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Allied Health Professional (AHP)
March 14, 2013
10:19 am
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Simon Cairns
South Carolina
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This is my first post here, so hello everyone!
I would like to know if there are those here who have experience working within a western medical facility as a "Allied Health Professional" and if so what advice about the pitfalls,hurdles, and lessons learned would you pass on to those who were considering going this route.

Thank You,
Simon

March 14, 2013
10:44 am
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Anna Kelly
Atlanta GA
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Hi Simon, and welcome!

We have experience practicing with many WM doctors and hospitals in various settings (lectures, grand rounds, consults, outpatient referrals etc) and we have had several discussions about that here, so you may search the archives/previous posts. Also we have a practice with 2 MDs and 2 LAcs, so we examine often the integration of the 2 paradigms in the clinical setting.

Here are some bullet points I have learned over the years:

-Be humble and listen well.
-Discuss acupuncture simply and avoid terms that are foreign to WM practitioners. When we do hospital consults, we avoid using TCM terms/names of meridians etc without also using a simple translation. Recently I have been avoiding CM terms completely, but each situation is different. Spend some time discerning what the needs of the facility are.
-The hospital and most established clinics are well-oiled machines. Don't challenge existing structures until you are well-known to your colleagues there. Defer to nurses and doctors most of the time. Don't be defensive about what we are doing.
-Be willing to give excellent lectures on what we do. Be well prepared (we have a series of power points we give with a nice combination of the science and art of acupuncture)
_Be knowledgeable about scholarly articles/science on acupuncture.

_Write thank you notes when anyone refers you patients. If it's an MD, I type them; if the referral is from a patient or friend, I hand write them. This is common sense to me, but I am surprised that people younger than me don't know about thank-you notes, so I thought I would mention it.

There is more about high-end customer service (such as return all phone calls promptly) but I need to see someone now, which reminds to mention....always be on time or early!

March 14, 2013
11:23 am
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Lonny Jarrett

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Hi Simon, Welcome to the site......Lonny

LonnyJarrett.com

Spiritpathpress.com

Loveandrevolution.com

Shenmingseminars.blogspot.com

March 14, 2013
9:42 pm
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Simon Cairns
South Carolina
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Thanks Lonny, Good to be here!

March 14, 2013
10:53 pm
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Amy Jo Gengler
Boston, MA
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Hi Simon,

It's great to see you here! I met you briefly at a SCOMA meeting in Greenville a few years ago.

I would definitely recommend following Anna's advice. She has taught me a lot about interacting w/ WM practitioners, and has humbled me, too :) . I think it's common for CM practitioners to feel unsure about how our medicine fits in, when trying to integrate w/ the WM system, but it's good to remember that we are all learning (WM practitioners, too!). The real truth is that integrated medicine is the future. There are some days that I think CM is all anyone would ever need and I question the usefulness of other approaches, but when I encounter people who are very sick, I realize how short-sighted that assumption is.

Are there particular concerns, doubts or fears you have, or just the general unknown? I'm willing to bet that you will have to create some of the edges as you go along, and in this case the 'be humble, but also be honest & forthright about what you know about CM' balance will be required. We often speak here of 'working at your edge', and in this type of integrated medicine setting you will have to work within the system they have already set-up, but you are also bringing something inherently valuable, though perhaps mysterious, to them, so the more you can articulate clearly some of the changes you see in your patients, perhaps the more they will also see and start to observe more deeply.

March 14, 2013
11:08 pm
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Simon Cairns
South Carolina
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Thank You Anna for your response and welcome, very helpful. I will look back through the archives and find the related material that you mentioned.

All your points are well taken. For starters, it is good to be reminded that the right attitude is paramount in all dealings.

This will be the first time acupuncture is to be used here. All the details of the job description are yet to be ironed out right down to the available days, billing options, kinds of needles used and so on. As I believe is typical of AHP contracts the term is for two years at a time.

Doctors, nurses and admin will have to be "won over" and I will have to provide talks and lectures (if I have to!) to spread the word.

It took quite a long time to get to this point and finding a sponsor within the hospital system was painfully slow. (for the most part it seemed like nothing would ever happen) Now with the application having passed the rigors of the credentialing department, things have begun to move swiftly.

So I am doing my homework, trying to get up to speed and learn as much of the ropes before hand, that I can.

Thanks Again,
Simon

March 15, 2013
6:21 am
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Anna Kelly
Atlanta GA
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Don't sign a no-compete clause and don't use moxa in the hospital, or try to sell herbs there.

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Simon Cairns
March 15, 2013
2:40 pm
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Kelly Hora
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Simon - I have contracted as an acupuncturist providing treatments for cancer patients in the outpatient clinic for three years, the program has been in place for 7.

If you can cultivate some enthusiasm for "winning over" the providers, administrators, schedulers, wig makers, cafeteria cooks, candy stripers and anyone else you will get to interact with, then your job will be all the more fun and effective. We've recently experienced a dip in volume which prompted several early morning staff meeting visits by me, reminding people the who, what, when, where, and why for acupuncture services. What a great chance to make a personal connection, answer questions, and solicit real partnership in the whole process of helping patients find acupuncture. As with anything, this process of building relationships is paramount. We all want the best for our patients.

The hospital has its own unique culture, notably for me, one in which patients EXPECT care to be covered. Well, since acupuncture is NOT covered, then it has been great to go to these staff meetings and be very explicit that it is OK to tell patients that its an out of pocket expense. Its not a "dirty word" and that I need their help in connecting with patients so that they can find me, acupuncture and get some needed relief and support.

Anna's response was great - I am WAY behind on thank you notes and will get right to it.

March 18, 2013
5:33 pm
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Simon Cairns
South Carolina
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Hi Amy Jo,

I certainly remember meeting you, nice to re-connect with you here. I believe you had a great big dog with you (is my memory serving me right?) I also remember speaking to you about some "Lonny Jarrett" character, who seemed to me, to be too big for his boots and you setting me straight on that. (How right you were!) A couple of weeks ago I gave your number to someone looking for an acupuncturist in Charleston, SC. I got a note back the following day saying that you had moved to Boston. Hope all is well there with you.

Thanks for your thoughtful reply..."integrated medicine is the medicine of the future" that's true, although I never thought of it that way before.

"working at the edges" I am not familiar with this notion!

There are some fears or uncertainty around this for sure..perhaps under the heading "General Unknown" also some excitement mixed in there too. Good question....have to think about that!

Thanks,

March 18, 2013
5:36 pm
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Simon Cairns
South Carolina
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Kelly Hora said

Simon - I have contracted as an acupuncturist providing treatments for cancer patients in the outpatient clinic for three years, the program has been in place for 7.

If you can cultivate some enthusiasm for "winning over" the providers, administrators, schedulers, wig makers, cafeteria cooks, candy stripers and anyone else you will get to interact with, then your job will be all the more fun and effective. We've recently experienced a dip in volume which prompted several early morning staff meeting visits by me, reminding people the who, what, when, where, and why for acupuncture services. What a great chance to make a personal connection, answer questions, and solicit real partnership in the whole process of helping patients find acupuncture. As with anything, this process of building relationships is paramount. We all want the best for our patients.

The hospital has its own unique culture, notably for me, one in which patients EXPECT care to be covered. Well, since acupuncture is NOT covered, then it has been great to go to these staff meetings and be very explicit that it is OK to tell patients that its an out of pocket expense. Its not a "dirty word" and that I need their help in connecting with patients so that they can find me, acupuncture and get some needed relief and support.

Anna's response was great - I am WAY behind on thank you notes and will get right to it.

March 18, 2013
6:15 pm
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Simon Cairns
South Carolina
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Hi Kelly,

Somehow I just saved your message above..just getting the swing of how things work.

Any way, Thank You! The underlying feeling I get from your post is that an assertive, pro-active and uber-friendly approach is the way to go. Totally agree.
Are you the only acupuncturist there? Do you treat in-patients and staff for free and do you use computerised custom designed patient records that every one can understand?
How many days a week are you contracted out for? Do they pay you an agreed salary or per patient? Do you have your own treatment room/area within the hospital?
You sound very happy in your role there!

March 19, 2013
2:26 pm
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Kelly Hora
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Hi Simon,

Yes, its been about 3 years that I've been there. I am contracted through a integrative medicine program here and work only in outpatient, though if I find out that one of my clients is an in-patient I often go up to see them and treat. Our program is in the process of setting in-patient services that would offer a "salary" to the person who was otherwise on call and not getting to see many people.

I am one of two acupuncturists in our out-patient clinic. The other person has been on for 7 years and I was added due to demand. Though demand has waned a bit for a few reasons which has prompted all of the outreach I described in the previous post. I am charting in the Epic computer system which allows me access to the entire chart and enables other physicians to see my notes for acupuncture (which is great!). I can also contact physicians directly for follow-up, etc. I see up to 5 patients/week (half day once a week) and there is a contracted rate per visit that I get. Its quite a bit less than what I receive in private practice, though I am learning so much, seeing patients I wouldn't otherwise see and the treatments help so tremendously during chemo/radiation that it balances out for me. We use a designated space that is a procedure room the other days so it pretty much looks and feels like a hospital room, though we did put in a dimmer lamp and some nice room dividing curtains for the times when we have two people in a the same time. Sometimes I go to the chemo bay where a person is have their chemo treatment and do acupuncture at the same time, but that's not too often.

March 21, 2013
10:24 am
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Simon Cairns
South Carolina
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Hi Kelly,
I will also be in a cancer division of the hospital and starting out will work one day a week. I have a room to work from that is used for massage the other days. My "gateway" to all this is through their integrative "Body Mind" set up which is seperate to the main goings on there, so patient records etc will be seperate for the time being. (change happens very slowly I am told!)
My pay will be either per patient or by the hour...I suppose there are merits to both.
The real benefit I take from this are the new experience's, meeting different people and the learning opportunities that are ahead. I also love any chance to work outside of my clinic, as much as I enjoy it here....my underlying ADD tendencies push me to seek out "there" wherever that is!!
I am due to start in roughly one month.

March 21, 2013
10:35 am
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Kelly Hora
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Sounds great, Simon! And I'm happy to be in touch. Email me directly anytime...

March 21, 2013
11:41 am
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Carlos Chan cordeiro
China Pharmaceutical University, Nanjing, China
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Hi Simon,

I have been doing internship and preparing herbal research at a cancer department of the Jiangsu Province Integrated Chinese and Western medicine hospital in China. We got 50 beds, very busy, and most patients almost always come in advanced (or terminal) stage.

Although most prescription in the inpatient ward is WM (they need to follow international guidelines), 70% of doctors have CM/WM background and even nurses have learned (some degree of) CM in school, enough to do indirect moxa or put ear seeds. I'd say there is the best - and the worst - of both worlds. But definitely much more pluralism and an open mind than one sees in a WM hospital. I have been very well treated and, although not always smooth, I am really loving it.

Computerized medical records include CM diagnosis (no detailed description) and detailed CM therapies, when needed. When we do the rounds, it's not uncommon to discuss pulses (too basic..), tongue and patterns. And we always keep in mind alternatives to conventional medication. There are about 20-30 standardized CM formulas for specific cancers or cancer related symptoms, plus individual raw herb prescription whenever needed. In the outpatient ward, they prescribe mostly raw herbs or individual granules formulas and a doctor may get to see 40 patients in a day. When needed, acupuncture is requested to an acupuncturist from another dept. I have had a few chances to give acupuncture to patients and some results are interesting and worth exploring.

If you are interested in research, your position could be a nice break, and a good opportunity to do a great integration work.

Best

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Simon Cairns
March 31, 2013
10:22 am
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Simon Cairns
South Carolina
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Hi Carlos,

Great to hear from you. I spent 3 wonderful months there in Nanjing in 1997. I remember getting around on my big black bicycle, many times carrying the bike due to a faulty chain. We couldn't imagine then that the average citizen would get a car because with so many people there could never be enough road space, we were wrong on that!!

You are very fortunate to work in such an integrative setting and gain hands on experience.

When I am up and going perhaps we can compare notes.

Thanks,

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