fire more,

And kidney yin deficiency, maybe not so much liver young. Right.

Who knows, I’d be curious to find it, but that would be my guess. Yeah.

The takeaway from this, everybody is that, and this is something that we teach a lot in our education and our school is that when you’re looking at musculoskeletal, it’s never just musculoskeletal. There’s always some kind of zone food component, and we are TCM practitioners. So always look at that [inaudible] component, being able to supplement the musculoskeletal treatment, it should be held together. So this is something that a sheet for you guys to be able to take a look at. This is going to be just for the local muscles themselves, that you can be able to treat in addition to the person’s constitutional points and zone food. So, um, the peroneus longus and the peroneus brevis, these are going to be locked short. They’re going to be accessed. These muscles are going to be real, uh, primary in treating this. So you want to reduce the access so that the deficiency starts to come up. So we’ll address the deficiency as well. But since we don’t have a heck of a lot of time on this webinar, we are going to be showing you the peroneus longest and the prone peroneus brevis needle technique. We’ll also going to be showing you the abductor hallucis and flexor hallucis brevis needle technique as well. Um, there’s also an image I believe of the abductor digital me that you can be able to use. So, Brian, anything you want to say before?

Yeah. I’m sure there’s people watching this who are going Fronius longest and breakfast. That’s on the gallbladder channel. Uh, this is interpretation, but go back and open up Deadman or any book that has image of the channel send news. Of course, they just show topography. They’re not showing him in particular muscles, but you’ll see that the urinary bladder send you channel has a lateral branch that could be interpreted. We interpret it as pretty, as long as in brevis those muscles have a much stronger fascial connection to the hamstrings. I’m in link with the urinary bladder channel. Whereas we put the gallbladder, send new channel more with the extensor digitorum longest, which is just in front of the fibula. And really, if you look at it from primary channels, you’d see the gallbladder 34 and many of the gallbladder points along the lower part of the channel would actually go right into extensor digitorum longest. So yeah, go back and check out those images and you’ll see there’s a lateral branch. And that’s what we’re interpreting is plenty as long as some brevis

In addition, Brian and I actually, we proved this relationship on a cadaver specimen and it’s on our YouTube video channels, sports medicine, acupuncture, where we put a needle into the Proteus longest motor point. We put a needle into gallbladder 34, and then we put a needle into the biceps for more the hamstring motor point. We pulled on the biceps for Morris motor point. You could see where the force tension was going, and it was moving the Proteus longest needle substantially, but not gallbladder 34. So this is a really linking that urinary bladder sinew channel that’s on the YouTube channel sports medicine acupuncture. If you guys want to check that out, let’s go into the video showing the peroneus longest. And the peroneus brevis, I’m going to set this up a little bit. So you can see is that we have one needle in the peroneus longest motor point, which is located just two stone below the head of the fibula. And then we have a needle in the peroneus brevis that’s angled upward. So we’re wrapping the twist, the needle. We wrapped the fibers around the brevis and we’re pulling down so that you’ll see the needle moving on the Proteus longest because we want that. She took me moving downward in PEs planus with every step, as we talked about earlier in this, that she is moving upward on that lateral side, being the young side, we want to pull it down. So here we go.

Peroneus longest motor points too soon down from the head of the fibula peroneus brevis motor points. One soon above gallbladder, 35, this needle technique for the perennials that are in a shortened position from foot overpronation. We want to try to be able to pull the muscle fibers downward in order to be able to change the cheesy within the channel change, the appropriate perception. When I wrapped the fibers around the peroneus brevis and I start to pull down, you can see the movement in the peroneus longest motor point. So I’m going to maintain the traction. You can see how that needle is moving. So therefore the muscles, the fascia, all the proprioception here is starting to change and I’ll hold this. So the muscle can get used to being in its new position.

Alright, so that needle technique is in combination with something that we talked about earlier, lifting up the medial arch. So this is a needle technique that you can apply to everyone, but it is very useful to apply to those people that can handle the strong cheese sensation I’m using a thinner needle is also useful, but you, in my experience, you need to have this as a Chinese needle. Um, some of the needles that are coded, um, will not allow the fibers to wrap around that. So, um, it’s a good idea to be able to have our Chinese, you know, I’ll watch, those are my favorite to use in this particular case. But again, you can use a thinner gauge needle, but two muscles are the abductor hallucis in the flexor. Hallucis brevis that we’re needling here. The motor points of each muscle found on the kidney and the spleen sr channels are needle to lift the collapsed tissue at increased proprioception. So you’re needling there underneath kidney too. And then also you’re needling halfway between spleen three and spleen for going into the muscles themselves, twisting the needle to patient tolerance, and then gently just lifting that arch so that you are starting to change the proprioception with that. Then you would leave those needles in place. In addition to all the rest of the needles that we have in that formula, treating adjacent points, distal points, and also constitutional zone crew. Yeah. I might add something to that. As Matt mentioned, you’re leaving those needles in, uh, so usually

If they’re in for 10 minutes and you go to bring the needle out, no problem that comes out, the tissues relaxed, you know, it might be the case that the needle wouldn’t come out right away. That’s the point is you’re trying to lift that tissue, but it usually will come out, no problem, but do pay attention to which direction do you turn the needle on case? Uh, it really doesn’t happen with me this way, but in case of where to get stuck, you’d want to unwind it. And the other directions of your going clockwise, you know, make a note of that. And if you, if the person can’t tolerate this type of treatment, it’s not too bad that you’re, you know, you’re going slow and gentle and to patient tolerance, but needling, the motor points would still be useful on their own. But it’s going to give a little bit more bang for the buck by doing this lifting technique.

Yeah. Sure. All right. So here’s the needle technique. That’s kind of based on the same idea. Brian, do you want to go ahead and discuss that?

Yeah. The image I’m just kind of glancing at this now and noticing that the little black line for UV 63 and UV 64 is a, is a, um, just a pointer. The needles are a copper kind of colored. So, uh, take note where you can see my thumbs holding onto those needles. So same idea. Uh, the needles are put into UV 64 and UV 63 64 is the motor point for the abductor digit I minimize, which has a strong connection to the lateral band of the plantar fascia. So you’d be 62 would be into that lateral plantar fascial band. And then the needles are twisted gently. And until they catch the tissue until they catch the fascia and then pulled away from each other to help widen that, uh, lateral portion of the, uh, urinary bladder send you a channel, the part they get shortened as the foot goes into abduction. And that whole side of that lateral plantar fascia become shortened. You’re widening that lateral band of the plantar fascia. So it reduces, you know, reducing technique.

Yeah. So this technique followed by a really good, mild fascia technique. They were going to show you an image here in just a second is really quite good doing this technique and then the mild fascia. So Brian would take away some of the myofascial work.

Yeah. So myofascial work is really going to be, um, following the same principles. So a, this, you can see the two knuckles on the urinary, excuse me, on the peroneus longus. And brevis going down that, uh, lateral band of the urinary bladder send you a channel. It’s kind of widening that lateral band, but each time you’re, tractioning this issue down and then widening kind of like making little Chevron type, uh, positions and move down a little bit, bring the tissue down, widen, go down next step. So the whole time you’re, you are widening that, that portion of the lateral compartment, which is containing the, the peroneus longus and brevis, but you’re bringing that tissue down. That’s the key takeaway from this as you’re helping, uh, encourage the fascia and muscle and all the appropriate sectors downward in the same way you were with the needle technique.

Yeah. Starting top pending at the bottom. Yeah. Good. That lateral band would be pulling the foot into, um, into IE versions that you’re helping correct that by, by dropping it very useful after the needle technique and see what the next myofascial release, Oh, it’s an exercise. Right? So inchworm exercise, this is a very useful exercise for helping to restore some of the integrity in that medial arch. Um, it’s warm. You can actually Google that if you wanted to, and you can get this step by step, you can see with the foot on the left. Um, this is I think, prions foot. So he doesn’t have a Pez plaintiffs on there, but if it was a flat foot, um, you can see as what he’s doing in the middle of the images, he’s bringing the first metatarsal and the big toe up toward the calcaneum as the calc Aeneas stays in place.

So he’s increasing the integrity of that medial arch. Then he puts his way on the forefoot and he brings the cow Kanyes back, which will flatten the foot again. And then he repeats the exercise. This is an exercise that you could probably find step by step. I would think on Google, this is also something that we teach in its entirety. I think though, a usually in Google, it’s not going to be under insure. Um, it’s uh, and cause usually people don’t walk it back like this and it’d be called a, uh, short foot exercise, but we modified that. Okay. Yeah. So the short foot exercise is going to be a little simpler than this one. So, and that would be probably, you know, you can find videos of that, uh, curls probably to take it away on this one. Yeah. This one that is, if you look at the, the, the kind of ghost image on the top little corner portion, that is your, you are taking the foot and you’re dropping the medial arts, you’re taking the foot into abduction and just, you know, basically collapsing your weight into the medial arch.

And then you’re starting from a position, I guess, a dysfunction and then you’re curling the foot and lifting the medial arch. Um, so this one would also strengthen those, um, intrinsic muscles of the foot along the, the kidney and spleen channel. But it would also be calling on things like the tip posterior, because it starts to take the foot into a position that, that, uh, engages the tip posterior. So this is, uh, training, both the intrinsic and extrinsic flip muscles. Yeah. Good. Yeah. So the ghost image is the, before the, not the fall images the after, and it’s not a ghost image because it’s so white, it’s actually because the right funnel doesn’t move on. Okay. There’s a references, right? So you guys thank you very much for attending this. We want to thank the American acupuncture council for having us. This has been really a lot of fun. We hope that with this very complicated and in depth topic, we just took some portions of it actually. And hopefully we gave you some useful insights or clinical pearls that you can be able use to be able to help other

People to help your patients. Uh, Brian, thanks very much, Matt. I do want to highlight that there is also on the YouTube channels, sports, medicine, acupuncture, uh, full needle treatment, uh, that shows both before and after for changes in the foot that was done in one of our classes that covers this whole whole protocol, basically without the myofascial and corrective exercises, but just the needle abortion. Yeah. Good point. Okay. Well thanks very much. Appreciate it. Yeah. Thank you. Alright. Take care everybody.

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Poney Chiang Thumb

Acupoint Injection Therapy Poney Chiang and Scott Richardson

 

Click here to download the transcript.

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.

Good afternoon, everyone. Welcome to this Week’s American Acupuncture Council’s Live, Facebook podcast show. My name is Poney Chiang your host for today, I’m coming to you from Toronto Canada. I’m an engineer’s vacation pro provider from Newark radiant.net. Today. My special guest is Dr. Scott Richardson, who is joining us from Denver, Dr. Scott Richardson, and is a doctor of acupuncture and Oriental medicine who competed his master’s and doctorate degree from Pacific college, went into medicine in San Diego while attending Pittcon. He was able to study abroad. I changed to university in China, and later did some apprenticeships in connects in Taipei Taiwan. He’s an NCCR credentials, acupuncture, CU provider. He has lived in Colorado since 2012. We have served as the vice president, president and letters that have a chair of the agricultural association of Colorado. He worked on the legislation that put acupuncture, injection therapy written into the scope of practice for Colorado acupuncturist.

He teaches acupoint injection therapy at Colorado school of TCM and in various institutions around the world. He’s the owner of Denver acupuncture and sports medicine, and prolotherapy of Denver, where you continue to see patients with a wide variety of concerns. Thank you for joining us, Scott. Absolutely. So the reason why I wanted to, uh, interview an expert in acupuncture point ingestion is because this is something that more and more patients asking about and more and more jurisdictions in the, in the West and in Europe and in North America are starting to explore. For example, the Ontario in Canada, where I’m located, we are currently unable to do daily injections. However, we are working on a doctoral class of a, of a, of licensure and we’re exploring things like injection therapy as a potential scope of practice. I personally think that is going to be super powerful and super beneficial for our patients. So I can’t wait to have this conversation with you Scott today. Can you tell us, how did you get interested in point injection?

Sure. And like you said, it’s really important to make sure that you are aware of what you’re able to do within your own state or jurisdiction. if you are unclear then, you know, contacting your local governance board would be a good way to make sure. but, uh, this is really an amazing tool that we have within a TCM. again, like you said, I started my program, I learning out in, uh, San Diego that Pacific college of Oriental medicine. I moved to Colorado in 2012 and that’s where I first got exposed to acupoint injection therapy. I studied from Michael Young, pretty much that first year, uh, within a few months of moving there. and then just took off from there. I’ve also studied with, Jeff Harris out of Bastyr university. Andrew Taylor who’s also up in Canada is an amazing teacher. I’ve studied with him and, and even had him come out to Colorado to teach some advanced classes. but, uh, it’s been an amazing tool to add to my practice and to help my patients.

Wonderful. And, can you tell us for those of you are, those of us are not familiar with it a little bit about the history of acupuncture point injection and what is it exactly

Sure. And this is something that I’ve been kind of been a hobby of it I’ve been trying to find more literature, more research about how this all started and what has been injected traditionally. from what I’ve been able to understand, this really started, around the 1940s or even pre 1940s, when China started experimenting with doing and they were actually herbal formula injections, they would do single herb extracts or herbal formula injections. And a lot of times they would use it for things like flu influenza. and then it kind of expanded from there and has continued to be used in China quite a bit, including with, uh, some of the SARS outbreaks. it is something that has been around, for quite a long time and within the, and I’m going to mess up the name, it’s the Shanghai acupuncture compendium.

I believe the Shanghai acupuncture texts, uh, within that textbook, they actually talk about, acupoint injection therapy, substances that can be used where it can be used and how to use it. And so, uh, that was a required reading for our text. And, uh, I think a lot of people, or a lot of schools use that text and it’s something that is part of that tradition, substances that can be used again in China. A lot of times they’ll be using herbal extracts and even herbal formulas. in the United States, I am not aware of any FDA regulated facilities that are doing single herb extracts or herbal formula extracts. A lot of what we’re using are homeopathic formulations. Hiebert is one of the companies, that is local here in Colorado. they have, uh, a very, they have five main formulas that they sell, here in the United States. But again, uh, internationally, they have a wide range of homeopathic formulas. heal is another very popular one. If you’re familiar with Traumeel for acute injuries, they actually make an injectable form of true meal. So when you have bruising swelling, when you have a localized heat, you can use that formulation to help to speed the recovery and it works amazingly well.

can you give us a sense of what type of situations would you, uh, would you think about acupuncture in, in point injection therapy compared to quote unquote standard acupuncture? And a lot of it is a case by case

Spaces, and I am really hoping that as this starts becoming more mainstream, especially here in North America, we can start doing more research to figure out, you know, when is this better than doing acupuncture by itself? and when is acupuncture, going to be just as effective? one of the, research studies that was recently done, this came out of, uh, North Carolina university. There’s a medical doctor that was doing, procedures to try to do injections for back pain. And he was doing it on mice. And one of the things he was finding is by doing it on mice, he had a high rate of injuring the nerves or the spine. And so he wasn’t getting good results. He is not a TCM practitioner. He didn’t practice acupuncture before this study, but he found out about you before he doesn’t call it that.

But he found out about an acupuncture point behind the knee, and he started doing his injections there and he got amazing results with his, uh, research trial. he went on to later state that, uh, doing an injection at an acupuncture point can last 100 times longer than doing traditional acupuncture alone. So it’s a situation where we can have longer lasting results, and do it in a shorter amount of time. now when to do it versus when not, it can be a little bit more tricky. And again, a lot of that comes with personal experience. I do a lot of sports medicine. so when I have an athlete that comes in with a chronic muscle, not a, an area of tissue, that’s just not recovering. I go in, I needle it and it’s not releasing. one of the benefits I see with acupoint injection therapy is that I can go in and hydrate locally at that muscle tissue.

what does that mean in terms of TCM? I am literally adding in fluids or in fluids to that local area to help it to and recover, common solutions, uh, a 5% dextrose. It’s a sugar water, very easy to use, as something that is a sugar that’s sweet. I see that as, as a spleen tonic, another very easy, uh, thing to, to get ahold of is normal saline saline as assault. it’s a kidney tonic, as a mineral, it clears heat as something just as simple as normal saline into a hot localized area. It can help to clear heat out of that area. And again, can be very effective. you know, we don’t have to get overly complicated again with yin deficient patients or in deficient patients. It works extremely well on adding those that nourishment adding, helping to tonify the spleen to nourish the muscles and sinews. and it’s something that, uh, is a great way to either use standalone or in conjunction with an acupuncture treatment.

Oh, okay. So it sounds like not only is it using for that a chronic problem that you’re nourishing like a year influenza, like blood, the red blood for the seniors, when there’s actually something acute you can use, like something like sailing to actually combine with the injection to get an immediate results. I didn’t know that that’s really powerful.

Absolutely. And, and I I’ve, I’ve done it a couple of times. I, I I’ve had patients come in where they’ve gone to their doctor, they had a cortisone shot. and one patient, she spent over $1,800 on this cortisone shot because she didn’t have insurance to cover it. So she had to pay $1,800 out of pocket. She came into my clinic, we did one shot, uh, and she immediately felt relief. it wasn’t a cure, but immediately felt relief and felt benefit at less than one 10th. The cost of seeing her, her dog. Right.

That’s fantastic. Not to mention, you know, there’s some recent research showing that there’s actually a long term, uh, wear and tear associated with the stair usage injection of cortisone injections, the knee. Right. Yeah. so can you give us an example of a particular case in your own practice, private practice that was particularly memorable that you felt, you know, I probably wouldn’t have gotten this resolved if I didn’t practice acupuncture, injection therapy, something to just kind of wet our appetite a little bit.

Sure. And again, I do a lot of sports medicine, and so a lot of what I’m seeing are muscular skeletal conditions, had a patient come in with frozen shoulder. and so, uh, had very limited range of motion, had trouble even just going into the rotator cuff and needling some of those muscles. our first treatment we, we did, Eastern, and we were going into subscap. and then kind of like an [inaudible] 10. Sometimes I call it OSI nine and a half house. as I 11 area, and we were doing some East them to try get to those muscles to release and help. We saw some improvement. There are some reduction in pain. The second time she came in, I actually did an injection and it was, again, very simple. It was normal saline, 5% dextrose and B12 combined. and we injected into the subscap and there were multiple trigger points all throughout that area.

So, I wouldn’t necessarily say it was a heart one because we were aiming specifically for that muscle, but going in hydrating the muscle. And then we did a couple more again [inaudible] when she got off the table, after that second treatment, she had noticeable improvement about 20 degrees range of motion improvement. just following that injection, the next 24 hours, she got another about 5% range of motion, uh, after the treatment, but it was something where again, it was kind of a, she was definitely a yin deficient patient. but going in and hydrating, nourishing those muscles, we were able to get significantly better improvement than just doing our first acupuncture and Eastern treatment.

Yeah. And was the patient impressed?

Oh yeah. And she loved it. Cause sometimes especially when the muscles are chronically tied and they can’t get that relief, getting that nourishment in there, you get that, uh, that satisfaction. I mean, not so many times that like, yes, that’s what I needed. And, and, uh, a lot of times I’m seeing that I can use less number of treatments and get faster recovery with them.

I know that, there are some people that are a little bit more, conservative when it comes to, uh, uh, embracing new new techniques or perceived new techniques on that I’m hearing is may not actually be dine you. uh, but for those people that, that, uh, do you have a, an encouragement for them, they will have, why would I, why should I acupuncturist and learn this? How would this be able to allow them to do things or take care of their patients better than they were otherwise?

Well, and I think that this is one of the areas where us as acupunctures can really help to, benefit the medical community. Uh, when we go through our training, uh, four years master’s program, we’re required to have a minimum of 660 supervise clinical hours and 700 didactic hours learning how to puncture the skin in a safe and effective manner. Other medical professions don’t have this type of training. I worked inside of a family practice for about eight years and the PAs were constantly coming to me, asking me how to do an injection on a different area of the body because they couldn’t get the needle in and knees. I can’t tell you how many times I’ve seen a provider, tried to inject a knee with the leg straight out. and so I think that, as a profession where we, have much training on how to do this safely and effectively, uh, the patients appreciate it because it’s much safer.

but then as far as being TCM, again, we’re still applying those same principles that we learn, you know, fluid deficiency, yin deficiency, heat, excess deficiency, all or these things are, are what we apply to our treatment protocols. And then again, learning where we inject, you know, can we combine the properties of what we’re injecting to the therapeutic properties of the point that we’re injecting? So a common example I bring up is, you know, if we use the Harare point on the kidney channel and inject water there, you know, can we have a stronger effect than if we’re just needling there? B12, I consider B12 a blood tonic. you know, it actually helps in the production of red blood cells. So if we use a B12 injection at the influential point of blood, you know, can we have a stronger therapeutic effect then, you know, if they’re just popping B12 pills and, and, and trying to, you know, eliminate symptoms that way.

so I think with our training, we really have a strong foundation that we can provide these types of techniques. like you mentioned, with cortisone, we can provide safer solutions to people where they are lasting more longterm, uh, without a lot of the side effects. A lot of what we do in our profession is to help to facilitate that healing in the body, make the person stronger after our treatments with minimal side effects. and so, yeah, I think that this is a perfect addition, for people to learn about and train with. And, you know, again, if this is something that’s not currently in your area or your jurisdiction, uh, reach out to your local, association and, and see what steps need to be taken to, to help get this in there.

Hmm. Yeah. I like, I like what you have to say about that because, obviously, uh, as decent practitioners, we have a competitive advantage. We can apply what we injecting to the point specific functions that you inject into. So that’s, that’s a scope of practice that, that, uh, the other professionals can do. But what I hadn’t realized was that we’re actually better at putting needles into their joint and a new joint because I do it all the time, large intestines and the theme that she end or something 35, we’re really good at that. Hopefully we can, we can, you know, deliver the substance more effectively. And so, and this way it’s kind of building on the skills that we’ve already had. It’s not really relearning anything. We actually going to be able to pick this up faster than, a comparable, uh, biomedical, uh, practitioners to injections. the, can you, you know, give it down, you got to excite as though.

And do you mind if I share another story real quick? Oh, of course. Yeah.

So I was, uh, I was teaching at CSTC and this was our first time that we were doing live classes after we were shut down for Corona and, you know, same type of thing, that one, I had three hours to go over clean needle technique. And by the way, injections are a part of clean needle technique. Again, we have all these, competencies that we already go through to show that we’re safe and effective, but had a three hour class and the last 45 minutes or so is when the students really get to start trying this out and injecting. And again, this is a, an acupuncture student, and they’re testing this out. He did an injection at bilateral, bladder 23, and then y’all tongue sway on, on the opposite of the effected side and started moving it around and immediately had relieved. And so this is, you know, again, uh, an acupuncture student, that’s starting to play around with this and can already see how there’s benefit to this just from doing, you know, his traditional acupuncture classes and how, you know, again, with our training, we just build on that to get better results. And I, I just love it. I get excited as well. I think it’s fantastic.

Can you, I know, you know, obviously we haven’t learned how to do injections and, and a, I hope to do that in the very near future. but are there any lessons you learned little curls or advising you give us, like using the approach of acupuncture, injector, maybe, or assessment, whatever that you think would be able to be, that we would benefit from looking at the body or approaching the patient the way you do

Well. And, and again, I always try to get people to build on the, on the tools that they already have, you know, feeling the pulse and seeing if this is someone who feels like their fluid division or the tongue usually is my biggest assessment tool. And right now it’s difficult because, uh, you know, we’re not looking at patients tongues, but if you see a yin deficient tongue, that’s one of the big, indications for me of saying, okay, this is something that could benefit from using an acupoint injection therapy. if you feel a really thin pulse, then, you know, B 12 is something that’s readily assessable to help to build the blood. And again, use those on, yin channels or blood building points to help to amplify that effect. I am not a huge fertility. Specialtist a specialty person. I generally will refer out to them, but, again, it’s a going stray, I’m doing acupoint injection therapy over to going Shea and, and, uh, spleen six.

there’s lots of ways where we, again, take what we learn from our schools, what we practice, what we see, and then this can help to accentuate that. And, you know, again, assuming that the MD, the scientists that I mentioned at the beginning of it, he was able to validate that, you know, we can have a stronger stimulation lasts 100 times longer without having to need leave needles in for a long period of time or doing intro normal intradermals and having the patients take that home. but, uh, yeah, I, I get excited about it and I, I do, I see people just pick it up. I, I do the same time. I use guide tubes and I know studying in China guide tubes, you’re not supposed to use them, uh, freehand dealers pick this up very quickly, but, I do the same, uh, muscle memory doing injections as I do with guide tubes and, and, yeah, it, it works well.

I, something pop into my mind, about, uh, people that have some concerns about practicing injection, you know, is it TCM or NY? I wanna, I want to just mention that when, uh, back when I was a student, had a teacher that told me that, uh, told me, told me these fantastic stories, but as soon as to me out there, the doctor who made it easy and physician code of conduct, and that the person that document that 13 goes points just in case, uh, you know, the name of the case, our listeners and [inaudible] was really a role model about sincerely. I would say he was very embracing of different styles approaches. He was the one that brought peer visitor Kerbal materia Medica into TC. So he didn’t care. It was Chinese medicine, or not as long as somebody help people. I mean, he also dabbled in a lot of our chemical and spiritual practices, as long as you can help people.

So I had teachers that would tell me, you know, I bet you if, since I was alive today and he had access to point injection therapy, he probably would have used it as well. Okay. So, uh, that, that was always a story that I thought was, you know, helps me feel comfortable. I don’t know about other people, but it helps me feel that it’s okay to, to use new new techniques because, just because Chinese medicine is not, uh, no longer merely a classical textual medicine, it doesn’t mean that it hasn’t had a history of always evolving. I want to finish with, a question. That’s a really big question. I know it’s probably not going to be something we can cover in the span of today’s little interview, but a lot of us are, living in a jurisdiction where we are not able to, we are not yet able to practice injection on our patients. And I know you have a lot of experience with that. So is there some general, I know this is a lot of work. It probably takes a lot of time, but, you know, we have to start somewhere, right. So if you don’t start in, it’s never going to happen. So give us some advice on how, how you help transition your state from a state that that was not part I could punch his scope of practice into the wine that is now almost well known for being able to do that

Well. And a lot of it is building bridges. And, and again, the best thing that you can do is work with your state association, then build that, uh, that network within other associations. And that’s going to take a lot of education. That’s going to take a lot of reaching out. so we ran our bill in 2015, and we were lucky because we had a letter from our regulatory agency saying that it was their opinion that we could do, injections within our state. And that had been there, I believe since 1999. and so when we went to the, our state medical society, we were able to say, we’ve been doing this for a while. There haven’t been complaints. There haven’t been adverse events. but one of the big things is being able to communicate to medical providers, what it is that we want to do and why this is something that’s in our scope of practice.

You know, again, emphasizing how much training we have on being able to puncture the skin safely and effectively, uh, being able to educate them in a way that they understand that this is part of traditional Chinese medicine that, you know, we’re not trying to do injections so we can do, you know, Kenalog or pharmaceutical, injections, where we’re trying to use this from a healthy, safe aspect so that we can continue that tradition of TCM as it relates to our patient. And then using this tool to continue with those diagnosis and protocols. When generally you educate the different communities on what you’re trying to do, that you’re trying to use substances that are safe, that you’re not trying to do again, pharmaceutical or, or, you know, cortisone, Kenalog, uh, these types of injections. They’re generally very supportive because again, your MD, they’re not going to be doing, you know, a B12 shot.

You know, they’re not going to be doing these types of things. And so if we can take that population and we can help, or if we can help with these chronic pain patients in a way that we’re not using opioids or addictive substances, then they see this as a benefit. again, in Colorado, when we ran this bill, we sat down our state association, which, uh, at that time I was president of, we sat down with our medical society. I had a binder of over 300 pages of research and trials and everything that I handed to them. And we sat there and we answered all their questions. And the end result was that our state medical society officially supported this bill to help us put this in writing in our scope of practice. so talking with other States, the biggest thing you can do is to educate the other associations on what it is you’re trying to do, what substances you’re trying to use, and inform them on the training and the expertise we have in this field. And again, generally when that’s done in a collaborative and informative manner, then they see this as a positive thing and are willing to help with it.

Thank you for that. What encouragement and guidance, you know, uh, I’m inspired. I, I want, I want my jurisdiction to be able to do this kind of a procedure so that we can help our patients to the most of our ability. So to finish up, would you be able to tell us where we can get more information about nutrition P O L and how we can stay updated on your teaching schedule? Sure. And so I have a website where I have a few different types of classes that I teach. I have an introduction class. I have a class that’s specific to muscular skeletal conditions and, uh, trigger point injections. and then I briefly go into some of the cosmetics I’m using natural substances to fill in fine lines and wrinkles, and to give the population a, an alternative to Botox and, and some of those other kind of toxic chemicals.

my website that has my education classes is prolotherapy of Denver. so that’s www.proloden.com. and then on the upper right hand side, I have a tab for education and that’s where I keep my classes up to date. Great. Thank you very much. And even if you’re not somebody that sees a lot of athletes, I mean, but wheel, which I keep punches, doesn’t see a lot of pain, right. So if you, maybe if you’re more inclined to do stuff for aesthetic cosmetic stuff, you just heard everyone from Skype, you can also apply this to great results for, for rejuvenation, okay. For longevity anti-aging practices. So I like to thank you once again, Scott your time with us and share your knowledge and experience with us and to our listeners. I hope you enjoyed that. And that was very informative for you. Please. Don’t forget to join us next week. Our host for next week is Matt Callison and Brian Lau. And, and I thank you everybody for your attention. And, uh, if you have any questions, don’t feel free to post them. And if you found this, little interview useful, maybe let your colleagues know about it may be, uh, show some love. And, and, uh, and I look forward to speaking to everybody very soon. Thank you. Stay safe and stay strong. Thank you.

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Jeffrey Grossman Thumbnail

How To Grow Your Acupuncture Practice Using Email Marketing

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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.

Hello folks, Jeffrey Grossman here from Acupuncture MediaWorks. And thank you so much once again, to the American Acupuncture Council for inviting me back here to put on a, another short training for you guys. I really appreciate the fact that they are doing this and that they’ve been doing this weekly consistently for months, because these times are really tough. Many practitioners are struggling. Many practitioners are really frustrated and to be able to provide you with some tools, some insights, some tips, and some strategies to help you grow your practice and understand what it is that you can do should be doing and what you could be doing to grow and to attract patients and to be in communication with the patients that you already have. So thank you AAC for inviting me here and thank you for showing up and being part of this learning experience.

So you can further your knowledge and your time in order to, uh, keep your practice alive and prosperous. One of the things that I understand is I’ve been helping acupunctures since 2002, to grow their practice and to build a business and to provide them with patient education and specific communication tools. And what I’ve come to learn is that both acupunctures really, really shy away from marketing and business tools to grow their practice, especially when it comes to email marketing email is one of those things that makes every practitioner want to run the other way and not even consider using in their practice. But it’s one of those things that I really feel is imperative to integrate into your practice in the first place. It is a consistent way for you to engage your patients and your prospects. And it can completely change the way you connect with patients while growing your practice.

Especially in this day and age with these kinds of uncertain times that are happening around us. Many of you might not be in practice right now. Some of you might be having a slow practice or even struggling your practice. But one of the things that is tried and true that can absolutely break through this monotony breakthrough. This anxiety is email because let me ask you this. How many times a day do you check your email? One, two, three, five. For me, it’s about five to a hundred times a day. Well, not, not really, but I still do check my email quite a bit because it is the way that I connect to the world and the people around me. And then there are studies out there that’s good. Just that 89% of Americans check their email at least once a day. And on average, most there are some people that spend about five hours a day, checking their email five hours a day, checking email.

So there’s a lot of time devoted to checking email every day. So it’s important to use email marketing in your practice because patients will be absolutely checking their email. And it’s a great way for you to pop into their inbox and say hello, and to check in with them and to just connect and to let them know that you’re here and what you have to offer and how you are available for them. So today we’re going to talk about a few ways to help integrate email into your practice and how you can avoid the spam folder specific emails that you could and should be sending out to your patients regularly. And a few other tips and ideas on how to properly integrate email marketing into your practice. And I really want to urge you that don’t be scared about emails. Don’t think that email is a sleazy approach to business, or that it’s not cool to email your patients because people will read your email if you are doing it correctly.

And if you are providing quality content, because if I ask you another question and that would be, how many times have you saved an email or forwarded an email that felt compelling to you? Because there’s really good information in there, whether it was a recipe or a self-help ideas and techniques and things like that. I know I have many, many times. So I want you to realize the fact that email is and should be part of your every day marketing activities that you participate in in order to stay in top of mind awareness with your patients and in order to keep patients in care and engaged and active and to constantly check in and communicate with them. So a couple of things I want to talk about is the first thing I want to share with you is how to avoid the spam folder. And the fact of the matter is that most acupuncturists are not doing email marketing at all.

And if so, they’re most likely doing it a little incorrectly. So if you follow these essential tips, it it’ll minimize your chances of falling into the spam folder. First thing to do is make sure that you use a compelling headline. This is your only chance to get people to open your email, still make you more compelling and clickable. So you want to avoid sounding like a commercial. You want to use words like you and your in the subject line. And it’s a wonderful way to use, to get people engaged from the get go. And don’t make your subject line too long because there’s a lot of email systems out there that, uh, are, are being looked at on mobile devices, because most people, these days are using their phones to read their emails. And a lot of times when you have a subject line that is too long, it doesn’t properly render on a mobile device and people are not getting the full message in there.

So when you do do your email marketing, make sure you do a test to yourself and review it on your cell phone to see how it, uh, how the subject line and how everything else appears, um, in, um, when it renders. So a couple of sample subject lines that are really effective are using the person’s name. And Hey there, Jeff, you know, it would be, it would say Jeffrey where investing in technology and investing in you, and this is a way to announce a new arrival of a technique or, or, or some type of tool that you’re using their practice. Another subject line is keeping you healthy is our goal. How is your way to you holding up Jeffery? Are you curious about acupuncture and back pain? Are you curious about alleviating anxiety? When will we get a chance to see you again? Quick question for you, Jeffrey.

Those are a few good subject lines. When used correctly can help impart a greater opening of your emails. The subject line determines if the rest of your email is red. So it’s important for you to get it right, right from the start. The next thing to help you avoid the spam folders to format your emails correctly, avoid spelling mistakes, and make sure that you use a recognizable normal center’s name like jeffrey@gmail.com or jeffrey@acupunctureanddeliham.com. Okay. Make sure you also use a reliable email service provider like outlook or Gmail or constant contact or MailChimp, and avoid sending too many emails to the same person and don’t make your subject lines too long. The next step is to create emails that are for mobile readiness. The vast majority of people are going to be reading your emails via their mobile device. Therefore, you need to make sure that your email is written and formatted so that it is easily readable on the phone, avoid large high resolution images, because it’s going to take a while for them to render on the phone, make sure to use numbers or symbols or emojis whenever possible.

And whenever they relate to the content that you’re sending to your patients. The other thing is to keep it personal personalize your emails so that your patients pay attention and feel like they’re speaking that that you’re speaking to them. So you can use merge fields that merge their first names or merge fields that merge the specific things that are, that, that are, that are, um, um, uh, concerns for them share about yourself. Share about your life, include unique recommendations in each email by taking advantage of particular merge fields. And these merge fields are part of email software. And if you remember, and if you look at some of the emails right now, you probably get some emails that have your name in there. And what they’re doing is they’re using an automated, uh, merge field that goes through there, your contact in their database and plugs in what that merge field is looking for.

So most email programs have those kinds of things. And then the next step to help stay out of the spam folders to build trust with your subscribers. And this is one of the golden email marketing best practices take away with you do not spam with constant communications, respect the people who unsubscribe and avoid manipulative or overly emotional appeals in your email communications, and make sure that what you are doing is providing tons of value and don’t simply sell or tell, try to share and inspire and educate and enlightened patients through the content of your emails. And the beautiful thing about our medicine is, is that we have so much to share so much to talk about that there shouldn’t be any lack of topics that you could be discussing and sharing with your patients. So right now, what I want to do is I want to jump into the five types of emails that every practitioner should be sending.

So these are their texts, emails, and also newsletter emails. And you should be using both of them on a regular basis and consider creating an email content schedule where one week you send off a text email, the next week you send off a monthly newsletter, then you, maybe you follow up with a new research piece and so on. But if you don’t do that, the least you should do is as follows. And you should have these types of emails as part of your email software program, or even your EHR software. And I’m going to talk about a couple of different EHR softwares in a few minutes that do integrate email. So you should definitely have a welcome emails for your practice. Every patient should get a welcome to the family email. And this email can lay the foundation of the care that you offer. They can ask for referrals and support your new patient in a fact that they made the right decision choosing you and your clinic.

You also need to have reactivation emails, these, these emails help to reactivate the patients that have fallen out of care that you have not seen in a little while. You can message them. And, you know, you know, it’s a, it’s a quick email that says time for your checkup or time to come in to get your chia regulated. Um, and those two alone could do the trick and you should have it set up where you have a system in place in your practice that you are out there doing patient reactivation protocols, where every three, six, nine weeks you’re going back through your files and sending out emails and making phone calls to reactivate your inactive patients. Another essential email that you should be sending out regularly, our birthday and new year’s emails, and these are essential. And these could include a special offer, such as a gift or simply a happy birthday to show you care, because when you get something like that in the mail yourself, whether it is snail mail or email, it kind of puts a little warm fuzzy in your heart.

So it’s important for you to remind yourself that you are a caretaker for these patients and you’re supporting them in their journey towards health and wellbeing and giving them, you know, just a little kudos or a little heads up, or a little hello or a little sweet gift during their birthday is a really sweet thing to do another type of email that you should be sending our seasonal and holiday emails. Great time to reconnect with patients include your office closures in this. And the types of emails can be little reminders to help, you know, remind your patients as to what’s going on and make, you know, to provide them with some suggestions as to what they could be doing during the holiday season, that where you might be closed. And the other type of email that if you say sending out regularly or couple times a year, is it informational research email, and this is where your expertise can really shine.

So you can use your email marketing to send patients health tips, or research updates, or strategies that they could use at home to compliment their acupuncture care, or even you can send them a little deed, you know, email about a specific benefit that acupuncture can do, and this can go a long way toward patient retention. So those are just five of the types of emails that I suggest that you should be sending to your patients. Now, for those of you that are watching this video, I have a series of free template emails that you can have, um, that I’d love to send to you that you could just copy paste and swipe. Just send me an email, a M w biz, a M w B I z@outlook.com and say, I have temple and I will leads to download those free templates that you could be using in your practice.

And you could just put them into your software, whether it’s EHR or software program and let them start running again. Does that mean email it a M w B I z@outlook.com and I’ll be sure to reach out to you shortly. So the next question is, what kind of programs do you use? Well, there are so many email options out there that this can make your head spin. So I’ve narrowed it down to a few that I think are really important. Some email programs are free. Others might cost a little bit more, but this is an important investment, not only in your practice, not only in your patient communication process, but in helping you market and grow your practice. Okay. So couple different email programs that I would recommend are MailChimp. They have a free version up to, I think, 500 or a thousand contacts. Constant contact is a really great one.

Gmail is good, but in order to be HIPAA compliant, you need to sign a HIPAA business associate agreement. They call that a BAA. And if you are using Gmail, and if you want to make sure that you’re HIPAA compliant, just Google Gmail, be AA or business associate agreement, and you’ll be able to find that form that you can fill out to help you become more HIPAA compliant. Jane app also offers email Accu simple offers, email and unified practice also offers email integration. So those are the three top billing and EHR software programs that I’m familiar with that I would highly recommend. And for various reasons, and that also integrate email. Now some of these have already predisposed emails that are already prewritten others. You can just set them up yourself, pretty straight forward, um, on that. And now a couple of ways on how to format your emails to get them open, um, you know, make the subject line a must open email, right?

This differentiates your email from an opportunity from being open or just being completely skipped over. All right, make sure your email has a clear purpose and that it’s useful. It could be a reminder about an appointment. It could be a list of tips or helpful suggestions. It could be a recommendation about how to deal with a particular problem, or it could be a promotion, but make sure your email has a clear purpose. What is this email about? Is it about welcoming patients to the clinic? Is it about sharing a insight or a research topic for somebody be clear in your email and deliver on your promise in the content that you are creating for them, make sure that your emails are personal and connection worthy. You don’t want to just throw out generic information out there, try to use merge fields that are part of your software program to make it more personal, make it more heartfelt, um, in that way and make it more of a connection that’s going, um, make sure that your emails are visually appealing.

So you can use templates that some of these software programs already have. Um, you can, you can format your email like your letterhead. You can add your logo, you can insert your map on the bottom of it. You can include pictures of you in the signature section, um, and also make sure that your email is shareable on social media, add links or share buttons that help them easily share the content of your emails. So that they’ll be more inclined to tell friends and about your services and be able to share those emails just by forwarding that to them. Don’t send emails to people who have asked you to stop and consider getting help. There’s no reason that you need to hit, you know, that you’d take a hit or miss approach to using email, get professional, help planning your auto responses or your followups or your emails or your practice building campaigns.

Like I said, I’ve got those emails that are ready to be sent to you. Send me an email@amwbizatoutlook.com and I’ll forward them over to you. And then the last thing can make sure is that make sure that each of your emails that you put out there has a specific call to action. What do you want your patients to do next? Do you want them to schedule an appointment? Do you want them to share with a friend? Do you want them to click a link to access a free gift? Do you want them to give you a call? What is it that you want them to do in your email? You need to have that call to action to make sure that they take those next steps. And it’s important not only to provide quality content and well-written emails, but you also need to direct them toward the next steps that you wish them to take.

All right. So I want to give you a chance, quick little word on HIPAA compliance. So make sure that your emails were main HIPAA compliant, and that means your email communications shouldn’t steer clear of any protected health information. So no photos, no, no, no link to health records or reference to particular health concerns. Okay. Also make sure that your email provider is HIPAA compliant. And this usually means that there is end to end encryption. That takes place, just ask the customer service center and they should know whether or not there’s HIPAA compliant. Maybe you need to upgrade your, your, your email provider to make that happen. And whether you’re sending a monthly newsletter, uh, an appointment reminder or research update, always make it clear, get consent, and keep the information generic. And a couple of final words with these email marketing tips, you’ll be able to connect with your clients that you want to, uh, that you want and to generate meaningful leads and connections to fortify these relationships.

Even if you’re not a good writer, or even if you don’t think you have enough to say, I can promise you that with practice, it will get much easier. And when done correctly, an acupuncture email marketing strategy can be an effective way to connect with your patients and attract more business to your practice. So once you started growing your list, it’s imperative to start sending regular emails. So start small work your way up, start with one email a week. And if you haven’t been emailed, don’t jump and just start on creating a newsletter campaign that’s automated right now. It’s just not going to work for you. So keep it simple. One message, one clear content piece, one call to action, and be prepared to the fact that it might be harder than you think. And it might take longer for you to get results and that people are going to unsubscribe to your emails.

That’s just, what’s going to happen. Don’t take it. Personally. People will ignore or not click through on anything. Again, don’t take it personally and you will see results. It’s going to take a little while to really instigate and integrate this into your practice, but I promise you that you will see results from it. You will see responses, it takes a strategy. It takes a plan and it takes time, but you’ll see light at the end of the tunnel with your email marketing. And the beautiful thing is that you build the emails and automation once and it’s relatively plug and play for every patient and prospect thereafter. Now, one more final note, I realized that I have not been the resources that you need in the last 90 days, and I’ve done three things to help you. If you’re interested in a no cost one-to-one time with me, I’ve made it available so we can connect. We can talk about email marketing. We can talk about any type of business strategies or growth or planning or what the heck you should be doing next in your practice in order to get going and get started, or even to start educating your patients.

If you’re interested in, in, in connecting with me, comment below the videos here and say yes, one to one, and I’ll reach out to you or send me a private message in Facebook. And I will reach out to you and tell you about the next steps. It’s absolutely free. There’s no cost to this. I am sincerely wanting to help you and practitioners in the profession to stay in business, to grow your practice, because I know the value of this medicine, and I know how powerful it is to change lives. And I don’t want you to have to do this alone. I don’t want you to have to figure out a way to, you know, struggle through the, the, the, the, the muck and the mire of what’s happening in today’s world. I’ve got you. I’ve been helping practitioners for awhile to help them grow their practice and to outline some strategies to take them to the next steps.

Okay. Um, so if you have any questions or any comments, please leave them below this video. Thank you so much for, um, for joining me, um, on, uh, on today’s trading. I really appreciate that. Again, don’t struggle. There are so many opportunities here with the AAC and also, um, through this website and through this Facebook group right here, that you can find the help that you need and the resources to help you grow your practice. Again, thank you so much for the American Acupuncture Council for inviting me back here to help educate and to inform you guys about particular marketing strategies to grow your practice. I know that email marketing is not the top of your list, but it is something that’s imperative to integrate into your practice. Join us joining, join us next week when Poney Chang will be here to do some further education and some inspiration, take care, have a beautiful day. Talk to you soon. Bye. Bye

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Chen Yen Thumbnail

Winning the Referral Game

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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.

Welcome to the American Acupuncture Council show w so good to see you here. This is Chen Yen, nine, six, and seven figure, practice makeover, mentor@introvertedvisionary.com and also a host of this show. So today, and also in our shows, we’re going to be talking. My show is, and we’ll be talking about how to grow your acupuncture, practice more effectively and adapting with the times. So, uh, have you been in a place where you are slow right now? And there’s been a dip also, especially right now summer time and summertime had traditionally been slow before. And then now along with this climate, you, you would like to be in a place in your practice where you’re busier and helping more people and, and wanting more money to come in because to make up for that, that lost time during the last few months as well. So, so today we’re going to be talking about, I’m going to give you some, some sense of my overall predictions for what I speak coming up here.

I’m also going to be sharing with you one strategy. That’s often overlooked and it’s working right now in this climate to be bringing in patients without you having to always do run around and marketing. So as we get started here, I’d love for you to go ahead and type comment below right now. Um, let us, let us know where, where you are watching this right now and, um, love to love to see. So let’s type in the chat. What, what, uh, what city state your you’re watching this from and, and then what kind of a practice do you have in terms of, do you have a private practice? You have a community acupuncture practice. Do you do telehealth? I I’d love to say so a little bit about myself for those of you who might be new to me. So I, um, I started out as a pharmacist on native American reservations and really loved the adventure of traveling to different tribes and reservations, trying to get, get to know, I mean, getting, it was very adventurous for me and I love the culture of the different tribes.

After awhile though, I started feeling really dissatisfied. I would go in the pharmacy. I would hand people, their medications and feel so jaded about the whole thing I remember. So I remember once when I was handing this woman, her Prozac medication, and I just felt so upset, not at her, but at when our healthcare system was putting in front of her as if that were the option. And I was endorsing it. The truth was I grew up in a family that was very holistic. We, you know, like if my sister and I were ever sick, when you’re younger, my mom might open up the Chinese. I mean the medicine cabinet and pull out some Chinese herbal syrup. And that was about the extent of what we’d get. Whereas I would see these people come into the pharmacy and little kids. They would have just gotten their immunization shots and they would leave with a cocktail of medications even when they weren’t hurting anymore.

That, and seeing people taking 15, 20 medications home as if they’re a candy that drove me nuts. Have you ever been in a place in your life where you didn’t really like what was going on, but didn’t know what to do next? So that was what was happening to me. And that’s, you know, one thing that I did know was that I had to get out. So then, um, fast forward five years I had started and grown a successful recruiting business, sending pharmacists to different, um, travel assignments and, uh, hospitals in different settings, um, so that they could actually be in jobs. They enjoyed more. And I used to always think that if I made more money than I’d be happy doing what I really cared about outside of work, but didn’t didn’t happen that way for me. I ended up going through a timeframe of soul searching when I came out on the other end and realizing, wow, I need to stop pretending here, stop pretending that it was okay.

I was primarily selling my soul for people to be on drugs. When, when your had had this secret life in a way, like I shared with you before super holistic and extreme, to some extent, little things like I don’t own a cell phone. I still can’t see myself owning a cell phone. So in any case, that’s what led me to have this inspiration of what can we do to really change our healthcare system. And so much our people are more open to holistic options, acupuncture, other holistic options, but in functional medicine, you know, but it’s not happening quickly enough and it’s not going to be the government changing things. It’s not going to the drug company is not meaning insurance company changing things. It’s really start with you as acupuncture, holistic practitioners, really getting the word out about what you do. So then that’s when things will really change.

And so that since then, we’ve helped many acupuncturists with, with growing their practices. Um, anywhere from starting out to growing, they’re getting their first patients to, um, taking acupuncturists from 5,000 a month to 10,000 a month and a few minutes timeframe, or even even 10 to 20,000 a month in a few minutes timeframe, and then ushering our claims to seven figures. Even though we have clients who are, you know, for example, the American society of American society of acupuncture, board members of client, of ours and the American association of naturopathic physicians and client of ours as well. So just giving you a little window for the Disney brand, new to me about who is this, this person, just all of a sudden having this credibility. So, so let’s talk a little bit about like dive straight into predictions that I see, um, about what can be that I foresee coming up based on my experience of constantly working with acupuncturists during these times in the last few months continuously working, you know, over the last quite a few years anyways, but, you know, especially during, during this time and even now as well.

So there are a couple of key predictions that I will say that I see affecting acupuncturists and other hosted practitioners coming up, number one has to do with economy. So what do you think, what do you think is going to happen with our economy? Is there, is there going to be a V shape? Recovery is gonna be a w shape. Recovery is gonna be an L shape recovery. So Paul Krugman, who is the Nobel peace prize winner earlier on during these times, like when the whole career thing started, he was talking about that there will likely be more of a, um, he was expecting a Nike swoosh kind of recovery, right? So by the way, type type the chat, what do you think I may not chop it in the comments, write out what do you think or type of, um, what do you think it will be?

And so, but recently I’ve been seeing more about how it’ll be more like a w shape recovery. Great. And I economists talk about this and I, and I would say that I feel like it’ll probably be something like that as well, which means, you know, dipping once and then another dip again. And, but what is, how does this have to do with your practices regardless of what shaped, you know, recovery we have? Well, what is what I think we can all agree on is that things have changed where people are looking at things differently. Like people are being tighter with their money right now, they’re looking at things twice more. Um, but at the same time, keep in mind, just cause how many of you have noticed that, that you’re finding patients or potential patients saying, Oh, I can’t afford it. Or, you know, I have been out of work store.

I don’t think I can come in as frequently. It’s something related to money. How many of you are noticing that? Go ahead and type in the right now and so, uh, type below. So, um, yes. And then what do we do about that? So, one thing to keep in mind about it is that, um, even in times of, of economic challenges, whether it’s the great depression, whether it’s recent recession, guess what, there are always people who do have the money. So there will always be people who do have the money and were willing to pay. And especially, you’re so lucky because you’re in a healthcare industry and people will, even if they decide they’re not going to buy that latest car, even if they decide they’re not gonna buy clothes as much anymore, they still need their health. Would you agree? Like how many of you find that if you’re not healthy, if you’re feeling grumpy and if you’re sick, you can’t really do anything.

You can’t really, um, be what you’re meant to really be right. And it’s not, not a good feeling. So, um, what’s uh, so what I’m trying to say with this impacts your practice is that I believe that it will be even more important for you to set yourself apart. Why? Because when people are, are, whether it’s comparing prices or being concerned about prices, then they are, um, it’s like, they’re almost treating you as a commodity. Oh, how much is it right? Oh, I can’t afford it. Um, whereas instead, if you set yourself apart and people see you as being the person to go to, it won’t matter as much for those who do have the money to pay for it, to actually come in and see you. So it’s more important now than ever to be able to communicate effectively what you do in a way that people get it.

They put the two together. I feel like I have to see you, right? So this comes from the first two steps of the consistent patients formula for introverts. So, one thing I hadn’t mentioned here earlier is that a lot of our clients come to us because there are so many approaches out there that are very extroverted approaches and give you a really exhausting, you know, those things like, Oh, you have to go out there and network and you’ve got to go talk to people. You’ve got to go in and do this thing and that thing, Oh my gosh, it just feels so exhausting. Right. Did you know that actually 30 to 50% of our people are introverts, but most of what’s taught about how to grow an acupuncture practice assumes that you’re an extrovert. So no wonder it doesn’t really work for you. Right. Um, we introverts need a different approach.

So what I’m trying to say is, especially as an introvert, you need a different approach during these times. Um, and you know, we, and we’re also more limited in terms of, of, um, ways that you can actually get the word out. So what can you actually do to get the word out? So we’ll talk about that a little moment here. And one thing I want to bring up in terms of predictions, what I see coming up, I believe that it’s also going to be the house calls are going to be more pop popular in more demand than in the past. So if you, why, because, you know, people might be concerned about, about, um, safety and being out and, and, um, they are likely to consider it or be more open to considering house call where you don’t have to go anywhere. And then especially if you’re also protecting yourself and going there and then, um, that can help peace of mind for some people.

Right? So, so that could be another option for you to look at if that’s something of interest to you and you could charge a premium for house calls too, um, because of the travel, that kind of thing. So, so I foresee that being an area in demand, at least for the near future coming up here. So because what can happen, right? This can happen in the fall again. So, um, so the other thing, so if you have an interest in it, then yeah, that could be an area to look into. Another thing is that I think is gonna be really important is looking at, um, I think there’ll be even more important. It’s almost like looking at, remember how we talked about setting yourself apart. So setting yourself apart, as we look at it in the consistent patients formula for introverts, it doesn’t have to do so much with like, uh, just this one, if we’re going to talk about, but it’s still, it can help be helpful, which is niching, right?

So I think niching down and being, being more like, and also reaching out to people who really need your services, because there are people who need it. And then there are people who don’t need it as much. So for example, who are the people who need it, for example, health care workers or frontline workers, um, also being able to take care of their health quite well right now. And then people who are just think about this people who are in the it industry, they weren’t there, they were more immune to this whole thing. They could still work from home as a whole whole industry. Right. So how could you reach people in those kinds of industries where people who are dealing with, um, having co-morbidity kinds of factors like diabetes or, or respiratory issues, they need to really pay attention to this even more. So are you actually communicating and talking about this, or so, um, by the way, I’m going to give you a link so that you can, cause I know some of you are, um, cause how many of you would actually like to book more patients, whether it’s to bring your existing patients back in the door because they’re scared or afraid of coming in right now, um, or to attract new patients.

Right. So how can you do that? Um, without having to feel like, Oh my gosh, I have to do a ton of money marketing. So I’m gonna give you, I’m going to give you a link to where you’re going to be able to get, um, the free templates that like literally copy and paste that you could either email, text, or, um, there are a couple of social media templates there too, that you could, um, model as well. So, um, I will, uh, let, let me give it to you right now. So it’s get it’s www dot, get more M D referrals.com and then for slash AAC, right? So it’s www.getmoremdreferrals.com/aac. So I just wanna make sure you get that. Um, so in terms of, so you can just click on that and then, then end up downloading it on the other end. Like it’ll be in your inbox once you, once you go there. Um, so what I wanted to bring up is we need to look at changing our strategy in terms of, well, another prediction that I foresee is that there will be more of a, um,

More of an interest in, in businesses advertising in front of people more online. And what does this mean for you? It’s acupuncture. So this, and why is this? Because, you know, while, um, places were closed, more people were online. Still a lot of businesses are flooding it, not just your practice, but your kinds of practices in your active contributors, but, um, other businesses are flooding in trying to get people’s interests online. So I think there’s gonna be a rush towards that, but what does that mean for you? It’s actually gonna mean that ad costs will be driven up, right? Because there’s more people advertising, there’s more people, more businesses and there are businesses out there with bigger, um, like backing financially, right? Like big companies they’re coming in and wanting to advertise on Facebook, um, or wanting to advertise on other kinds of channels, online, YouTube or other kind of channels along the lines.

So what does that mean? It’s going to make the ad costs go up. So for those of you who, who, um, do advertising of any kind, especially online, then you may want to have a look at that. You might need other strategies that, that are, um, so actually get in front of people who, who need your services without you having to be spending a lot of money. Right. Um, and in terms of, for example, if those of you who are doing more organic social media posts, some of you know, that like a lot of times there’s because of the algorithms changing and things like that in Facebook and all that. Um, you know, there, a lot of people, aren’t actually seeing some of the posts that you’ve put so much hard work into putting up. So how can you navigate that? And also ideally be able to attract patients without having to always be doing something, right.

So one great Avenue that’s really overlooked and is working really well for our clients right now. So there’s three that are working really well. I’m going to talk about one of them today. Um, and then you can always come to our blog also to, to check out, um, in terms of, of, um, more that I talk about with this and, and other strategies as well. So you always go to introverted visionary.com to read more about this, but, um, and other strategies, but one is, uh, attracting more doctor referrals. So have you ever thought about that before and sorry, as, as getting more patients through, through medical doctor referrals and why is this a great thing to consider even in this climate, especially in this climate, actually it is because many medical doctors have patients you can help. And in fact, they have thousands of patients in their practices is pretty common and a lot of their patients are this limited in terms of what, what medical doctors can offer with drugs and surgery, because that’s what they’ve been trained to do.

And they, I, and so whether it’s just something as simple as pain, or I know you help people with much more than just that, but I’m just talking about a little sliver, right? You have the ability to help those people in a much more effective way in a lot of cases. And the truth is MDs will refer if they knew about you and they trusted in you. Um, and you know, also right now, people don’t really want to go to, for example, the hospital, the ER, as much. Right. So, so, um, it really puts you in a climate of being able to be someone who could be of service to help a lot of patients out there. And when MDs have thousands of, of patients in their practices getting three to five, like even having, imagine if you had three providers sending you one or two referrals a week, what would that do for your practice?

That’s like at least three new patients a week or six new patients a week, what would that do for your practice? Great. And so that’s totally doable. And, um, but I often hear cause how many of you have tried actually we thought about it before, but then you think, well, how, uh, I don’t, I feel intimidated. I’m not really sure where to start, go and type in the comment below. I’d love to see what are some of your most, uh, like have you tried it before? And if you have, you know, what’s been the most challenging thing or most frustrating thing. So, um, you know, some of the things I hear also are, I’m not sure should I really, you know, they’re so busy right now, especially during these times when they really listened to me or anything like that, as I have a lot of other things that I’m, I’m, I’m dealing with right now, like this is really the best use of my time even.

Right. So have you, have you thought that before, but just think back to this, like how can you actually have your MD referrals that many times they are, when they’re referred a patient’s referred by an MD, they will listen to that referral because they trust that, that doctor’s referrals there they’ll be more likely to come in and we’ll be more likely to stick with Cara as well. And then, um, the other thing is there’s something else I was gonna run. So, so then, um, yeah, it’s just a matter of, but also, Oh, that’s right. So this is one of the few strategies that if you put in place, you can be getting referrals three months from now, six months from now a year from now. And that is not something you can say about other strategies, whether you’re networking with other people, one on one, or doing ads or trying to do, you know, send emails out and social media, right?

Like you still have to keep doing those things. Wouldn’t you rather be seeing patients wins. You rather just be the acupuncture, seeing patients and not have to deal with any of this. So you could deal with less of it. Right? Because even more effective, I have clients who have full practices primarily from doctor referrals. So let’s talk a few about a few key tips. I’m going to leave you with that, that you can get started with right away to be, I’m starting to get more, more doctor referrals into your practice. So in terms of, of one of the biggest challenges I see is I’m wondering, well, how do I actually get my foot in the door? Right. So actually the first step is because a lot of mistakes, one common mistake is to go straight into, Oh, let me go. And yeah. And connect with someone and, and then see, you know, have a, and then I’ll talk to them.

And then I’m, you know, have you talked to him about referring and that’s usually, that’s usually what most, most acupuncturists do. And that’s a mistake. Why? Because it’s like, without thinking about, well, how could it be more strategic with this? Cause have you ever had a good conversation with maybe a medical doctor and then you, it didn’t go anywhere and you thought, Oh, this is kind of like, it feels like it was like, I wish I had something came of it. I’ve never felt that way before. So instead the tip number one is to actually be strategic about, well, who, who are the doctors to reach out to? And they’re not all created equal in terms of doctor relationships. Right. And so, cause sometimes I get the feeling that, that sense of, Oh well, but they see me as competition. They don’t, they won’t even want to refer.

And you know, that those kinds of things, the truth is, yes, you’re right. There are doctors who won’t ever refer. And then they’re also a medical doctors who absolutely will refer. And so it’s about getting through to those physicians. So one hot tip for you. Cause for example, someone wrote me in beforehand and said, Oh, I, um, I’m not in their insurance, you know, plan kind of thing. So, so then they’re not going to refer and all this kind of thing. So if you don’t accept insurance, for example, then look for medical doctors or physicians who do, I mean, who are primarily cash based practices or have concierge based practices, then you’re going to be more likely to attract cash patients who have the ability to pay because their patients are used to that. That’s hot tip number one. And then number, then the other thing, next thing we need to do is look at, okay, how can we get your foot in the door?

Right. So how can get your foot in the door without feeling like you need to be bugging people without feeling like you’re, you’re, um, you’re like a newest sensor or something, but you’re not, you’re not anyway. Cause you’re, you’re a provider. Y you know, you aren’t one. And so, but you’re afraid of being that way and you’re afraid of breaking people somewhere. So, um, or feel like you’re, you’re good at before reaching out or, you know, something, whatever that might be, how many of you have had had that fairness before go ahead and type in the comment. So, um, so then the, you know, what you can do two is looking at well, how can you, I’m going to share one, one very simple thing. Each one of you can do right now, if you already have an existing existing patients, but then I’m going to share with you go around strategy, right?

Because we can look at getting past gatekeepers, how can we go to go around and go around strategy and said, so in terms of, of, um, getting past gatekeepers, one thing you could do right is to go through your existing patients. So do you have a mutual patient who, um, you had good results with and, uh, and that the doctor will actually, um, like it’ll be easier, right? It’s more of a warm introduction. And I’m going to give you a, um, what to say here in a moment here. And I’ll also give you a script that you can also access some of them just looking at it here. But the second thing is, so you can go, so that’s one, one thing, and then you just need to be introduced in a warm, warm introduction way. And then what do you say, right. So I’m going to give you a script, a moment, which is to say that that’s actually working for clients right now.

The second strategy is to, um, a goal around strategy, which is I, you know, connecting with the doctors more or more directly in how, in terms of who, um, for example, many, some patients will actually need COVID-19 testing. So, but how do you, you know, cause how do you get get a hold of a doctor if they don’t want to talk to you, they’re too busy. Like, who are you? Right. You could look at reaching out to a doctor who is doing COVID-19 testing and then collaborate that with them and say, Hey, I would like to, um, let my patients know about you so that, you know, if, or I’d like to just know more about what you’re doing and I hear that you offer Coca testing. And, um, I’d like to just know a little bit more about your practice. Cause then if the need arises, then that’d be happy to send patients to you.

So then that way, you know, you have a reason to reach out to these doctors because of these times a third strategy that’s working really well for clients right now is to actually, um, do a what? So you know, how you feel like, well, I don’t really want to go out right now, or doctors are busy. They don’t want us ever want to see me right now. Right. We can’t do. Um, and so what you can do, there’s something that’s working really well for clients right now is actually do a video. So for example, I helped a client of ours recently do this, a short two to three minute video and making some really key points and sending it off to the doctor and then getting interesting referrals that way. So that’s something you could do right now, but then you need to know what to say, um, to actually not get their attention to actually want to refer.

Right. So that that’s really important. The other thing is that you can also interview, so this is one thing that, that one of my clients, she’s an acupuncturist. She was getting, um, she, she had this doctor in her area who she felt like, Oh, that doctor’s referring to another acupuncturist in my area. I wish he would refer more to me. So what do we do? So we, I suggested why don’t you do more of a, um, a, an interview of this doctor. So she did exactly that. She interviewed this doctor and guess what? She got seven referrals from that doctor that week she had, the doctor was super excited. He was, he was actually showing, so they also aired on Facebook live. So she, he was actually showing his patients on the Honda store and like, Hey, look, see I was on Facebook glide, I’m here.

And he’s really proud of it. And so he shared it with his patients. She shared it with her patients, she put on her website. So, you know, these are some simple things that you could be doing, but then you need to know what what’s, what do you say? Right. Cause it’s not just any asking that medical doctor, uh, questions that, that, um, in an interview that just all of a sudden magically just has him referring to. Like, you need to be strategic about also what you bring up in the interview and that kind of thing. And, you know, we have scripts and templates for things like this. So I’m going to give you, I’m going to make sure to give you, um, the, um, in terms of approaching doctor referrals, if, if it were, if you did have a mutual patient. So let me just show this to you.

Let’s see here. Um, let me pull this up for you and you’ll be able to see it here in a moment as we wrap up here shortly. So also you can go to the, you can go to this website, um, to get the download of this exact template as well. So, um, you can go to www dot, get, um, get more MD referrals.com forward slash um, whoops, let’s see here. That’s on the page. I was gonna show you, but, um, from cars, I’d say, um, Ford slash AAC, right? So www dot, um, get more MD referrals for slash uh, AAC. So here’s the script I’m going to make sure to give you when you go to that link, um, as a free template I think, or use right away. Great. So, um, and this is from, this is from the third step of the consistent patients formula for insurance.

So, um, you can say something like that. So I’d love to hear more about your practice. I’m looking for a good.dot dot. So whatever doctor you would like to get the attention of, put in, put that in there, looking for good primary care doctor to send my patients to when the need arises. What kind of patients do you enjoy seeding? What’s your philosophy seeing what’s your philosophy or approach, or you can say something like, uh, many of my patients or clients will need such and such physician. Some people ask me for recommendations. I would like to know what your philosophy is and what kinds of clients or patients you most like working with. So I can refer the right people to you when, when the need arises. So notice that when you actually have more of a, more of a, um, a structure, right? Like, you know what to say, it can, it can be easy, right?

It doesn’t have to be difficult and you can be getting, getting more paid for. Um, you just need to have a system, right? So we just talked about some of these key things, the doctor referrals, success roadmap. And so the things about this is that you just need to know what to do and the plugin play and start seeing more referrals coming in and not have to be feeling like, Oh my gosh, you want me to do, to, to market, to get patients right now? Cause it’s been really slow, but this can be such an, uh, helpful and effective strategy for you right now. So with that, I’m just going to make sure you have the link there. And, uh, so, so awesome to see you here and joining us. And, um, and then thanks to American Acupuncture Council, also putting out, you know, such helpful things.

Cause there are all the other hosts that you can check out too, and, and upcoming, um, Facebook lives on this to really help you in your profession. And, um, in terms of, of, uh, not just with, with growing the practice kinds of things, but other kinds of, of aspects that affect your practice as well. So definitely stay tuned and, and uh, and then here’s the link also, I’ll make sure it gets popped in on the, in the, uh, in what you’re checking out right now, watching me on, I’ll make sure it gets popped into the comment section. So you can just click on a link and, and, uh, download those free templates. And, uh, you know, if you’re in a place where you’re, you’re feeling like you’re, you’re, um, you’re, it’s just like a dip in income and that kind of thing. And, and you just know you’re, you even love to see more patients you’re capable of so much more and you just enjoy it when you are rave and, uh, feel free to, to reach out and happy to have, uh, um, a chat and see, yep. See how and give you insight into your situation. So feel free to get the templates then, and so good to see you type in the, in the, in the comment. And, um, let me know how, how, uh, what’s one tip that you can, that you liked. Right? And, and, uh, they can start incorporating. So.

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Dr. Virginia Doran

AAC Modern Language, Ancient Knowledge

Hello, I’m Virginia Doran. And this week’s show title is modern language, ancient knowledge using acupuncture research to communicate acupuncture’s evidence. The guest today is Sandro Graca, who is just doing amazing things for this field. We really need to thank him and people like Mel hopper, Koppelman, who are doing things through the evidence based acupuncture, uh, organization, and other things. Sandro originally from Portugal, though, he graduated from the Irish college of TCM.

Click here to download the transcript.

He’s a fellow with a bar and practices in Dublin fertility medicine at the Sims clinic. He’s also a member of evidence-based acupuncture board and is an avid and a speaker and promoter of acupuncture research. Additionally, he teaches at the Northern college of acupuncture in New York and UK, and sits on the board of the obstetrical acupuncture association. So Sandro, thank you for being a guest. Thank you for having me here. It’s a pleasure to be here with you having a chance to chat and thanks to the American acupuncture council for having me.

It’s a pleasure. Yeah. And we all want to thank the American Acupuncture Council for so generously, you know, supporting these shows and producing them. Um, so I wanted to start by asking, how did you get into research? It’s not a path everybody takes in acupuncture. Yeah. It’s um, I suppose it’s a, it’s a follow on from the acupuncture, right? The, um, and it’s funny when you, when you asked me that my brain was like, Oh, a few years ago, people used to ask me and we all used to this in the clinic. How’d you get into acupuncture in the first place. And now it’s, how do I get into, um, to research? And actually the answer is pretty simple. And I, I started reading the papers after qualifying and, you know, you read all the books and you’re in college and you have your teachers and you start practicing in the clinic. And eventually

It just led to my field being, you know, more into, um, acupuncture for fertility and pregnancy. And I just started to read papers, you know, studies that were out. And at the time, I honestly, I didn’t know how to, or you know, that there was a way of reading them. I would just jump straight into the methods.

Well, that’s encouraging because for a lot of us, it’s a challenge too. We haven’t had sufficient training in school to really read and analyze research papers.

It’s, it’s a different, it’s a different language, isn’t it? And then, you know, it’s a different language, but here I am, you know, from Portugal and studying Chinese medicine in Ireland. So I guess I’m missing the different languages. Right. But, but yeah, I would just, you know, initially it would be like, what you’re saying it is, it is, it is a more complicated language. Like academic writing is different and from what we’re used to from a book, for example, and I was just, yeah, I was just jumping to that method section because I wanted to see what points they were using for the studies and almost like a compare and contrast on what I was using in the clinic as well.

So why do you think acupuncture’s should be research literate even if they don’t plan to use it and they just intend to be a practitioner clinical practitioner.

Yeah. So, so kind of like the same principle. So first of all, to keep up to date and there’s, there’s that, there’s that difference between, you know, how much do you need to know about research and do you just want to be able to read and know how to read it and interpret the paper and get the, I suppose, the juice from the paper, or are you really interested in doing research because that’s way further down the line, right? So for, for a practitioner in the clinic and independent of specializing in one particular field, or, or just being more general practitioner, just to keep up to date, because, you know, unfortunately, you know, books are written, it could be five years plus before there’s a second edition of that book. And in terms of getting like what’s up to date, you know, getting it from from research is the quickest way to, um, to learn, you know, and to keep up to date and then you start getting into, you know, why, and, and really why it matters for the profession as well.

And not just for the individual is because of trying to learn how to use that language and whether we want it or not. The reality is that for most of the other medical fields, they understand that language. They like to communicate in that language. And they like to use research for argument, you know, argumentation between people, right? So learning how to, again, get the information from it and know how to use it, you know, get familiar with the language just means that you will be able to then communicate with people. I I’ll give you one very quick example. And it’s like, I’m very practical in terms of telling people why and giving them examples. If you’re going to be talking to someone, it being a new patient, just a member of the public, a consultant, or even a healthcare policy maker. If you’re going to talk to them about what you do, if you have that chance of like the five minutes, you know, golden ticket to tell them what you do, if you use terminology that we would use to one another, because we’re both practitioners, they don’t understand it. Right. And sometimes people think about this and go like, Oh, but it’s what we do. And if you’re good at explaining, and I always say, no,

Know your audience,

Think about how you felt during the first day in TCM school. Think about how you were during that first week, during that first month with all the different terminology, you know, there was she and Shen and jingle. It, it, it was all new to you. And it took you a little bit of time to understand the concepts, to get, you know, it’s a new way of looking at things, right? It’s like a new reality. It’s like the new lens to look at it. Right. You only have five minutes with these people. They don’t know the terminology, but there’s other terminology that they’re familiar with. Right. And if you use that, you just going to engage with them and you’re going to be able to communicate with them.

Makes sense. Absolutely. I always don’t, it’s like, don’t explain it in Chinese medical terminology because you know, for a lot of people they’re not going to understand, and they’re either going to think you’re trying to fool them or they’re going to think, Oh, that’s very poetic, but it sounds like gobbledygook, you know, talk to them at the level they’re at. So if it’s a doctor using research language, if it’s just a lay person, you know, keeping it scientific, but simple enough for them to understand.

Yeah. There’s different levels, right? Unlike again, if we go to the different levels and the extreme of like the healthcare policy maker, a lot of the times healthcare policy makers don’t even come from a medical background that could be from a law background. So not only that person might not have the medical background, they definitely don’t have your own medical paradigm background because they’re not TCM. They’re not even, you know, biomedical, how are you going to communicate with them? Right. So I always say like, as you pointed out, you know, it’s have that in your head about know your audience. Who are you talking to? You might only have a few minutes if you’re talking to another practitioner. Absolutely. I love talking about the classics. I love talking about Chinese medicine. Love talking about acupuncture, use the terminology with your colleagues, but when you’re talking to other people, they might not know it and you’re just going to, you’re going to lose.

Right. Right. Now, what would be your advice for starting into some sort of knowledge of research literacy? Like where would somebody start assuming they didn’t have a good program in school for that practice?

Yeah. You know, this is the, this is the lecture in me. Can just go, you have to practice more. Um, yeah, it’s true. I it’s difficult because you know, a lot of the times you don’t even, you don’t even learn it in school as such like the basic research skills of, you know, where to find the papers, how to go about finding them. And then there’s the whole thing about, you know, what’s the quality and how do I know that this is a good paper or not? And I would say, just start and get to it. So go online. Pub med is the easiest way to do it. It’s free, you know, indexes, most of the papers there. And again, think about the levels and think about the steps. There’s, you know, whenever, whenever we hear the word research, we’re thinking about, you know, lab coats and run the mice control trials.

And, you know, for those, and, you know, can look at the pyramid and think that you’re all the way up the top of the pyramid, but, you know, think about lower down the pyramid because it needs that space too. So, you know, start reading about case studies case reports, learn how you learn, what are the different types of studies that go up that pyramid of evidence and get familiar with it because there is, it’s really difficult to jump ahead and think that you just, you have to read all the RCTs. It’s difficult. It’s like trying to learn how to drive in a Ferrari, you know, get your little binder car first and get familiar with it. And then once you’re, once you’re more comfortable, then you get your next car and so on and so on. So pub med will be my first recommendation, you know, Google scholar as well.

Um, the results from Google scholar, just because it includes more stuff. And it just it’s a lot like there’s chapters of books and books and stuff like that. I prefer pub med. And I would always say to colleagues, start there and look at, you know, different years, different publications, you will start to know as well. You might have a particular author that you read the book from college or that, you know, from before and just try and follow and see what other publications that particular author has and, and just practice really, you know, it’s it’s, you gotta get used to it. It’s a different language, but again, look, we’re TCM practitioners. We are used to different languages, right. We can study Chinese medicine. So yeah, practice scholar would be the key ones.

I was surprised when you really encouraged, uh, when we spoke yesterday about, uh, practitioners doing case reports that that really filled a need. I just thought I didn’t really see the value in it until you explained it to me.

I think that, you know, it’s, it’s a big passion of mine and with evidence-based acupuncture, both Mel and I have spoken about this before in public and in our own work and trying to how to approach this in a way to, again, having those five minutes and getting people involved with us. And I always mentioned too, when, when I’m doing my presentations, I always say that I love to put it out there because that’s, you know, the standing on the shoulders of giants and you see something and you try to improve on that and build up on that. But it always breaks my heart a little bit to see that you read the research paper and independent of the results you look at who was doing the treatment, who was doing the acupuncture. And a lot of the times it’s not acupuncturist.

Right, right.

Why, you know, why can’t I get involved in this? Why can’t we as a profession? You know, it should be us doing this. So again, thinking about the different steps and jumping ahead and thinking that, you know, someone is going to arrive with a bunch of money and get us to do a big, huge RCT. Yeah. Let’s keep our fingers crossed and hope that that’s going to happen, but probably won’t. So let’s start somewhere else. And that was something that recently we started to put that together and get that point across of let’s build that bottom of the pyramid of the case studies and the case reports and just write them and write them according to the guidelines. So you can go online and you can find it’s care, hyphen, a statement, care, hyphen statement.org, and you can get the guideline. It’s like a roadmap that you follow those, you know, those guidelines, those principles to write your case report, that’s where the name comes from.

Just kind of keep it in your head it’s care because it’s for case reports, CA R E. Yeah. So, um, you know, research, we love acronyms. It’s amazing. And, but, but it’s, it’s going to, a lot of the times it’s going to turn people’s head because it’s like a case studies case reports are at the bottom of the pyramid. But last year I was doing a day, it was a pre symposium lecture in a, in Portugal. And that came about, and I just had those few seconds when someone asked a question in the audience about a case reports and I was like, but hang on a minute, look at the pyramid. It doesn’t matter how much you look at the top of the pyramid. If the bottom of it is not strong and full, the whole thing is going to collapse. It’s like the house, right?

So for us to be thinking that as, as starting in research and has not having enough funding and all that start aiming and thinking about our CTS, I think in my opinion, that it’s just going to take a lot of energy and we’re just not going to get there. Let’s get familiar with the case studies and the case reports. And look at the time that we’re going through right now, where there’s, the virus is going around. There is no time for RCTs. There is no time for huge literature reviews and studies. We’re going on case reports, we’re going on case studies, right until the month start building up. And then you start putting that amount of work together. And eventually there will be trials, right? Right. We can do this. Right. We have the guidelines. It doesn’t matter how much training you had in school.

You’re doing this all the time. You’re treating patients, you’re in clinic, you’re treating patients, you’re taking notes, put those notes into those guidelines, start producing case studies, start putting case reports out there, you know, try and get them published. You know, you get your name out there. It looks good on your CV. And eventually you just start building up that bottom of the pyramid and Hey, some of those case studies and those case reports might end up being a pilot trial. They might end up being an RCT at some stage, you know, fingers crossed. Yeah.

How can a practitioner, uh, incorporate the knowledge from the existing literature in their practice?

Well, I’ll give you a very, very, again, an example that was like, wow. So if I can’t remember exactly how many years ago, but a few years ago in Australia, when the legislation changed, one of the things that came out for the acupuncturist is that they couldn’t do any direct advertising of any kind. So they couldn’t even, it’s almost like they can’t even talk about what they do. Right. And, and yeah, you know, it’s a bit like I do this, but I can’t tell you anything. And you know, there’s different levels of advertising, right? So that, wasn’t the point of it. The point was what some practitioners then started to develop and credit to the first person I heard saying, and then using it this way, it was Deborah bets. And she was like, well, you can’t talk about what you do, but you can talk about the research that is out there.

Right? So instead of writing on your website about what you do, and these are the conditions that you see, and then having hassle with people saying, Oh, you can’t say this. You can’t say that. Why don’t you start talking about the papers that are out there and start saying something like, Hey, here’s a paper from the study and 2019. And Hey, there were 10 people. It was a small trial, but isn’t it funny that even from that small trial, they found that blah, blah, blah. And at point they can’t come to you and say that, Oh, you can’t write that because it’s advertising because you’re saying I’m not advertising. I’m just talking about what they found from the paper.

Yeah. There’s always a work around isn’t there.

I shouldn’t be saying this life. Yes. But you know what I mean? Like if you’re reporting and if you’re talking about stuff that is in the study, number one, you’re informing the public. So you can use that as a training for you for when you’re talking to the person in the clinic, you can use it for your website. Right. You can use it for your blog. You can use it for your social media and, you know, for the public it’s information, you’re not selling that, Hey, come to my clinic because I do this. You’re just saying, I’m an acupuncturist. Here’s what, you know, a study from last year, I found about acupuncture and this, I do this type of acupuncture in my clinic, you know, work with us. Um, that would be, you know, that would be kind of like the main thing also remember, and I keep saying this all the time, stay up to date, right. If there is, you know, you’re doing, you’re doing

Well these days, that’s hard. There’s so much coming out.

Exactly. Right? Like even with research, it’s tough sometimes because there’s so much coming out, but you know, don’t stay in the same place and, you know, I know want to be critical, but you know, it’s not the same points all the time, the same people all the time, it’s everyone is different. And there’s been times when something comes out of a research paper that I go, wow, I actually, I never thought of it, but that’s actually a very good idea to use that particular point prescription for this. Or even not with a point prescription, even with the timing of the treatments, you know, recently there has been a lot of stuff that came out about dosage and considering that, you know, maybe once or twice a week might not be enough for some conditions. Maybe we leave three times a week for condition X. Right. So it’s not about, it’s not about read on the paper and change your practice. It’s about read it on the paper and think about it.

Yeah. I think some of the viewers might be wondering, is there a fast track to learning acupuncture reasons literacy? Well, I know the answer to this. I’m just wanting to hear your response

That look ideally, and this again, going towards what we are exploring with evidence-based acupuncture and what we would like to do. And we’ve done some lectures on this already is just trying to have, start with the basics. Right. And I really mean it. Like, it’s not about trying to teach someone to do RCTs, start with basic research skills and try and talk to the colleges to see can that be incorporated as part of the curriculum. And I know like I’ve been at these meetings and I know that the first thing that the college director is going to say is we don’t have the time we don’t the budget. You know, if you’re going to add something else to the curriculum, what are you going to take? I understand that, but let’s work together. You know, let’s try and find a little bit of space. And, and I can’t say too much about a paper that I’ve been involved with recently and it’s not published yet, but it’s fascinating stuff in terms of how we can get the colleges involved, you know, the associations involved as well. You know, we already have the associations, you know, some of them pushing for practitioners to do ethics CEO’s and to doing, you know, practice CU like proper stuff in terms of ethics and safety, maybe there’s room to incorporate something to do with basic research skills as well.

Right. And, and, and updating it for your, you know, CU or yeah, absolutely.

Absolutely. You know, so, you know, trying to talk, I know it’s very early days to be talking about this, but it would be something that we would really like to explore. And hopefully I’ve been in touch with, with the main authors on that paper. And they did allow me to just say, keep your eyes out for four days, it’s going to be published soon. And hopefully we can engage in this conversation and just say, in my opinion, I think there are a lot of people are just thinking about research as doing research. And I think that we need that little bit of education and say that first, let’s talk about knowing how to find it as you ask, and then how to read us, you know, out to get some points from it. You know, I don’t mean acupuncture points, but points from the paper in terms of how, you know, dosage, what are they doing?

How are they doing it? And ultimately if this doesn’t convince people, ultimately the goal is I, we, as the BA Mel would say the same thing, we would like acupuncturist to be doing the research. We would like to be involved in the design of the trials, right? Because it’s, I’m not the kind of guy to be on the outside saying that that’s wrong and that should change. And the kind of guy that goes, I’ll, I’ll go in and get stuck in and let’s see, can we change it? And I think that the first steps would be that, you know, involve the colleges involved, the associations journal clubs, you know, online education and start, start small, start with the first steps of learning.

Hmm. Now for some people who don’t have access through an institution, uh, they, they may not be able to get anything but abstracts, especially for certain papers. Um, you know, talk about the difference between an abstract and the full text and, uh, why it’s important. If you can to get the full text,

It’s a lot of the times you will hear this, that, you know, you can find a lot of the times they can find the, the, the abstract, you know, the index paper on pub med. And then if you search on Google scholar, you might find the full paper. So when I gave you the example of how I started looking at research, a lot of the times that stuff doesn’t come up on the abstract, you know, abstracts are really condensed in terms of the word count because of publication and to start what you’re, if you’re just starting and you’re reading only the abstract, you’re actually missing out on the, on the, the important thing and kind of like what helps you to build your own confidence, which is go to the method section and see what points were they using? How long were they treating for?

What were they checking for baseline, you know, checkups? Like what were, what did they want to see on the patients first? And then how many months later were they doing and what were they doing again? That sort of information comes up the paper. Sure, absolutely. Yeah. Yeah. So, yeah. So you have, even from, you know, if you go up in that pyramid again, we look at things like, you know, who was the person doing the acupuncture, um, what, what type of training they had and for how many years, a lot of the times, you know, this is encouraged to come up on the paper as well. And if you read the abstract, you’re, you’re missing out on that. You know, the abstract is a little bit like the poster for your movie, right. How they got there, right. It’s just going to tell you the start, like the context of, you know, the context of the story, and then the happy ending for the story, right? That’s your abstract and what you’re missing out from the other one, one of the things that you hear a lot from, and I know, you know this, but for people listening is that it’s very rare that someone actually reads a paper from start to finish. Right? You tend to go through the results first.

Okay.

The results first, then you go like, Oh, I want to read a bit more about this. And then, you know, you come to normally the methods, you know, just to see what way they were, what they were using. So it’s, it’s not something it’s not bedtime reading.

No, unless you want to use it for insomnia.

I mean, like, it’s not something that I’m going to read this now and I’m going to get 20 papers and I’ll read them in one day. It’s not like that. You know, I, I would really encourage look at authors that you like in your field and it’s more than like that they have something published and just start reading about it. And for sure read the full paper because it’s, it’s inside. You’re going to get these gems.

Yeah. Is there anything else you want to leave us with,

Um, roll up your sleeves and let’s go, and let’s this look, I like to focus on the positives and I like to encourage people to do things. And that’s how I got, you know, how I got stuck in doing things. And a lot of the times there is this attitude towards research and using the language of science, which we actually have as part of the, the slogan for EBA. And I always say to everyone, look, if it wasn’t for changing the language and adapting the language, I wouldn’t be here. And a lot of my colleagues wouldn’t be here because what was there in terms of Chinese medicine had to be translated. A lot of, you know, this, a lot of the stuff that got to Europe was actually translated from French right into French first. Right. And when I got super enthusiastic about Chinese medicine, the first book that the college got me, like the first big book, the college got me to read was Giovanni’s book, you know, and the great late Giovanni, my church, he took all that knowledge and took all that Chinese medicine and a lot of Chinese writing too.

And put it in that book. And the version that I got first from the college was actually a Portuguese translation. So it was translated again. Right. And yes, we acknowledged that some things are going to be lost in translation is why you go back to the classics and you learn more and you go a little bit deeper changing that now into the language of science is just going to allow for more people to get stuck in. Otherwise you would have to know Chinese to do Chinese medicine. It would never get to the point where I got interested in it and I was reading it. It would never get to the point where I move and I get to study Chinese medicine in English as well. It’s a different language. It’s not changing anything. It’s just changing the way that you’re explaining it to someone else.

So don’t be afraid of the language of science. Don’t be afraid of research. There’s different levels. Read about it, find out a little bit more about it and Hey, get in touch with us having a space occupant. We’re happy to help. And you’re part of a program at the Northern college where there, there is more emphasis on research, right? Yeah. True. Yeah. The Northern college of acupuncture has started that, um, the online MSC. So it allowed for people from all over the world to actually come together and do that. And, you know, the pleasure of being part of that program. And they asked me to stay on and lecture on the program as well. So yeah, the, um, the online MSC, I can tell you, for example, the last it that I was teaching, there was someone in that cohort. Two is from South Africa. There was someone from New Zealand finding the times for everyone be online at the same

Time. And yeah, it’s, it’s fascinating. And it’s fascinating. The amount of work that people that gone through that, you know, practitioners have gone through the, the courses I’ve been able to do quickly, like a colleague of mine was able to create, create something from nothing based on just the, you know, it was one of his ideas from, from the MSC for, for a project for it and took ideas from the MSC, took ideas from EBA and created this new wing in the hospital for treatment. And, you know, based on acupuncture and Chinese medicine and the potential, you know, it’s there, you, you can do it. Like, I didn’t know how to do it either. And it’s just like going to school and learning again. So every one of the Northern college, it is really like being, it’s like my second family and I love them all dearly.

And there’s people from that college involved in research all over the world. So it’s fascinating. It’s a great school. And despite the, there’s always been an emphasis on research with Richard Blackwell. And, um, and yet when I taught there, you know, in person, I was impressed with their clinical skills, more than many schools that I’ve taught at. So, um, they’ve really stuck, struck a good note there on the balance between something like that, didactic and the clinical. So yeah, I recommended the names, you know, you mentioned a couple of names, but people will be familiar with the names from there and you know, it’s, it’s a, it’s a, it’s a second family. Really. I love it. Yeah. Well, thank you so much. Thank you for having, um, you know, we’ll do it again. We’ll get Mel on here too. She’s got time. And, uh, next week our get us, our, our new hosts is Chen Yen. So be sure and catch that and you can find me on luminous beauty.com and, uh, we’ll see you all very soon. Thanks.

[inaudible].

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Brian Lau and Matt Callison

AAC Neurophysiology and Acupuncture Brain Lau, Matt Callison & Michael Corradino

Click here for transcript.

Hello everyone. Thank you very much for joining us. My name is Matt Callison and with me is Dr. Brian Lau we’re with the Sports Medicine Acupuncture Certification program. We’re lucky enough to be able to have this, this sports podcast with the American Acupuncture Council. So we want to give a big shout out to the American Acupuncture Council. Thank you very much. We have a great opportunity today that we can invite a number of top speakers in the sports acupuncture field. And today we have Dr. Michael Corradino, he’s the creator and founder of neuropuncture. It’s the only complete neuroscience acupuncture system that we have here in the United States. He has been clinically practicing acupuncture for 25 years has been traveling the world, teaching a system and researching neuroscience acupuncture for the past 15 years. He’s been involved in groundbreaking electrical acupuncture research, and as a published author in this field.

And from what we understand, he’s actually working on his third book. Michael. Welcome. Thank you so much for joining us. Really appreciate it. Welcome, Michael. Thank you guys so much. It’s a real incredible honor. Thank you. Well, um, should we just jump right into the first topic? Sure, sure. So what we discussed was let’s, let’s get into a talk a conversation about neurophysiological mechanism of acupuncture. Why don’t you go ahead and take it, Michael. All right. So I think on this particular topic, I think it’s important to kind of plant the little, little flag right here of acknowledging that the language of our medicine, um, being, you know, from 2,500 years ago was our ancient predecessors and founders of our medicine, observing physiological phenomenon and putting it in the language and terms that they had at that date. And that, um, the, unfortunately I believe the very strong, unfortunate, uh, mistranslations of energy and meridians.

And I know that a lot of our professional professions liked to use that was who was, was really, you know, mistranslated by Soulié de Morant, who was not a physician. I think that’s very clear to make that point because in my travels to China, uh, you know, there’s strong documentation of physicians from Germany, America, and France that traveled to China in the 16 hundreds in the physicians, when they looked at the classics, understanding anatomy, physiology, pathology clearly really translated jingluo, and mai and qi more as breath as qi and pathways and channels and networks and actually points they translate as neurovascular nodes. So when you put the physician hat on as a, as a physician, I think that the neurophysiology understanding of acupuncture was kind of side routed because the energetic model, but today using 20th and 21st century medical sciences, we can absolutely understand the physiology of acupuncture. I think a lot of the groundbreaking research with functional MRIs clearly denotes that we are modulating the nervous system. We can target specific regions of the brain specific receptors with electrical frequencies and different hand techniques, which is measured by frequencies. And we transmit signals along, uh, the neuropathways that then communicate with the entire body because, you know, brain being the CPU, um, you know, uh, I teach five main neurophysiological mechanisms and I think they really clearly do explain all of acupuncture’s clinical phenomenon today. Awesome. Awesome.

Alright, we’ll set. Brian, do you have anything to add? Yeah, well, you know, and, and, um, the work we do in sports medicine, acupuncture, I think, uh, you know, Michael, you probably look much more from the neurological aspect than we do though. Of course, we do take a lot of, um, consideration of the neurology jiaji points, and we’ll get into those in a little bit, uh, of course, motor points, we’ll get into those in a little bit, but one of the influences of, of mine, um, in the last several years and, uh, and I think speak for Matt, maybe he’ll agree with this is some of the work, uh, from, uh, the, the, um, physio from Italy, Luigi Stecco, and he has a very, um, fascial, you know, kind of, um, myofascial, uh, mechanism, but also, you know, his, his work is called myofascial techniques or something like that, myofascial therapy, but he, uh, initial terminology they use was neuromyofascial, because you know, he’s looking at how the fascia

Communicates mechanical pull, um, and helps, uh, um,

Through that mechanical pull helps inform proprioceptors in that area. Uh, you know, that there’s, it’s really a mechanical stimulation that, that informs those proprioceptors, and then that

helps in terms of coordinated movement, helps certain muscle groups work together,

Uh, to be able to fire and then the antagonist to be able to relax. And there’s a communication network that is some degree is the brain, but it’s really,

His view is a little bit of the mechanical,

Uh, communication that is really driving that stimulation. It’s a little bit more of the fascial aspect. I think you’re a little bit more in the neurology aspect. I don’t know if the two necessarily are exclusive, but it’s an interesting, interesting perspective.

Yeah, that’s true. That’s a good point. Um, and as we know, it’s that there’s no real segregation with the human body, right? I mean, you’ve gets all interconnected. So with the nerves, I think we can probably say that those nerves are a big part of the channels, but that’s not the only part of the channels. Right? So with the neural stimulation that is going to be affecting every cell in the body, no matter where you end up putting the points, there’s always going to end up being a change. So that’s the fantastic thing about neurophysiological aspect. So I mean, adding the different frequencies and the different waves onto the needle itself is going to be obtaining a number of different rewards or penalties sometimes. Exactly. Unfortunately, you know, you can still treat the excess and the deficiencies using electric stimulation. And so it’s, it’s, it’s fantastic.

I love this topic. It’s a good one, Michael, back to you. Um, I would like to definitely, I like what Brian was saying. I don’t think there are not connected as Matt just clearly stated the fascia nervous system, because there’s been some real strong research that supports the fascial being indicated with acupuncture, but the fascia won’t be able to transmit some of those signals without neural innervation. So I think there is an absolute, you know, connection there and that, uh, again, you know, in my, uh, my research, I think that the neurophysiology really just really powerfully, powerfully empowers the practitioner when they understand that. Yeah, absolutely. On all levels, right? Your primary channel channels, your sinew channels, your luo channels, it’s all being affected. Absolutely. This is good. This is actually a good segue into points unless Brian, that you wanted something that

Actually I was curious about, um, you know, when you’re through your perspective in your work, when you’re needling points, especially, you know, the in acupuncture, we have a lot of primacy of the, the transporting points and xi-cleft and luo-connecting points and the points below the elbow and below the knee, when you’re working with those points, are you then thinking of what nerves being stimulated is that sort of your, your first sort of go to, in terms of the effect you’re trying to achieve

100% Brian that’s exactly. Then, you know, I, you know, the classics actually state that, right? That, that, that the qi and the pathways get closer to the surface from the elbows in those joints below. And that shows actually that we have more clear access to those nerves. We can use an example using luo and source points, like a LU7 LI4 both on the radial nerve, right BL58 and KID3, you got the tibial and sural bifurcations of the sciatic and peroneal nerve. So I think they do lie and they do definitely communicate. They modulate each other. Um, when we’re looking at points, um, again, I look at, you know, neurovascular nodes, NIH came out with this wonderful study where they used an invisible marker and they had a, I think we’ve got like 10 practitioners mark and locate a point, then needle it, and then stimulate and took a function MRI of it, and what they found out was that none of the practitioners found the point the same way or the same location. So that’s not a point, right? It’s more of a unit or region, but there is differences from on the same nerve, different regions. Right. And that’s been confirmed as well, like P6 or P5. They actually different regions that affects on the brain. So there could be a nerve, but the, your locations, but they’re not points. Yeah, that’s it.

I have a very, um, been very curious about that. Is there something

Unique about the various,

You know, stream points are jing-river points. Is there something unique about those points neurologically, like, do some of them tend to

Correlate with branches where the nerve branches, or is it really just point by point? Obviously there’s something unique in terms of how they affect physiology. Right. Is there something anatomically that’s, that’s something that you’ve observed that’s unique about them? LI4 to LU 7 has that. Oh, I’m sorry for interrupting. Was that question for Michael? I’m sorry, go ahead buddy. Oh, it’s just whoever. Yeah, no, Matt, I think you’ll be able to probably answer this better. You both can do this, but check this out. Okay. So we know the daqi sensations has about seven main class main classical sensations. You guys are all familiar with spinal anatomy of the spinothalamic tract, right. And there’s three of them, the anterior, posterior, and lateral. There’s also the spinocerebellar tract that brings up transmissions from the exterior. And how can we affect those spinocerebellar tracts for balance and proprioception is through the points on the wrist or the river points, because those tend to actually target more of the spinocerebellar tracts. So Brian, to your answer, I think yes, there can be these points that do maybe affect certain spinal tracts different than other ones. And that’s based on the receptors you’re stimulating and where they’re located. Yeah. That’s really interesting. Brian. I think what I understood you say, Brian is their actual physical conduit going from one nerve to the next, like for example, xi-cleft, no, I’m sorry, Like a source and luo combination. Is that where you’re talking about Brian?

I guess I was thinking, you know, I’ll, I’ll use, uh, jing well points. I would assume jing well points being where they are, that they’re at the termination

of various cutaneous nerves.

And that would seem like a pretty consistent of how that affects, um, in terms of, uh, communication back into the central nervous system

is kind of what Michael was speaking at. But I guess what I’m wondering is if the jing well points are at termination of, of certain, um, cutaneous nerve pathways,

Other nerves, do you tend to see a correlation that there may be at a bifurcation of the nerve? Or is that really not… Is that really more of a point by point. Well, I do know that perfect example again, right. Using the luo and source of large intestine four and lung seven, you know, that’s great for upper respiratory things. We know that’s the radial nerve goes into the brachial plexus, the cervical eight nervous part of the brachial plexus and those nerves do affect the lungs. So you do see, I think those correlations just like bladder 58, kidney 3 surreal tibial, or a peroneal tibial running up into the low back, helping out with low back pain and then any visceral muscular reflexes, which I’m sure we’ll go over with the huatuojiaji points. I see some correlations to that. We have a video on YouTube channel that shows the interdigital nerve, that branches off of the radial nerve and it goes right in toward LI4.

So we saw that. Yeah, it’s is so much fun. We saw that. So we saw that connection, but then in our cadaver dissections, we looked at other sources of luo anatomical areas to see if there was a branch like that. And we couldn’t quite find it. And this is where we hypothesize that is probably more of a going from nerve to that fascial plane that connects to that point. And then you have that mechanical aspect. I don’t know, but you know, it’s just kids, we’re just loving what we’re doing. So we’ll check out the next cadaver, see what we can find. Absolutely. I mean, when I was there for your cadaver, I’ll bring it up. We get to the motor points, but you guys just do phenomenal cadaver work and dissection work, and I’m really impressed. And I know that we’ll talk about it well that, you know, we’ll, we’ll talk about when we get to the other stuff.

Definitely pleasure to hang out with, do you as well that’s for sure. Thank you. Should we get into the motor points? Sure. All right. Okay. Um, well, something that I’ve been researching for a long time is the, the neurophysiological location of the motor point located on the skin and then going deeper to see where that motor entry point actually is. So there’s different names for the motor point. Some people call it a neuro muscular junction, which can be a motor point. That is from what I know of as being an internal motor point. The research that I’ve been working on would be where the actual motor nerve enters into the muscle itself. Some people call that the neuromuscular junction. That’s not my understanding of it. That would actually be the motor entry point. Then the nerve would then branch off and go into proximal, neuromuscular junctions, and then still branch travel along into distal intramuscular, junctions, or muscular junctions.

So yeah, I mean, this is something, these, these points become Ashi points that have been treated for thousands and thousands of years. And, um, very, very useful as we know, to be able to treat these and mixing these with acupuncture points, acupuncture points, many of them are acupuncture points. Exactly. And also many of them are our notable Ashi points. So by treating these in a, in a, in a system we’ve seen that it can be able to relax the myofascial systems and change posture and such. Now what’s something that we haven’t actually done, which in the seminars that we have, Michael. in SMAC, but people ask questions about, do you apply electric stim to certain things. I do use electric stim on some, but only probably about 10%. This is why I refer my class to you, to your program. And that’s what I refer the neuromuscular section of mine to you, Matt.

I swear to God, I tell all my practitioners. You want to really dive into this, go to the master, go to Matt, trust me. Well, they both compliment each other, you know, each other very well. Absolutely. Hey, if I can add some to that, you know, when we were dissecting and I was doing that when we were working together, man, you know, I have a picture of it, of the dissection of that neuromuscular junction that you were able to dissect right down to that junction. So we were able to do that with what scalpels, our hands and our eyes. So going back again, knowledge, knowledge, and I don’t think that it would behoove. I think it would behoove us to not think that maybe our ancestors had some of that understanding as well. Yes. They definitely SAW those wonderful nerves, activating the muscles and put some of this together. You know, it might have got lost in translation a little bit, but man, Matt, you impressed me so much when you went right down and you nailed it, man. I mean, that was beautiful. It was really incredible. I got lucky. Thank you for that. I appreciate it.

Like that’s a common misconception about dissection. You know what I mean? The weights of the organs are in the classics. There’s a lot of anatomical description in there and how much of how much information is lost too, and how much of the information didn’t carry forward and books that maybe got lost along the way. So I think it’s a, it’s obvious that there was dissection going on an exploration of anatomy and how well that, how, how deep that understanding was, it’s hard to say, but it seems like it’s pretty, pretty solid.

Yeah, absolutely. So when they were doing the dissections, like Huatuo, my hero. Can you see him over my shoulder here? My inspiration, my leader, there was ever a person that I would like to be able to have met, it would have been Huatuo, right. I would have liked to have sat down with tea with Huatuo and Galen from the Roman empire, that we’re at the same time, 188 AD. Galen knew the afferent and effernet nerves, Huatuo knew the spinal segments, man let’s have tea or maybe Italian wine with them. Do you think they would have gotten along. I don’t know. Yeah. Right. Two empires. Right? Yeah. Funny, funny. Yeah. Well, what you’re saying, Michael, when they were doing dissection centuries ago and they saw it, we call it nerves, they were calling it channels and collaterals and the main nerves and the tributaries branch off from that and innervate the body. Absolutely. Absolutely. Okay. So Michael, you want to, you want to lead off with Huatuo points and why you love them so much.

Ooh, gosh. These are, you know, when we get through this section, neuro puncture, I, when I first came across this, I, you know, it just, I just dropped the microphone. I was like, are you kidding me? Like this was just such a beautiful explanation of our back shoe points and how powerful they are. And in short, the huatuojiaji points created by Huatuo discovered by him. It’s not a coincidence that they line up viscerally with the motor or the muscular visceral reflex that’s in the spinal segment. So when you needle into the muscle and there’s also a cutaneous visceral reflex, you’re, you’re affecting these inner motor neurons in the spinal cord and you can absolutely affect this rule change and that’s been proven and it is just amazing. And the only thing that we do a little differently is we now know through, again, the great anatomy biomedicine.

We know now that there’s not just one segment per organ, right. They might have three or four and we can really maximize that effect on the visceral function by having those deeper understanding. But man, they are just, it’s incredible what he did. That’s right. That’s why I always joke when you see images of him, his forehead is so big because his brains are so hard, right? Yeah. Way ahead of his time. Brian, is there anything that you want to add to the huatuojiaji points? Well, you know, they’re just the reflex and that segmental relationship between, uh, you know, I think most acupuncturists know this, but maybe not all. Cause it’s, it’s kinda spotty, the anatomy understanding that’s taught at school, but you know, it’s the same through the sympathetic division of the nervous system, the same branch that goes out and innervates the liver or innervates, depending on which segments you’re at, innervates the various viscera to give sympathetic nervous system information to regulate those organs at that same segmental relationship are the ones that send that posterior dorsal rami, the medial branch of it into the huatuo, and then the lateral branches into the, uh, internal and external back shu line.

So, I mean, it’s really a segmental relationship between those, those viscera, those organs, the muscles and the skin of the back. And then, uh, in that coming up through the lamina for the huatuos and then the outer ones for the, uh, the back shu points. And then of course, you know, wrapping around that same pathway and then coming into the innervating the front mu points. It’s very, it’s it’s neurology. Yeah. I mean, it’s, it’s like under, so you can understand it so much better when you can see that neurology, when you can open up Netter and look at those cross sections and see the relationship between those nerves and how they would, uh, sort of have an influence on those various points front mu, back shu points. hutuojiaji points. Yeah. I mean, yin yang therapy, the classical needle technique utilizes that.

It was Yin Yng therapy was front mu and back shu. So front mu point and the back shoot point, wow. By adding the Huatuojiaji points, you can see because it is the same nerve pathway. It’ll just emphasize that needle technique. It’s useful to see a cross section, I think like in thoracic spine to be able to see how the dorsal primary rami goes up to the huatuojiaji, goes to the inner bladder line, goes to the outer bladder line and the anterior Rami of that spinal nerve goes to the sympathetic ganglion, which as we were discussing stimulates the organs. Right. So, and this has all been proven, then that same nerve goes all the way around to the front mu point, right? So you can see if there’s going to be pathology, it will be facilitated. Therefore, all of those points along that spinal segment can be very, very tender.

If we could be able to take ourselves in a small little car and actually drive from the dorsal primary rami, you can actually make it to the anterior rami, so hello to the sympathetic ganglion, make a u-turn and go all the way back that intercostal nerve and say hello to the front mu point. Yeah, absolutely. That’s amazing. And there’s also, you know, I mean, Ren 12, right, having such a great effect on digestion. If you were a needle that properly, I believe you’re actually splitting both dermatomes of seven and eight. So you’re getting liver spleen, gallbladder, stomach, pancreas, just by Ren 12. But I think that’s why that front mu is such a great point for the middle jiao, right. And when you line that up with dermatomes and our front mu points, it really does show those connections that were found, again, you know, a hundred AD, which is just incredible. Michael, I have a question for you, how I’m sorry, Brian, go for it, buddy.

So, um, uh, at one point I think there was some, some questions on this about needling Huatuo points and why I particularly like, the back shu points are great, but the Huatuo points being that they’re so protected by the laminae, um, you know, even over the thoracic region, you can, you can needle them as long as you understand, and you can palpate correctly. And you know, maybe with the exception with somebody who has really severe

Scoliosis and you might lose sight of those angles, but if somebody’s

Spine and you have good palpation

And it’s, they’re very safe to needle, cause you can go perpendicular and that’s

protect by the laminate as long as you’re at that 0.5 cun. Um, you know, I know some people do angle. I don’t know Michael, how you do it. Some people angle perpendicular is how we teach it too, though. I think you get a good result, needling it angled, too. But the point is that the points are very protected and you don’t have to be

Afraid of depth. Again, assuming you have the palpation and you were taught properly how to needle it. Brian, go ahead and plug the YouTube video that we have with that. Oh yeah, yeah,

Yeah. We have a, um, so we did a dissection, um, and we cut out. It is in the thoracic region. What was it about T7.

We’ve done it five or six times, but the video that’s that’s on YouTube I think is that T8 or T7Yeah. So it’s in that

thoracic region and we dissected a triangle from like, if this is a spine, a triangle out, I’m covering like three range of three levels, something like T7, T8, T9. And then we cut the skin away and then the subcutaneous tissue and then the first, you know, the lower traps, first muscle layer and piece by piece so that you can fold, you know, like a book, you can, you can fold the skin back, you can fold the subcutaneous tissue back. You can fold the first muscle layer, a second muscle layer all the way to the deep paraspinals and eventually seeing the lamina. And then you can see where the needle goes, you know, putting the needle in and then folding those layers back and seeing the target tissue. Awesome. Yeah. Sports, medicine, acupuncture, YouTube sports medicine acupuncture, YouTube watch Huatuojiaji video. It was a bit of work to do the dissection.

Remember guys, when we were, when we were working together, we did, I did the upper back like that and we pulled the skin, Yeah, that’s right, the trap, the rhomboid, and then the paraspinals. We put the needle, I think we use the 40 or 50, you know, length needle and we’re just tapping and there was, there was room. So you can really show that depending on the patient. But that was, that was so excellent. I loved that. I think our acupuncture field would, would, would take off if we add more dissection as part of the standard training, I know it’s expensive and that’s really where the trick comes in. That’s where we’re going, right, Ggentlemen? We’re trying to be able to do in both of our programs is to educate the acupuncture field with the cadaver dissection is that we do in your program.

The neuropuncture, and in our program, sports medicine acupuncture. So it’s great. And also other ones that we have, Matt, I did have something that I thought you might want to add something to. And that is, um, and I know we don’t have a ton of time left, but I don’t think it will take long, this idea with the Huatuojiaji points and, uh, the, um, affecting the muscle therefore affecting the neurology, affecting the skin, but also the facet joints, and I know that’s a big part of the sports medicine acupuncture program in terms of the first module. If you wanted to add anything to that. Um, the location of it and then different needle techniques at different target tissue. Okay. So if we’re thinking about the movement of the facet, so, you know, for fixations, vertebral fixations. so you’re wanting me to talk about vertebral fixations and needling the facets?

Is that what you’re saying? No, not necessarily needling the facet, but for vertebral fixations and movement as a facets and how that relates to the neurological aspect, too. I’m not following you. I’m sure you’re trying to dig something out of me from a conversation that we had, sorry for being so dumb. So why don’t you take it over and all, you know what you’re talking about? In Sports Medicine Acupuncture, we also look at the, um, the movement of the vertebral facets. It’s in the first module. And we assess when, when the facets, when the joints are moving, when the spinal joints are moving or not moving and how that, um, you know, we a whole protocol, I don’t know if we have time to go in into the protocol now, but, um, that can relate when we’re working in vertebral fixations of the neck, it can relate to injuries in the arm, low back. It can relate to injuries of the lower extremities, but, but you know, a lot of times practitioners are also working with, um, visceral problems and they’re doing various mobilizations in combination with

huatuojiaji point needling, in combination with distal points,

In combination with the whole thing, they’re also going in and doing tuina mobilization to return mobility to those facets, which has a really big impact on digestive problems and really a lot of different things.
Yeah. I would say that’s probably one of the biggest successes that we’re having with that. Thank you for dumbing that down. Now I can join you. I didn’t ask it really well, I guess. Now that I understand that I’ll say we know we do very similar work in neuropuncture, as well. I’ve been taught traditional Chinese bone setting, and I teach that to my certified members. And that’s exactly a great combination with huatuojiaji for visceral or peripheral injuries due to those nerves. Absolutely. Yeah. That’s a great combo. Fixated vertebrae or subluxed vertebrae are obstructions in the channel particularly the du mai. And so when you got obstructions in that du mai, it’s going to offset the rest of the channels. Absolutely. So getting that vertebrae back into place, however you do it, a forceful manipulation or mobilizations, movement therapy, all that it’s going to be important. I mean, that’s how the Chinese do it, right? So they would go from acupuncture to taiji, qigong exercises, their physical therapy. Yup. Yeah. Hey, you guys, we’re already at 1o:28. Anything else that you want to say real quick before we give our, thanks again, say goodbye.

I would just say that if our practitioners and our listeners, um, open their hearts and their minds to what we’re saying and do a little best investigating and check us out, they’re going to really have a deeper understanding, learn a language to communicate and really get, I think quite, you know, you know, just amazing clinical outcomes. And that is just, that’s the bottom line. And we started with neurophysiology of acupuncture and everything we just said, and the discussion we had just eliminate all that, even bring it in historical relevance. I think that’s just cements it back in and galvanizes it. Yeah, absolutely. Yeah. I second the motion with that, for those people that are interested in what we were discussing and it really excites you. Yeah. Please check out both programs and just see which one’s the best fit or both of them. Absolutely. Because Michael’s a great guy.

As you can see super knowledgeable, he’s a hell of a practitioner and his protocols work. So that’s something that you want and you need to be able to have that in your, in your main focus of practice and also different things. Do you put in your back your back pocket? So when you’re actually practicing yourself, you remember when Michael taught you and that can get you out of a lot of problems are very, uh, are very treatment or assessment or treatment oriented. Absolutely. I think we have to do our little goodbyes now because it’s 10 29. So I’m Matt Callison. I’m the president of the sports medicine acupuncture certification program. My colleague and dear friend, Brian Lau, go ahead, Brian. Okay. I’m a faculty of sports medicine acupuncture certification, and a practitioner in Florida, along with Michael, though we’re in different cities and thank you very much, Michael Corradino. And I really appreciate you. Yeah, it was really, really nice. We want to thank you. Thank the American acupuncture council again for having us next week. Stay tuned for Virginia Doran. She’s going to be with us in the American acupuncture council. So that’d be something to check out. Um, again, you guys thank you very much. It was a lot of fun. It’s fun. You guys are awesome. I appreciate it. Very honorable. OK, take care. Bye. Thanks guys.