Autumn is here! Is your clinic ready?

After the often slower Summer season, Autumn is, traditionally, a season when acupuncture practitioners see the most patients in our clinics. Fall seasonal allergies, changeable weather with fluctuating temperatures, and exposure to more pathogens from school-aged children are all factors that can bring more people to our door.

How can you encourage and make the most of this trend?

1. Signage inside your clinic. Make sure you have some signs up on the wall or in plexiglass sign-holders telling your patients (or anyone who visits your clinic for any reason) that acupuncture and Chinese medicine can be helpful care for seasonal allergies, sinusitis, pediatric earache and cough, cold and flu symptoms. Both herbal medicines and acupuncture can be helpful, but you can also advertise preventive, immune-boosting acupuncture treatments during this season.
2. Fall Acupuncture packages. Why not offer a package deal for 3-5 treatments over a 2-3 week period to help strengthen the immune system and relieve stress?
3. Waiting room displays. If you carry products like Cold Quell and CQ Jr, Lung Qi Jr., Moisten Dryness, Aller-Ease, Fragrant Passage, and Golden Qi, that support a return to balance for patients with some of the conditions listed above, why not create a little display with some of these products, including one of those signs to show people that you have formulas on hand that can help them as well as their children through some of the common ailments of Autumn?
4. Blog posts and YouTube videos on your website. Write articles or, better yet, create a very short YouTube video to post front and center on your website and/or on your YouTube channel (create one for free), to demonstrate an "Autumn" Qigong exercise, an "Autumn" Jook or Conjee recipe, an "Autumn" self-massage protocol, or explain an "Autumn" medicinal wine recipe? While sharing something useful at no charge, you get to demonstrate your knowledge and perhaps mention that package deal discussed in #1 above.
5. Articles in local newsletters. If your town has any large(ish) employers, I'll bet they have an in-house, online newsletter. Ask if you can post a health article twice a year or quarterly. The only thing you ask is to put a contact email or website URL at the end of the article. In this forum, you don't advertise yourself. You share something useful about how to stay healthy. Photos are great to use in this format.
6. Does your town have a Fall festival, Octoberfest, or other community event? How could you participate in these events: a booth or a float in the local parade sponsored by 5-10 local acupuncturists, joining a committee that has lots of other folks involved? However you get involved, this shows that you are a participant in and someone who cares about your community. Don't underestimate the power of this kind of volunteering.
7. Schedule a free talk at an upcoming PTA meeting. In our society, Mothers make most of their families' healthcare decisions. What better place to find lots of Moms that at a PTA meeting? Give a talk about managing children's earaches or coughs through Chinese medicine (once any serious infection has been ruled out by the child's PCP). We have to say that even if we wish they'd come to us first. This project is even easier if you know someone in your community who is a member of the PTA and can mention your name to the right person in the association.

So there are a few ideas for pumping up your practice during the Fall. Thanks for reading it. Good luck and stay healthy!

Next...Watch for my video presentation on treating the common cold with tuina, coming to the Blue Poppy YouTube channel next week!

What is tuina and how is it different from other massage forms?

As promised in my last blog, here is the next installment about Tuina. IN this blog I discuss the most important method of the Shanghai family school, guen-fa or rolling method. You can see the entire course (actually 3 courses) that I offer on tuina and how to combine it successfully with acumoxa therapy at Blue Poppy's website on the following page. 
http://www.bluepoppy.com/Tuina-Techniques-Protocols-for-Specific-Conditions/productinfo/DLTUINATEC/
There are also some videos of simple techniques at the Blue PoppyTV Youtube page.
https://www.youtube.com/watch?v=yqOsFKLkP8Y
This blog is excerpted from the handout notes for the entire series of classes on Tuina Basic Techniques and Specific Treatments for Specific Ailments.

-->

Thanks for reading my blog.

Tui simply means to push and na means to grasp, although there are a dozen different specific movements or techniques to most schools of tuina. Some of these have analogs in various Western massage forms, but the most important ones do not. Also, the basis for using tuina is pattern discrimination (bian zheng lun zhi) exactly the same as any other sort of therapy used in Chinese medicine.

1. What does Tuina do physiologically? From the point of view of Chinese medical treatment principles, its main function is to move and rectify the qi and quicken the blood to resolve stasis. Some treatments state that they are supplementing or draining specific points and, by extension, specific viscera and bowels so that they will perform their jobs with more efficiency. One example of that might be to supplement the spleen so that it can transform and transport fluids more effectively. More of these discussions may come up as we go through this material.
2. There are, historically, five schools of tuina therapy. The one that is most important in Shanghai is the Rolling School, which is the style of tuina in which I was trained. This style is flexible, includes many specific techniques, and has a broad range of application in terms of conditions and symptoms for which it is commonly applied.
3. The six main techniques of this style and that I will cover and demonstrate in this video include: Rolling method, Kneading method, Pressing method, Grasping method, Twisting method, and Rub rolling method. There are a few other, less important techniques that we will cover more briefly as they are similar to massage therapy techniques in the West, while these main techniques have no Western massage analog.
4. Many of these techniques may be accompanied by passive movements of the limbs or head. I will discuss what each of these techniques is indicated for as I demonstrate them.
5. What are the essential requirements for effective tuina therapy? The Chinese list four main and one secondary characteristic of the form as general requirements for successful outcomes.
1. The therapy must be gentle so that it does not damage the tissues  (GENTLE)
2. The therapy must have enough qi power behind it to penetrate the tissue (POWERFUL)
3. The movements must be even and smooth throughout contact with the patient (EVEN & SMOOTH)
4. The therapy must last long enough to engender a change in the tissue (ENDURING)
5. Finally, in some cases passive movements must be added where appropriate (PASSIVE MOVEMENTS)
6. The correct movements of the therapist’s hand, wrist and body must be mastered. This is important to keep you from injuring your wrist, hand, elbow, or low back.
7. In the case of injury management or specific musculoskeletal conditions and diseases, we may also apply liniments or herbal compresses of one type or another.

A word about your practice bag…

In Chinese medical school, tuina students begin their practice on a rice bag, although I suppose any grain would do the job. Instructions for making a rice bag are included with the notes, but basically it is a double layer of a soft fabric such as flannel or very smooth cotton for the sake of the skin over your knuckles, about 6 or 7 inches by 10-12 inches and very, very stuffed. If you don’t stuff it as full as absolutely possible, practice is frustrating as your movements work all the rice out of the way and you are down to the table almost instantly. The Tuina “lore” says that you should have worked your rice into flour before you are allowed to touch a patient. In this video, I will demonstrate each movement first on the rice bag and then on a human being. By the way, animals also love tuina!

With that introduction, let’s begin with the first and most important technique of the rolling school, which is Rolling method.

Rolling Method (Guen Fa)

This movement is the basis or foundation upon which most of this school is built. This movement is used for the neck, back, shoulder, and limbs, but not for the face or abdomen. It utilizes the strength of the entire core and upper body transferred through the shoulder, arm, wrist and hand. The important features start with the practitioner’s body position.

Body position

Again, this is important to master to keep you from injuring your own body, especially your forearm and wrist.

1. knees slightly bent, core awake or engaged, shoulders and hips straight ahead of you
2. body at a 45 degree angle to the treatment table
3. relax shoulder down, keep elbow close to your body
4. use the arm that is away from the table, not the one closest to the table
5. Your wrist is relaxed, almost limp, never stiff
6. The main contact with the patient is made with the triangle of the knuckles and the large end, or styloid process of the ulna

Then, using the distal end or styloid process of the radius to describe an arc, you move that part of your wrist back and forth in a wave like motion  away from and your body. Again, the carpal bones on the back of the hand, extending out to the knuckles, form a sort of triangle that is the surface actually making contact with the patient’s body, which, by the way, is usually clothed or covered with a cloth to protect their skin as well as their modesty.

This movement is extremely efficient. When done well it penetrates deeply without pain and should be maintained for 6-8-10 minutes as the first movement done on most body parts. It is often combined with passive movements and with liniments, which we will return to later on. All the other techniques are subordinant to this main technique.

When beginning your practice, start with little to no pressure in your hand and wrist and work up to stronger pressure as your hand and wrist strengthen. Keep practice sessions to 20-30 minutes maximum. Otherwise you can create tendonitis! I’m serious about this. Increase your pressure slowly over a period of days and weeks until you can feel the tissue moving pretty deeply underneath your hand and wrist….up to a few kilos of pressure per square centimeter.

Lots more in these notes...but cannot give it all away free. Thanks for reading. Check out the video link for a hot compress for pain recipe.

What medium do you use for Chinese medical massage therapy?

In advance of a Summer garage sale coming up soon, I was going through a box that had not seen the light of day in far too long. (Anybody out there familiar with that experience?) In the process I discovered some notes from my first trip to China to study tuina (1983? 1984?). I'm really not a pack rat, so I figured there must be some good stuff in these notes. I had forgotten how much great information we were given by the wonderful doctors who were our teachers at that time and was especially struck by the depth of knowledge and experience reflected in these notes.

Thirty years later it's a good review (my goodness how much we forget) and I'm thinking about how to share all this material in a series blogs. I'm starting today with something simple but fun: the "herbal" aspect of massage therapy. Below is a short catalog of the various media that can be used with patients for various patterns. Many of these can be created in your kitchen. Others you can find at Whole Foods or similar stores, create from your clinic herb dispensary, or order on line. If you are serious tuina or anmo practitioner and are not using this aspect of our craft, you may want to take another look. I love this kind of stuff.

Enjoy.

1. Ginger Juice– Good for treating children to dispel external pathogens from the exterior layers of the body. With adults use especially this for abdominal massage.

2. Cold water– for pediatric tuina in cases of fever

3. Slippery elm (Ulmus fulva) wood shavings– good for very young children or elderly patients with very tender skin. The slippery quality keeps the skin from being scraped, bruised, or chapped. In a powder form, it can be added to other oil or cream formulas for the treatment of eczema and various dermatitis conditions.

4. Talcum– not suggested. If you need a powder, consider corn starch with an appropriate herbal extract powder added for the specific pattern the patient exhibits (cinnamon for cold conditions; huang qin for heat conditions, etc.)

5. Alcohol– to move the blood and dispel stasis, wind, cold, and/or damp. Also can lower a fever in an adult. Do not use with children. (Note: If you are worried about isopropyl alcohol, consider keeping a bottle of the highest-proof clear alcohol you can get....like Everclear.)

6. Herbal tinctures– these can be endless and most people who do tuina have a favorite or two. I use Blue Poppy's Green Willow Liniment when I want a warming and moving effect, or Zheng Gu Shui when I want a cooling and moving effect. I've posted other recipes for liniments in the past, and you can of course find endless variations in the book Shaolin Secret Formulas for External Injury.

7. Green onion and ginger– mashed and soaked in Everclear for 2-4 weeks. Used for treating upper body in the case of common cold and especially good for pediatric tuina.

8.Cajeput oil– (Melaleuca leucadendron), a relative of Tea Tree, this oil is available online. It is resolvent and analgesic, can be used for injuries as well as on the chest for common cold and asthma, bronchitis, chest congestion.

9.Sesame oil– Lubricant, smooth, comforting, this oil relaxes the muscles and is a great base for creating your own musculoskeletal treatment oil with other herbs or essential oil added based upon the patient's patterns.

10. Conduction oil– The doctors at the hospital where I studied and worked created this from equal parts cajeput oil, glycerine, turpentine, alcohol. and distilled water. It requires shaking (sort of like a vinegar and oil dressing) prior to use.

11. Zhanjindan (muscle stretching powder)– made from extract granules or powders in a mortar and pestle this powder is for tight, constricted, painful musculature with both stagnation of qi and blood stasis. It moves the blood, recitfies the qi, and stops pain.
• Mo Yao, 2 parts
• Ru Xiang, 2 parts
• Hong hua, 1 part
• Xue Jie, 1/2 part
• Camphor and borneol, 1/2 part each

12. Cinnamon oil– This is either an essential oil or you can make it with sesame oil and cinnamon extract. This is for treating any condition caused by cold.

How long has it been since you considered some new and different massage media for the various conditions that your patients may present? I know that I get easily into a rut, using only one or two oils or liniments. Of course you can use this information flexibly, adding various herbal extracts to your favorite oil or to alcohol base. But if using these can make us more effective at caring for our patients, it's pretty easy to give some of these a try.

Next time: Basics of Tuina and What Does Tuina Treat Best?

Thanks for reading.

Aging boomers could pay your mortgage (or student loans) for years to come

by Honora Lee Wolfe

Facebook just became 1,300,000,000 and counting. If it were a country, Facebook would be the second largest in the world. The next link in this thought chain is that Boomers (49-70 years old) are the fastest growing group of new users at Facebook and other social media sites, worldwide.  The younger generations, Genexer, Millennials, and younger folks than that are already there and have been for awhile; thus, new users in those age groups is growing at a slower pace than Boomers at this point.

Think about this for a minute. The urban legend is that 50,000 boomers turn 55+ every day. Even if the numbers are sketchy, it’s a whole bunch. And, so far, boomers are still the largest population of folks interested in our medicine. If that’s true, let’s think about what boomers want over and above food, shelter, and safety:

1. To still be able to hike and walk and travel the world on their own two feet at 60+ and 70+ years old
2. Not to get fat (or any fatter)
3. Many don’t want to take lipitor or other cholesterol lowering meds
4. Many more (millions maybe) don’t want to take arthiritis drugs like Vioxx
5. To keep their minds sharp (especially since in the current economy many will have to work for several more years (which I think is actually a good thing).
6. To keep their youthful skin and looks as long as possible.

So what do we have here….aging Boomers, a huge population of them experimenting with social media, and things they want that you can provide. It’s not very hard to see the marketing opportunities there.

Remember that social media networks are about sharing useful information…they are not about “you” as a practitioner or businessperson. While you can refer to things of value that you offer for sale, both services or products, you want to be perceived as sharing really useful, good information that is patient-focused, even if it is stuff on your own website. You might want to get in on the conversation, link up your site or your Wordpress blog and your Facebook page and Twitter accounts to as many other people as possible, share what you know and about any great resources or products that you find. For example, below are a few websites and blogs I have found that have great info for Boomers who are fighting the dragon of aging. It only took me about 10 minutes to find these.

http://www.otbskincare.com/blog/  (Skip the Tan and Eat Your Vegees and Fruits for Beautiful Skin)

http://www.topantiagingtips.com/anti-aging-blog.html  (All things anti-aging...)

http://www.cnn.com/2009/HEALTH/08/20/cholesterol.lowering.supplements/index.html (A great report on what can really work at CCN. Do you sell any of these products in your clinic?)

http://www.youtube.com/watch?v=V-y4db-Zp8g

(A series of great videos showing specific exercises for various arthritic joints.)

Those are a few examples of sites you might share with your patients and prospective patients on Facebook, Twitter, LinkedIn, your website, your blog and that you can mine for information to use as a health educator in your clinic. You could also, of course, mention that you do Facial Rejuvenation Acupuncture or specialize in Weight Loss or teach special exercise classes for arthritis relief. Maybe the best way to advertise these things on your site or on social media sites is with some fun, short YouTube videos (3-4-5 minutes long max.) Then if they want “more” they can “click here to schedule a free mini-consult” to see if OM can help them. Or put up a Facebook discount for patients on whatever is your slowest day of the week. You get the idea.

For those of you who want to get in on this type of marketing, here, also, are some industry-specific sites that use this conversational, viral aspect of the internet extremely well!

www.amazinghealing.com

(This is Juliette Aiyana’s site. Juliette really knows how to use the internet, blogging, and social media effectively in an inter-related and patient-focused way.)

http://acupunctureinthepark.com/ (This is Lynn Jaffee’s site. Very integrated and shows up easily in a web search. Tons of links and great information here.)

www.insights-for-acupuncturists.com  (Lisa Hanfileti’s site will give you tons of great tips…and has a bunch of other things for sale…but you can learn lots without necessarily spending money. Her newsletter is great and she is a master at online marketing.)

Here’s another one: Ask to “friend” Luna Acupuncture in Jacksonville, FL on Facebook. She does great little posts for her friends and patients. Her website is OK, but her Facebook use is intelligent and relevant.

To get the hang of using the expanse of the internet and social media networks well to help grow your business, visit all these sites and many more. At the end of the day, you have to participate…and I don’t mean sending out tweets like “I just went to Starbucks for my afternoon fix.”  May your posts useful, specific to your market (in this example, Boomers, but whoever your market is) and regular (once or twice a week at least for a blog; daily or every other day for Facebook or Twitter). Point your customers back to your website or blog to get more (articles and information that you have posted right next to your “free consultation click-through”), so that they end up seeing you as one of the experts they rely on.

Good luck out there everyone.

How to Start a Successful Ready-Made Formula Pharmacy (Excerpt)

This text is a excerpt taken from The SuccessfulChinese Herbalist: How to Prescribe Correctly, Gain Patient Compliance, and Operate a Profitable Dispensary by Bob Flaws and Honora Lee Wolfe, 2005. Read more at 

 

Chapter 11: How to Start a Successful Ready-Made Formula Pharmacy

by Bob Flaws & Honora Lee Wolfe

Some new practitioners don't set up a pharmacy right away because they're not sure what to do or buy in what order. If you have never had your own business before, there=s a lot to think about, and a pharmacy may not be your first priority. However, if all you offer is acupuncture, then your income is limited by the number of patients you can see in the number of hours you can work. If you also sell your patients other goods and services (which they need and are good for them), then you make a profit on those items as well. In addition, herbal medicines are consumables, which means they are something the patient must usually buy more than once. Setting up an in-house pharmacy or dispensary also has the benefit of providing one-stop shopping for your patients, and, depending upon what lines of products you sell, this may help you set yourself off from your competitors.

Starting a ready-made formula dispensary

Until and unless we feel very confident about our skills writing customized prescriptions, most of us start our dispensaries with a line of ready-made medicines. These ready-made medicines can be either Asian or American made. Typically, Asian-made ready-made pills are pretty low potency, but have of advantage of being inexpensive and easy to store. However they may not be very effective for remedial treatment at the bottle-suggested doses. Asian-made extract granules are higher potency. These come in either loose "powder" form or encapsulated. Already encapsulated extract powders range in potency from 3:1 to 15:1. Most American-made Chinese herbal pills are also made out of extracts. However, exactly what potency must be determined from your supplier. In any case, I recommend that you start with the following classical formulas, all of which you should have studied in school:

Bu Zhong Yi Qi Tang (Supplement the Center & Boost the Qi Pills): Liver-spleen disharmony

Dan Zhi Xiao Yao San (Moutan & Gardenia Rambling Pills): Liver-spleen disharmony w/ blood vacuity & depressive heat

Du Huo Ji Sheng Wan (Angelica Pubescens & Loranthus Pills): Wind, cold, damp impediment

Er Xian Wan (Two Immortals Pills): Yin & yang dual vacuity w/ vacuity heat

Er Chen Wan (Two Aged [Ingredients] Pills): Phlegm dampness

Gui Pi Wan (Restore the Spleen Pills): Heart-spleen dual vacuity

Huang Lian Jie Du Wan (Coptis Resolve Toxins Pills): Damp heat, replete heat, heat toxins

Jin Gui Shen Qi Wan (Golden Cabinet Kidney Qi Pills): Kidney yin & yang vacuity

Liu Jun Zi Wan (Six Gentlemen Pills): Spleen qi vacuity w/ dampness

Liu Wei Di Huang Wan (Six Flavors Rehmannia Pills): Kidney yin vacuity

Si Jun Zi Wan (Four Gentlemen Pills): Spleen qi vacuity

Suan Zao Ren Wan (Zizyphus Spinosa Pills): Liver blood vacuity, vacuity, disquieted spirit

Tian Wang Bu Xin Dan (Heavenly Emperor Supplement the Heart Elixir): Heart qi & yin vacuity

Wu Ling Wan (Five [Ingredients] Poria Pills): Water dampness

Xiao Chai Hu Wan (Minor Bupleurum Pills): Liver-spleen vacuity w/ lung and/or stomach depressive heat

Xiao Yao Wan (Rambling Pills): Liver-spleen disharmony w/ blood vacuity

Xue Fu Zhu Yu Wan (Blood Mansion Dispel Stasis Pills): Blood stasis in the chest

Yin Qiao Jie Du Wan (Lonicera & Forsythia Resolve Toxins Pills): Wind heat external contraction

Zhi Bai Di Huang Wan (Anemarrhena & Phellodendron Rehmannia Pills): Yin vacuity w/ vacuity heat

You can treat many, many patients with combinations of these basic formulas. When you need something for a patient that you don't currently have on your shelf, order it. However, we don't recommend that you order every ready-made medicine in the book just to have on hand. This ties up too much working capital and with FedEx or UPS, you usually can order things as you actually need them. You should probably be able to store these ready-made medicines without any problem in your current space with your current front desk set-up and clinic storage cabinets.

As your practice gets larger and you understand more about Chinese herbal medicine, you can add more ready-made medicines to your inventory as seems prudent. You may also find that you need higher potency, more complicated ready-made medicines for your patients, such as the ones described in this newsletter.

For more details on how to set up a singles pharmacy with bulk medicinals or granule singles, a list of what 50-60 specific herbs to start with, and how to set prices for all your herbal products, see The SuccessfulChinese Herbalist: How to Prescribe Correctly, Gain Patient Compliance, andOperate a Profitable Pharmacy by Bob Flaws and Honora Lee Wolfe sold at Bluepoppy.com or Amazon.com.

How & Why to Create Business Rituals For Your Patients (and Yourself!)

This morning I was listening to an online marketing presentation about ways to become irresistible to your customers. One of the things they discussed that struck me as really relevant and important for people in the business of healing was to create a series of “business rituals” for how your business communicates with patients...from the very first "touch" (phone call, visit to website, meet at a health fair, whatever) until the final day they leave your practice. Most of us have some of these processes in place intuitively without having labeled them; but what do we mean by this and why should you bother?
First I will discuss why it is valuable for you and your patients. Then I will give some possible examples.

What can business rituals do for you?
1. You only need to invent the wheel once. The process of designing rituals for your patients as a planning tool for managing all patient and prospective patient interaction. This is valuable to you first because it means you have a created a system that can be repeated in the same way, in the same order, and with relatively predictable results with every patient. Of course your system can be tweaked whenever, as needed, but how you communicate and manage patients becomes built in.
2. Most parts of this process can be delegated. You want and need to focus on treating your patients; it is what you were trained for. So, creating a series of tasks that are all repeated in the same way and same order and then taught to your front desk staff or other subordinate (if you don't ahve such a person, make it a short term goal to hire one!!) frees you up to be the healer that you want to be.
3. Some of your rituals can be designed to increase your patients trust and belief in you, increase their perception of value for your services, or help you tell your unique "story." Let's face it, with only 5% of all Americans using Chinese medicine and acupuncture, what we do is downright weird in some people's minds. We have some work to do to gain the trust of more potential patients. Some of the information we may send/give out or post on our website for the benefit of potential patients (things that all potential patients should receive) should be designed to increase their trust and belief. More on that below.
4. One ritual you can use would be to "pre-qualify" your patients to see if they are a good fit for our services. This can be done with a questionnaire or with a pre-intake free consultation. You may say that you want to simply take every patient who might walk through the door, but it really is not true if you think about it, and it's not even good for your practice or the industry. For example, if a prospective patient shows up with a condition that you have no experience with and you know that someone across town is an expert at this condition, it's probably best for our profession in the long run if you refer that person to the expert. If you make sure they know that you were the source of the referral, perhaps they will return the favor. I've had the question in classes, "What do you say when someone says 'I've tried acupuncture and it did not work.'?" Such remarks are very discouraging, but one response might be, "Perhaps you were not with the right practitioner for the condition you have." Also, most of us have had the experience of trying to work with a patient that, for whatever reason, just wasn't right for us and in whose presence we feel uncomfortable. Such pre-qualification rituals can help us know immediately whether a patient is a good fit for us, and probably whether or not we can really help them. I believe it’s a bad idea to take a patient that we don’t think we can help…just for the short-term income. If we are not able to help them, we don’t get any good word of mouth from that interaction and it leaves a bad taste in both our mouth and theirs.
Secondly, the pre-qualification ritual add to a mystique of exclusivity...perhaps making a potential patient really want to become our patient simply because we are not immediately herding them into our treatment room.

5. Follow-up and follow-through rituals are often what make the sale. Let’s say you give a free lecture at the library called “Insomnia? What Can Acupuncture Do For You?”. Fifteen people show up and one actually makes an appointment with you on the spot. Ten others leave you their contact information. What are you going to send them after the lecture to convince them to trust you and come in for care? Whatever the piece is, it should be ready to go before you ever gave the talk. This could be a coupon for a free private 15-minute consult attached to an article you wrote quoting some research and with a current patient testimonial at the bottom of the letter. It could be a phone call thanking them for coming to the talk and asking if they have any other questions they may want to ask in private. Whatever that follow-up looks like, it should be a built-in, standard part of giving public talks…a business ritual. If two more bite, you still have relationship building to do with the other eight that gave you their information. So then what? Perhaps a monthly email with a link to your website articles section? Perhaps a phone call to see if they are still interested in hearing from you?

What could be a list of standard business rituals?

1. Giving one free talk per month, with appropriate handout literature and follow-up procedures (see above) until your practice is as full as you want it for three months in a row.
2. Your website includes a free report, a video, an ebook, or some other downloadable educational tool that requires people to leave an email address. Anyone who signs up for this free download gets a thank you note and an offer for a free consult or to have you answer one question for them free of charge. This item is refreshed with new copy at least once per month.
3. Potential clients are always scheduled for a free consult to see if he or she is a good candidate for your services, or not. If not the right patient for you, have a list of referrals available as a hand-out.
4. If they are a good potential patient, a simple treatment plan form to give them at the end of the consult so they know what to expect when they come in. This gives patients confidence that they know what is going to happen…no secrets. Also, don’t try to sell 12 treatments if you really think you only need five! If you don’t know, suggest 4-5 treatments and then a review of progress.
5. When patients first come to your clinic, what info, gift, educational materials, or free samples do they get?
6. A free tea and cookies service in your waiting area?
7. A play area for young children?
8. Send out “haven’t seen you in a while” letters to patients who have not been in for six months. Send out birthday cards for this month’s birthdays with “Get a free Tx on your birthday!” coupons.
9. Bonding calls to follow up with first-time appointments (‘How are you feeling? Any further question we can answer? Looking forward to seeing you at your next appointment. Please call if you have any questions at all.”…etc.)
10. You have both morning and evening check-lists for your front desk staff to perform daily, weekly, monthly. (e.g., pull charts at 9 AM, back up the computer at 5 PM, do reminder calls after 3 PM, check needle inventory in all treatment rooms each morning, order needles and herbs on Friday afternoon, etc.).
11. A monthly promotion for the community…”Come in this Saturday, get an acupuncture treatment for $35; All Proceeds Donated to the Local Homeless Shelter (a different non-profit each month?) When people come in, have handouts, “sign-up for our newsletter” forms, brochures, business cards. A different non-profit every month will draw a different crowd. Get the non-profit to help to promote this.
12. Asking for a testimonial note whenever a patient says “I feel so much better. Thank you.”
13. Standard “release from therapy” letter…for patients who are better and have gotten a great result.

So there’s my list. Yours could be completely different…but it’s good to have one. You know what “happens next” with each patient or potential patient. Check out the new edition of Points for Profit: The Essential Guide to Practice Success for Acupuncturists at http://www.bluepoppy.com/Practice-Management/products/39/

Great Patient Communication is Your Basis of Success

Here are 20 tips for improving your patient communication, placebo effect, and keeping your appointment book closer to full!

1. Focus on each existing patients, communication with them, and educating them, rather than just working on attracting new patients. The new patients will happen organically at some point,
but effective patient communication and management of that communication is up to you from the day your open your door.

2. See each first patient appointment as if it were a job interview…because it is. To get a feel for real patient response, walk a friend through a first appointment at your clinic and ask them to critique everything. What did they like and what should you consider doing differently? Some things to look at… in this "audit" include phone service, ease of finding you, parking, paperwork, educational materials, smells, sights, lighting, retail displays, office accoutrements, bedside manner, check out process.)

3. If there is time, get new patients to do the required paperwork in advance. If possible, read it thoroughly PRIOR to their visit. If the appointment is same day or next day, schedule them 15-20 minutes prior to when you wish to see them so there is no rushing with your paperwork. Make sure the forms are neat, easy to read and understand. Ask if they have questions or understood everything on you forms.
Also...always at least skim each patient chart prior to a visit. They won’t believe you care if you cannot remember anything about their case each time they come in.

4. Send or give all new patients a Welcome to Our Clinic Folder. Make sure there is an information sheet about “what to expect on your first visit” for them to read. Talk about how much you look forward to helping them regain balance and health in their bodies and lives and how much you look forward to working with them. Tell them what to wear and not wear; when to eat prior to coming in. Ask them to arrive a few minutes early so that they can rest…and because the pulse and other aspects of the diagnosis will be more accurate. What else could go into your welcome folder?
    • Cover letter welcoming them
    • Brochure about your clinic services and what you can treat
    • What to expect, what to wear, what will happen
    • Basic FAQ (similar to phone scripts you wrote)
    • Map to your clinic
    • Picture of yourself treating someone
    • Referral letter from a satisfied patient?

5. If a patient must wait to be seen on the first visit, control what happens during that wait. Give them a specific checklist to do such as what did they eat that day or a 1-10 severity of their symptoms today, yesterday, the day before that. Have  some interesting retail displays that are either educational, fun, exotic, or enticing. Control the waiting time as well. 5-7 minutes can be useful, more than 10 is insulting. If you are running behind, come and tell them so in person.

6. To generate relaxation, show new patients around your clinic…patients will get a feeling for how proud you are of the clinic and your medicine. Demonstrate needling on yourself if you think they seem really nervous. Look them in the eye; nod your head; explain what you are going to do before you do it. Consider headsets with healing music or sounds while the needles are in as an option for nervous patients. Don’t keep your clinic freezing cold.

7. The practitioners with the happiest patients are the great listeners. People feel cared for and understood when you listen…even for just a few minutes. Try to ask one question that you already know the answer to but which may surprise them…it increases placebo effect. You must stay in charge of the clock, but listen as much as you can, especially this 1st time. Good listeners get more patients! Remember, you are applying for the job of being this person’s healthcare provider.

8. What patients really care about is feeling heard, feeling cared for, and feeling touched at a deep level. To foster this, do a great physical exam…wow them with its thorough nature, but learn which questions to ask or signs and symptoms to look for quickly to confirm or deny a hypothesis. Don’t waste too much time learning everything about their life. Keep it medical not personal this 1st visit. Touch and treat with confidence. Your body language should be “all about them”  and “I know what to do” even if the only thing you can think to do is needle St 36.

9. It's nice to surprise a patient when you can. For example, if you know they have spleen qi deficiency, press Sp 2, 3, and 6, and perhaps Sp 17 and say something like “I expect you may be tender on these spots.” If you know they are under stress, probably vertebrae T4 and T5 will be tender. In their minds, if you know where they hurt, what else will you magically understand about them?

10. When patients ask questions, take a moment to formulate an answer. Think clearly before you speak. If you don’t know the answer, tell them you will find out the answer, but don’t lie or equivocate. Give hope and be reassuring without boasting or promising; our medicine can do wonders for people

11. Your office can and should have lots of relevant, interesting signage. These can be in treatment rooms, hallways, bathrooms, or inside small plexiglass photo frames. Here are a few ideas.
    “Did you know that Chinese medicine has successful treatments for: (WHO LIST)?”
    “Western and Eastern medicine can be compliments. Western medicine is usually better for acute problems such as trauma and infectious disease. Asian medicine is usually more effective for chronic conditions.”
    “If you have to wait more than 20 minutes for your treatment; it’s free!”
    “Want to take some information to a friend? Ask for a brochure or some research about your friends’ health challenges.”

12. If you feel you need to do research for a patient, then start with something simple
Acupuncture: do a simple treatment that usually produces good relaxation like Four Bars…then add ONE thing for their major complaint and do research prior to the next appointment.
Herbal med: decide on the major pattern discrimination & give a 1-2 day dose. Research the formula, review the S&S, call them the next day to hear results, and revise more accurately for a revised formula on day three.

13. Do a bonding call… Within first 24 hours at latest. This can be done by a front desk person, but it's even better if it’s you,
This allows you to do a number of things.
    • Shows you care and are on their health team
    • Allows you to find out if what you did so far was effective
    • Allows you to nip any potential problems in the bud and get patient back in quickly

14. From the first visit and even the first phone call, make sure people understand that 6-8-10 visits is usual and expected and that you need 2-3 visits just to refine the treatment plan. Reiterate this in the bonding call and in your educational materials. Patients don’t know what to expect; be reassuring and educate, educate, educate! You create the treatment plan; people are actually happier with having your guidance in most cases.

15. During those first appointments, your most powerful educational and marketing tool is to focus all your attention on your patient while with them. Never talk about yourself.
And, every time they come in, you should teach them something new about themselves and their health. These can and should be small things …about diet, about their daily routine, about feng shui, about natural cosmetics and their skin, about self-massage of points. It does not matter what, but it can keep their fascination, interest, appreciation, and buzz.

16. Send patients home with something to do to keep their health (and your services) in mind:
    • Food diary for a week
    • Breathing or other exercise (one or two only!!)
    • An article, brochure, or book to read
    • A liniment, patch, or compress to use daily
    • A handout about their treatment protocol and plan…

17. When you take antibiotics or other Western drugs, you are told to take the whole course even if the symptoms abate after 4-5 days. Make sure your patients understand that your treatment plan is similar! Without adequate treatment, they may go away saying that CM does not work. Give them a treatment plan handout with a fixed minimum number of treatments (or weeks/months of care in the case of herbal medicine). Voice and on paper increases compliance.  Especially if your Tx plan calls for 5,6,8 treatments, make as many of those appointments in advance as possible…even ok in CO to offer package discounts.

18. Always get another appointment scheduled before they leave the office if possible. Try to keep appointments at the same time of day and same days of week…helps patients remember. Also do reminder calls the day before every appointment. This will cut missed appointments by as much as half.

19. When a prospective patient calls and you have treated the condition they are experiencing, say so. If you do not, show/send/email them some research or a reference in a book. Discuss that you can help with their underlying imbalances allowing their body to heal itself no matter what the condition. Then suggest a limited tx protocol of 4 sessions and then a reassessment. However, if you think you CANNOT treat them, refer them to another practitioner who you think could and tell them you hope they appreciate your honesty and will refer others in any case.

20. Remember to say thank you every time they come in. They could be someone else’s patient, but they have chosen you. Make sure they know that they are appreciated.
Let them know you always want their referrals and that this is the highest compliment they could ever give you.

Good luck and best wishes to all my readers!
Honora Wolfe • Copyright 2014