That they’re not paying for exams and they’re also still recouping. We’re gonna talk a little bit about that, but we have to update from what we did in April.
Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Greetings, friends and colleagues. It’s Sam Collins, the coding and billing expert for acupuncture, the profession, of course, the American Acupuncture Council. Of course, I’ve got a little update coming up because obviously many of you have been contacting me, network members, and even others have contacted me.
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Say, Hey, Sam, what’s going on? I notice. That they’re not paying for exams and they’re also still recouping. We’re gonna talk a little bit about that, but we have to update from what we did in April. So let’s go to the slides. Let’s talk about what’s going on with recoupment and standard episode of care specific to acupuncture and frankly non-physician providers.
So you’ll see here is a letter dated June 23rd from Tri West and it says, we received the above claim. Let me bring it so I can blow it up. And it says. Try West. Receive the above-mentioned claim for your offer. And notice I highlighted and yes says evaluation and management procedure codes are not paid for this rendering provider specialty.
This is the latest thing we’re seeing. It appears, and I’ve seen it absolutely published way that to me would make it more, but it appears they have taken the ability for acupuncturists to be paid. Separate exams when it comes to the va. That of course is very frustrating because of course is an exam necessary thing.
Of course, I to determine the need for care, to determine the continuation of care. So what’s recurring I think is maybe a Leo GE cut here at they’re eliminating the payment for exams. That doesn’t mean you don’t need one, they’re just not. Pay for it. I think it’s probably worth seeing the patient for the overall payments, but they’re not covering it.
We’ll see directly. Now the word that they did this in April, what I’ve seen when their newsletter is not quite clear enough for me. So I’m waiting to see the full publishing standard episode of care, but I’m sure many of you have met. Now. Here’s gonna be the pushback if the exam after April when they published it.
They’re gonna be am behind it because published, however, then I want you all to think of standard episode of Care for Acup Occupy. Whenever you notice the standard episode of care, you’ll notice whether it’s going to be initial chronic follow ups. They include e and M codes. You’ll see really, 9 9 0 2 to 2 0 5 9 9 2 1 to 2 1 5, and I bet pro your authorization has so my argument’s gonna be, they’re saying they’re not gonna cut well, if it’s after April, send an updated authorization, not listed, I’m waiting to see that, then I would say, okay, but if it’s prior dispute’s gonna be, how did you send me an authorization?
Clearly indicates exams and they’re, now, I’m not gonna pay for it. Now, it appears April. This is gonna true. But prior to, it’s gonna be a pushback. Now, is that very frustrating? Of course it is. But I’m gonna ask you, is it worth it to still be part of it? I do, because think of the overall payment on a VA patient.
You’re getting 12 visits to start, probably eight and eight to follow up. Assuming you’re doing three sets of acupuncture and a therapy or two, that’s maybe 110 to $150 of reimbursement. Am I going to take away potentially, three to $4,000 a payment? Because they’re not gonna pay for a couple of exams.
I prefer they do, but I’m gonna say I’m not gonna go that far. It’s something I think though we’re gonna be fighting. I shouldn’t say think. I know we’re gonna be fighting as a profession on a national level along with chiropractors and physical therapists, because this affects them too. Because this goes against the equality provision.
Equality says that if it’s within scope and you pay, other providers have to pay you because this is not Medicare. Now that’s gonna be a little bit of a fight, and that’s not gonna happen in short term. So when you get this, I do think we should dispute it. I would certainly push back if it were pre-AP April, that they should, if it’s after April, not so much.
Of course, if you’re a network member with me, reach out. We’ve got some letters for that as well. But I do wanna highlight also beyond that, just a couple of quick updates. Let’s talk about what’s happening and what’s gone on with doing. Things with 9 7 0 3 9 or 1 3 9, and that’s of course what a lot of offices have used for cupping.
Remember that was removed more than a year ago, so please do not use that code for cupping. It is not appropriate. I. Do not list it. They may pay it, but they’re gonna recoup it. So do not, if you’re gonna do cupping, use 9 7 0 1 6, which is a vaso pneumatic device. It’s not a high payer. It’s about 11 to $15, but at least you are being paid for it.
But again, do not use 9 7 0 3 9 and if they are recouping that, if it’s pre 2024. I would argue they can’t, but if it’s after 2024, they can. Now some people have argued. What about statute of limitations? Statute of limitations, I would argue certainly does apply. Unfortunately, you know what I’ve realized or what I’ve learned, the statute of limitations for the VA is actually six years, so we’re not gonna win on that one as far as this goes.
The other thing here is, and this has come up recently because obviously a lot of you are using pain indexes or similar. To verify how the patient’s improving. I recently had an office, or actually a few that they were denied few further care because they weren’t showing at least a seven point difference on the general pain index.
I really like the general pain index. It’s certainly the similar to the pain interference. Make sure though, if you’re using it. If you’re doing it once a month, there’s gotta be at least a seven point change to be considered significant. Now, most of you, I hope, are getting bigger than seven point changes, frankly, but if you’re not realize it’s going to be a problem ’cause they’re gonna push back, which means you also have to focus in what if I’m using the pain scale?
That also has a limitation, which means it’s gotta be three points or more. Obviously if I say I’m a seven, I go to a six. That means I’m better, but it’s not considered significant. So if they start at seven, the next time you do it to really be considered significant, say on re-exam, it’s gotta be four.
So a three point difference, I would say. Then obviously those two factors are important. If you’re not getting at least one three, you better focus in on something about activity, particularly a home or work activity that couldn’t do before. What they care about is the getting better. Because remember, once they’re stabilized, they have to be on a continua care with flareups.
So keep in mind, acupuncture works well. We need to demonstrate it. Show me on this general PEX pain scale or function, how much improvement there is. Now, this brings me to, for some of you, and I’ve had this question a lot, is being part of the VA worth it? Does it cost anything to join? No. Do the patients sometimes have some hassles getting authorization?
Yes, that’s true. But when you’re paid. Let’s go over it. If you’re getting a standard episode of care for 12 and eight visits, just say the first two 20 visits in a year, considering just the treatment, that’s probably 2000 to $2,500 now, even with taking out exams. Is that worth it to me? Absolutely.
However, am I frustrated with the exam part not being paid? I am. But at the same token, that’s not gonna stop me, but this is where if you’re not part of your state and national association, this is where we need to belong. ’cause this is where we need to push back because how are they treating us differently?
Now the downside is they are doing it to chiropractors. I. To physical therapists as well as massage therapists. So it’s not just you. But at the same token, I think it’s valid to say that it should be covered. ’cause how are you supposed to determine care without an exam because they’re doing this based on a Medicare rule?
Medicare only sets the fees for the va. It’s not the protocol. ’cause if that were true, they shouldn’t pay for acupuncture at all unless it were chronic low back pain and under supervision. So we know that they’re just. Choosing and picking certain ones. So I think we’re gonna have a pretty good pushback, but I do still, it is worth it if you’re thinking, I’m not so sure we are doing next month in August, a whole seminar on the va, what to do, how to make it work for you, make sure you tune into that.
Otherwise, I’m gonna say to everyone, we always want to be resource. If you’re having issues, reach out to American Acupuncture Council. The next specifically, we highlight updates right on our website. And if you’re a member, it allows you to have direct interaction with me via calls and zooms. And otherwise, until next time to my friend, be well.
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So there are quite a few neuromuscular conditions that affect the face, such as Bell’s Palsy, Ramsey Hunt Syndrome, synchronic cys, stroke, TMJ, trigeminal Neuralgia,…
Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Hi, my name’s Michelle Gellis. I am an acupuncture physician, and I would like to thank the American Acupuncture Council for this opportunity for me to present to you today on treating the face a multidimensional approach. So today we’re going to do part two. And you can go ahead and go.
So a little bit about me. I’m currently on the doctoral faculty at Jossane University. Before that, I was a faculty member and clinic supervisor at the Maryland University of Integrative Health from 2003 until 2021. I am a published author and contributor to the Journal of Chinese Medicine and I’m a regular columnist for acupuncture today.
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And I’ve been treated teaching facial acupuncture classes internationally since 2005. My book Treating the Face was released in November of 2024. It is a 500 page 15 chapter, hard cover book, and it covers all aspects of treating the face. I’m going to talk mostly about the information that’s in chapter six, and that is neuromuscular facial conditions.
So when we think about facial acupuncture, we tend to think about cosmetic facial acupuncture. But facial acupuncture is really about a holistic approach to not just treating the face. Cosmetically, but also all different aspects of treating the face. So there are quite a few neuromuscular conditions that affect the face, such as Bell’s Palsy, Ramsey Hunt Syndrome, synchronic cys, stroke, TMJ, trigeminal Neuralgia, Ms.
Whoops. Ms. Ptosis, HEFA spasm, myasthenia gravis, shingles, and facial ticks, just to name a few. And many of these are very unique to the face itself. And. Since I specialize in treating the face, after a few years of doing cosmetic acupuncture, I started getting people calling me, asking me if I could help them with a lot of these neuro conditions.
And through studying and doing a lot of research. I and some trial and error. I learned that the best way to really manage these conditions is through a multifaceted approach using scalp, acupuncture, submuscular needling, facial motor points, facial cupping. And so I’m gonna touch on these, the.
And so Scalp acupuncture is based on neuroanatomy. It is not based on acupuncture points. And you have to measure the scalp appropriately. And there’s a motor area and there’s a sensory area, and the bottom two fifths of each one of these lines, the sensory area is not shown on this picture. The. The bottom two fifths corresponds to the face, and so you would needle this area and stimulate it either with electro acupuncture or with manual stimulation in order to help with either motor conditions such as Bell’s palsy or with sensory conditions such as trigeminal neuralgia.
Facial motor points. This is from an old medical textbook. These are the motor points that have been discovered on the face, head and neck. And in part one of this talk I talked about using motor points for cosmetic concerns, but facial motor points are wonderful for neuromuscular concerns because what a motor point is the most electrically acceptable part.
The muscle where the motor neuron goes into the muscle, and by stimulating it, you can cause the muscle to get back into normal functioning. And the reason why this is important for the face, besides the functioning of opening the lid or closing the lid, the. Skin on the face is directly attached to the muscle.
So if someone’s face is paralyzed and is drooping in one area by getting the muscle back into normal functioning, by stimulating the motor point, the skin itself will. Snap back and be working in a more normal fashion with the muscle. So I do have examples of a couple of motor points. This was a student of mine in class and she had.
Had Bell’s Palsy many years ago and was still having trouble cursing her lips, whistling spitting like when she’d brush her teeth. And so I did the Mentalis Motorpoint and as soon as I put the needle in. Her chin started to twitch and then when I stimulated the point, it really started to jump.
And then after the treatment, she reported that she was able to make a lot of facial expressions that she hadn’t been able to make in the past.
Next example I have is a student in a class I was teaching in London and he had been in a bike accident and he had some neuropathy and a little ptosis on his left eyebrows and. I put this needle and stimulated it. So this is the motor point for the frontals. It’s gallbladder 14.
Sorry, that was so loud. But you could see the needle moving back and forth when, once it was put in the muscle, which meant it was starting to wake up. Submuscular needling is another technique that I use, which involves needling underneath and in some instances through a muscle in order to.
Blood and cheese circulation into the muscle itself. And I have a little demo here, which I.
Facial cupping and GU can also be very beneficial. For neuromuscular facial conditions, as long as your patient can tolerate it. These techniques are very gentle if done properly, and can help with blood and cheese circulation into the face. It can help with any sort of fascial adhesions. That is because over time.
If a muscle in the face isn’t used, the fascia can become stiff, and by using the cups it can help with lymphatic, the lymphatic system of the face, and it’s also very relaxing and very enjoyable for your patients. I am gonna talk really quickly about Bell’s Palsy. Bell’s Palsy is the most common cause of facial paralysis, usually temporary, and it’s caused by a disruption of the facial nerve, which causes either weakened or paralyzed facial muscles.
So here’s one patient you can see. This entire when asked to smile, they can only, she can only smile on one side of her face and the other side is completely paralyzed. This was a patient of mine. I only focused on her eyes, but I asked her to close her eyes. You can see one eye closed and the other one.
She could not close it at all. And then I did some submuscular needling and some acupuncture points and used gallbladder 14 as a motor point, did some scalp acupuncture for the face, and, after one month,
you can see she can close her eyes. Still a little difficult, but she had complete recovery.
So I do offer many different classes on. Facial and cosmetic acupuncture, you might wanna check those out. You can scan the QR code or go to my website, facial acupuncture classes.com and you can find me on social under my name, Michelle Gellis, or I have a Facebook group called Facial Acupuncture.
Very active group. Thank you so much.
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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Hi there. My name is Michelle Grasek. I am a practicing acupuncturist and the host of the Acupuncture Marketing School podcast, as well as the lead instructor for acupuncture marketing school, the online class. And today I am looking forward to sharing with you some really helpful, practical tips to make networking more.
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Comfortable and effective for introverts. And before we dive in, I’d like to thank the American Acupuncture Council for the opportunity to be here with you today. All right, let’s get into the slides. I.
So before we begin, I’d like to talk really briefly about why it’s worth it to try networking as an introvert. I have found over the years, I’ve been teaching marketing in our industry for about 11 years, and I found that. Most acupuncturists are introverts, at least the ones that come into my orbit, which is maybe not surprising because I am also an introvert.
So I’m speaking from personal experience as well as what I’ve been sharing with my marketing students and clients over the past more than a decade. And most introverts will say, why? I don’t want to do that. Why would you suggest networking? So first of all, if you, if you’re watching this, you’ll probably have some level of interest in trying networking, but I always tell people to think about your marketing, like an experiment, try new things.
You might be surprised about what’s a good fit for you and what’s effective in your community. And if you try something and it doesn’t work for you, that’s okay. You don’t have to do it anymore. Commit to other ways of getting visible in your community. But the reason I always recommend that introverts at least try networking is that, especially using these tips I’m going to share with you to make it more comfortable.
Networking is an incredibly effective way to build trust in your community. And really, marketing for acupuncture is about building trust. It’s about helping people understand that acupuncture can help their symptoms and trust. Trust you to put needles in them, trust in making a financial investment feel safe, sharing their personal health information with you their story, their background, et cetera.
So we need to build a lot of trust in our marketing as acupuncturists and any sort of in-person interaction builds trust very quickly. And I think we, we really can’t, we really have to acknowledge how significant a referral is from someone who knows you, right? That’s a very trust building type of marketing, a personal referral, and that’s our goal with networking, is building relationships so that people get to know us so that they feel comfortable referring people to us and also so that we are top of mind.
If they’re speaking to someone about acupuncture or maybe our specialty or something we’ve discussed, so they can say, oh wait, I know an acupuncture from my networking group. Okay. So that’s why I think it’s worth it for introverts to try networking because it really is very effective because one-on-one conversations and getting to know people in person, that’s what builds a strong referral network.
Okay, out of all of these seven tips I have saved my personal favorite for last, the one that I think can make the biggest difference in how comfortable you are with networking. But I hope that all of these are really useful for you. So let’s dive in. The first tip is to always bring a friend with you.
If you are an introvert, going to a networking meeting, there’s absolutely no reason that you should torture yourself by trying to go alone. Most of my. Introvert marketing students and clients have told me that they’ll say they’re gonna go to a networking, they’ll make the commitment and then it will approach and they’ll feel pretty nervous and bail at the last second.
So bringing a friend. It has two purposes. One is there’s accountability because if you’re meeting someone there or if you’re gonna drive together, this person is expecting you to show up, right? So it makes people much more likely to show up and go to the event. And of course, bringing a friend or an acquaintance gives you.
Kind of a fallback so that you know at any point during that networking event, there’s always someone that you can talk to that you can find or turn to. So you’re never just standing there alone awkwardly with a drink. ’cause that’s the thing people tell me they’re afraid of the most, is walking into this big space filled with strangers and a lot of people, and having to stand there by themselves until someone approaches them and introduces themself.
Or having to get up the gumption to approach a group of people who already seem like they know each other. It can feel a little cliquey. It’s really hard to just walk up to them and introduce yourself alone, right? So bringing a friend helps soften all of these things and gives you accountability and also helps you have someone to talk to in case maybe you’re having a nice discussion with someone you just met and they see someone else they know and they have to go.
You can always turn and chat with your friend. Now, I would say the one thing you wanna be careful of if you bring a friend is do not only speak to each other. That is also very common, right? So you have to make a pact, make a commitment beforehand that you are going to try to meet other people and you’re not just gonna stand in a corner and only talk to each other.
Okay. Bring an extrovert friend if you can, because obviously they are going to be a little more comfortable in the situation and probably get you introduced to more people. And lastly, when I say bring a friend, it doesn’t, it could be just like a. Personal friend most networking events, you can bring a plus one, but it could also be your receptionist or it could be a fellow business owner.
Okay? So just someone that you’re already familiar with makes a huge difference. So tip number two is a big mindset shift that matters a lot. It helps a lot. Often people tell me they don’t wanna do networking because it feels pushy and salesy and they’re just expected to hand out business cards to as many people as possible and try to get someone on their calendar.
And if they don’t schedule a new patient, they feel like it was a waste of time. So this is way too high pressure, I think. It’s much more useful to think about networking as a long-term game in which you are becoming a member of this community. If it’s the Chamber of Commerce or BNI or Toastmasters, whatever it is, your goal is to build relationships, which is building trust so that people get to know you well enough that they wanna refer people to you and that you’re top of mind.
And. I think that approaching it from this perspective takes a lot of pressure off because you get to be yourself. You’ll probably make some. Fellow business owner friends, and you can also think about how can I be a resource for other people in this community? How can I get to know them and understand like what are the things that they might need help with?
Who can I refer them to? I just had my roof done and then I hear so and so is talking about getting their roof done. I have someone who did a great job for me, and I can share that, right? So think about this as. Taking time to become part of a community where you can be a resource and other people can be a resource for you.
You can support each other and refer to each other. Okay. But it doesn’t have to be the kind of thing where you’re just throwing your business cards out at everybody who walks by and you’re trying really hard to convince people to get on your calendar. I will say, if you are speaking to someone and they seem really interested in acupuncture.
Do ask if they wanna get on your schedule and pull up your app on your phone and say, oh, I could put you in right now if you’d like. Don’t miss that opportunity. I’m just saying that, if you go to a networking meeting and you feel like I didn’t get a new patient from this event, that is normal.
That’s not really how we are thinking about the purpose of this exercise. Okay. Which also brings to mind that, relationship and trust building. Takes not only time, but repetition. So it is very important to try to go to these events regularly, right? If there’s a monthly meeting, trying to go to most of them is really helpful for building relationships.
You become a familiar face. Tip number three is I think it can be very fun. You can host your own event. Now, most introverts prefer to be in control of the environment, we’ll say. So let’s say that really big noisy meetings with a ton of strangers. Are just not your cup of tea, but you still wanna get to know some people in your community.
You could, for example, host a networking event in your office for fellow wellness providers. You could invite, I don’t know, four to 10 very specific people. You could keep it brief, maybe 45 minutes. And this works for a lot of people because you’re in control of the location. The duration, the number of people and the specific guests.
And that helps a lot of people just enjoy the event more and feel like it’s not so overwhelming. I. I also think it’s really a great idea to host this kind of event in your office because then people can see what your space is like. It’s gonna bring up questions about acupuncture for them, and it helps build trust because now they can picture themselves being comfortable in your office space, and they can easily extrapolate that to getting a treatment or referring someone to get a treatment there.
So again, ideally if you’re gonna host your own networking event, you’d want it to be repeated so that you can build relationships with these specific people that you’re inviting. I know some wellness people who do this, and it’s a book club. So they invite, like the wellness business owners, the wellness entrepreneurs in the area, and everybody reads like a wellness oriented book.
And then they discuss and then. It’s very casual. It evolves into other conversations between people. Okay. So think about how you might make this event something you’d actually enjoy going to. Most of my introvert friends and colleagues really like reading, so that could be a nice way to make this something that you actually look forward to.
Tip number four is to practice some conversation starters before you get to a networking event. And I, this is one of those tips that is actually so helpful and effective, but it’s so basic that people don’t do it. They’re like yeah, that’s not gonna help me. It will really help, especially if you’re an introvert and especially if you practice your sentences out loud.
And again, I know it sounds lame, just give it a try. I before your next event come up with a couple questions that you can ask. We’ll say just two questions to have in your back pocket that you can ask new people. Say, if you are standing next to the buffet. Or if you are maybe you’re already eating and you’re standing in a corner and there’s a group near you and you wanna get an in with them, come up with two questions that you can start a conversation with.
And these are so basic, they just need to be open-ended. So no yes or no questions and focus on the context that you share with this person. So if you are just meeting them, probably the only thing that you know that you share is the event, the location. The food, if it’s a charity fundraiser, then you’re both here for that reason.
So you share that. But you could start a conversation simply by making eye contact with someone and then just saying I see you got the shrimp. Do you recommend it? So basic, right? You can also think about, let me back up. I would have two of those types of questions, right? If it’s a charity event, your other icebreaker question could be, why do you support the Boys and Girls Club of America?
Or something like that. But practicing those questions out loud and mentally preparing to have them helps you actually say them out loud when the moment comes. ’cause I know that a lot of introverts. It’s, they have a hard time being the first person to speak, okay. Which is necessary for meeting new people at these events.
Okay, so pick two super basic icebreakers about something that you have in common with this other person, and then just go for it. Okay? The other thing is that. People love to talk about themselves. So an icebreaker question that I like to use, and this maybe isn’t an icebreaker because it’s not like the first question, but when I’ve been introduced to someone new I like to ask about their history in their career and also.
What is their favorite part of their job? So for example how did you get into real estate or what inspired you to become a chiropractor, or what’s your favorite part about being a massage therapist? People like to talk about themselves. These are open-ended questions and they help. They’re memorable questions because it’s not every day that a stranger says to you, what’s your favorite part about your job?
It really requires them to think and hopefully they like their job and they’re gonna feel enthusiastic and passionate as they’re answering you, and they are going to remember you. This is a memorable question, and again, our goal is partly to stay top of mind. We want to be memorable. Okay, so again, I know these are basic.
Give it a try. Tip number five is to try speed networking. So hear me out. I always think this is a little funny, but can actually be an enjoyable experience even if you are an introvert. It’s just like speed dating, but it’s just to meet new business owners locally. Or professionals locally. So you spend three or four minutes with someone, you exchange business cards and then a bell rings and you move to the next station.
So just like speed dating, but for professionals. And the beauty of this for introverts is that it is structured so you don’t have to walk into a big room and try to introduce yourself to strangers. You know that you’re gonna sit in this spot. And then other person’s gonna sit with you, you get to talk, the bell rings and you move on, right?
There’s no awkward standing around or introductions. And because it’s fast paced, there is no time for awkward silences. So the downside of this, of course, is if we’re trying to do relationship building, this is quick and superficial for that to happen. So what I recommend is when you are done with the event, if you met 15 people.
Pick the ones who you are really interested in getting to know, or you think you could be supportive of each other. You wanna build a relationship with them and send them an email, ask, do they wanna collaborate or could you buy them a coffee? Okay. And then that really can get the ball rolling to build that connection.
Okay? So tip number six is to ask. Anybody that you know at the event for an introduction. So people love to, be connectors and introduce us to other people that they think will genuinely enjoy. It’s like it gives them an endorphin hit to be helpful in that way. So let’s say you go with your receptionist, they’re the friend that you bring to the event and you say to them, do you know anybody here?
And they’re like actually I know one person. They’re standing over there oh, could you introduce me to them? And usually that one introduction has this ripple effect where, you’re gonna talk to that person in a group, you’re gonna meet other people, and then you’ll be carried along that wave for the rest of the meeting, whether it’s like an hour or 90 minutes.
So just one introduction can really help start that process. And let’s say that you get there and you don’t know anybody right away, but you manage to introduce yourself to one person. Even if you just met this person, you can say, Hey, thank you so much. It’s been so nice to get to know you before you, go mingle.
Would you introduce me to someone that you think would be interesting or can you just introduce me to one person? And they trust me, they’ll be happy to do this. Okay. They’re never gonna say no watch and see how their eyes light up and they’ll be like, oh yeah, I’d love to. Okay. So the last tip, and one that I find incredibly helpful is to get to know the people who are hosting the networking event.
So this is assuming that you are going to regular events. For example, the. Monthly Chamber of Commerce small business mixer event, whatever they call it. I’ll share a personal story with you. Since I’m an introvert as well. I have always felt very uncomfortable going to networking events by myself and walking in the door and just being confronted with these groups of people who know each other very well, and they’re.
Standing together, it feels very cliquey and I just stand there awkwardly with my drink. So it occurred to me that maybe it would be helpful to get to know the employees at the Chamber of Commerce. So what I started doing was when they were hosting fundraisers, I volunteered with them a couple of times and just through volunteering, I think three times.
I became such a familiar face to them and they’re, they’re so appreciative when you’re volunteering to help them at a fundraiser that whenever I go to a networking meeting now, I always am greeted by them like an old friend. And. It makes it that there’s always somebody at the networking event that I know I can speak to.
’cause there’s five employees at the Chamber of Commerce. So even if they’re not all there that day, I know at least one of them will be there running the thing. And I can approach them and I can say hello. We can have a nice chat. And I usually ask them. While we’re here, can you introduce me to someone new today?
Which they love doing ’cause that’s literally their job. But I found that getting to know them through volunteering with them was really helpful because, I walk into a Chamber of Commerce meeting now and they’re like, oh, hi, how are you? And that has really expanded with each person they’ve introduced me to.
Okay. They, and it’s I’m a regular. You know what I mean? That makes the pressure to go by myself so low because I know when I get there, there’s gonna be people who are basically my friends now. Okay, so don’t underestimate this tactic. I guarantee if you message the Chamber of Commerce and ask if you can volunteer with them a little bit, they’re going to say yes and be so grateful and always happy to see you.
Okay, so I hope this was helpful. Just keep in mind that networking is a long-term game and you are there to build trust, build relationships, make business friends, become part of a referral community that is genuinely supportive. And I think this will make the experience more enjoyable, less stressful, and overall more effective.
Okay. So as always, if you have questions, I would love to chat with you. My email is michelle@michelleGrasek.com and I really hope you’ll listen to the podcast, acupuncture Marketing School. And before I go today, I would like to thank the American Acupuncture Council, one more time for the opportunity to be here with you today.
Have a great day.
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One of the things we were doing is evisceration and kind of exploring those internal branches of the channel. So this is gonna be a very anatomical perspective of that internal branch of the kidney channel. We’ll go over the anatomy.
Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Hello, thanks for joining and thanks to the American Acupuncture Council for having me again. My name’s Brian Lau and I teach with the Sports Medicine Acupuncture Certification Program. I also have a YouTube channel, Jingjin Movement Training, where I go over a lot of channel oriented approaches to movement, especially for the Jing J or channel Send You Perspective.
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So check out my YouTube channel if you get a chance. You’ll see some very similar ideas that I’m gonna be presenting today. So what we’re gonna be looking at today is we’re gonna dive into the internal branch, or at least a portion of the internal branch of the kidney channel. In sports medicine, acupuncture.
We have some three day cadaver dissection classes, and I just finished one. I. One of the things we were doing is evisceration and kind of exploring those internal branches of the channel. So this is gonna be a very anatomical perspective of that internal branch of the kidney channel. We’ll go over the anatomy.
We’re gonna look at some netter slides. We’re not gonna look at cadaver images, but they’re drawn from, or they’re illustrated from cadaver dissection. Very good illustration, so we should get a somewhat of a clear idea. What those internal branches look like. There’s really no substitute to doing it in person though, but this will be pretty good.
We’ll get a little bit of a window into that internal branch of the kidney channel and then we’re gonna look at a very simple movement exercise that will kinda stretch, move some of those fossil planes engage that internal branch of the kidney channel. This is something you can do for your own cultivation and development.
It’s also a very easy exercise to give to patients. So I’ll give some thoughts on prescribing it to patients. So a lot to look at, but it’ll be a fairly easy and straightforward exercise that we can we can extrapolate from that to be able to put movement into that portion of the channel to really be specific in our thought process for the movement through that plane.
So let’s start with looking at the channels. We’ll go to the presentation. And start right away from one that you’re very common and familiar with is this Deadman image from a manual of acupuncture. We know the kidney channel, so you know, the kidney channel coming up, the medial portion posterior or medial portion of the thigh up into the abdomen.
I would say at the level of the transverse abdominis when you’re needling, that, that would be deep to the rectus abdominis and getting the deepest abdominal layer. Then it goes up into the chest and terminates, but. We’re gonna look at this internal branch, especially in the abdomen area. So let’s zoom into this area that goes from the urinary bladder and to the kidneys.
Many people think this follows the ureters that makes sense, but we’re gonna be looking at a whole fascial plane. First off, let me say from this Deadman illustration that from an illustrative standpoint, he draws or not whoever the illustrator is, they draw this much bigger. The kidneys are very large and it looks like this.
Whole internal branch is very anterior, but that’s not particularly it’s useful for the illustration to see the structures, but it’s not very informative of where this actually lives. It would be just posterior to the midline. So if you think about this internal core, this portion of the internal branch is gonna be on the back portion of the core.
And by core I don’t mean core musculature, I’m talking about the central. The the peritoneal cavity, this is in the back. This is retroperitoneal, so it’s closer to the front of the spine, closer to the back, but it’s pretty center back center. So keep that in mind from this illustration. When you come back and use this as a guide, understand that this is not forward as we’re seeing in the illustration.
So let’s look at some netter images and get a little clarity. So first thing, this is the anterior, the ventral portion of the peritoneal cavity. This isn’t the target we’re looking for today. I just wanna walk you in. This would be pretty much the approach we do when we do eviscera evisceration, where we’re taking the ventral cavity.
We’re taking the contents of the peritoneal cavity out of the body, putting them on a table to study. They’re still connected through their peritoneal connections. They’re still all, it’s all one piece. It’s still organized. You just have to put it on a table and you can study it out of the table instead of trying to look in the ventral cavity.
But when we first start, everything’s intact. So we’ve, reflected back the abdominal muscles. We’ve cut open the peritoneum. This would be the first thing and what is the stomach. You might see a little portion of the liver, but it’s a little more buried under the ribcage, the stomach, and the greater omentum hanging off of the stomach.
It’s not the subject of this of this presentation, but I can note that this, in my opinion is what’s being described by the internal branch of the lung channel because this greater momentum hangs off the stomach much like it’s described as connecting with the stomach. It hangs off the stomach if you lift the greater momentum up, which you can do very easily unless there’s been a lot of peritonitis and scar tissue.
You’ll see that the transverse colon is attached intimately right to the back surface of that greater momentum. And when you look back at the lung channel, it comes off the stomach and links with a large intestine. I think they’re not describing a channel per se, but a plane they’re describing anatomy with this particular internal branch.
We could go more into that another day, but just to highlight the start of what we’re looking at, because once we have that ventral cavity open. We’re gonna start to come in and gently cut away the abdominal contents from the parietal peritoneum from the peritoneal wall. So that’s gonna be our first access.
And over time it’s gonna maybe look something like this. I’ll tell you when we do evisceration, we’re cutting the intestines out also. But we’re gonna come around the intestines and go behind them to the posterior abdominal wall and eventually. You’re gonna see the strong connection of the small intestines to the root of the mesentery that goes basically from the jejunum all the way to the ileum.
So I put this slide in here just to highlight how stronger bound the abdominal contents are to the back of the abdominal wall compared to the front of the abdominal wall. But it also gives us a window in how we would do the evisceration would be coming around the intestines. Maybe this image doesn’t quite show that as well as this image.
This image is showing a cross section so I can see where I might bring that scalpel around the intestines and cut it away from the abdominal wall. I’m gonna follow in front of the kidneys and in front of the perren fat, which is generally much thicker than what in this in this image.
I’m gonna come around the inferior vena cava. Generally, when we do evisceration, we go behind the pancreas. The pancreas, at least a majority of it is retroperitoneal. So you could go in front of the pancreas. We usually go behind the pancreas, take the spleen out, and take the whole abdominal contents out.
So you know, you have one person lifting up. Pulling everything to the right while there’s gentle cutting, maybe move, pull to the left. Gentle cutting. Eventually we bring the whole abdominal contents up, bring the liver away from the diaphragm, clamp the bowels, cut those so we can eventually lift everything and remove the abdominal contents.
And once that happens, this is what something like this. This is a pretty good illustration that doesn’t quite. Look like it would be in, in a a real body. It’s simplified a little bit to make it a little bit easier for, for study for med students and such. But we’ll see that the intestines were removed.
Some things were kept in this case, the pancreas was kept in this netter image. Like I said, I usually go behind the pancreas and bring that out. The kidneys are left in though there’s a lot of perren fat around them. You don’t actually see the kidneys until you remove that fat. The adrenal glands are left in.
A lot of the vasculature is left in so we can study. In dissection, we can study this posterior retroperitoneal space, which is basically what we’re looking at. Especially if the peritoneum was cut off in this illustration, it’s left on. So imagine this film of the peritoneum off, the pancreas out.
That’s what we really end up with, is that retroperitoneal space. And this, in my opinion, is that internal branch of the kidney channel. It could follow the ureters. There’s the ureter. To the kidney from the urinary bladder. So urinary bladder to kidney. So the ureters are in there, but I don’t think of it as necessarily like a line or a space.
I think of it as a plane. I think they’re talking about this retroperitoneal space. And when you’re doing this dissection, it’s amazing how loosely held all of this is. You’re using a scalpel, but sometimes you can just tease it apart with your hands. You have gloved hands of course, but you can tease it apart with the hands and break up.
Some of those little cross links that are connecting the peritoneum to the retroperitoneal space. It’s very loosely held. Now. It’s a large space, so collectively there’s some integrity there, but individual spots of that are pretty loosely held, or at least we want ’em to be fairly loosely held. We want a little bit of movement in that plane.
And this is what I wanna explore with the exercises I’m gonna show is not to think of the movement exclusively as musculoskeletal movement. Yes, the muscles are gonna be active. Yes, the spine’s gonna be moving. But can we sense, can we bring our attention and our awareness to that space that’s in front of the spine and let that sort of elongate and come back up and move.
Can there be some movement there to increase circulation in this internal branch of the kidney channel? So what is in this retroperitoneal space? We have the kidneys. That’s gonna be a big part. The SOAs, you can see a little shadow of the SOAs. Right in here. It’s covered by a lot of the fascia in this retroperitoneal space.
So to view the SOAs, you’d have to remove that fascia, but you can see the outline of it there. The kidneys are intimately tied to the SOAs. So the SOAs would be a big part of it. The ureters going down to the bladder. A lot of the blood vessels. So if we can get movement in this plane what’s gonna happen with the aorta and the inferior vena cavas, those can create a little bit of a stretching and elongation to help for their suppleness because that’s very important that they have a certain amount of suppleness in those vascular structures.
There’s lymph nodes, pancreas is in there, but I’m not sure if that’s relevant for the internal kidney. Channel as much as it is, maybe other aspects. But the pancreas would be in that retroperitoneal space. A lot of nerves coming through there. The perren fat that covers the kidneys, but there’s a lot of other fat back here that has a lot of implications for health.
It’s a very metabolic tissue. So there’s some hormone production from that. I don’t know if movement would help that, but I think that just getting circulation and free movement in that area can’t hurt. I think it has a lot of implications for health, not in an area that’s been explored much in terms of how we understand movement, but I think there could be a lot of implications for improved health, and maybe that’s one of the mechanisms of Qigong and those types of practices is to introduce movement into these internal cavities of the body.
And this one, the kidney channel in particular. All right, so just some, quick sample of some distortion of those. Internal branch of the kidney channels. I could have picked a whole lot of other types of images. But overweight is people who are obese a big portion because that abdominal wall is less tightly held in the front than it is in the back.
So oftentimes that extra weight pulls everything forward. And you can picture how compressed that internal branch of the kidney channel that retroperitoneal space was. How. Close that area is, and how little movement is gonna occur in that retroperitoneal space. Not somebody who’s heavy, but this is not an uncommon posture.
It’s a kidney deficient posture where the pelvis moves forward. We look at this in sports medicine, acupuncture. See a lot of correlations with various types of kidney deficiency, kidney in deficiency. Commonly with this, you see this with older people. This person’s not particularly older, but you see it a lot with elderly too, where the body starts collapsing, where the pelvis shifts anterior and the rib cage collapses down onto the pelvis.
And again, you can imagine that region of that retroperitoneal space. Just posterior to the midline, how compressed that area is, how compressed that area is, and how potentially little movement there is. So we wanna introduce movement, build core strength for this person, which is also involved with the kidney network, but also to start to introduce movement into that retroperitoneal space.
So that’s the last slide. Why don’t we look at the movement. It’s very much a squatting exercise. It’s a Qigong exercise, a type of spinal wave. Very simply, it’s a squat, but I’m focusing on getting an expansion and compression throughout the spine, particularly in the space we’re talking about.
You’ll still be an arm motion, it could be interpreted as a macrocosmic orbit. You know that circulation up and down the spine is the microcosmic orbit. That’ll be inherent in this movement, but then that expresses out into the arms. So you’ll see that there’s an arm component. I wanna start though, on parallel bars and just show this dropping.
You can see it a little bit better when I’m off the ground. You can see the pelvis in that area drop a little bit more than you’ll see in the squatting exercise. That’s not the exercise I’m showing. That’s just for demonstration. So we’ll show a static hold on parallel bars so I can let the pelvis drop and you can visualize that area elongating and softly, gently stretching a little bit.
Then I’ll show it in the squat activity. So let’s move to that position and we’ll look at the exercise today and keep in mind that that kidney channel internal branch. So I wanna start off with an exercise that’ll let you see what I was talking about in the slides with the anatomy.
This isn’t the exercise I wanna show, but it’s a little bit more visible. The next exercise is a little bit more subtle. So this is gonna show just that ability for the lower pelvis to drop and that internal branch of the kidney channel just elongate and stretch and have a little bit of movement and just coming up.
Into a hold on the parallel bars. I wanna initially pull the pelvis up, so I’m engaging my core to pull them, pull the pelvis towards the shoulders, and then let everything relax. So just letting gravity take the pelvis down. So it’s that initial drop sinking of the pelvis. Elongation of the pelvis and the spine, especially the lumbar spine, but that internal branch of the kidney channel will stretch.
So one more time just to see that I’m gonna do this while I’m sitting in just a moment. I just wanna let gravity take the pelvis down so I can get that stretch on the internal branch of the kidney channel. All right. I’m gonna move these.
Move that out the way. Do you want me to move it all the way outta the way, Alan? I guess it’s fine. Fine there. As long as it’s a little more.
So let’s look at the full exercise. So maybe I’ll start with a little bit of a spinal wave motion to warm the spine up. I’ll show this from the side in a moment. I’m just getting things moving. This will start to engage that internal branch of the kidney channel, but a little bit more of the musculature of the front and back is engaged.
I’m just warming up. So just a little bit of spinal wave activity. Let me show that from the side. So if you’re working on these exercises and following along with this, I just wanna initiate that from the pelvis tuck. The pelvis under chest comes down, so rectus abdominis is engaged back, muscles are engaged, front muscles are engaged.
I’m creating a circulation up and down the spine.
Exhale, if I wanna bring my breathing into it. Inhale, exhale, and inhale. I could do other variations of that to get the chest involved, but I’m gonna go into the main exercise now, so I’ll show it first from the side. I wanna get about a pelvic width stance outside of my pelvis could fit on the inside of my feet.
And elongate the spine, chest relaxes, and here’s that part. Whereas on the parallel bars, I want to drop the pelvis down. A little less visible, but it has a feeling of that elongation that you got on the parallel bars. So chest softens, pelvis sinks. Drop the pelvis down. Gauge that internal branch of the kidney channel by letting it just relax and stretch.
Sink. Let it go. I’ll do a few more from the side, and then we’ll look at it from the front.
All right, so chest softens, everything comes slightly in. I have a very slight hollow shape to the spine. Then the next part is I wanna let the pelvis sink. Let the pelvis sink. Let the pelvis sink. Everything’s getting longer inside. Eventually the whole body’s gonna start coming down, but there’s a moment where my pelvis is moving away from my head as I push up, everything’s coming together as I fully stand up, everything’s spreading apart.
Chest is coming higher than the pelvis. Chest sinks down towards the pelvis. Pelvis sits away. Pelvis comes up, chest expands away, chest softens down, pelvis sits away. So I return length to the body. There’s like a compression, a lengthening. I don’t wanna go down all compressed. I don’t wanna lean forward.
I wanna let everything drop, stretch, elongate, relax, soften inside, and just let it go. Okay, so a couple times from the front. So again, the setup is hips can fit between my two feet. So about the inside of my feet are about as wide as my hips. I’m going to open the chest, press up, relax the chest, sit down,
press up, get taller, soften the chest, sit the pelvis away.
Sink down, push up.
And up.
All right, that shows the main exercise, very subtle, quiet exercise. You can show it for patients quite easily. Easy to work with, easy to work with for yourself. But a couple highlights is that you can watch out for is sometimes people don’t have enough strength on the adductors, or excuse me, the abductors, so when they go down, the knees collapse in.
So that might be something to work with. Of course flexibility in the spine. You don’t want ’em to be like you saw from the side, very rigid or sticking their behind out. A lot of that can be strength and flexibility. So I’m gonna take just a quick step forward and note that I might use something to hold onto.
Especially if I’m giving this to patients and they’re new, I have a TRX in my room, so TRX might even be better if there’s a slight angle where they’re holding onto. But even just kitchen sink, parallel bars, a door, something like that, just so they can go down in a controlled manner, let the pelvis sink down and just having something to hold onto can make it a little easier so they can concentrate on not letting the knees pull in.
They keep the shape open, they can. Work on just letting everything soften and just having that extra little support can be very helpful for ’em pushing up. The other thing is they don’t have to go super low, right? If it starts getting distorted, going farther than that, maybe that’s where they stop for now, push up, et cetera, so they build the leg strength, build the flexibility.
Build the relaxation to let the spine go and holding on is a perfectly acceptable way to do it.
So simple exercise, but it offers a ton for patients and even just for your own self practice. All right, so I hope you found that informative. It’s one exercise. I particularly like that exercise and I use it a lot in my own practice, and I do show variations of that to patients. But I think the bigger thing is to start thinking about therapeutic functional type movement patterns and considering that visceral component.
How does that move the inside? How does that move and engage these internal branches of our channel network? It gives you a different perspective on movement instead of just thinking about the muscles that are involved. And I think there’s a ton of implications for health and development and wellness from that.
So play with the ideas. You can use this exercise for this particular internal branch, but it’s not tied to one exercise. It’s a. It’s a thought process that, a change in paradigm, a paradigm shift for movement. So give it a thought, put it into your own practice and see see how it goes.
So thanks again to the American Acupuncture Council. I always appreciate having the opportunity to come on and present. Hope you found this informative. Again, if you wanted some more information, you could look at my YouTube channel, Jingjin Movement Training. I cover a lot of these types of exercises, and again, from a channel perspective but there will be other times we’ll be here with the American Acupuncture Council.
We’ll look at some other ideas with it at that time. So thanks again.
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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Greetings, friends and colleagues. This is Sam Collins, your coding and billing expert for acupuncture. The Profession, acupuncture network of course, and the American Acupuncture Council here to always make sure you have the best and latest information. And one of the things I run into all the time in teaching seminars, but also acting as an expert, is trying to understand what are the differences between certain types of CPT codes.
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The one I want to give an example to is, one that’s come up quite a bit recently is what is the difference between 9 7 1 1 0? 9 7 5 3 0. So let’s go to the slides. Let’s talk about it. What are these two codes? 9, 7 1, 1 0 is exercise, therapeutic exercise 9 7 5 3 0 is therapeutic activities. What is the difference?
How do we understand that? I wanna make sure acupuncturists have a clear understanding, ’cause that certainly can be within scope. Let’s first get into, we have to always make sure we understand the codes well, to choose the right service. Based on the right code, based on the services we’re providing.
So it says here per CPT that select the CPT code of the procedure or service that accurately identifies the procedure or service performed. Do not select a CPT code that merely approximated. So you can’t say it’s like it. Like I had someone that found out that hot packs aren’t payable by almost all insurances and haven’t been for quite some time.
So he said I’m going to bill hot packs. Infrared heat with the idea being, theoretically any warm body. Emits an infrared portion of the heat spectrum to some degree. That’s not really the intent. Certainly infrared heat is a little bit beyond just a hot pack. So again, we want to be careful of trying to twist things.
If it doesn’t fit exactly, make sure you’re using an unlisted code, which pretty much means it’s not gonna be paid, but use the code that best identifies it. Here we have to remember as an acupuncturist. Can you do more than just deliver acupuncture? Of course, your scope of practice often can be very broad, and I will say certainly look at your state.
If I teach in your state, certainly get a hold of me. We can work on that. Understanding what type of services you can do beyond obviously evaluations, but you’ll often see in your scope it’ll say adjunctive services. The adjunctive services often are very broad. It includes a lot of physical medicine services that might include heat, massage, exercise, and so on.
So do verify your scope. But generally all physical medicine services are generally within scope done with the idea of a traditional medicine slant to it. So let’s take a look specifically at two codes here today. 9 7 1 1 0. You’ll notice as a therapeutic procedure, one or more areas 15 minutes, which means it’s face-to-face time, just like acupuncture and therapeutic exercise Says therapeutic exercise is to develop strength and endurance, range of motion and flexibility.
Okay, so the standard things you do, if you told someone to go out and exercise, what would they think they’re going to improve? I think that’s what we’re seeing with that. Pretty generic, Qigong, if you will, but what about a therapeutic activity? Now you’ll notice the one in the bottom, 9, 7, 5, 3 0 says therapeutic activities, direct one-on-one patient contact by the provider.
So that’s still the same, have to be there. But then it says, use of dynamic activities to improve functional performance. Therein is probably the biggest difference. Exercises generically just to increase strength, flexibility. Therapeutic activities are exercises, but specifically done to create a certain or specific functional outcome.
So 9 7 1 1 0 are movements and physical activities designed to restore function and flexibility. Okay, it. It includes instruction and feedback. So realize when you’re doing this face-to-face, it doesn’t necessarily mean that you’re staring at the person touching them, but you’re supervising, making sure they’re doing it properly, safely, maybe assisting them.
But it does require you be one-on-one. You cannot do exercise with two people at the same time. They can be doing that, but it wouldn’t be this code 9 7 1 1 0 is one-on-one. When you’re with a patient, maybe they’re doing yoga poses, maybe they’re doing tai chi or any type of exercise for strength, flexibility, endurance.
In fact, if you think of exercise generically, it fits almost everything we think of when you go to the gym. Bikes and treadmills, gym equipment, weight equipment, isometric, isotonic, isokinetic, but includes passive things like stretching. Might be assisting the person just in stretching.
So certainly any of that fits. Just make sure you’re documenting what exercises I. How much time you’re spending in doing it. So simple things like knee to chest stretching, maybe a low back rotational stretch, anything like that certainly fits. Notice. These are ones that you might be directing the patient to do.
Now this might be one we probably give them to do it more at home later, but certainly when they’re doing this in the office with you, that is absolutely a billable service. Now, what is the difference of 9, 7, 5, 3 0 exercise? I think we can see pretty easy and straightforward, however. 9 7 5 3 0 says one-on-one patient to improve functional performance.
So this involves functional activities, bending, reaching overhead activities with very specific outcomes to increase a function. So let’s say by example, you had a person that is a grocery store clerk and they hurt their wrist. When you strengthen that wrist, is it just to strengthen or is it to strengthen it to have specific tasks to allow them to do their job at the grocery store?
The same exercise that might be for someone just to strengthen the wrist generically, may be the same for the grocery clerk, but because you’re specifically liking to do a specific task, whether it’s going to be reaching in and out of a bag and lifting items, makes it more an activity. So always think of the outcome, realize all exercises.
Could be therapeutic activities. All therapeutic activities potentially could fit under exercise, depends on the why. So here’s the best way to think of it in choosing it. Look at all these pictures on the right. Could you say to me, oh, Sam, that one is exercise. This one’s a therapeutic activity. We cannot tell from the picture because choosing the code depends on the intent of the task.
So follow me here. If you’re doing abdominal curls, they certainly can be used to strengthen weak abdominal muscles and build as exercise. They come in their stomach muscles are weak. We’re doing abdominal curl strength in the stomach. Great. However, what if the patient is performing the abdominal corals specifically because their abdomen is so weak, they don’t have an ability to rise up from a lying down position or get out of a chair because the stomach is too weak.
Now all of a sudden. Those exercises, yes, they’re strengthening the stomach, but it’s there because we need an outcome that it’s there to perform. Getting in and out of a chair or lying down, that’s the activity and that’s why this is worth more. To give an example, 9 7 1 1 0 has a RVU of about 0.89.
Compared to 9 7 1 9 7 5 3 0, which is 1.15. So you’re gonna see that’s almost a 30% difference. It’s worth quite a bit more because this is designed specifically for that patient, something for them to do, not just generic for everyone. If everyone does the same thing, I’m gonna say, ah, that’s probably exercise.
But best practices determine what is the outcome expected from the task. Is it simply just to strengthen? Or is it a functional performance? When it becomes a functional performance, realize the higher value is you’re designing something specific for this patient’s needs. And I think when you think of most exercises, I think that’s what we do.
Now, obviously if everyone gets the same sheet, the same things, okay? But assuming we’re gonna have some nuanced differences, I think it’s far better to look to make sure we’re choosing the right one, because certainly one is worth quite a bit more. And I want you to be paid what you’re worth. Don’t be afraid to code what you’re doing so long as you document it properly, I will always support you.
That’s what we do at the American Acupuncture Council and the network. To differentiate things. Make sure you have the right resources. That’s what our network does. You’ve been to our seminars, but have you ever thought of, Hey, let’s have an expert on task. I could be part of that. Join our network. We’re with you one-on-one, and you get all our seminars free.
Till next time, my friends, I wish you the best.
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When we’re treating the face, we’re treating the entire person because facial acupuncture impacts not just our appearance, but it affects the function of the face, and it also affects a person’s spirit. So when we think about facial. Cosmetic acupuncture, which is what I’m going to talk about first.
Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Hi, my name’s Michelle Gellis. I’d like to thank the American Acupuncture Council for an opportunity to present to you today on treating the face as a whole. And this is part one, so you can go ahead and go to the slides.
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So my presentation today is on a multidimensional approach to facial acupuncture. As I mentioned, my name’s Michelle Gellis. I am currently on the doctoral faculty at Ossan University. I’m a formal faculty member and clinic supervisor at the Maryland University of Integrative Health. And I am a published author and regular contributor to the Journal of Chinese Medicine, and I’m a columnist on acupuncture today, and I’ve been teaching facial inter facial acupuncture classes internationally since 2005.
This is the cup of my. Book that has recently been published on Treating the Face. It is a hard cover 15 chapter book on all aspects of treating the face. And you can scan that QR code if you wanna check it out. So when people think of facial acupuncture, the first thing that comes to mind is cosmetic acupuncture.
But treating the face is much more than just cosmetic. When we’re treating the face, we’re treating the entire person because facial acupuncture impacts not just our appearance, but it affects the function of the face, and it also affects a person’s spirit. So when we think about facial. Cosmetic acupuncture, which is what I’m going to talk about first.
That works with both the body and the face, bringing blood and cheese circulation up to targeted areas in the face. It stimulates collagen and elast in production, improves the tone of the skin and the of the skin. It enhances circulation and reduces inflammation. So puffiness and increases the natural glow of the face.
So you look rested. You have more color in your cheeks. And additionally, because of the. Nature of the acupuncture points on the face, you are supporting your patients’ overall health, their digestion, their immunity, and their overall circulation. Facial acupuncture can erase five to 15 years off of the face, and it’s great for lifting and treating on a very deep level.
The important thing when you are performing facial acupuncture is to use precision needling techniques, which typically involves training with someone who’s very well experienced, who’s been doing facial acupuncture and teaching facial acupuncture for many years. So how does cosmetic acupuncture work?
Cosmetic acupuncture brings blood flow and oxygen up to the face and it brings nutrients to the skin cells so your skin will look better. It does take about 28 days for collagen to regenerate, and that is increased if someone is older. So you really do have to do a series of treatments. It’s not just a one and done.
And once a person has gone through a series of approximately 12 weekly treatments, then usually they can start to spread their treatments out over time and eventually come once a month or just seasonally for touchups. Cosmetic acupuncture also utilizes motorpoint stimulation, and this can help with the functioning of the muscles in the face, and it will therefore balance.
Overactive muscles. Muscles that are too tight, causing the skin to contract or weak muscles, which can cause the skin to sag. It can help to enhance the jawline, giving a more lifted and supported appearance. And it also helps with the mid-face support. And this all happens through proper engagement of the facial muscles.
So if we just look at the layers of the face, we have the skin, then there’s some superficial fat, and then this mass layer. The superficial muscular AP neurotics, AP neurotic system, which is very unique to the face. We have some retaining ligaments, deeper fat on the lower part of the face, and then we have some deeper fascia and the bones and this mass layer.
Is what enables us to make our expressions because the muscles on the face are connected directly out to the skin. So as we can see, we have bone muscle. And skin. And so what happens is as the muscle contracts, the skin moves, and over time when we’re contracting these muscles, either through smiling or frowning, the skin that’s over the muscle will contract and it will eventually form lines and wrinkles and folds.
So here is someone who doesn’t have a lot of signs of aging, someone who’s a little younger. Then as we get older into our fifties, we can begin to see some signs of aging. And then as someone is progressively older, they’ll start to get forehead lines, bolts and more wrinkles.
In addition to wrinkles from facial expressions, gravity can cause the neck to hang down and jowling, especially around the mouth area and the skin on the cheeks and underneath the neck. The platysma bands start to form the cheeks start to sag.
And different facial expressions related to our emotions will cause different sorts of wrinkles. For example, smiling can cause crow’s feet frowning or being angry can cause these lines in between the eyebrows and cursing the lips a lot. If you were pensive, that’s an expression can cause lip lines.
The forehead is a kind of a zone of anger and frustration. The crow’s feet area, smiling. Sometimes sadness, depending the lips from overuse or estrogen loss can lose their. Plumpness and cause wrinkling the chin, if there’s a lot of fear, the chin can pucker and then jowling and the neck area frequently is a sign of cheat deficiency.
So we have emotions that can cause wrinkles cheap. Blood and body fluid are also related to the skin and how the skin looks. If the chi is deficient, you can get a withered looking appearance. If the chi is stagnant, it can block the flow of blood and fluids. So blood causing discoloration and fluids and cause puffiness, especially under the eye area.
So let’s take the liver, for example. If we’re looking at the liver system, we can see that stagnant liver blood can cause liver spots and liver blood deficiency can cause the skin to be dry. And liver cheese stagnation can sometimes manifest as anger and frustration, and this can show up in between the eyes.
So there’s a lot of different ways with our medicine to treat the emotions. A five element. Treatment. If you’re trained in five element, acupuncture can help to balance the organ systems and the emotions. Additionally, using the entry exit points on the face can be very beneficial for opening the face up, getting a smooth flow of Qi between the face and the body, between the Z and the.
Also allowing for a balancing between the organs, facial motor points can be very beneficial for treating the face, especially expression lines. And there are many muscles on the face and neck, as you can see. Some of them are listed here. This is not. A comprehensive list, but this is these are the muscles that we frequently use motor points for when we’re looking to treat some of the emotional manifestations.
Some of the, of some of the expressions. So here for example, we have the expression of anger. So here we have a relaxed face, and here we have an angry face, and you can see how the muscles get contracted. And by using the motor points or the different muscles, which are the motor points are located. The most electrically acceptable part of the muscle.
So you treat the motor point and it treats the muscle and it allows the muscle to get back into normal functioning. And this can help with not only the manifestation, the external manifestation of the emotion, but it can treat the muscle, it can treat the acupuncture point. Which helps to treat the whole person.
Many motor points on the face are acupuncture points.
This is actually an image from my book. This is from a chapter called The Anatomy of Expression. And it’s a little easier to see here. Side by side, a person making the expression, and then a split view of a relaxed face with the motor points and then the contracted muscles on the right.
Facial Gus Sha can be very beneficial for treating the skin, helping to work with fascial adhesions and tension in the face can help to sculpt the face. It’s very relaxing to the patient. It’s very calming to the spirit. I really love Jade Guha tools. I find that they tonify the skin and they help to nourish the blood.
Facial cupping is also a wonderful technique. These small glass facial cups. That are easy to squeeze, are wonderful for treating the face. And of course, when you’re doing facial cupping or facial gua, you never wanna leave any marks on the face. So if you’re going to do either one of these techniques, protocols, please get properly trained.
And everything that’s happened to us in our life gets etched on our face. Our fla, our face reflects our life story and needling the face helps to release stored trauma and can really transform the she on a very skin level. Related to what we do, but in no way a deep level or a spiritual level treatment microneedling using a device like this, a microneedle pen with microneedle cartridges. This can treat very skin level conditions on the face and on the body chest. Back and other parts of the body as well.
And here’s an example of microneedling. You can see on a very skin level, some wrinkles around the mouth. And then after a few treatments the wrinkles are gone. So if you’re interested in learning more about facial acupuncture. There’s a QR code there for my website, facial acupuncture classes.com, and you can find me on Facebook into Instagram, LinkedIn, and TikTok.
Under my name, Michelle Gellis and I have a Facebook group called Facial Acupuncture. Thank you so much.
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