Fostering Life

I think it’s very easy to get so caught up in labeling life experiences good and bad.  There’s nothing wrong with doing this.  Of course, when we do that, we risk alienating ourselves from the stuff we label bad which is part of life too.

Mauricio Quintana, writes about the Wisdom of enough in Chinese Medicine over at Deepest Health.  I love this post because it’s a great reminder about balance, about acceptance and about the concept of not too little and not too much.  The article is definitely worth a read.

Planet Calarmari: Acupuncture and Art

Recently I talked to Jeanie Marie Kraft of Four Paws Acupuncture about her work at Planet Calamari.  Jeanie has been treating people with acupuncture since 1995.  In addition to her practice, where she focused on canines, Jeanie is also an artist.

Planet Calamari is Art for the Bohemian Soul.  At the time of writing, the website focuses on Jeanie’s jewelry, lovely airy works what suggest another time or place.  Tomorrow this could be different, as Jeanie tells me, “My art changes like the color of my hair! I never know what the muse will inspire me to do.”

In addition to art, Jeanie has also written several books.  Currently her coloring book of acupuncture herbs and planets is out of print, but we can hope it comes back into print soon. This is a great learning book.  Jeanie says, “My first year in acupuncture college my herb professor, Toni Narins, gave us a project that had to be turned in at the end of the semester. The assignment was to come up with a way to memorize all the herbs, functions, categories and everything else in a fun way. Since i have always been a right brain person i found it easier to make up stories for each herb with cartoons and odd songs. By the end of that project i had a coloring book and students wanted to buy it. So i continued working on it in the next few semesters. The title of the book was Dr. Calamari’s Coloring Book of the Plants, Minerals and Bugs of China

Jeanie says the book needs updating before reprinting, but we can only hope that she is moved to do that.

In addition to her coloring book, she also has a book on Canine Pain and a course on treating Painful Canine Disorders.  Jeanie’s art is making her a great resource for those still learning about the practice of acupuncture.  Check it out.

Hiring a Locum Tenens

The hardest part of vacation is finding someone to cover.  Practitioners who share space with other acupuncturists may have an easier time of this.  However, if both practices are busy, patients may not get in at the times they need or as frequently as they need.

Most people willing to work as locum tenens are acupuncturists who are just starting out.  Many of these people are very capable.   More senior practitioners may have concerns about leaving their practice in the hands of someone who is just starting out.  There are fears about the other acupuncturist trying to “steal” their patients.  They may also fear that the other practitioner will make an error of judgment and the patient will stop treatments.

There is no way to guarrantee that this won’t happen.  Know who your locum is.  Know what sorts of things they are best with.   Make sure those are the patients they see.  If you have a good relationship with your patients to begin with, it’s unlikely that a locum will be able to “steal” them away.  If the acupuncturist you have covering for you really does have special knowledge or insight into a particular patient’s condition, you may also want to consider whether sending the patient to this other person might be in the best interests of the patient, even if it is not in your best financial interest.

Very often when someone covers for you, you have them there whatever days they can be available.  They may not have as many days as you would like.  It’s best for everyone if you have only one person at a time cover your office if at all possible. Your patients are already seeing someone new.  They may be uncomfortable with the new person.  It’s not fair to have multiple new people in your office, changing the treatments each time.  Even if you work very hard to have someone do the exact treatment you did, it will always come out a little differently.  Every acupuncturist has their own style.

The most important thing is that you find someone who can fit in with your office.  The locum may not do the same things you do, but their style complements yours in a way that is not too disruptive to the patient.  This can involve meeting with the potential locum, perhaps even being treated by them.  Of course, knowing you are leaving your office in the hands of someone else can be scary.  Consider having them in for one day before you’re going to be gone.  Get feedback from the patients who were seen by that person.

No one can be available all the time. Everyone needs down time. Patients need care.  At some point there’s a good chance someone will have to cover your practice.  Take the time to find the right person.  Keep your expectations realistic.  Then enjoy your vacation.


What Does Acupuncture Do?

What Does Acupuncture Do image from was reading that some people wanted a poster that had some nice graphics about the kinds of problems acupuncture could treat.  I’ve also had people want things that explain what acupuncture does.   This is a colorful poster that shows the kinds of things acupuncture can do, illustrated by our very own Siamese Mix.  We hope that he remains as active and flexible as he is in these photos.

You can find this as a poster here or even on a t-shirt!

Acupuncture on the Seas

Acupuncture on the SeasEver consider taking your practice traveling? Recently, on an online discussion several practitioners expressed an interest in working aboard a ship.  Marie Veverka, a graduate of Oregon College of Oriental Medicine, shared bits about her experience working as a cruise ship acupuncturist.  She was kind enough to give longer responses to me in a private message.

Marie started doing cruise ship acupuncture because she  wanted to travel.  Unfortunately she didn’t have the money.  A friend had worked on a cruise ship.  Marie called her and found out how to go about applying.  She worked on ships on and off for two years.

I asked Marie how an acupuncturist gets placed  and she said, “My first contract was in the Mediterranean working on a Princess ship and my second and 3rd contracts were working for Crystal Cruises which travels all over the world. When you apply for cruise ships, you apply to Steiner and they contract you out to different cruise lines. You can request a region and tell them where you want to go, but that doesn’t mean you will get it. If you have a certain area you want to travel to, you may have to wait until they offer you a ship you really want. The longer you work for them and the better you do on board, the better ship offers you get.”

Having cruised a few times, I knew many of the crew members had other duties around the ship. While acupuncturists will probably have to participate in emergency drills, most duties will revolve around the spa area.  An acupuncturist may have to do some reception work or random tasks to fill in.  They are also commonly required to give seminars.  Marie said, ” If you are not keeping yourself busy enough, they may send you to a common area on the ship to do sample treatments or had out brochures.”

One disadvantage of the work is that sometimes you are required to be part of IPM, which means “in port manning.” The cruise ship has to maintain a certain number of  crew on board even while in port in case of an emergency.  This prevents the practitioner from being able to have the day to explore.  Instead they have to stay aboard the ship.

Many of the crew work very long hours during the cruise.  Acupuncturists fair a bit better than the wait staff and cleaning staff. Marie said, “As an acupuncturist, you are required to work 52 hours a week. You work 12 hours on all sea days and other than that, you should be able to make your own schedule. .. I usually saw most ports and I escaped IPM most of the time I worked on board. We often had 12 day cruises so I would take 52, divide it by 7 (this amounts to about 7.5 hours a day), and then multiply that number of days on the cruise so I could figure out my hours per cruise. This sounds like a lot, but keep in mind, sea days eat up hours and you can schedule yourself for a few hours in the morning and a few in the evening, take a morning off entirely, or whatever to coordinate with the hours the ship is in port. ”

Marie was quick to point out that if acupuncturists are required to work more or have difficulties on board, they have a very nice management team on shore to back them up.

Earning potential varies depending upon where you travel.  Marie says that you probably earn the most in the Caribbean or Mexico but she wanted to see the world.  Her earnings were about $3000 to $4000 per month.  She had no rent or food bills while on board either.

Marie says, “I am a small ship girl, but that is because I like smaller ports that are less touristy. Big ships are fun, but less personal and it is much easier to get lost in the mix. I always chose ships on itinerary. I would get offered a ship, look it up online and check to see where it would be going. If I wanted to go there, I was in. Plus, I told them what I was looking for. If you want to make money, let them know. If you want to travel to really exotic places tell them. Unfortunately, you are less likely to make a ton of money traveling to exotic places, but it is oh so much fun!”

I was curious about products and limitations.   Moxa is not allowed on board, which is no surprise given that fire is a huge hazard on a ship.  There is also no gua sha or cupping.  There is an herbal line of products that can be used.  Acupuncturists are encouraged to sell the products on board.   Practitioners are also encouraged to cross promote other therapies.

So do people use acupuncture on board a ship?  If so what sorts of things do they come for? Marie said she saw lots of back pain and sciatic pain on board.   On the smaller ships where she worked, most people were older and retired, which meant that there were a lot of kidney issues.  She used a lot of kidney tonic formulas.  On a larger ship, she theorizes that Spleen qi formulas and Liver Qi stagnation formulas would be the big sellers.

Many people are feeling adventurous on a cruise and try acupuncture for the first time.  Marie tried very hard to get them in at least three times.  She felt that most people would start seeing some sort of result in those three treatments.  Encouraging frequent treatments helped patients understand that an acupuncturist isn’t a miracle worker but it did allow them to see benefit.  She encouraged patients to continue with their treatments when their cruise was finished.

The people who had had acupuncture before all saw “the best acupuncturist in the world”.  Marie was careful to explain that her style might be different from their regular practitioner.  Explaining that each person has  a unique style allowed most patients to relax and enjoy the treatment on board.  There is always one person though. Marie recalls, “one guy… thought I had terrible technique and didn’t know what I was doing because I only put 14 needles in.”

Many people have practices but would like to cruise.  Is it possible to do both?  Marie said it  can be difficult.  She was mostly just cruising and doing some house calls when back at home.  She was also resting up for the next cruise, which she says is exhausting.

“One of my biggest recommendations for acupuncturists on cruise ships is get out and about on the ship. I took full advantage of the shore excursion department. You can volunteer to escort excursions on your time off which is an excellent way to go on great tours for free and to meet guests on the ship! As I got to know the shore-ex team, they started sending me on progressively more amazing tours, it was totally awesome. Plus, my manager loved it and encouraged me to go because I was always bringing in new patients that way. I also went to all the cruise events I could. People will recognize you from your picture in the cruise daily, lectures, or even the cruise TV program (if you decide to do it) and they will stop and ask you questions. I would chat with them a bit and often walk to the nearest phone and schedule an appointment for them right there.”

If you’re ready to travel, consider looking into working aboard a cruise ship and see the world!


An Interview with Thomas Jahn, On Acupuncture and South Africa

Thomas JahnI was connected to Thomas Jahn, an acupuncturist in South Africa by a mutual acquaintance.  Originally I had planned to do an interview more on how acupuncture is viewed in South Africa.  I was so taken by Dr. Jahn’s response to his background that I had to cut and paste his email in it’s entirety.  I am struck by how many of my classmates dreamed of the education he was able to follow up on.  I am also struck by the opportunities that so many practitioners dream of, but he has been able to create in his life.  It is my hope that Dr. Jahn will write more on his experiences as an acupuncturist and his thoughts on the profession.

In his words, the rest of this is written by Dr. Thomas Jahn:

“My first exposure to Asian culture came with the time I relocated with my parents to Tokyo, Japan when I was twelve years old. The philosophy aspect started with my study of martial arts about a year later, practicing the Japanese art of Kempo. At age fourteen I started regular classes at an internal martial arts school in Tokyo, practicing Qi Gong, Tai Ji Quan and eventually Xing Yi Quan. The time spent here furthered my sense of how our actions relate to their consequences, and so started to see how the practice of these sorts of disciplines actually support an ever-increasing awareness of this – this is where partner exercises such as ‘pushing hands’ are very insightful.

This I pursued for four years at the end of which I was increasingly frustrated to still not have been able to sense any real ‘internal’ changes in my body after that time. As ‘fate’ would have it, through a good friend of mine I was introduced to a Chinese man who was teaching Qi Gong and Shao Lin boxing weekly on Sundays. Conveniently, he was looking for someone to teach him English.

Consequently I joined his class on Sundays and would meet with him during the week for English classes. From the beginning I was quite curious as to what he did for his livelihood, since teaching a class once a week was not it. It turned out that he is a Chinese medicine doctor, at which point I became even more curious, and so our English sessions subsequently revolved exclusively around Chinese medicine. This relationship developed over three years, during which time I honed an ever-growing desire to pursue Chinese medicine more seriously.

My Japanese language skills were not quite appropriate to allow me to attend school for oriental medicine in Japan, and so on recommendation of a Chinese medicine doctor in Tokyo, I applied to several schools in California, to then move to San Diego in 1997 to eventually attend Pacific College of Oriental Medicine, later receiving my degree, and subsequently my California license to practice Chinese medicine.

The time spent in San Diego was beyond what I had hoped, and must say that I was extremely fortunate to have had the opportunity to attend PCOM, along with all the incredibly meaningful clinical experience gained, especially also the off-site clinics and the voluntary assistantships throughout my time there.

My studies were wonderfully complemented with the tutelage of my martial arts teacher, Dr. Justin Ehrlich, who also exposed me to the specialty of ‘hit medicine’ – Chinese trauma medicine.

I still went to Tokyo every year to visit my family and my mentor, which eventually compelled me to continue my Chinese medicine studies in China once having graduated in the U.S. and had sat for the California licensing examination, to gain more exposure to the medicine in its cultural context.

In 2003 I moved to Beijing, with the intention of attending advanced Chinese medicine studies at the Beijing Chinese Medicine University once having completed one year worth of intense study of spoken Mandarin Chinese – I have been very lucky in that my time spent in Japan had allowed to gain an ever-increasing proficiency in the Chinese written language, so that was one thing I thankfully no longer had to be concerned about. My language studies ensued, during which time I started to regularly meet with a Chinese medicine doctor Dr. Li Xin to start getting some more insight into the medicine from a ‘local’s’ perspective. Through him I was introduced to a colleague of his, Dr. Xu Wen-bo, who in turn introduced me to her brother, Dr. Xu Wen-bing, who founded the Hope Insitute of Chinese Medicine, Beijing, where he runs a busy clinic as well as teaches foreigners various classes in Chinese medicine.

When I met Dr. Xu Wen-bing I was quite taken by his very open and honest account of his experience as a Chinese having grown up with Chinese medicine in China from a young age through his mother, herself a Chinese medicine doctor, to then later study at the very university I had originally planned on attending myself, and work there as an associate professor. He had a definite authentic feel about him which had me realize I was standing at the next crossroads in my life, and whole-heartedly continued with Dr. Xu, and not with the Beijing Chinese Medicine University as initially intended.

Dr. Xu introduced me to my new Qi Gong teacher, Mr. Ma Shi-qi, who guided us through various solo and partner Qi Gong exercises for two hours prior to each class with Dr. Xu, since it was extremely important to Dr. Xu that his students have a sound understanding of Qi in their own bodies before attempting to interpret that of their patients, and must say that this heavily influenced my enthusiasm to take Dr. Xu and Master Ma both that much more seriously. So much so, that after the first few months of classes I devoted myself entirely to my two new teachers. Subsequently, Dr. Xu offered me a personal assistantship, which also included doing a lot of translation work, functioning as teaching assistant to Dr. Xu and also Master Ma during his Qi Gong classes. The following year Master Ma offered me an apprenticeship to be fully included into his circle, as I had expressed many times my wish to some day be able to teach others.

I have practiced with many teachers of martial arts and Qi Gong in the past in numerous countries, and can without doubt say that Master Ma is second to none in his level of personal development of Qi ‘refinement’. With the commencement of the apprenticeship our classes took place on an almost daily basis for almost two years. With my fortune at the time of having no other commitments, I was also able to invest that much more time in the day to practice on my own.

Since my family was in South Africa, and I have had such a long connection with this country, I had already planned years before to move back, which I then did with my wife-to-be in February of 2007. I started working in private practice, relying on house calls, to then eventually sit for the South African licensing examination for Chinese medicine and acupuncture. It was at the exam venue that I met my new friend and soon-to-be colleague, also taking the exam with me, who was telling about a hospital clinic outside of Cape Town where he regularly performs acupuncture treatments. My ears perked up when I heard this, as I had fantasized about at some point in the distant future to being able work in such an environment, and there it just fell into my lap. I tagged along the following week and have been active there on an ongoing basis right up until the clinic was very coldly shut down end of November, 2011. We are currently still involved with legal proceedings and can tell you that corruption is in no short supply.

You had asked about how people in South Africa view acupuncture / Chinese medicine – mind you, I prefer to rather refer to it as ‘Chinese acupuncture’, in that too often ‘acupuncture’ by itself is often misconstrued as purely a physiotherapy tool – well, if you ask the people that came to the hospital clinic, among them diabetics, stroke patients, HIV patients, people with arthritis, kidney disease, liver disease, skin conditions, digestive conditions, addictions, depression, lupus, trauma, asthmatics, post-operative pain, etc., etc., then many will tell you about how their medications were reduced, others will confirm that their prescriptions were not renewed since they were no longer warranted, yet others about no longer needing walking aides such as canes, crutches, walkers and wheelchairs.

In fact, the popularity of this clinic was such, that there were just too many people to treat and not enough people to do the treatments! Originally there were three people active in the clinic, then about six months later two discontinued which left me to run the clinic for another one and a half years until I was joined by a new and very committed colleague. At times we saw 20, sometimes over 50 people during a shift. For a time I also had the chance to treat people in the in-patient wards of the hospital who would be struggling with the consequences of their medications, pain, constipation, phantom limb pain, etc.

We were fundamentally reliant on acupuncture in that the majority of patients simply do not have the financial resources to afford the regular use of herbs, although for several people this was an option at times. This is also where the inclusion of Qi Gong therapy in the form specific postural and breathing principles had proven to also be extremely effective. For a time there was an actual medical Qi Gong clinic that I ran at the hospital which was very popular, giving people a heightened sense of empowerment over their health situation, along with meaningful effects on their health.

Many other people one asks here about acupuncture will have experienced it in the form of ’dry-needling’, which, since the point prescription is not based on Chinese medical diagnostics, has nothing really to do with Chinese medicine per se. Hence why many people in the western world will understandably not associate it with an actually medical modality, particularly in internal medicine.

This is something that greatly bothers me with the legislature in the U.S. – which I must admit am not current with – that one receives the title of “Licensed Acupuncturist” on completing a full-course of study in Chinese medicine. This is obviously extremely misleading to the general public and therefore very undermining to the scope and very legitimacy of our profession – but that’s politics for you. Mind you, it’s obviously not a very lucrative business to actually promote a healthy society.

Interestingly, here in South Africa one is granted the titles of “Doctor of Acupuncture” and “Doctor of Traditional Chinese Medicine” on fulfilling the respective licensing requirements – certainly does more for one’s sense of credibility in terms of being an actual health care provider.

I have recently been a regular guest on a tv show called “Open Studio” produced by a local NGO tv station Cape Town Television hosted by a great friend of mine, with the topic of health and wellness, using Chinese medicine as a treatment tool and just as much also as a preventative tool, allowing more of the general population to have more access to Chinese medicine. Considering the overall socio-economic situation here in South Africa, modalities like Chinese medicine have HUGE potential in significantly bringing down the burden of illness amongst the masses – my experience at the hospital confirms this. The rest is just a matter of schlepping through all the darned bureaucracy to allow for things to happen!”


What are You Offering Patients

What Are You Offering Your Patients?What are you offering your patients?

That may seem like an easy question. Most people will say acupuncture or acupuncture and herbal treatments.  But what does this do for the patient?  What are the patients getting?  Are they getting better health?  Are they getting stress relief. Are they get someone who is present for the experience they are having with their body?

Sometimes it’s good to sit back and stop thinking about how you deliver something and consider what it is, at heart, that you are delivering.  When I had my own practice and practice website my website highlighted that quality of life was important to me.  In my life I can easily get overwhelmed with the need for perfection in how I do things, from doing the right amount of acupuncture and herbs to the right amount of exercise and doing it perfectly.  My perfect is not everyone’s perfect.  As I worked with chronically ill patients I became used to an ebb and flow in their commitment to coming to acupuncture to help their health.  In fact, that ebb and flow of commitment often extended to any lifestyle changes.  It became important to me to meet patients where they were at that moment in time.

This didn’t mean that I didn’t let them know what would work best. It meant we had an open conversation about what they wanted THAT day.  Sometimes they were feeling pretty good and just wanted to feel like a “normal” person who didn’t have healthcare appointments every day.  Sometimes it meant getting into the best physical condition they could.  For me, it meant being there with the patients as honestly as possible to help the get what it was they needed for their best quality of life at the time they sat in my office.

Other practitioners may focus on delivering a pain-free life, or the healthiest life possible.  What do you offer?

Acupuncture Matters

Sara Calabro writes an acupuncture blog called AcuTake.  Her background in journalism helped her found a site that is written by a variety of people on the subject of acupuncture and health.  Recently she has written a book called Acupuncture Matters.  Calabro says, “Acupuncture Matters looks at how acupuncture lessons can potentially improve how we approach everything from urban planning to personal finance to relationships.”

Check it out.

Making that Connection

Creating ConnectionsI started creating my artwork and marketing materials to reach potential patients who had never tried acupuncture.  I started with my midwest relatives in mind.  Not all of them. Some of them would happily try acupuncture.  A lot of them (and read A LOT because the families were big), would never try it.  They have a niece, cousin, and grand-niece who practices acupuncture and can answer all their questions but they would never really grasp it.  There was this attitude of,  “There she goes again talking about that weird stuff she does.”

What I didn’t get until recently, nor do many acupuncturists, is that there are people for whom acupuncture is so far out of their experience and their life that they can’t even imagine it being for them.  This wouldn’t matter except that there are a lot of them.   Those same people are often getting a little older and have lots of chronic health problems that acupuncture could help.

Educating them about how acupuncture works, doesn’t work.  After all, they know the basics of illegal drugs but that isn’t part of their experience either, really.  They’re “normal” people.  They are not a Hollywood star, an Asian immigrant, a university professor, a rich person, a well-traveled person.  They are just themselves and they may not even know the kinds of questions you would ask an acupuncturist.  They don’t know how to form a bond of trust with the medicine.

There is this story that says when the large ships that Columbus sailed to the New World on, the Natives couldn’t see them.  It wasn’t that they were invisible, but the tribes had never seen anything like it so their brain didn’t even register these ships.  I have no idea if this is true.  However, as an acupuncturist, sometimes it feels like people are often blind to the successes of acupuncture because it’s too different for them.

So how to make that connection?  Talking to people in their language is a good start.  This means that they don’t have to learn anything new to understand that acupuncture can help them. It’s not about educating them to acupuncture, but habituating them to the idea.  It’s about reaching them on an unconscious level.  That’s what I seek to do with artwork.  I’m a huge fan of having acupuncturists who see a broad cross-section of people having familiar touchstones in their offices, so that the office isn’t all about Asian beauty and Feng Shui.  Not everyone is comfortable in that setting.  Even one picture or a few magazines that speak a common language can go a long way to making the patient feel more at home.

It’s a tough line to walk to be who you are and embrace all that you are as a practitioner and still make that reach over to the person who has trouble accepting it.  If the profession is to grow then more practitioners need to offer that helping hand, to show people that acupuncture isn’t just for other people but that it can be for them.



Facebook and Your Practice

There are a lot of acupuncturists using Facebook.  There are acupuncture groups where acupuncturists can join in discussions about cases, insurance questions and case-law.  My school has both a general Facebook group and an alumni group that is closed to all but approved people.  I see lots of practitioners with their own Facebook pages.

I find it interesting when practitioners want to share their page with other practitioners.  It’s not that it’s a bad thing but is this really the best use of the page?

A Facebook page can be a quick and easy way for patients for find you.  You can offer quick tips about what’s happening at your local practice.  You can keep updates about the weather. What is happening in your community.  It’s probably far more effective for patients for the practitioner to share with local businesses than with acupuncturists from across the country.

I do follow lots of practitioners. I’m looking for acupuncture news.  I want to find news that’s unique to practitioners and see who is doing something novel. Unfortunately all this following means that everyone seems to be doing the same thing.  I find it ironic given that most practitioners strive to be unique.  While many articles are for the general public and talk about acupuncture, often these kinds of articles get tiresome for patients.  Patients want something that touches their lives.  Finding local news can be a way to engage them and get conversation going.  Conversation on the page can be very helpful in the long run, especially if the practitioner can monitor it.

Moving beyond Facebook to other social media is important only if you, as a practitioner enjoy that.  The best social media advice I ever got was to do only those things that I liked and forget about the others.