I recently received an email from a practitioner asking some really important questions about AcuGraph. I thought many of you would benefit from hearing the answer too–so I’ll address it in today’s blog.
I have been in deep thought the past couple of weeks on how to really know how many treatments each patient needs. I have been starting patients out with 1 course of care (12 visits) and then doing a progress exam to determine what steps to take next and now as I am reaching my progress exams I do not have a definite answer of how to move forward. I graph my patients during their exam and once again at the progress exam–the graphs come back either improved or worse and I know that when the body is healing other areas become blocked or deficient while the body learns how to function normally again.
I am wondering what you base your treatment plans on? Do you have some sort of rating system that you use?
Any suggestions, advice or ideas is greatly appreciated!
These are really GREAT questions–which are common for a lot of practitioners. I’ll break my answer into three parts.
#1: What Happens when a New Patient Comes into my Clinic?
When a patient comes in for their FIRST visit–I do a full evaluation which includes a complete history and intake, AcuGraph diagnostics, a printed AcuGraph report, AND treatment.
While I’m going over the AcuGraph findings, patients almost always ask how many times they will need to be treated. My answer goes something like this:
- It depends on how chronic your condition is.
- The longer you have had your condition, the more visits it will take to balance your meridians.
- I start all of my patients on an initial five visit regimen–which includes their initial examination plus treatment, along with four more visits. We’ll be doing the same for you.
- After we’ve treated you for five weekly visits, we’ll know how well your body is responding to acupuncture.
- A general rule of thumb is this: For every month you have suffered with a chronic condition, it will take an additional week of acupuncture for your body to return to normal. Example: If you have had chronic shoulder pain for two years–you should expect an additional 24 treatments.
- But–everyone responds differently. Some respond faster and some take a little longer. Regardless, you will see progress along the way.
- After five visits, you and I will sit down to evaluate how well you are progressing. At that time, I’ll be able to make a better judgment on how many future visits you will need.
- Let’s get ahead and put you on the schedule for the next four visits right now…
#2: The Importance of Graphing on EVERY Visit
Energy constantly shifts in the body from day to day–even from minute to minute. Graphing and developing a long-term treatment strategy based on a FIRST graph is ineffective. After the first treatment, the body will continue to change (which it should). AcuGraph allows you to grasp a picture of what has changed from visit to visit. The points that were important to treat on your first visit, will not likely be the same points that need attention on the next visit.
The graph above was taken on a first visit. Let’s analyze it:
- There are obvious excesses and deficiencies that need to be addressed. I could treat the sedation points for the Liver, Kidney and Gallbladder meridians; the tonification points for the Pericardium and the Large Intestine meridians; and the Luo point for the Bladder.
- In fact, there is an obvious difference between the upper body meridians and the lower body meridians in this graph. Notice how the meridians listed on the left are much lower than the ones listed on the right. This tells me that this patient has a lot more energy in the lower body in comparison to the upper body. Another strategy might be to simply treat the Dai Mai channel to develop a better flow between the hand and the foot meridians.
Same patient, new graph–one week later:
Would it make sense to repeat the same treatment plan that I developed for her the previous visit?
I’ll repeat this pattern of re-graphing and treating based on what I find each day, throughout the entire treatment series. It wouldn’t be wise if the treatment strategy for the next four visits, was based on the graph findings from this patient’s first visit.
Our goal is to create a positive change, or shift, in the meridian systems with acupuncture treatment. AcuGraph tells you where the imbalances are on each visit, and then keeps a record of changes that are happening from treatment to treatment.
#3: It’s Time to Re-evaluate
After the patient has received their first five visits, we look at all the graphs and reevaluate. The first five visits are very important.
I tell each of my patients that it takes a minimum of five visits for me to work through several layers of possible factors, which may be contributing to their blockages. With each visit, I balance the graph and look for underlying problems.
- Musculoskeletal tension
- Scar tissue
- Bowel function
These five visits allow me the chance to gather AcuGraph data.
In the end–I can use the data I have collected in my AcuGraph reports to show how well my patient has progressed. AND then–we can make logical decisions about future treatment plans.
Shana, I hope this helped. How about the rest of you? Was this helpful information for your clinic? I’ll bet that many of our AcuGraph users have great information to share. Tell us how you manage your treatment strategies? Let’s turn this into a discussion so we can all learn!
Kimberly Thompson, L.Ac.
Acupuncture Research Analyst
5 Replies to “Treatment Plans –You’ve Gotta Have One…or Two!”
I have worked out an answer to this question for both my chiropractic and acupuncture patients.
Twice a week until you feel better.
Once a week until it stays better.
Once a month to keep it better.
This is an original so please reference me if you want to use it. 🙂
It took me nearly 20 years to work this out, but it is simple, easy to remember and helps my patients answer that question for their friends and family generating referrals.
Thank you Dr. Drumright! I love your answer!!! I just might be quoting you in the future–and I will add your name to my quote. Don’t be surprised if your name shows up in my column for Acupuncture Today down the line. If you become famous–I want a little cut, okay? 😉
You are welcome Kim. Spread the word!
Great timing; I’ve been getting closer to contacting Adrian or Dr. Yennie to ask about frequency of graphing. I’ve been starting to think that every visit would give best results, so reading that above is encouraging on that thought. But since this will add time to each visit, I should also increase the cost a little.
This might be a slightly sophomoric question (as I am a second year doc), but what recommendations can anyone give on how I could explain the change in visit protocol and treatment cost?
I think if we try to look at the screen of yin meridians ; it may reveal the trend and direction of the healing process.