Hospital Intregration

July 5, 2000

Julie, my experience with the intregration process as being a " struggle "

stems primarily from having to work with administrators who don't have the

personal experience and knowledge base of what it is we do and why it works.

Despite numerous attempts to educate through invites to observe, patient

testimonies and onsite workshops there was still incredible fear and

skepticism. Everything that we are " allowed " to do must go through the

hospital medical board and typically the board members don't have experience

in TCM either. They had fear over allowing me to use herbs due to potential

liability risk factors. Many of which were imagined. The one true

discouragement came when after one year of my being in the hospital clinic

(after which the patients were extremely pleased with their treatments and I

had a 9+ month wait list after starting from scratch) the director asked to

follow me through the day. I did much explaining as we went as did the

patients share their thoughts. At the close of the day, he looked at me and

said " we could hire a medical assistant to do what you do and save alot of

money on salary " ! All he saw that whole day was a " technical " process.

Somehow he completely overlooked all the personal spent with patients and the

careful questioning of how they were changing. When faced with that sort of

response you realize there isn't much of anything you can do-it all becomes a

budget issue.

I wanted to believe in the beginning that it would be a wonderful thing to be

alongside the rest of the medical community doing what I love to do.

However, it isn't realistic to believe the rest of the medical community is

ready for us. I am sure in some states it is somewhat better. The demand

for our services is incredible here but supporting medical staff controls

what you can and can't do. I was not allowed to do moxa due to having to

light the sticks and it was a fire risk. Cupping wasn't allowed because of

the visual outcome, again perceived liability risk. I could go on and on

with examples of restrictions. It gets to the point where all you can do is

insert needles and as TCM practitioners we know there is alot more to what we

can offer and should be offering.

I am happy to give any further information you may want.

By the way, you must come visit Michigan. It is especially beautiful from

now through fall. Let me know if you get this way.

April

July 5, 2000

I had a different sort of struggle when I worked in an outpatient clinic affiliated with a small hospital in rural Iowa ('97-98). There were 2 MDs, a PA, and a couple of once a week speciality clinics, myself and another acupuncturist. They hired us to replace a Korean doctor who was also an acupuncturist. Dr. Park had been there 4 years and had a very busy TCM practice. People came from all over Iowa and out of state to see him. When he left, they decided to continue offering Oriental medicine.

We had a lot of support from the administrator who hired us, and from the nurses (who had worked with Dr. Park) and from the P.A. The MDs basically ignored us. We gave in-service talks to staff and administrative staff and nurses attended but not one of the doctors.

We could use herbs, moxa, cupping, anything we wanted to do. They did not get involved at all. Then this administrator was fired and a new one came in who was much more realistic financially. We had had almost no limit on what we could order initially, which was wonderful.

But they didn't have any idea on how to integrate us into the clinic and had not thought it through before hiring us. This was a town of 2,000 in rural Iowa! Dr. Park had finagled getting insurance coverage for acupuncture because he was a D.O. He also self-referred. Patients who came to him for allopathic treatment were encouraged to try acupuncture. When Dr. Park left, the patient load went from 10-15 patients a day to 10-15 patients a week between the two of us! It gradually got better, but they were paying us very well and losing a lot of money.

I saw the handwriting on the wall that at least one of us would be let go after our year contracts ran out, so I arranged to have them buy out my contract and I moved back to the southwest and the sunshine. Rural Iowa was too isolated, cold and grey for me.

The other acupuncturist is still there, into her third year. She works 3 or 4 days a week at the clinic and spends one day in a hospital in another small town.

The allopathic community wasn't hostile, just pretended we weren't there. I think I may have gotten one referral from them while I was there. The administration was generally more interested in our work, as was the community. We did a lot of talks in the community and in the surrounding area. We arranged to have someone teach a T'ai Qi class and we ran weight-loss groups.

But this was a very small town and small hospital -- the hospital had about 10 beds. We were not given hospital privileges and while I was there we didn't push it. I think the hospital finally closed as there were usually no more than 3 patients at a time.

Despite the problems, it was basically a good experience for me and if there had been the possibility of having a very busy practice I would have stayed for a couple of years.

Catherine

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Artemisia110

Wednesday, July 05, 2000 7:39 AM

Hospital Intregration

Julie, my experience with the intregration process as being a "struggle" stems primarily from having to work with administrators who don't have the personal experience and knowledge base of what it is we do and why it works. Despite numerous attempts to educate through invites to observe, patient testimonies and onsite workshops there was still incredible fear and skepticism. Everything that we are "allowed" to do must go through the hospital medical board and typically the board members don't have experience in TCM either. They had fear over allowing me to use herbs due to potential liability risk factors. Many of which were imagined. The one true discouragement came when after one year of my being in the hospital clinic (after which the patients were extremely pleased with their treatments and I had a 9+ month wait list after starting from scratch) the director asked to follow me through the day. I did much explaining as we went as did the patients share their thoughts. At the close of the day, he looked at me and said "we could hire a medical assistant to do what you do and save alot of money on salary"! All he saw that whole day was a "technical" process. Somehow he completely overlooked all the personal spent with patients and the careful questioning of how they were changing. When faced with that sort of response you realize there isn't much of anything you can do-it all becomes a budget issue.I wanted to believe in the beginning that it would be a wonderful thing to be alongside the rest of the medical community doing what I love to do. However, it isn't realistic to believe the rest of the medical community is ready for us. I am sure in some states it is somewhat better. The demand for our services is incredible here but supporting medical staff controls what you can and can't do. I was not allowed to do moxa due to having to light the sticks and it was a fire risk. Cupping wasn't allowed because of the visual outcome, again perceived liability risk. I could go on and on with examples of restrictions. It gets to the point where all you can do is insert needles and as TCM practitioners we know there is alot more to what we can offer and should be offering.I am happy to give any further information you may want.By the way, you must come visit Michigan. It is especially beautiful from now through fall. Let me know if you get this way.AprilChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.