July 2018

July 2018

    The Office: How To Optimize Initial Consultations

  • Do events and make an impression on the people when they get their free pulse diagnosis (or free acupuncture/ acupressure) and then make them pay (a discounted rate) in advance for the initial consultation, so skin is in the game!
  • Get them laughing to loosen them up and connect with them- Chinese medicine is perceived as a very exotic medicine in most Western places, so people are not very trusting towards it.
  • Patients have filled out paper-work, but I don’t look at it and then I read their pulse first – most patients love this because it is somewhat like “fortune telling”.
  • I tell them that even though I might find certain things in their pulse, we are really only concerned about what might kill them – eg heart problems.
  • When you find eg a blocked pulse in the left cun, you then tell them “You seem to have a little bit of a blood flow problem though your heart. Are you tired? Do you have trouble sleeping?” and if they say “Yes!”, now you gained their trust. If they don’t have any internal symptoms or they don’t admit them, then they are usually in your office because their main complaint is a pain problem – then you look for pulses that would show you where their pain is.
  • If it is a pain problem, do not sell them a plan right then – see episode The Office: How To Greatly Optimize Your Clinic – but schedule them for 3 visits.
  • The 3 visits are to see how they respond to acupuncture. Make them a special offer. We do it the following way:
    • 1st visit is a medical history visit – $150; and acupuncture – $125; the medical history is waived by the money they paid for the initial consultation fee and the acupuncture is discounted to $65
    • 2nd visit is acupuncture only – normally $125, discounted to $65
    • 3nd visit is acupuncture only – normally $125, discounted to $65
    • These 3 visits then total to $195 instead of $525 but they must all be done within a week, because this method works on momentum.
    • So you took an initial consult and you turned them into Day 1, Day 2 and Day 3. Then on Day 3 you present a plan to them after the patient and you see if/ how well the acupuncture works.
  • If they say “Yes, yes, yes!” to what you found in your pulse diagnosis and their main complaints are internal systemic problems (and especially if they come from a distance) then you can present a five month plan to them immediately at the initial consultation.
    • Tell them: “It will take 5 months to take care of these problems. You will feel better immediately, but if I pull the herbs back, the symptoms will all come roaring back. Basically we have to make your problems go away or almost go away and then treat them for another 2-3 months to nuke it, so they won’t come back when the herbs are pulled back.”
    • Herbal plans are $2800 if they pay as they go and only $2200 if they pay in advance – they save $600, so most patients will pay in advance. All plans are refundable, so a patient can cancel anytime and they will get a refund on everything that they have not spent yet.
    • We always make a big deal out of the fact that they have to feel more than 50% better in 3 months to justify continuing treatment, otherwise we fire ourselves, because less than 50% is placebo and is considered a failure.
    • We tell them our failure rate with xyz problem (eg 10%).
    • We also give options to pay the treatment plan monthly over 6 months (at o% interest) or over 12 months (at 8% interest). With both options patients will loose the $600 (20%) discount, so it is usually cheaper for them to pay the plan in advance and put it on a credit card and then pay the credit card off over time.
    • After you explained the payment options simply ask them what they would like to do.
    • Then most patients immediately commit to the care, pay at the front-desk and we start right there and then with their treatment – MPD, herbs, weight loss plan & schedule acupuncture visits (if included in their plan).

 
 
 

    The Office: The New & Improved DNA™ Case Study: Upper Back Pain

  • Case Study patient presents with pain in the left upper back that radiates up the left neck and into the shoulder (posterior lateral).
  • Bob first needles joint zone (prioceptive focus) : He needles into sore area at SI Joint Zone 2 bilaterally first – posterior lateral treats posterior lateral (PL). Pain reduced greatly.
  • Choose a combination of a Yang and Yin vessel instead of only Yang or Yin vessels.
  • Remember that there are 1/8, 1/4, 1/2 images, not just full images.
  • Bob then moves to Musculo‐Fascial Sites (nociceptive focus): he applies simple acupressure to the contralateral HT MF Zone 3 on the sore spot and needles into the contralateral HT MF Zone 2.
  • You can place multiple needles into the joint zones (to ’nuke’ it).
  • A mid-sagittal headache is MM, therefore can be treated via the LV/SP (MM on the lower limbs) or the PC (MM on the upper limbs).
  • The New & Improved DNA™ Concept review:
    • AM treats AM
    • AL treats AL
    • AM treats AL and vice-versa
    • PM treats PM
    • PL treats PL
    • PM treats PL and vice-versa
    • AM treats PL and vice-versa
    • AL treats PM and vice-versa
    • MM treats MM
    • LL treats LL
    • MM treats LL and vice-versa
    • all regardless of upper or lower limbs!
  • These relationships are based on functional anatomy and open up a wider range of treatment options than acupuncture based on Yi Jing relations!
  • The New & Improved DNA™ notes also include referred pain treatment sites.
  • Keep the needles in for 30-45 min.

 
 
 

    The Office: How to hire staff for a TCM clinic

    Notes:

  • I mostly look for the vitality and energy of the person I am hiring, regardless of position. Have them run a full clinic day with you and watch their energy levels.
  • Secondly, watch how patients respond to them. They don’t have to be beautiful, but they should be trustworthy, happy, honest and likable.
  • You have to be careful with acupuncturists, some of them come with health related baggage and have low batteries.
  • Thirdly, remember that when it comes to hiring people past performance indicated future performance! Hire people who have been successful and hard-working in their previous job position(s).
  • I have a color category system for hiring people:
    • Blues: mostly suited for tour back-office (accountant); there you need a rule-follower – book keeper types.
    • Yellows: mostly suited your front-desk (and acupuncturists); there you need the up-beat, friendly, kind type – sales types.
    • Greens: The green people are highly emphatic. They like to figure out what the people want and give it to them (acupuncturists/ medical staff) – empathetic type.
    • Red(s): They can be charge. Don’t have too many reds, otherwise they will be fighting with each other – leader types.

 
 
 

    The Office: Management Series – How To Handle Difficult Patients

  • Generally what I do is to quickly figure out whether we did something wrong or if the patient is just being outrageous. In other words, are we wrong or is the patient wrong? Which side did the mistake?
  • You need to always let patient voice out their complaint and you need to sit down and listen to it.
  • Then, if the mistake was on our side, I will then 100% admit that we did a mistake, that we screwed up and that we are sorry. I completely take the blame. That will solve 90% of all bad scenarios and completely calms down the patient.
  • I will then name the measurements that will be undertaken to not do this mistake again in the future (e.g. better scheduling or not having that patient be treated by a certain practitioner).
  • I will then leave the decision to them if they want to continue treatment or not, so it’s 100% their decision.
  • If they are still angry after you fully apologized, you need to get this patient out of your clinic by suggesting an alternative place to them and refund the money they have not spent yet.
  • Usually the difficult patients are the ones that are not getting better, which is what is fueling their unhappiness with the clinic.
  • I tell them: “Usually this medicine works extremely well and when it works it’s obvious, it’s not a guessing game. And when it does not work, it looks like your chart – The person is 10-20% better and then they are chopping sideways for a while. It’s possible that if we continue your care we cannot achieve the goals that we set out. So I think it’s best to stop your plan and refund what you have not spent. And then I will try to find a practitioner that will do better than us in trying to fix your particular situation.”
  • Now, 90% of the time these kind of difficult patients want to stay and take the opposite position to yours (which was to let them go and refund).
  • The more people you help, the more you grow in stature as a human being, which is essentially the reason for us being here.

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