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

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!

I have other artwork that just seems so much easier to work on and I have more reach.  However, there are more people doing that sort of work so although I have more reach, I also have more competition.  It also doesn’t seem quite as important.

So it is something I have to ask myself.  How important is the ease of work? Is it easy because I love it more? Maybe.  I don’t have all the answers.  As I reflect on this internal struggle and uncertainty, it feels rather universal.  How often to do we think we are led to something because it feels so easy?  Is that really the sign that we are led? Is it really easy or does it feel that way?  Are there always questions along a path.  How do we know what we need to focus on?  What I do know is that this isn’t an either or proposition.  It’s merely the question of what gets focused on today. There will be other things to focus on later.   There may be some of the same choices or there will be new ones.  It’s just a matter of what is happening in the universe.

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!”

Something else came up for me in that call.  I work on artwork for acupuncturists and I started the class thinking I wanted to focus on that. After that call I realized that this blog and this work is harder for me than the writing I do on my cat blog.  A big part of the reason was because this isn’t as fun.  I feel like I have to be serious when I talk about acupuncture.  I don’t know why.  I feel like in writing something valuable for acupuncturists I have to have some thought provoking and useful post.  I can’t just post the latest Frank and Ernest cartoon that shows them looking at a picture of someone lying face down with needles in their back saying how much back stabbing when on in that school.

Part of that is the fear that such jokes offend people.  The other part is that it feels like it’s not appropriate as a way of offering information.   On the other hand, I am a huge believer that if you can’t laugh at something there’s a problem.  Yes I do laugh at acupuncture but not often among acupuncturists.  When I have patients who were really worried and nervous and it seems appropriate my approach would be to say if it hurt was to “Scream loudly so everyone will know.”  It was such an unexpected response to the fears that they were usually too busy laughing to feel the first insertion, at which point I’d chide them for not screaming loudly.  Most patients were surprised that I had done anything.

Fact it, acupuncture is an energetic medicine that current science can’t quantify in the way the people of the US likes things quantified.  So it’s this strange medicine where people who are already in pain have a bunch of needles poked into them (doesn’t that hurt more?) to get out of pain.  And no one really knows how it works. Acupuncturists do but they can’t put it into terms that Westerners get, usually.  That lack of understanding and that fear of being thought foolish is another reason there is so little humor around acupuncture.   Acupuncturists aren’t out making jokes about their profession.  They want to be taken seriously.

Oddly, the most serious place I worked, an animal hospital, where we were helping people make life and death decisions had more joking around than any place else I’ve ever worked. There was no humor too black or too ironic for the veterinary clinic.  In fact, we had a staff holiday party in a restaurant once.  We were asked not to do it again as everyone seated around us left and many complained about our inappropriate dinner conversation.    We even thought that was funny, if a bit embarrassing.

Why did that staff laugh at things that shouldn’t be laughed at?  Because what else do you do?  As Kurt Vonnegut famously said, if you don’t laugh at it, you’ll cry.  Maybe I need to start realizing that the best way to be taken seriously is to let my hair down long enough to laugh at what I do as an acupuncture practitioner.  How can I be “heart centered” if I don’t laugh? The challenge, of course, is how to lighten the tone of an acupuncture blog like this one.

I guess that’s something we’ll all find out, won’t we?

I tend to get caught up in work and in worrying that it is easy to forget to find something that is just delightful and fun.  It exists and it is there.   Remember that the more delight you have in your life, the more that will carry over into your business.  Customers will see that and take their own delight in the small things you do.

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?

Check it out.

However, there are few things to consider.  Some companies offer templates that can be customized.  These templates may belong to the webmaster, not to you as the business owner.  Some of these same companies may offer a certain amount of free content that can be customized.  This content too may belong to the webmaster.  If it is very customized at some point, it may no longer belong to the webmaster but to the writer (which in many cases is the business owner).  This would be an issue for copyright if it went to court.

If something happens to the webmaster, what happens to the site.  This is a good question for any web host or design company.  While I believe my clients owned their sites, I was always a one person show.  Certainly I had a plan for it I needed to go out of business.  I could move sites into the names of the businesses and they could then use any new webmaster or maintain the site themselves with full access.  What happened if something serious happened to me?  What if I fell off a cliff and went into a coma? What happened if I died?  My husband knew about the workings of the business and has enough web savvy to get the company I was using as a reseller host to port the sites to their own hosting accounts with the help of the clients.  Certainly, I would hope that clients would be a little patient given that it might not go as smoothly as I’d like but at that point,  probably wouldn’t be around to care.

Given how many people do this work on their own, what are their plans?  It’s a tough question to ask.  Perhaps asking what sort of assistance they have if they can’t work would be a way to start.   This way you know that your site is safe no matter what happens to the other person.  Yes, it would be hassle to have to find someone else but at least you have a working website and don’t have to start from square one.

Ownership may not be the best way for phrasing these issues, but it’s a good way to think about it.  Who are you entrusting the care of your website to? Will they love it and understand it’s importance to your business? Do they have contingencies in place if they can’t work?

Consider that if you are self-employed, you need to be making a certain amount to survive with your overhead.  Certainly insurance companies have been slow to keep up with cost of living but that doesn’t mean that acupuncture rates don’t need to go up.  It doesn’t mean you can’t ask for what you are worth.  Ultimately each practitioner can figure out what they can agree on as far as the amount they need to make per patient.  Someone seeing several patients per hour can leverage their time such they can charge a lower rate per patient than the practitioner who sees only one person per hour.

The fact that the second practitioner sees fewer patients may be a selling point as to why they charge higher rates.

If you, as a practitioner, honestly feel you are worth the money people will come in and pay you no matter what you ask.  It helps to be clear about exactly how much you think you deserve. If you don’t think you can charge enough to live on, it might help to consider why you don’t value your time.  Sometimes that discomfort is about issues around personal value that may not even be realized.