Observations of a CA practitioner

After working for two years as an acupuncturist in a busy community acupuncture (CA) clinic I have started to notice some consistent patterns in my clinical experience. The following are a few of my observations. I hope these ideas help other acupuncturists reflect on the many benefits of the CA practice model.

Feeling safe is a common thread in healing environments:

I think a safe place to let down your guard in comfort is a vital piece of any treatment room. The CA model allows patients to go within and relax deeply, which seems to produce a strong healing response. Effective acupuncture care seems to have a lot to do with how you create a safe environment for your patients. For example, in the community treatment room at the Working Class Acupuncture (WCA) clinic up to fifteen or more patients relax deeply and often sleep for an average of 45 minutes once the needles have been placed. Patients relax in a room with low lighting, soft music and the background shuffle of people coming and going mixed with occasional overhead heater sounds.

There is a feeling of safety in numbers:

My experience with CA shows me that most people feel safe in a space where many people are sharing a similar healing experience.

Friends and family relations tend to prefer to schedule their acupuncture treatments together:

Treating people in a community setting allows the practitioner to treat multiple friends or family members in the same room at the same time. For new patients, it feels safe to try something new and different like acupuncture if you can watch someone you know get treated in front of you. The thinking goes something like: “if the person next to me is able to have needles inserted without too much fuss, and it makes them feel better, it’s probably OK and worth a try.”

Healing energy appears to become amplified when many people share a healing experience:

Having an acupuncture treatment in a CA treatment room can feel very powerful. There is a unique feeling of “community energy/ qi” that is specific to CA clinics due to their multiple treatment chairs or tables in the same room. This feeling is particularly strong in larger community treatment spaces. This sensation is something like the energy that can sometimes be felt in large group meditations. At WCA the energy in the treatment room is powerful to the point of feeling palpable.

You direct your own energy:

Focused intention has everything to do with your effectiveness as a practitioner. Whatever your intentions during your interaction with patients, it comes across and is felt by your patients, for better or for worse. If you are anxious about something while treating patients your patients pick up on your energy and become more anxious as well. If you are consciously alert, attentive and calm patients pick up on that energy as well and feel safe to relax into the treatment process. One important question this raises for CA practitioners is how do I consistently direct my energy in a calm and positive way while treating many patients each day? Won’t I burn out if I interact with so many people every day? I think the answer to avoiding burnout lies mainly in how we acupuncturists interact with our patients, yet responding fully to this question is beyond the scope of what I plan to cover here (see Lisa’s recent blog post about retaining patients for more ideas). I think as acupuncturists we each have to find something to do daily that helps us refine our ability to focus our energy clearly and without distraction. There are many options for developing the ability to focus more steadily; yet, part of the answer is just more acupuncture treatment experience, a clear perk of CA. Other possible focus enhancing activities are the many forms of exercise and meditation available today. Personally, I skateboard and do Somatic Qigong outside of practicing CA.

When you see a new patient you have to build trust above all:

Before patients are comfortable telling you their health concerns, they need to get to know you as a practitioner and judge for themselves if you are worth trusting with their health information. In a first appointment I don’t expect to learn all I need to know about my new patients to address all of their health concerns, I simply read their health history, ask them about their chief complaint and begin the treatment process. I am learning that people open up in baby steps, so I start with what is most important to them at the time and let them feel out the process to see if it is a good fit for them. Beyond actively listening and actively observing I make an effort not to make a lot of health recommendations on the first 1-3 visits unless something clearly needs to be brought up sooner. After a few treatments, I am more acquainted with my new patient and as the acupuncture does its work (smoothes their qi and thus calms them and reduces or relieves their immediate symptoms) the patient becomes more responsive and more comfortable with any future health questions. The CA clinic approach is especially conducive to the above type of practitioner/ patient interaction because the acupuncturist builds a relationship with each patient over a longer period of time than in most acupuncture practice settings.

Acupuncture is effective to treat many different disorders:

CA practice makes acupuncture more accessible so a more diverse array of patients tends to walk through the door. Acupuncture is a very effective tool to trigger the bodies own healing potential. Acupuncture is mainly thought to be effective for pain and stress relief; yet, it has such a wide scope that there are few “garden variety” disorders that I have not seen at least some improvement through acupuncture treatment. I didn’t expect it but I have treated odd things like pain from pleurisy (from pneumonia) with good effect. In this example, the patient had been given a 3-week regimen of antibiotics from her MD and told the pain would get better in time. In two treatments over two days this patient had a subjective reduction in pain of 80%.

Effective acupuncture relies heavily on frequency of treatment and the degree of frequency varies from patient to patient:

I have treated a few people where they had such acute symptoms that 1-3 treatments were enough. However, for the vast majority of patients, around 2-3 treatments per week for 3-4 weeks is adequate to reduce symptoms consistently by around 60-80% and keep the symptoms away. Patients will often come in over the long term for one treatment per week to incrementally increase immune resistance, manage stress, and/ or address some long term health issue. Some people only come in for maintenance treatments during key times in their lives, a change of seasons or short term high stress in the home or work life. CA makes acupuncture treatments more affordable so frequent treatments as needed are more easily accessible.

When you talk less your other senses become heightened:

Specific to CA and acupuncture as it is practiced in current day China, efficiency of dialogue with each patient is important so the acupuncturist is able to treat many patients each day. Observing body language and constitutional types is a large part of my clinical work day to day. I never expected to use body language signals so extensively in my practice as an acupuncturist. Less talking allows me to pick up on other aspects of patient care with more clarity. I feel that the CA format has helped me to organically develop my palpation and observation skills quickly.

Part of my job as an acupuncturist is to provide a restful pause for my patients:

Communicating efficiently and clearly with my patients allows them to focus on relaxing rather than the anxiety producing details of their current health concerns. CA is set up to provide acupuncture treatment in a way that is both relaxing and very easy for patients from start to finish.

Acupuncture treatments tend to make people more self-aware:

Patients that come for weekly acupuncture treatments tend to make health-correcting decisions in their lives. These patients also seem to become more and more aware of when they are “out of balance” with their state of health and could use one or more acupuncture treatments to get back on track.

People need time to heal:

Given enough time and frequency of acupuncture treatments, the healing process is accelerated, yet adequate time is a large part of the equation. Some acupuncturists want to see their patients heal quickly and when symptoms do not improve as fast as they think they should, the practitioner gives up before the symptoms are given a chance to shift for the better. Many CA patients receive acupuncture treatment for chronic and stubborn disorders that take months for symptoms to improve. The CA model makes frequent treatments accessible to patients so that both the patient and practitioner get to see improvements in health. In addition, chronic pain is sometimes hard to fully resolve through acupuncture or any other means. In these cases acupuncture is one part of a larger treatment plan that is focused mainly on maintaining a reasonable quality of life for the patient by keeping the pain and/ or other symptoms at a manageable level of intensity. Again, the CA model makes this type of treatment accessible.

Just a few of my observations for now.

Comments are welcome.

- Moses