Friday, January 7, 2022

22-3 Treating other practitioners' patients

Treating other practitioners' patients

One of the things I have never liked to do is treat the patients of other practitioners.  There can be many reasons why we are asked to do that, some of them very valid, others not quite so valid.  So let's go through some of the reasons.


1. A practitioner may be moving away or giving up their practice and needs to pass on their patients permanently to another practitioner.

2. A practitioner may be away for a short time, such as on holiday, and needs somebody to fill the gap in treatments.

3. A practitioner may be finding it difficult dealing with a particular patient, and has suggested to the patient that it might be good for him/her to move to another practitioner.


A patient will always find the change from one therapist to another difficult to cope with, and this is particularly true for therapies such as five element acupuncture or any form of psychotherapy, which emphasize the importance of establishing a caring relationship between patient and practitioner.  This was why I always hesitated before agreeing to take over treatment from another practitioner.  And this was particularly true if I was being asked to do this for only a few treatments to cover for a practitioner on holiday, for example.  I would always refuse to do so for several reasons.


The first most important one for me was that I was concerned that I might not agree with the practitioner's diagnosis of the patient's element, and, if so, what was I going to do?  I could not simply change element, and start treating the patient as though they were coming for their first treatment on a new element, nor did I feel it was right for me to continue treating an element which I did not agree with.  So I would simply refuse to cover for my fellow practitioner's short absence.  I noted that other practitioners seemed far less bothered about this than I was, and simply continued treating on the original practitioner's choice of element.


I approached taking over a patient on a permanent basis completely differently, but also with some trepidation, because I would feel that I needed to base my treatment on my own diagnosis, rather than blindly following that of the previous practitioner.  I felt that I needed to explain to the patient before they agreed to my becoming their new practitioner that I would be approaching their treatment as if they were completely new to acupuncture.  Of course I would take account of how they had reacted to their previous treatment, and deep down I would hope that I would feel that there was no need to change element, but there might be.  I had to let the patient know that they would have to accept what might be a different approach to treatment from me, and would they be happy with that?


Things were of course easier if the original practitioner quite honestly felt that they were not helping their patient, and I therefore felt I had a free hand to direct the treatment in any way I wanted.


There is one further crucial point which is often overlooked, and a point which I confess I didn't always emphasize to my students.  We were told by JR Worsley that, if possible, we should always allow a gap of a few months between a patient having treatment from a different style of acupuncture before starting five element treatment.  This would allow their elements time to settle down and be receptive to a new form of treatment.  This is very much akin to what homeopaths advise, which is not to have acupuncture whilst receiving homeopathy.  This is because otherwise it will not be clear which treatment is effecting any change or, of course, indeed making things worse.  We are often so keen to help patients as quickly as we can, and no patient likes being asked to wait a few months before we can treat them, so this instruction often falls by the wayside in our efforts to help people in distress.  But it is worth remembering that we should wait to allow a patient's element to settle and be in as receptive a condition as possible when they start receiving treatment from us.


This blog is prompted by an email from Sarah, a Chinese five element acupuncturist, saying "Help needed!".  She tells me about some problems she has had treating patients, who were "all new patients transferred to me from another practitioner".  Some patients complained that "they felt very tired after my treatment".  But then she adds: "Despite 1-2 days' exhaustion, patients told me that the effect is good, or even better than forecast."


What would be good for me to know is whether Sarah is treating the patients on the same elements as the previous practitioners, or has changed elements. Some of this tiredness could be coming from the elements' confusion at being addressed differently by the treatment.  Or, as she herself points out, could it be "because I didn't do an AE drain for them?".


Well yes, there could be many reasons for the tiredness the patients complained of, not least my concern that maybe they are picking up on Sarah's own anxiety about how the treatments are going, which I am reading throughout her email.  Many practitioners just starting on their practice, as Sarah is, often anxiously ask their patients how they are feeling after treatment as a way of reassuring themselves, and that often makes patients anxious because they can feel their practitioner's uncertainty.  I never ask patients how they feel after treatment.  I instead look at the patients and gauge for myself if I can see any positive changes in them.  There may be many changes which point to effective treatment which patients are often not themselves aware of, because they may be so subtle to start with.  Patients may also choose not to mention any improvement because they fear that they will lose their practitioner's interest if they tell us that they are feeling better.


This is a very full answer to Sarah's email, but she has touched on many topics of interest to all five element acupuncturist as we try to work out how best to treat our patients.

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