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Dynamic Chiropractic – September 1, 2005, Vol. 23, Issue 18
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Dynamic Chiropractic

How to Be Extremely Successful in the Practice of Acupuncture

By John Amaro, LAc, DC, Dipl. Ac.(NCCAOM), Dipl.Med.Ac.(IAMA)

As a practitioner of the Asian healing arts, I have been blessed with what most would consider a very successful practice. Of course, I realize success may be defined by a host of various attributes, depending on who is doing the defining.

Some measure success simply by the amount of time they have away from their work environment; others measure it by income, numbers of people served, conditions successfully treated, prominent lifestyle, fame, happiness, contentment, pleasing environment, lack of stress and perhaps a variety of other factors. It is my contention that all of these factors comprise the definition of success.

Recently, I had the opportunity to re-read Miriam Lee's excellent book, Insights of a Senior Acupuncturist. Of course, anyone who has read and studied that publication knows Dr. Lee to be a stunningly successful practitioner who practices in the Taiwanese style of acupuncture. She attends to scores of patients daily - approaching or exceeding 100 per day. Most practitioners or students of traditional Chinese medicine (TCM) have a very difficult time relating to that intensity of practice. I have heard numerous practitioners question the logistics of seeing that sheer volume of patients per day - how could one practice the myriad of ramifications of Oriental medicine on more than a handful of patients in a day? Of course, it must be understood that the Taiwanese style of acupuncture is far removed from TCM; however, no one knowledgeable could ever argue of its incredible clinical effectiveness being any less than what one would expect of TCM.

In 1973, on my first trip to China, and again in 1975, when I went to study acupuncture, my travels took me to other places, including Taiwan. This of course was six full years before The People's Republic of China would allow the first observers to enter the country, and three years before Chairman Mao Tse Tung's death. As a result, I was immersed academically in the Taiwanese/Hong Kong style of acupuncture. In 1976, when I received my diploma from the Chinese Medical Institute in Kowloon, China, my education and clinical awareness were of that particular style of acupuncture. As a result of this exposure to acupuncture, in addition to my enthusiasm, the demand of the public and the expectation of quick and seemingly miraculous response, my personal practice grew to incredible dimensions. I was seeing between 85 and 125 patients per day, with a nursing/clinical technician staff of 12.

For all of the years I practiced acupuncture until my semi-retirement in 1986 to Arizona, my practice would see an average of five new patients a day, five days a week. Even today and since 1986, my practice (in which I see patients on Tuesdays and Thursdays) sees an average of three new patients per day. This is by my request to the staff to keep it to this level. My wife, Dr. Debra Richel, on the other hand, who practices the same style as me in the same office with her own private practice, will see up to five new patients per day. Even though both of us only practice two days per week, if we were to practice five days per week, the new-patient volume would still be the same. Because of the number of new patients we collectively see per day, neither one of us has what would be considered a maintenance style of practice. With the sheer numbers of people who are seeking our care, to keep these patients on a maintenance program would turn our practice into a closed practice within 18 months. As a result, we refer a great number of patients to colleagues for ongoing care. The patients are advised to seek our office again as necessary.

Due to our intense lecture schedule, we now practice just two days a week and maximize our patient visits individually to 40 per day. This of course is a monumental difference between seeing 100 patients a day; however, those high patient levels were because of necessity at the time and were not necessarily the definition of success.

When students and practitioners ask me my recipe for success and what it takes to achieve overwhelming professional success in the field of acupuncture, the answers are incredibly simple:

1. Virtually millions of potential patients have heard of acupuncture's stunning clinical success and would welcome an opportunity to try it, if only they knew where to go. You are the one they need to go to. This simple energetic mentality must be put into the universal energy by the process of thought. You may be amazed to learn of how many people will hear your unspoken message. This rule, unfortunately, will only be understood by a small percentage of those who read this.

2. According to several polls, 65% of the American public would never try acupuncture, regardless of how good it is, because they are afraid of needles. They can hardly imagine having a host of needles thrust into their bodies. If they only were aware of alternative stimulus modalities, such as electronic stimulation and soft laser, the doors would be open to millions of additional patients. Allow current and potential patients to understand that "Acupuncture is a principle, not a technique." Even though the acupuncture needle and moxa are the traditional methods of stimulation, bear in mind that electricity is a brand-new discovery compared to acupuncture. It is OK to break from tradition and use modern technology - especially if you want to succeed.

3. "The human body cannot determine how much you decided to pay for something." This means that when it comes to utilizing technology in the treatment of acupuncture points, the human body could care less how much you paid for it. Therefore, it is important that you adopt rule #4.

4. "Less is More!" This rule affects virtually every aspect of your practice. Ponder its stunning ramifications for outlandish success.

5. The fewer the number of office visits and treatments it takes to achieve pain relief and condition response, the more new patients you will receive. Many practitioners are mistakenly under the impression that the more treatments you give someone, the larger your practice will be and the more successful you will become. The problem with that is those same practitioners are constantly seeking new patients through advertising, personal promotions, lectures, gimmicks, phone book ads, supermarket flyers, etc. Their practices are in a constant struggle, as new patients by referral are very meager. You will find more people are apt to refer to you when their enthusiasm is high than when they are feeling taken advantage of. Their enthusiasm is high when they are achieving quick clinical results.

6. Acupuncture is without question one of the most significant healing discoveries of all time. Its clinical effectiveness can only be disputed by those who know absolutely nothing about it. When one hears criticisms of acupuncture (or the profession), simply consider the source and continue on with a success mentality. Do not be brought down to the level of those who wish to discredit or alter your perception of the profession. Refer back to rule #1.

7. Ask for referrals! Your barber or hair stylist is someone you know on a personal basis. You actually talk to this person on an ongoing basis at frequent intervals. You like them and know many aspects of their life. They perform their job for the express purpose of earning a living and becoming successful. Question: How many people did you refer to your barber last year? If you say none, ask yourself: Why should anyone refer to you? If your barber just said to you, "I'm trying to build the best haircutting establishment in this part of the city, would you help me with your referrals?" you know exactly how you would respond.

8. Upon releasing a patient, always hand them one of your referral cards and tell the patient, "There is now a hole in my appointment book; it is your responsibility to replace yourself." If you say you could never do that, how passionate are you about having a successful practice?

9. Understand that TCM is a fantastic method of healing; however, it is only one of numerous methods that achieve incredible clinical response. Do not be afraid to utilize methods in your practice other than TCM. Always be able to fall back on TCM, and keep your skills honed for those special cases.

10. Allow your patients to understand the immense diversity of acupuncture. Many patients do not have a clue that acupuncture can be effective for mental depression, allergies, digestive disease, etc. Clearly, the number-one question anyone has about acupuncture is simply, "Can acupuncture help with ...?" Let those you come into contact with understand that acupuncture treats the body, not necessarily an individual condition. This is why it has such diverse and effective clinical results.

11. It is imperative to achieve the highest level of referrals to your office. As a result, two specific things are absolutely necessary:

  1. The patient must be able to explain to another party (their husband, wife, friend, boss, family, co-worker, etc.) exactly what you are going to do, how you are going to do it, and provide a general explanation of how acupuncture works that makes sense to them and that they can clearly repeat to someone. Do your very best to use caution when discussing the theoretical foundations of Chinese medicine. Explore the possibility of adding electromeridian imaging (EMI) into your practice along with other diagnostic tests to determine the need and approach to treating the meridian system of the body. When conducting a simple electronic evaluation of the yuan points for the primary meridians or the tsing points for the musculotendinous meridians, it makes perfect sense to the patient to be able to see which meridians are in excess and which are deficient, in addition to those meridians that are extremely split between the left and right. The patient who is told she has damp heat in her gallbladder and phlegm misting the heart may be hard-pressed to be able to explain these findings to someone. It is usual for a patient to refer another for the express purpose of receiving an EMI evaluation to determine the balance of their meridian system, only because they understand it. It is easy to explain and it makes perfect sense.

    When one adopts the radio analogy to the concepts of acupuncture, its understanding may be accepted by virtually everyone. Even though we can see and examine the nerves, arteries, veins, and muscles of the body, we are unable to visualize the meridian system. The meridians are much like radio waves as they are known to exist; however, they likewise cannot be visualized. They carry electromagnetic waves, much like the acupuncture meridians carry electromagnetic energy. If one were to turn on the radio and realize there were 12 different stations, each with different call numbers, it is evident that if the radio comes in at that precise call number, it would come in loud and clear; however, if it were to come in at a higher or lower call number, there would be static. It would soon be realized that there was nothing wrong with the radio, only that it was out of balance, and a simple adjustment would restore the radio to full working function. When the patient can understand this simple concept in relation to the electro-meridian imaging evaluation, the balance of the meridian system is easily understood and explained to others.

  2. Achieve impressive clinical response in the shortest time possible. Remember rule #4. This is imperative. If you have noticed your clinical results are not as dramatic as you think they should be, do not be afraid to take some postgraduate programs to hear what you may already know from a totally new or different perspective. This alone can increase your awareness and results immensely.

12. When a patient is seeking care for extreme pain relief due to arthritis, migraine, sciatica, spinal stenosis, post-hepatic neuralgia, etc., they may be relieved of pain within several treatments. Do not be afraid to release the patient when the pain is relieved. Many adopt a mentality that the pain is gone but the condition still persists, which is the basis for lifetime care. Do yourself and the patient a favor and release them from care, even if it has only been one or two treatments. The referrals at this level go up dramatically. Believe me: By releasing one patient, you will make room for eight more. Again, I refer you to rule #4.

13. Charge a legitimate fee and be able to justify it to yourself. Do not charge a fee only because your colleagues charge that much unless you are totally comfortable with that fee. If you have any questions, alter the fee to what feels comfortable, even if it is considerably different than the prevailing rate. Again, I will refer you back to rule #4. So would Sam Walton!

14. Remember your barber? What third party pays them? None - and yet you still seek their service. Insurance is fantastic for long-term, life-threatening issues; however, it should not even be considered in cases such as acupuncture when the entire treatment is going to cost potentially less than admission, laboratory tests, a CT scan, incidentals, pharmacy charges and spending one day in a hospital. If you are intent on failure, do your best to get involved in managed care, insurance plans and other forms of third-party pay.

15. Charge a legitimate fee, collect it at the time of service, forget the insurance mess and welcome a fantastic, successful practice. I have been known to stun a number of people when I honestly say that if you as a practitioner are not collecting a minimum of $2,000 per day (not billing, but collecting), your practice needs a major overhaul. If you are not receiving considerable clinical response within six visits, something is being missed and the treatment needs to be changed.

There are more rules that are important, but these 15 thoughts will not only get you started, but also propel you through a lifetime of success. As I sit here, I am suddenly struck with a host of additional thoughts that are vital for success. Anyone interested in knowing what they are? Drop me a note.

Best wishes for a fantastic practice.

John Amaro, DC, FIAMA, Dipl. Ac., LAc
Carefree, Arizona



Click here for more information about John Amaro, LAc, DC, Dipl. Ac.(NCCAOM), Dipl.Med.Ac.(IAMA).

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