People in the Bay Area are busy. We don’t have time to spare for approaches that don’t produce real results. It’s great to lie down for a thirty minute Acupuncture treatment and relax to soothing nature sounds. But who has time for a nap if a little stress relief is all you get?
I’ve met so many new patients who have had Acupuncture in the past. When I ask if it worked, they reply, “I’m not sure.” Many of them aren’t even exactly sure what they were being treated for or what the desired outcome of the treatment was. This confusion comes about because people often equate “natural” or “holistic” with some kind of subtle, below the surface change that is not obvious. I myself have gone to the health food store and bought a homeopathic remedy (before becoming an Acupuncturist), say for muscle soreness, and not really been able to tell if it had an effect. This doesn’t necessarily mean homeopathy doesn’t work—I honestly don’t know if it does or not—but it reinforces the idea that drugs, whether I approve of them or not, produce obvious results and natural approaches do not.
This assumption is flatly false. Chinese medicine (this includes Acupuncture and herbs) administered after a proper evaluation and diagnosis should show concrete results within the first month—at the longest. Many patients experience a positive change—for example an obvious reduction in pain—during or after the very first treatment. More complex problems, however, may require a series of treatments to start to see a positive effect. That brings up the question, how do you know you are getting a positive effect?
In most Acupuncture offices, the patient report is the only measure of progress. And that patient report may be as vague as the answer to, “How are you doing today?” As people tend to have various factors which would influence the answer to such a question, this is not a very accurate way to gauge success. For example, if your car got towed this morning, the answer would likely be fairly negative. What we do at Wood Tiger Acupuncture is create a set of data at the initial exam that we then measure success against at the follow-up exams. Of course, this approach would require actually doing exams.
So what is this data? It’s simply a combination of percentage improvement on chief complaints and number of tests that were originally positive and are now negative. Let’s look at what that means.
Chief complaints are the issues that you come in hoping to resolve. For example, if someone has low back pain and migraine headaches, and these are the two problems they most want to get rid of, these would be their chief complaints and the main focus of the treatment. Someone else may come in for digestive problems, insomnia and arthritis pain. The chief complaints vary with every patient. The improvement in chief complaints is measured either by comparing a survey of the current frequency and intensity of the problem or by patient report—that is, the patient says, “My back pain is 60% better than when I started.”
The tests done at the initial exam follow the chief complaints. Range of motion exams will be performed on any joint that hurts or that may be involved in causing a nearby area to hurt. This is similar to the exam you would expect to receive from an MD. The pulse and tongue will be examined on every single patient; these are Chinese Medicine’s secret weapons. They allow us to see what’s happening inside the body. At our office, we also perform palpation exams. This means that we press on a lot of Acupuncture points to see which are tender. The resulting pattern can help inform treatment. Blood pressure, weight, and other measurements are commonly taken as well.
Periodically, all tests are re-measured and compared to the initial result. This is called a re-examination. The results of this re-examination tell whether or not you are improving at the expected rate. The value of this is two-fold. One, we are not overly influenced by an optimistic patient. For example, someone reports feeling 80% better, but the more objective tests show only a 30% improvement. Two, we are not overly influenced by a patient who is discouraged. For example, their frequency/intensity survey shows a 70% reduction in the frequency of their pain. Today, however, is part of the 30% and they are feeling down about their results. This causes them to underreport their improvement. Weighing the subjective and objective against each other allows us to get a clearer picture.
Why get a clearer picture? Because this is where treatment adjustments should be made. If a patient is not progressing as expected, we had better change the treatment approach immediately. They may require a different point prescription (the Acupuncture points used in the treatment), the addition of a modality (herbs, for example), increased treatment frequency or a different approach altogether (such as a referral to a different practitioner). If the patient’s condition is resolving faster than expected, they may actually need less treatment than previously anticipated. In this case, a particular modality may be removed or the treatment frequency may be reduced.
At Wood Tiger Acupuncture we graph these results to obtain an easy to interpret picture of a patient’s progress. Anyone can understand that a graph moving steeply upward is excellent, and one moving downward is not good. Through experience, we know what kind of graph shape represents average, excellent and poor results, and we can use these shapes to help inform continuing treatment.
If diagnosis is correct, then treatment should be correct. If treatment is correct, results will follow. Therefore, by monitoring results, it can be determined whether or not diagnosis and treatment are actually correct. In other words, if you are getting Acupuncture, and you’re not sure if you’re getting results, it is likely that either diagnosis or treatment (or both) are incorrect.
I didn’t make up tracking results all on my own. I was trained extensively by Curry Chadoir, LAc of Acupuncture and Holistic Health Associates http://www.holisticacupuncture.net/
I refined many of my methods through internship with Robert Doane, LAc of Acupuncture and Wellness Center http://www.acupuncturewellness.net/robert-doane/
Both of them are extremely generous with their time and expertise. If you are an Acupuncturist reading this, I highly recommend finding a way to learn what they have to teach.
And I never would have understood the value of re-examination if it weren’t for David Singer Enterprises http://www.davidsingerenterprises.com/