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October, 2010

Introducing Acupuncture Into a Chiropractic Practice

By Leslie Graham, MS, DC, LAc

Incorporating acupuncture into a pre-existing chiropractic practice is both easy and profitable. This is especially true today as the field of acupuncture is rapidly gaining acceptance as an adjunct to many Western medical protocols. Consequently many medical practitioners, especially those in the fields of fertility, pain, addiction and cancer, readily refer patients to acupuncture practitioners. In fact, M.D. Anderson Cancer Treatment Centers has acupuncture practitioners on staff and many fertility clinics throughout the United States, refer daily.

In addition, acupuncture, almost unknown in the United States prior to the 1970s, is now commonly seen in the mainstream media such as television, movies, Internet and print. With the exposure, the public is becoming aware of the benefits of treatment and thus, is actively searching out practitioners who perform this service. Why would you not want to add acupuncture to your practice?

Income generated with this kind of a practice can add thousands of dollars to the clinic's bottom line, with most of it being cash since many of the specialized procedures are not covered by insurance. Indeed, some practitioners who specialize in facial rejuvenation, which is usually packaged as a series of 10 visits, can earn up to $200 per session.

So how does one add acupuncture to a pre-existing chiropractic practice? It is quite simple. However, like all things, the ability to provide acupuncture treatments in your practice depends on the state in which you reside, as each state has different legislation. First and foremost, you must be aware of the scope of practice for the state in which you practice and what the requirements might be to practice acupuncture. Currently, the majority of the states require at least a 100-hour certification course, and then some require additional examination by the National Board of Chiropractic Examiners. In order to be sure of the most current legislation, refer to the state in which you currently are licensed to practice chiropractic.

Second, marketing this service is also easy as there are a variety of companies that provide professional-quality education cards, brochures, postcards, etc. that can be mailed out to the patients currently receiving chiropractic care. This way, an existing practice can send the education and marketing cards to all its active patients. These cards can also be used to "re-activate" patients who have not been to the clinic in a while. Education cards are also very useful for garnering referrals from medical practitioners as they are expertly written and are referenced with medical research. The education cards also cover a wide variety of conditions that would appeal to many different kinds of practices and patients.

Third, financial transactions are easily assimilated into an established practice because most patients prefer to pay cash or use credit cards for payments. This is especially true for protocols that are not covered by insurance, such as facial rejuvenation and fertility treatments. If you are doing protocols that can be billed to an insurance company or a "flex-pay" account, you can present the patient with a superbill and let them collect from the insurance company themselves. Or, if you are already billing for chiropractic, you merely need to add the acupuncture ICD-9 and CPT codes to your software or paperwork.

Fourth, and lastly, make sure you have malpractice insurance that covers acupuncture. There are chiropractic malpractice insurance companies that offer this coverage without additional charge to your premium.

There are very few pitfalls involved in adding acupuncture to your practice. The primary pitfall is the chiropractor themselves, who is hesitant to utilize acupuncture treatment modalities due to the lack of practice and self-confidence. A quick remedy to get comfortable with the techniques is to attend a lot of hands-on practice training courses or to take tutoring courses with skilled practitioners. There are many such courses offered by licensed acupuncturists at the post-graduate level that teach a variety of techniques and provide actual practice time during the course. These types of courses can give the practitioner more confidence and more techniques that can be used to treat a variety of specialty conditions. For instance, there are courses for fertility, pain, Japanese acupuncture methods such as Toyohari acupuncture modalities, and Korean hand modalities, that can be taken by licensed practitioners including DCs, MDs and nurse practitioners.

A second, minor pitfall is trying to memorize all the points and being sure that the points you have selected are beneficial to the patient and their condition. For those practitioners with less confidence in point location, charts can be placed on the walls for reference. Good quality charts are available from a variety of companies and can add to patient edification at the same time. One can also use one of the many apps that are available for the smartphones as quick reference material.

The third and final caution is believing in what you do, which is to move qi. For the majority of Westerners, and for those who have not grown up with the concept, qi is difficult to understand. This is especially true if you have not experienced or worked with it before. Qi is best defined as an electromagnetic energy that flows throughout the body, usually in the presence of blood. To best explain qi, one must look to the red blood cell with the iron molecule and its electrical charges. As the red blood cell moves through the heart, the iron molecule is charged by the SA and AV nodes. Acupuncture takes advantage of this electromagnetic energy. The needles that are inserted direct it to specific areas for treatment. Another example is to look at loss of blood in a patient. Why is it that a patient will die after a certain amount of blood is lost, in spite of replenishing the blood? The reason is that the blood being replenished is not living blood. There is no charge, as it is coming from a bag and an IV drip line. The blood must have qi in order to provide life. So, believe in what you do for best results.

Adding acupuncture to your practice is a definite win-win situation. It is an ideal adjunct to chiropractic care and can be assimilated quickly and effortlessly into your existing practice. Acupuncture is a natural. It is also very effective in dealing with conditions already being treated within the chiropractic clinic environment, such as acute pain conditions and in releasing stubborn muscle spasms. Acupuncture will add a dimension to your practice that further enhance the triad of health - mind, body and spirit - and it will most definitely add to your bottom line.

Dr. Leslie Graham is available for advanced training seminars in acupuncture, Chinese herbology and medical qi gong. She may be contacted at either or .

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