Poopy McPoopersen

Acupuncturists are probably more comfortable chatting about poop than most other groups of people. . . or poople, if you prefer. We talk about poop. A lot. And we do it for the same reason that archaeologists look through ancient garbage dumps and investigators look through dumpters: you can learn a lot about someone by looking at what they discard.

In TCM school we learn what healthy crap looks like, what unhealthy crap looks/smells like, and what to do about it. But we aren’t the only ones who delve more deeply into our own shit. There are other perspectives to health and it’s good to see them because your patients certainly do. . . or doo doo, if you prefer.

The link below takes you to Kim Carr’s Crazy Sexy Wellness page. Read her article about poop to enhance your own education and so you can give your patients some great tips about how to improve the health of their bodies and their poop….because sometimes you need to offer them something besides just herbal prescriptions.

Kim Carr’s Scoop on Poop

Cat’s Bonus Tip

If you type :poop: into a comment line on Facebook it puts in a very cute little shit after you hit return. You’re welcome.

Life After School And Other Ridiculous Notions

Life begins (again) after grad school.

When I was in acupuncture school I was so consumed with school itself I didn’t really have a picture of what life would look like once I graduated. I had some vague notions about being self-employed and going to Barton Springs whenever I wanted to, but other than that I had no clue how the actual ‘making a living’ part would work out.

Now here I am almost 2 years later and I’ve gotta tell you that the reality here is very different than I thought it would be. What you will find here, in no particular order, are the myths I told myself and the real scoop. Let me assure you that none of this is bad! I’m not going to tell you scary tales of bleakness and woe. But I do want to let you know what’s going on out here.

Myth #1: I will make my living doing acupuncture.

True and yet extremely incomplete. If you look at my schedule (which you can’t because that would be a HIPAA violation) you will see that in the last 30 calendar days I have treated 55 clients. I don’t work on weekends, so that’s 22 practice days worth of seeing clients. That’s 2.5 clients per day at 1.25 hours per treatment, which means in any given day I’m spending maybe 3-4 hours doing acupuncture. Now, really it’s more likely that a day or two out of the week is quite “empty” and that several days have 3-6 clients. So what am I doing with all of that “free” time?

Most of the time, as a matter of fact much more time than I spend doing acupuncture, I’m doing one of these things:

1. Teaching Stuff
   Preparing or delivering Reiki and/or Practice Management classes, tutoring acupuncture techniques/treatment/diagnostics, herbs, and all kinds of other subjects.
2. Business Stuff
   Marketing, accounting, networking, researching herb and nutraceutical companies and products, answering e-mail, identifying and pursuing alternative income streams.
3. Office Stuff
   This includes all the stuff I will someday delegate to an office staff and may that day come soon! This is stuff like typing charts, filing, chart maintenance, ordering office supplies, ordering herbs, filling out forms, sending out thank you notes and other kinds of correspondence. 

This leaves precious little time to learn new cool things or to write stuff like blogs, which honestly I could do 24 hours a day if I had the time. I seriously should have been born a trust fund baby. And that brings me to the last item I tucked into #2 above….identifying and pursuing alternative income streams.

If you plan to make your living only by giving acupuncture treatments and selling a few herbs, especially the first few years you are out of school, you’d better be living a very charmed life and maybe have you own leprechaun….one who squeezes gold out of rocks or something. Am I saying it’s impossible to make a living doing acupuncture? I am not. This is just a facet of owning a small business. Small business owners are always looking for multiple income streams. Look at Insights for Acupuncturists. The woman who runs this site has been in business for a long time now and yet she still advocates multiple income streams. Not only does this supplement your income when you are working, but it can continue to feed your income when you can’t work. “Can’t work” could be an illness (either yours or your family’s), vacations, funerals, or repairs to your office or to the road which goes to your office. If one or more of your multiple income streams is independent of your physical business location, even better. If it’s a passive income stream, hallelujah!!

The reality is this: most of us will be small business owners as soon as we are licensed. Running a small business is hard work no matter what it is you are doing. And most small business owners are always looking for income streams.

I hope you won’t be depressed by this, because it isn’t depressing. Really! I love what I’m doing. Love. It. But if you want to be successful you have to stop thinking of what you are going to be as just an acupuncturist/herbalist. You will be a small business owner. Don’t think in terms of running a practice, but in terms of running a business. This business will support your life, but in order to do this for years to come you must make it healthy by all of the moral, ethical, and legal means that are at your disposal.

Myth #2: I will never sell nutritional supplements!

I’m not talking about Chinese herbs – they work and I believe in them (and yes, I know the FDA considers them nutritional supplements). Besides, we were trained to love Chinese herbs, right? I’m talking about nutritional supplements like vitamins and probiotics. I declared loudly and with fervor that I would never sell these things. I thought that supplement sellers were just hacks who couldn’t cut it at their craft. Listen to me carefully when I say this, because I hate admitting it: I. Was. Wrong. Dead wrong. Selling product in general is a fabulous income stream. Find product lines you like, ones that work, lines that are reputable and you feel enhance your reputation.

In a perfect world we would prescribe food therapy, people would do as we recommend, they’d get fabulously healthy and love us for this forever. But the reality is health care practitioners, including acupuncturists/herbalists, spend an awful lot of time band-aid fixing things that are generated by diet and lifestyle choices which many patients are unwilling to abandon even if it greatly improves their health. Many (perhaps even most) people don’t  get what they need from the food they consume. That’s where nutritional supplementation comes in.

Almost everyone I’ve ever asked says they are taking some kind of vitamin supplement. If you google “vitamin pill passing through colon” you will see tale after tale of people seeing whole pills that have passed in their stools. This is more common in cheap pills like over the counter vitamins. My logic is I’d rather they get their vitamin supplements from me. At least I’m selling them something that will absorb, that is ethical and healthy, and that has good quality control. That’s better than the Centrum (or whatever) bullets that rocket through the digestive tract and pass unchanged into the stool.

The upshot of this tale is that I am selling nutritional supplements. It’s a lovely thing to do for my clients, I see improvements in health when they are compliant with them, and it’s a great additional income stream.

Sidebar: 
All of this said, beware of MLMs. MLMs are Multi-Level Marketing schemes. These include Amway, Shaklee, Tupperware, Advocare, Mary Kay and anything else that makes you a “distributor” where your profit goes largely to the people above you and in which you are promised riches untold once you get people under you too. Look for claims such as this (name “blah blah blah’d” out to avoid a potential lawsuit): “In our first six months in Blah Blah Blah, we earned over $30,000 in Rookie Bonuses alone!” If it looks too good to be true, it probably is. And these kinds of claims are mighty tempting when you are first starting out and might be short on cash.

Myth #3: The people who need to see me will be drawn to me

Ok, that one is actually true. There are people waiting for you to get out of school so they can come see you. That doesn’t mean you don’t have to market yourself because you do. Get in the habit of thinking of everything you do as marketing yourself. I’m not talking about the cheesy face-on-a-billboard kind of marketing. I’m talking about building relationships with people and being willing to talk about Chinese medicine in any given setting. Think of yourself as an ambassador for how great Oriental medicine is and what it can do for those with whom you come into contact.

I have magnets on my truck – both sides and the tailgate. A couple of people have come to see me just because of those magnets. Not many, but a few. So are they a waste of marketing money? Not really. I’m getting visibility in the world, but more importantly, they remind me that my behavior in public is always on display. I never want to hear of someone refusing to come see me because I was a jerk to them on the road…or in the parking lot. Whether you hang a sign on your body or your property advertising yourself as a health care professional or not, you are always on display.

People probably aren’t going to come to see you as the result of a flyer, a truck magnet, a t-shirt, or an advertisement in a local magazine. They are going to see you because 1) they have met you and like who they met, 2) they heard you speak somewhere, or 3) someone they know and trust says you are ok. All of these are either direct or indirect personal contact. Sticking needles in someone is a very intimate and personal activity. Do you really trust someone you saw on a billboard to do this for you without some personal knowledge of them? Well, neither will your potential clients.

Let me emphasize: In my opinion, the most effective marketing you can do is personal contact marketing. Here are a few suggestions for doing this.

1. Get comfortable with public speaking
   Does this terrify you? Join Toastmasters. This is the best way to learn to give talks. People at Toastmasters are there to help you get good at this in a supportive environment. If you do this for yourself you will thank me and them about a thousand times. Giving talks at workshops, public events, in offices at brown-bag lunches and such, at churches, etc. can directly increase your number of clients. This is also a fast way to interact with a number of people at once. Still too terrifying? Read on. 
2. Get your acupuncture speech down to a fine scienceYou need a couple of these speeches. People in our culture commonly make small-talk by asking what you do for a living. When you say “acupuncturist” they are almost always interested on some level. You can get them interested with your 5-second speech, also called an elevator speech because you that’s about how long you have between floors if someone speaks to you on an elevator. If you don’t catch someone’s attention in the 3 seconds, they probably won’t hang around for the next however many minutes you can wax poetically and raptly about acupuncture. If, at the end of your 5-second speech, they ask questions and want to know more, move to your 30-second speech. If they’re still asking questions by now, you have them and can converse freely.

A couple of general points about talking to people about acupuncture. First, you have to be able to speak in plain common terms in whatever language you are speaking in rather than in “Acu-speak.” If you start talking Qi, meridians, and ‘you have a weak Kidney’ you will lose your audience before they ever have a chance to know how awesome you are. What we do is rather out of the norm for most people. Your job is to make acupuncture make sense to an ‘acupuncture virgin.’ Second, don’t make your speeches “Al Gore-like.” The dude is brilliant, but he’s wooden. His speeches feel like static recordings – he rattles them off flawlessly, but I always have the impression his mind is off fishing on some lovely pond while his mouth is talking about global warming. Let your passion for our medicine come out even in your 5-second speeches. Which brings me to the third point: don’t be a freaky zealot. Those make people uncomfortable. Not the best way to win patients.

Myth #4: I will never get wealthy doing acupuncture.

True, it doesn’t happen very often, but why is that? It’s not society’s fault, it’s not western medicine’s fault. It’s our fault. Not so long ago chiropractors were in the same boat in which we now find ourselves. When I was a kid my mom started going to a chiropractor and everyone we knew thought she was throwing her money away. No more. Ask almost anyone you meet (assuming you don’t live in some tiny town far from a chiropractor) if they have a chiropractor and I’ll bet you they do. Their profession is only a little over 100 years old in this country and they have far greater student debt than we incur yet they make so much more than we do pretty quickly after they get started “chiropracting.”  What are they doing that we aren’t? They have figured out how to market themselves and they teach it to their students. We don’t know how to do that yet. Chiropractors who graduate from school know that they are probably going to be solo practitioners and they plan accordingly.

If you plan to have a practice you will have just that – a job you go to day after day and stick needles in strategic places on patients. Don’t build a practice. Build a business. There’s a big difference. A business is something you can sell. A practice is something you do. The next jump after business is an enterprise. An enterprise is something that keeps working even when you don’t.

I live in Austin, Texas. There are a lot of midwives here. I know some people who are just that – midwives. They see clients, deliver babies, and may or may not struggle to pay their bills. They run practices. There are a few who have businesses – they deliver babies, see clients, they have built communities of women who join together to do yoga, take walks, and who come back to the midwife for their next baby.

And then there is Jean Stokes. Jean has built the Austin Area Birthing Centers (AABC). Jean has a small army of people (midwives, birthing assistants, clerical staff, HR personnel etc.) working for her and two really beautiful birthing centers where whole families come for their birthing experience. AABC also offers classes free of charge to mommas who have given birth there – yoga classes for parents with newborns, toddlers and parents by themselves, breastfeeding classes and a kind of a ‘giving birth 101’ class. Jean has built an enterprise. This enterprise sustains her and a large number of people whom she treats really well. She lives in a beautiful house, she drives a nice car, she takes awesome trips. She has broken the mold of a poor but happy midwife who brings babies into the world. Jean has created wealth where most people said it could not be done.

Have you noticed there aren’t very many acupuncture stories like this? That’s ridiculous! We have the potential to do this. We just haven’t figured out how to do this as a collective group yet. I believe this is why we have to create petitions to submit to the White House begging to be included in the conversation about national health care.

Do we need to westernize Chinese medicine to be accepted? No. We need to market ourselves properly and build enterprises. This is what will get us automatically included in the national conversation about health care. Once everyone in America “has an acupuncturist” the way they “have” a chiropractor or a doctor then we will be integral to that conversation.

The moral to this story: the end of your acupuncture education is only the beginning of your business education. Educate yourself. Try reading The E-Myth Physician. It’s a real eye-opener and I think you will find it incredibly motivating. Also, it’s cheap to buy: $8 if you get the Kindle edition, $11.50 if you want a physical copy. You aren’t born as an entrepreneur, but you can become one.

That’s enough blah blah blah out of me. I’ve got some income streams to check out!

Waiting here to welcome you to the other side of school,

Cat

Did it stick?

Today’s Green Juice

I have a lot of great ideas, but I’ll admit I’m pretty weak on the persistence scale. You may have been wondering, as was I, whether I would be able to maintain a healthy diet for any length of time. The answer, as it turns out, is yes. Most mornings my beloved and I build a green juice. I’ve been eating from the Engine 2 Diet plan and I feel mostly good about my food choices.

Last night I had a couple of tablespoons of organic peanut butter…which was delicious…and I put 1 1/2 spoons of raw sugar on my whole grain spelt cereal. But those are my only cheats and in the grand scheme of things, it doesn’t seem so bad. Also, my pants are looser now than they have been in a long while. Bonus. Most importantly, I feel great. My thought processes are clear and I feel more upbeat and hopeful overall. Feels good to be clean!

Today’s juice was 2 pears, about 2 sprigs of parsley, 2 big handfuls of spinach, a chunk of pineapple, 1/2 of a golden beet and lemon juice. Delicious!

Want to really serve your patients? Get yourself healthy, but do it at a rate of speed that you can handle. No rush. Just keep improving your physical, emotional, and spiritual life and you’ll inspire your patients to do likewise.

Reboot – The Upshot of All This

Let food be thy medicine. 

–Hippocrates

I could go on talking about my Juice/Reboot fast, which isn’t really a fast at all at this point, but that’s not exactly what you’re looking for in a Cats TCM Blog, is it? Admit it. You’re over this topic. That’s ok. I can understand that. I would, however, like to take a moment and tell you what I’ve learned from all of this.

The short version is this: if the world ate like this you and I would be treating a vastly different set of problems in our patients. In eight short days I have seen a world of difference in my own body. One of the biggest surprises is that my stress is much lower and my anxiety levels went from a 7/10 to a very manageable 2/10. My memory and concentration have improved greatly. I have far more energy too. Before I started this Reboot my energy levels hovered between 3-5/10. Now I feel more like a 7-8/10. Sleep is easier and more restful. I haven’t had an energy drop in the afternoons during this whole 8 day change. My cravings for carbs and fats have dropped to a 1/10, which I can manage pretty well. Digestion is pretty good, but still needs some work. And I’ve actually discovered that I don’t loathe a lot of vegetables I thought I couldn’t tolerate.  I actually even like a few, like fresh spinach, which has a nutty taste. Who knew?! (But not broccoli…that’s still disgusting.)

I know the conventional wisdom says it takes more than 8 days to change your life, but I’ve started down a path on which I want to continue. I’ll check in about this from time to time, but for now we’ll move on.

Engage in self-care, peeps!

Cat

Day 6 – System Juice Reboot

One of the best things about juicing and eating a whole plant based diet is getting to go to the farmer’s markets on the weekends. Wandered around, bought some beautiful stuff from some small organic farmers, and ran into some old friends. There’s something awesome about knowing where your food comes from.

You know, pretty soon I’ll just be eating healthy stuff, juicing a couple of times per day, and that will just be how it is. I just want to warn you that’s coming. 🙂

I feel good and I’ve lost weight. My clothes fit better, my joints don’t hurt, and I’m able to go up and down my stairs with ease. I feel great and want to keep going. This morning we juiced orange beets, beet greens, parsley, an apple and some grapes. The combination was delicious. Lunch was brussels sprout soup followed by a few red organic grapes to soothe the spots I burned on the roof of my mouth with the hot soup. 🙂

Reboot – Day 4/5

Day 4

I felt great today. Kind of light headed but not in that spaced out stoner kind of way (that I’ve read about and of course never experienced…). Sleeping has been problematic. I have so much energy it’s hard to get to sleep or stay asleep. It’s not an ampy energy or an anxious energy though so it’s not uncomfortable. Just kind of weird not to need much sleep.

Tonight to bolster my burgeoning desire for real health I watched Forks Over Knives. Definitely not what I expected. This is a great follow-up film for Fat, Sick and Nearly Dead, both of which are available on Netflix and/or Hulu. “Forks” explains how the body responds to a plant based diet versus a processed, animal based diet. I think I need to watch this daily.

Day 5

My body feels light and my head feels remarkably clear. I am definitely ready to eat, but I don’t want the usual crap. I want soups, baked veggie delights, raw nuts. Do I feel hunger? Yes, I do. But I find the sensations are really mild and I suspect I might be mis-interpreting these signals for hunger. I’m not sure.

This body should really have come with an owner’s manual. Better yet, I wish my ‘tribe’ had raised me to know what the hell all this was about. How did we get so sidetracked?

Today I saw signs of Spleen Not Being So Happy after 4.5 days of nothing but juice. I think it’s time to eat something cooked, so I made a brussels sprout soup when I got home. My stomach is very happy. While this is technically the end of the juice portion, I will keep eating a whole plant diet for the next five days. I originally planned to go back  to five days of juice after that, but may continue to juice 1ce or 2ce per day and also consume whole plants. I’ll let you know how that goes. What I know for sure is that I want to keep eating organic plants and whole grains. What I don’t have a place for is animal proteins, dairy, processed foods or oils.

Tonight’s cinematic inspiration: Engine 2 Kitchen Rescue. I’ve watched about 20 minutes and I already know I need to clean out my pantry. Anybody need some organic olive oil, grapeseed oil, or a bunch of pasta?

Reboot – Day 3

Two apples, a kiwi and a butternut squash walk into a bar. “Gimme a dash of cinnamon,” the squash says…

Actually, they didn’t walk into a bar. I shoved them through a centrifugal juicer. They were delicious. Later, my mid-morning “snack” was the first foray away from sweet juices. I juiced two tomatoes, a little too much kale, a carrot, three stalks of celery, and a dash of parsley. I added a few drops of my own Worchestershire type sauce, a pinch of salt and a little pepper. It was much like drinking vegetable soup. The pulp didn’t get filtered out enough for my preferences, so I strained the whole thing through cheesecloth and squeezed all of the juice out. Now that was delicious! But I seriously should have backed off on the greenery a little. A little too “fresh-mown-lawn”ish.

The urge to eat yesterday was pretty strong. I wanted my usual dosage of junk, but managed to resist. Today was better and I wasn’t hungry as often. I’m feeling more powerful about this whole adventure having made 3 whole days with nothing but plant matter in my system and no junk.

I did have a big old headache today which I finally had to take ibuprofen to get rid of. I’ll also tell the TCM geeks in da house that I have noticed a big old bunch of what looks like damp heat in my tongue and pulse.  My tongue coating went from thin white, dry and roughish to thicker, greasy, yellow and easy to scrape off. My pulse went from it’s usual deficient weak and thin to fuller, almost bounding. I’m not eating/drinking anything that is causing damp or heat, so what the heck? I’m eating raw, right? So shouldn’t that be generating cold in my system? It’s not. No signs of that. None. Is my system detoxing? I’ll let you know.

Reboot – Day 2

I will confess that I was hungry a lot yesterday: not a huge roaring stomach kind of hunger, but a low-level gnawing in the middle sort of sensation. I read more on the Reboot fast and found that I am not drinking enough juice. Recommended amounts are something between 4-8 eight ounce glasses of juice. So today I stepped it up a notch and feel less hungry.

Unfortunately, this does not quell the desire to eat. Driving down the street I found I had to avert my eyes from the myriads of food related signs that line South Lamar: Chipotle’s, Redd’s Porch, Phoenicia Deli, Sonic, Matt’s El Rancho, Gordough’s Public House, Kerbey Lane, Torchy’s Tacos, Phil’s, Amy’s, Papalote. I don’t even eat at most of these places, yet they are catching my eye today. But I’m holding fast (pardon the pun). The JuiceBox/Soup Peddler on South Lamar have been my saving grace. The Red Dawn juice (apple, pineapple, and beet) is pretty awesome. And I just don’t let myself think about all the junky food-like-items I want to leave in my past.

When my dad had knee replacement surgery he said it hurt really badly for a while. His mantra was, “I am doing this for a more mobile lifestyle.” I think I need a mantra.

I’m a little light-headed today, but I feel good other than that. Some of my customary aches and pains aren’t bugging me at all today and I find that my lungs feel clearer than normal. I don’t know if that’s just the Universe cutting me a break or if my body is detoxing. All I know for sure is I’m looking forward to a tomato, onion, celery, carrot, parsley juice later on with a dash of vegan worchestershire sauce. Salad in a glass. Mmmmmn!

Reboot – Day 1

I might be the least healthy person to ever make it through acupuncture school. Everyone has addictions and I’ve had several doozies in my lifetime, but the most deadly one happens to be food. I love junky, crappy, overprocessed, deep-fried, carbohydrate laden “food.” Burgers, fries, shakes, candy bars, chicken fried steak, and pizza have made my world go ’round since I was a small child. Not only that, I hate vegetables. Not just hate, but loathe and abhor them. I like fruit, but would prefer it wrapped in pastry, deep fried and sugar-glazed, thank you very much.

I know I should eat better, but actually doing so is nearly impossible when you have a food addiction, access to the amazingly yummy junk that surrounds me on a daily basis, and an aversion to plant matter. Unfortunately, this diet is killing me. I am overweight by a small person’s worth. My joints hurt all the time. My dad had a massive heart attack when he was not much older than I am now. I figure I’ve got five or ten good years before I’m dead or disabled. This is no way to run a body.

I was discussing this with my Lovely One a couple of weeks ago when she said something about juicing and then pulled an absolutely antique juicer off of a shelf in the pantry I had forgotten was there. She cleaned it up, plugged it in, and whipped up a carrot apple juice. Needless to say I was skeptical, but I closed my eyes, held my breath and took a sip. I was amazed. My taste buds sang and angels who had been waiting in nervous anticipation wept with relief. I’ve been hooked since then, juicing our ‘breakfast’ several times per week.

You know how the Universe seems to put things into our pathway right as we need them? Last night while I was clicking through Netflix looking for something funny to watch my finger slipped and suddenly I was looking at Fat, Sick, and Nearly Dead. It was transforming. If you haven’t seen it, it’s about a guy named Joe Cross who, at 309 lbs, was diagnosed with urticarial vasculitis, an autoimmune disorder which causes urticaria with itching, swelling, redness, and pain. He did a 60 day juice fast to get himself off of steroids, to drop his excess weight, and get healthy. He wasn’t looking just for weight loss, but to reboot his life. Plot spoiler: he makes it, stays healthy and in the process both directly and indirectly helps a ton of other people (pardon the pun) make it too.

This morning after watching this documentary my GF and I decided to give it a try. I’m going to try the 15 day reboot – 5 days of juice only, 5 days of veggies/fruits/nuts/legumes only, 5 days of juice only. I need to reprogram myself if I’m going to live to continue to serve my patients. Today is Day 1 of my reboot. This morning we made our usual carrot and apple juice. Later in the day we went to a farmer’s market in East Austin and got some wonderful organic veggies. The GF was pretty scared of the greenery type juices and so was I. With a lot of trepidation I watched a whole head of broccoli go through the antique juicer as did lactinato kale and spinach and more things I could barely believe was going to go into my system.

The finished product was very….green. Very very green. It tasted much better than broccoli smells when cooking. It’s not my favorite flavor on earth, but not nearly as bad as I feared. I drank this glass without gagging. That may not seem like much to you, but I have never met a vegetable that I didn’t gag over.

Tonight we defaulted to our usual carrot and apple juice, but added celery, another vegetable I can’t stand. It was really good. I find myself fantasizing about tomato, celery, green pepper, and carrot juice with a little smoke flavoring, salt and pepper. I don’t know what on earth is happening, but I like it.

Wish me luck. I’ll keep you posted.

 

Cat

Three Reasons Not to Fire a Non-Compliant Patient

Marlin Q. Patient calls you one day and makes an appointment to come see you.  Upon arrival you discover that Marlin has gout and his big toe feels like someone has smashed it with a hammer. Marlin is understandably cranky. Upon evaluation you come to the conclusion that Marlin has some serious damp heat in the Liver channel. You treat him with the appropriate points, avoiding that big toe because you rightly suspect he’d be far crankier if you stuck a needle anywhere near it.

After the treatment Marlin says he feels much better. He’s smiling. Good sign. You tell him there is a Chinese herbal formula that will help him, explaining that it isn’t a drug and is pretty safe and what to watch out for. More smiling. Then you suggest he lay off of the beer and brisket, explaining how the amino acids in these yummy foods contribute to the gout. Marlin has stopped smiling, but pays you for the herbs and the treatment.

As the months go on you notice that Marlin comes in with relative regularity for gout flare-ups, requesting acupuncture and herbs. His diet clearly hasn’t changed and as a matter of fact he tells you in one conversation that changing his diet isn’t an option. That monthly tailgate party is one of his joys in life and it stays. The question now is: What do you do a non-compliant or semi-non-compliant patient like Marlin? I’ve heard a lot of arguments for firing them lately, but I don’t think that’s the best plan.

Here are some good reasons for not dismissing or referring these types of patients.

1. We are all these types of patients.
   How many times have you not done something you know you should do for your own good? Yeah. Me too. And I a master at finding justifications for doing what I know I shouldn’t and not doing what I know I should. If you don’t know how to do this, just ask me!

   Solution: Each person is a sovereign entity to whom we bring healing energy. Allow your patients to make health care decisions and don’t take it personally. From time to time you might gently and diplomatically remind them that their health condition could improve with modifications to their lifestyle.I had one patient who had some serious substantial and insubstantial phlegm problems at one point. After treating her every single week for well over a year she was finally ready to hear me when I suggested changing her diet. Instead of telling her she had to abandon her nightly ice cream fix I suggested she substitute rice or almond milk ice cream. It worked. She did it. Over the next two years – two years! – she slowly replaced all of the dairy in her diet with other things. Her health improved markedly and her crippling insomnia went away, but it took her time to make the changes. I am glad we both persisted.

   Tip: It’s far easier to get someone to substitute than it is to get them to give up something. It’s also far easier to convince your patient to do a little than to do a lot. Examples: walk for 15 minutes a day, add 2 vegetables to their plate daily, buy the organic for at least some foods, drink fewer sodas, smoke less, etc.

2. Cash flow.
   It’s really easy when you are in school to talk about what you will and won’t do, what you will and won’t accept, etc. But when you get into practice and those student loan payments are breathing down your Du 14 and you have office rent to pay, firing anyone is a scary prospect. Now I know most of us aren’t in this for the money. After all, how many millionaire acupuncturists do you see hanging out whiling away the hours by  counting their money. There are probably a few, but the rest of us are working to pay the bills by performing a job that feeds our souls.

   Solution: There are some good reasons to fire a patient, regardless of cash flow, but I don’t believe non-compliance is one of those reasons.That said, I did have to fire a patient for a form of non-complaince…she was a belligerent patient who threatened to sue every single session. Once when I was out of the room she grabbed her chart (body full of needles, mind you), and began to sharpie out large sections of my notes with which she did not agree. That was the day I was done. I sent a formal e-mail telling her that I could no longer be her practitioner, offered to provide referrals and copies of her records if she wanted them, then wished her well.

   But she wasn’t a Marlin and that’s not exactly the same thing.

3. Compassion.
   Our job as I see it is to bring healing energy to our clients, as they are drawn to what we have to offer. Notice I didn’t say we are supposed to heal people. We bring healing energy. It’s up to the client and the Universe/God/Your Higher Source as to what to do with that. In many cases acupuncture is the last stop for desperate people. Bringing compassion into the treatment is critical for someone who has tried everything else and been disappointed by the results.

   Solution: Even if they are non-compliant, do what you can for them. Be kind, but honest with them, letting them know that you are band-aid fixing what they continue to damage. If they are OK with that, then let it go.I have a patient who has been coming for facial rejuvenation. She smokes like mad. I informed her we weren’t likely to make much headway since smoking cigarettes damages collagen and that’s what we were trying to stimulate by doing the facial acupuncture. She wanted to try it anyway. We did. After 5 weeks there was some progress, but not as much as there could have been. When she saw the before and after pictures she was encouraged and cut down from 2 packs a day to 5 cigarettes a day. She’s been holding at that level for some time now and is starting to see better results, not just in her face and neck, but in her overall health. It may not be perfect, but it’s an improvement. And some progress is still progress.

We’re not going for perfect: while perfect would be nice, none of us are ever going to make it! Empower your patients by showing them that their health can change. What we are going for is better. And better is good.

Are you a non-compliant patient? Come see me. No judgments, compassionate care. Pay in cash and you get a $5 discount!