What helped me learn CA at the beginning

A colleague who has recently hired a new acupuncturist asked me about what helped to get me up to speed as a CA practitioner when I first started working at WCA. To be fair, it took me a while to fully understand and apply the concepts I am sharing here. There are three attached files, an example orientation page for new CA practitioners,

[attachment 135 WCAtrainingmanualexcerptsOCT2007.doc]

a CAN post of mine about my paradigm shift from TCM to CA,

[attachment 136 ParadigmshiftTCMtoCAOCT2007.doc]

and some excerpts from the first draft of the WCA acupuncture employee training manual that I am helping to create.

[attachment 137 WCACLINICORIENTATIONOCT2007.doc]

I hope this information provides new insights for CA practitioners that are getting ready to hire new acupuncturists, or have already done so.

The most useful thing that I learned from Lisa and Skip as I was starting as a community acupuncturist at WCA was to trust in frequency of treatment above all. Simply stated, this meant trusting that whatever point combination I came up with would benefit patients and that through frequency of treatment my skill would increase thereby benefiting patients even more.

Lisa and Skip gave me a few occupant protocols, based on the teachings of Miriam Lee and Dr. Richard Tan, and I started practicing knowing that the more acupuncture treatments my patients had, in the vast majority of cases, the better off they would be. If I felt like a more thorough western diagnosis needed to be pursued I would bring this up with Lisa or Skip and relate their recommendations to the patient in question. My main difficulty at the beginning was learning to trust that my acupuncture knowledge and clinical application were adequate to help the patients I was seeing get well quickly. Once I felt like my supervisors/ mentors were allowing me to be a beginning acupuncturist, I started to really improve quickly. They related that they had confidence that some change for the better happens when protocol point combinations are used and with more experience I would get quicker and more powerful healing results.

I feel the wisdom of this approach is that when you equip new practitioners with some structure in the way of point protocols (write them down and put them in view wherever you chart) and discuss with the new acupuncturist’s that with time they will progress, you create space for progress to occur. Letting your new practitioners know you expect them to develop their knowledge and clinical efficiency over time takes the pressure off to a large degree. In my experience, when I was encouraged to develop my skills over time I found that I tended to be able to use my energy more fully for the healing work of practicing and studying acupuncture.

One other useful piece of structure to develop in a CA clinic setting is the Jingei pulse diagnosis method. When truly understood, this method becomes very easy and quick to apply clinically. You won’t necessarily always get the correct ratio, but you will likely be very close. You can always needle source points for two main possible presenting channels and then just keep going. Again, the most difficult thing to get away from is the idea that you need to create “perfect” treatment plans (perfect in theory, method, and clinical application). The reality of the CA model is that you need to complete your treatments in a short amount of time. Beginning practitioners do not give “perfect treatments” so it works best if both the beginning practitioner and supervisor release that expectation. Focusing on a caring, honest, and adequate exchange of energy instead leads to energy exchanges that appear to build in power as the trust increases between practitioner and patient. In my experience CA acupuncture is the process of providing increments of useful service that build stepwise toward health of mind and body. The time allotted for each treatment is actually quite long, it is simply the interaction with the acupuncturist that is fairly short and “to the point” (ha, ha, ha).

Considerations for any employer hiring CA practitioners new to CA treatment philosophy and methods:

- Learning comes in stages and you have to practice what you have learned in the clinic over time to make it your own. Every once in a while I feel a plateau of understanding has occurred for me and at these times I sense that it’s my job to practice these new theories until I have integrated the most pertinent parts of this knowledge into my clinical practice.

- Consider learning styles. Are your new acupuncturists more auditory, kinesthetic, or visual? Do they understand things better when you write them down or when you talk about them or both?

- Meetings. Once you know the preferred learning style of your new partner reflect on your own learning style and decide based on this information how you want to check in over time. Progressing toward a goal means being clear about what you want to accomplish. Be clear what you hope to achieve with your clinic. Share your vision and discuss the specific types of behaviors you hope to see modeled to the patients in your clinic. After all of this, decide how to meet regularly. How often you meet will depend on your specific situation and needs.

- Begin with some amount of Point protocols that work for you (example: Miriam Lee 10 pts could be used as a base for other point groups or used when you want to create a more general treatment effect rather than pinpointing a specific location of discomfort)

- Study books/ videos on Richard Tans balance method and Dr Tung’s acupuncture methods as needed. Over time your new acupuncturist’s will make the connections and get faster with these methods

- Post some basic diagrams in your charting area of Dr Tan’s five systems (in pictures, like out of the back of his newest book acupuncture 1,2,3) as well as diagrams of the mirroring and imaging graphics.

- Provide a written orientation page to the basic train of thought and quick introduction to processes in your clinic (see sample orientation page from WCA).

- Provide a written mission statement for your clinic.

- Discuss why efficiency is important and why it can be enough for the patient to be seen briefly by the acupuncturist and then allowed to relax for about an hour in the treatment room, where the needles and group qi do most of the healing work.

- Remind new practitioners to take things one step at a time with new patients. You often won’t have enough time to address all of the patients complaints in one treatment---not to mention it would confuse the patient’s qi if the points direct it too many places at once---so relax but don’t collapse and start with the most pressing issues.

I hope these ideas help to generate more discussion regarding what helped other practitioners at the beginning of their community acupuncture experiences.

- Moses