Why We Give Treatments and Not Advice

 

A regular at the clinic and I had an excellent conversation a few weeks back.  
What initially began as Lisa asking how we were doing finding a replacement for our friend/colleague Tracy who recently moved to Vermont to open a clinic, turned into an exchange of ideas that left us both feeling relief from what the other had to share.  I'm inclined to recount our conversation in order to make clear to our patients how we work in a particular sense, and why.
 
-----
 
Finding an acupuncturist who is a good fit for Community Acupuncture clinics can be a tricky task.  What we find most valuable in our clinical staff - and perhaps more to the point, what we don't find valuable - are traits many of our colleagues are unprepared for.  
 
"What are you looking for in a hire?", Lisa inquired.  I began to list a few characteristics: a clear communicator, an honest and hard worker, someone who can quietly command a room full of sleeping people...
 
Lisa nodded.  
 
...a Populist, a lover of people first and Chinese medicine second.  
 
Now she looked confused.  
 
I began to explain how acupuncturists are taught lots of different therapies aside from acupuncture itself while in school.  As a result, graduates are often compelled to offer not only needle work, but also various lifestyle and dietary advice.  And for many acupuncturists this is well and good.  But I'd maintain this advice is not always welcome or constructive for patients.  
 
Two thoughts come to mind about giving lifestyle advice:
 
1.  Patients often already know what we've been trained to advise, namely the benefits of:  getting more exercise or more sleep, eating less low-quality food or not so late at night, etc. 
 
and
2. Many patients already work with a nutritionist or naturopath or weight-loss group and so already have plenty of information at hand.  
 
Community Acupuncturists consciously try to avoid adding to the information overload many are already reckoning with these days. Instead we simply offer people the time and space to decompress and sort things out through a steady stream of acupuncture treatments.   More often than not this is plenty to help initiate a positive response, allowing people to see patterns and situations more clearly for themselves.  
Lisa smiled and nodded.  
 
"If I did have questions and wanted your opinion, would you be willing to share it?" she asked.  
 
The answer is, of course, but we wouldn't just assume you didn't already know.
 
I asked her how she would have reacted during her first visits to the clinic when she showed up constipated and tired, if we had taken the liberty of suggesting she stop eating so much of her favorite cheese and drank more water.  "I would have thought to myself 'I already know I should do that'.  The reality of it is, I know I was eating too much cheese and not drinking enough.  It's a pattern I get into when I'm all stressed out.  The problem is when I get into that practice, it becomes a downward spiral - more stress, more poor eating and dehydration,  constipation and fatigue - and more lousy choices to follow.  Something else had to give before I could get my act together."
 
Knowing she was able to break this pattern a few months back, I asked what she attributed it to.  "An attitude adjustment thanks to a string of acupuncture treatments", she answered quickly then went on, "the treatments help me deal better with stress.  I'm able to let it all roll off my back.  When this happens, I make better decisons all-around on my own, including around eating. I have the resolve to carry through the things I should do, and avoid more of the things I shouldn't.  I can do this because I don't have that monkey on my back."  
 
I was nodding now.  
 
This is a great example of why we tend to give treatments (and enough of them) and not lifestyle advice, I explained.
 
It's also one of the most important traits of an effective Community Acupuncturist as they recognize what you just explained, to be true.  They know that acupuncture itself has a knack to help people make healthier choices.  
 
"So, did you find someone yet?"
 
Yes we did as a matter of fact...

 

This story was posted on September 23 2010 by andy wegman.

Comments

  • September 23 2010 at 1:40 PM
    baba roseananda writes:

    I’ll give ya some advise !!!

    #1 - it is amazing how acupucnturist think we know so damn much.

    #2 - it  amazing how little people listen.

    #3 - good blog 

    #4 - there is no number 4

      0 likes
  • September 23 2010 at 2:08 PM
    donnajoon writes:

    Brilliantly stated.  Thanks.

    Brilliantly stated.  Thanks.

      0 likes
  • September 23 2010 at 3:36 PM
    mitylene writes:

    Yes!

    And I tell you it’s such a relief to not have to give advice!

    It turns a visit from a blame game or a guilt trip to a space where you can come and just be. 

    Because we all know what we need to do, we just don’t have the energy or the space to do it!

    Jade Community Acupuncture, Winona, MN

    acupuncturewinona.com

      0 likes
  • September 23 2010 at 6:22 PM
    MichelleRivers writes:

    Nicely explained

    Thanks, Andy, for so clearly explaining that key piece of CA culture. I’d like to share that, on our intake form, we have a question that reads “Is there anything you’d like to discuss regarding lifestyle, exercise, or diet?” We do the same with libido “Is there anything you’d like to address?” What I hope this lets people know is - “We’re not going to give unsolicited advice or ask unwelcome questions about any of these things. We are here to listen and discuss if you want us to.”

     

    Michelle Faucher

    Chico Community Acupuncture

    http://www.ChicoCommunityAcupuncture.com

    530-564-1646

      1 likes
  • September 23 2010 at 6:27 PM
    andy wegman writes:

    Right back atcha, Michelle

    Well done.  I predict a change to our H & H forms shortly.

      0 likes
  • September 23 2010 at 6:57 PM
    SteveKnobler writes:

    Less is more!

    Nicely said Andy. Thanks for sharing your wisdom.

    Steve K

      0 likes
  • September 23 2010 at 9:49 PM
    Guest writes:

    Why we…

    Nice job, Boss.  Glad to see this posted here.  For the past year and a bit you have beaten it into my head to check my advice-giving at the door, and it has really made a difference in the relationships I have with patients.  I am no longer the big head honcho Doc.  I’m just part of the team.  It’s nice to let go of that part of my training.
    -Woolfie

      0 likes
  • September 23 2010 at 10:33 PM
    Justine writes:

    Well said!

    Another brilliantly written blog post.

    It brings to mind the conversations we had at the last community acupuncture training up at MAS.  I’m glad I learned from you and CAN not to give unsolicited advice to my patients - it really works!

      0 likes
  • September 28 2010 at 11:32 PM
    Nic writes:

    Nice!  One of my teachers

    Nice!  One of my teachers in school actually said that acupuncture is nothing without the coaching.  This has been a monkey on my back for a little while now.  I was knew it was not true from my own experience and yet this person I respect was telling me somthing else. 

    Maybe it is necessary in a BA model when a person is getting infrequent treatments but not with CA!  A patient can decompress and sort it out with their own inner wisdom.  

      0 likes
  • October 8 2010 at 4:17 PM
    Roppy writes:

    I agree on the nice job,

    I agree on the nice job, boss.  It brought tears to my eyes.   I am happy to be @ MAS.

     

    Elizabeth 

      0 likes
  • October 8 2010 at 8:00 PM
    andy wegman writes:

    On cue

    ...just received the following email this week.  A heavy-handed example perhaps, but one that’s germane to the topic of this post,  that is the transformative nature of acupuncture itself.

    —-

    I just returned from my fourth acupuncture session (over two weeks) and wanted to let you know that this acupuncture in this particular setting has been life-altering.  I know that sounds dramatic but I do not think it is an overstatement.

    After my first session, I walked out to my car and began to sob.  I cried for a few minutes and my tears were for both sadness—the recent loss of my father as well as my father-in-law and a hectic summer caring for lots of kids, my husband’s father, and many house guests.  But, I could also see the possibilities of beginning again – my kids were back in school and the possibility of life returning to normalcy was upon me.  This would be a year of healing and even after the first session I knew that acupuncture would play a important role.

    During my second session, I had a wonderful vision during the not quite asleep, not quite awake state I was experiencing and it was of me as a chrysalis – the possibilities of what were to come were real and the prospect of a becoming something beautiful and free like a butterfly gave me great hope.

    After my third session, I woke and when I began to see and hear and smell, I felt like I did when I was a child.  The colors were more vibrant than usual, the sounds were more nuanced than usual, and I really tasted the food that I had for lunch that day.  It was as if I was in a state of not-knowing, a state of discovering things without the filter of already knowing what it was suppose to be like…....

    Today during treatment, I realized something.  I have had acupuncture before.  I have had it alone and now I’ve had it in a community setting.  But, I’ve never had it in a quiet, safe, and profoundly healing space.  There is something that you have created that goes beyond the work of the needles.  Of course, the needles are wonderful and your practitioners are wonderful but in addition, the experience of “sleeping with strangers” (I have to admit I smiled when I first saw that) all who are there to heal is profoundly healing in and of itself.  I know that the benefit of a community setting is that it makes acupuncture accessible to many who normally would not be able to afford it.  What I didn’t realize is that gathering with other individuals in a quiet, warm, not-too-bright space all who are on their own healing journey facilitates the healing of the community created in that room at that moment.  This is now my preferred way for acupuncture and I never would have known it had I not been to the CA clinic.

    Thanks to you and to Mary and to all the people in the room each time I come in.  I am truly grateful.

    In peace—

    .......

      1 likes
    • kimzqi
  • October 9 2010 at 7:38 AM
    Nora writes:

    wow

    Just beautiful. 

      0 likes
  • October 9 2010 at 6:10 PM
    David Lesseps writes:

    I second that wow

    Very happy to read this.  Great.

    David
    The Hammer from SF

      0 likes
  • November 12 2012 at 5:14 PM
    narntson writes:

    Thanks for this post.  It is wonderful to be reminded of why we choose this model and of it’s potential.

      0 likes

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