Archive for tag: patients

Choosing Your Intern

You've made the first move. You've called to schedule an appointment in the AOM clinic. Just as you think you're almost done with this first critical step, the receptionist throws a massively important, yet completely unexpected, wrench in your plan. "Which intern are you looking to schedule with?"

Oh. My. God. What do you do? Which name do you say off the top of your head? As you feel the pressure mount in those two seconds of silence on the phone, your brain quickly scans the names, personalities, general skill levels, and specific competencies of every student you know at NUHS.

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It might not seem like a big decision to some, but for many patients, your intern will make or break the entire appointment. I've heard it all in the halls of the clinic, "He got a D on that Point Location Exam, so I don't want to schedule with him!" "She's the only one who follows up needling with tui na every week--I want her!" "I only (or, I don't) want my best friends seeing me with my pants down." If you're bringing sensitive people--the elderly or young children--then even appearance might matter. If I scheduled my kids with a super-tall bearded man, they might run outside and hide by the swans!

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If you haven't thought about which intern you will choose for your first or next acupuncture appointment, here is a handy guide to help weigh your options. No, I'm not going to provide a rating list of each intern in clinic this trimester, complete with names, pictures, and assorted blasphemies or accolades. Instead, I'm going to walk you through the options that may or may not be important to you in your decision-making process.

  1. Do you want your friends to see you naked?
    Most of us don't mind in a medical setting, but if you get stage fright in this arena, consider it a factor. If you can't relax, then your acupuncture treatment can't be fully effective.
  2. Do you want to build a long-lasting relationship with just one intern?
    Don't select someone who's graduating at the end of the trimester. Many of us are part-time, which means that we will be a regular presence in the clinic for a year or more.
  3. Are you only concerned about having the most informed, top-of-the-class intern right now?
    Then go ahead and choose that fabulous intern who has the most experience with add-on extras--if you can get into her packed schedule!
  4. Should your treatment philosophy match your provider's?
    I think so, and I consider this when scheduling an appointment myself. Do I get a good feeling from this person? Do they ooze positive energy? I come to the clinic to build my qi, not to have it stolen.

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Image source: www.visualphotos.com

Now for the great part--there isn't one intern who fits every criteria! This is wonderful news, because it means that a variety of options exist for each patient who walks through the door. Each patient is different, and each intern is different. If you've tried acupuncture once, but just didn't get that great feeling, then try again with someone else! If you were lucky and hit it out of the park with your first intern, then stick with that person, or ask him or her for a referral for another intern who treats in a similar style.

Good luck, and happy hunting!

Why Are We So Wimpy?

2014-06-10_wimpYes, I said "we." I'm lumping you all in with me and almost everyone else I know. We're wimpy. My sister said it best several years ago in a comment about the "wussification of America." No, I'm not sure how to spell that. She was speaking about the general wussiness of people these days, and I'll see that new word and raise it to another contextual use.

I'm sure you know what I'm talking about. If you have had a baby in the past 10 years, you've certainly had to explain to a grandmother (your kid's or otherwise) why baby has to ride in the car seat for every little trip. "Yes, grandma, I know we're just riding up the street to the corner store. Yes, she still needs to be strapped into her car seat. Just because." Grandma undoubtedly replies, "I never strapped your father into a car seat, and he lived. He would ride all the way to Florida to visit Aunt Ida every year and nothing ever happened to him." Then simply to justify my own wussiness, I make up something about how I'll be arrested if the police see me with my kid riding on my lap.

2014-06-10_signSome of you might not be convinced about the car seats. They're important. Even I strap my kids into those things just to ride up the street, and I don't consider myself a huge wussy. Just start extrapolating this theory, though, and you'll surely jump onto the "wussification of America" bandwagon. We all drink light beer. Every kid gets a trophy. They cancel school when it snows. I'm so hot walking the 10 feet from my air-conditioned car to my air-conditioned office. I have to wait 3 whole seconds for my Facebook page to load on this old phone. Waaaah.

How does this relate to Acupuncture and Oriental Medicine? Well, the wimps don't leave their wimpiness at the door of the clinic. That is for sure. I can write this post without fear of offending anyone, because I, myself, am a needle wuss. That's right. I don't want to feel the needles. I'll needle you, but don't you try to needle me.

Clearly I am not alone. Sure, you have a few patients who never flinch when you insert a needle. They never complain that something hurts or feels weird. These are the lovely "exception" patients, and they are few and far between. Most of us recoil in pain -- pain that is really just an unfulfilled apprehension of pain -- with the insertion of each needle. At first, I liked seeing this reaction from patients, because it justified my own wimpiness. Now, though, I've evolved. As I become less wimpy about needling myself and letting others needle me, I think I subconsciously expect more of my patients, too.

2014-06-10_smokeThe people in Nicaragua never flinched. We would jab those needles right into the sore back or the tired feet, and the patient would hardly notice. Are Nicaraguans simply a stronger people than Americans? Probably, but I didn't stop there. No, what about the Chinese needling? So deep, so hard, so scary for most Americans. Are they inherently stronger than us, too? They want to feel that moxa until it burns a blackened memorial into ST36. I would move to Japan, home of "shallow needling," to avoid those 6-inch needles I've been told so much about from the Chinese professors and clinicians.

2014-06-10_needleNo, I don't think it's that Nicaraguans are freakishly strong or that Chinese people are particularly masochistic. I just think Americans are caught in the throes of the recent trends towards wussification. Be careful, don't get hurt; don't let the sunshine get you! I reject wussification insofar as I legally can, but I am still and will always be one of the wimpy ones in the clinic when I'm on the receiving end of that needle business. So, if you're afraid of needles and therefore have not yet tried acupuncture, this post is for you. If I can do it, you can do it.

Doctors and Patients

What's the appropriate relationship for doctors to have with patients? How do you know when it's OK to accept a gift, meet for a coffee, or call a patient at home? What's the difference between being empathetic towards a patient's horrific home life and being taken advantage of by a patient who thinks you are her new best friend? 

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In a recent "Doctor and Patient Relationship" class with the talented Dr. Dennis Delfosse, we explored the all-too-common gap between what patients might be experiencing in life compared to what we assume their lives are like. The point of the discussion was that everyone is dealing with something. Maybe you've heard the saying "Everyone is fighting a battle that you know nothing about," and its usual ending, "...so be kind." But are you?

Do you, interns of acupuncture and oriental medicine, treat your patients as important individuals, worthy of your time and energy? Have you ever groaned when you discovered that you suddenly have an "add-on" patient halfway through your shift? Do you dread treating that "difficult" patient who keeps scheduling with you, stealing your qi? Are you counting the minutes until your shift in clinic is over for the day?

Much like the general population of American doctors (of whom only 54% would choose medicine as their career if they could do it all over), practitioners of acupuncture and oriental medicine might find themselves unfulfilled, unchallenged, or unhappy at work from time to time. How can we refocus, reframe, and recharge ourselves and our passion for helping patients find balance and wellness? We must revisit our goals from time to time, remembering why we chose our respective field in the first place, realizing that our next step might be in a slightly different direction than we originally planned. It's OK to change treatment strategies, to move towards a different specialization, or to study under a different clinician this trimester.

2014-01-23_wheelOne way to change your personal energy dial-back to "Positive" is to remember that the patients, their oftentimes unfortunate circumstances and their health needs, are the reasons that we're here. They aren't in the way, they aren't the reason we can't finish our paperwork, and they aren't the problem. Helping them is the whole picture. The key is figuring out how to strike the perfect--or at least, a workable--balance with each individual patient to optimize their satisfaction and yours.

Do you want to make your patients happy? Start by being happy yourself!

  

References:

Physician Frustration Grows, Income Falls - But a Ray of Hope. Medscape. Apr 24, 2012. Retrieved 1/18/14 at http://www.medscape.com/viewarticle/761870