In theory, the process of putting together the perfect lineup of healthcare practitioners could actually flow just the way you set up your Pinterest boards. Sure, you wade through some duds and, yes, there are going to be days where you lose the entire afternoon searching for just the right pin to add to the collection. But ultimately, there’s a perfect confluence of elements and it all looks and feels great. Right?
Each person is different, their needs are different, their resources are finite, and–without some planning and forethought–practitioners and allied healthcare professionals can become one big blur. And can you really trust the hype? What if you don’t know the right questions to ask? What if you don’t know where to start?
The purpose of this blog post is to raise a few questions (if you follow my blog, you know I love to do that) and to provide some thought-out suggestions (also a fave of yours truly). Practitioners and patients or clients alike can benefit from the considerations raised herein. What are some questions you should ask when you start looking for a new practitioner? And how does having a particular referral network help your practitioner to help you? Finally, how can we, the practitioners, help each other, thereby boosting our businesses as we create the very best scenarios for our patients and clients?
Questions, questions, and let’s see if what follows answers any of them for you, no matter where you stand in the big picture.
~~~If you are the patient or client…~~~
I am a traditional Chinese bodywork therapist and health coach in the process of becoming licensed to practice acupuncture and herbal medicine. [Update: I am now a licensed acupuncturist and herbalist]. Not everyone who comes to me has an extensive roster of healthcare support professionals in addition to me, but several do. These can include multiple Western allopathic professionals in the case of my Ehlers-Danlos hypermobility clientele. Some of my pain clients have orthopedic doctors or specific yoga classes they never skip. It can be a therapist plus a personal trainer plus others in the case of severe and chronic trauma. Some of my weight loss people have a trainer, a doctor, a nutritionist, and me. My aesthetics clients have maybe a dermatologist and me, or it might be a favorite aesthetician and my services that keep that face glowing. There are a lot of ways to build a health nurturing team and each person is unique. Each situation is unique. What is important for you, the client or patient, are a few broad themes that you can keep in mind.
Does you intend to see these people regularly? If so, do they hold completely opposing theories of health (and you turn into a ping-pong ball as a result) or are there some connecting threads to what you are building? This is an important consideration. If your doctor suggests that you go to a health coach, do you have a choice or did you get sent to the doctor’s in-house coach? And if so, do you think this helps you or do you think you’d be better served by finding someone else who may have somewhat of a different philosophy than that of your physician? It may be good to have some variation; it may not. Will your doctor talk to you about this? Can your potential health coach articulate how and whether their work with you meshes with your larger picture? And who is going to be the central authority who you trust and turn to first when you have questions?
Before this career, I was a professor. When a professor plans a class, they do it the year (or years) before actually teaching the class and often it’s part of a larger end-game. My professional specialty was Spanish literature. I still had to teach language, and when I put together that syllabus for Spanish I, or first-semester beginner’s Spanish, I did it with an end-goal (competency so that in a couple years that student could be in my literature class) in mind. Health should be the same. Not reactive but instead proactive. When you ask the right questions and have a long game in mind, your outcomes can be life-changing and indeed most wondrous. Finding the right people and seeing them as part of a tapestry is a good way to achieve this outcome.
~~~If you are the health coach or other allied health professional…~~~
I’m in some wonderful online groups and one topic of conversation revolves around building referral networks in order to generate business. In other words, finding healthcare providers who will refer to health coaches and personal trainers. One conversation that made me stop in my tracks included acupuncturists as potential referrers. Soon after, I met a surgeon at a health function. I asked him how an acupuncturist could approach a surgeon to develop a referral relationship. The surgeon sighed heavily and replied that his office gets an incredible and endless number of emails and letters from people who want referrals from him. He said that they do look at all of them, but that it is somewhat tiresome and annoying to get mass appeals. This conversation and my reaction to the first scenario made me ponder. How can I become a standout in the “Will you put me on your referrals list” sector and what would I do if a health coach sent me such an appeal?
My advice? Know your audience. If you are a health coach and you want to work with an acupuncturist, make sure you know that we are primary care providers in some states and very tightly regulated in others. As much as I love ACE and am certified by them, their literature to train health coaches and personal trainers (both certificates I hold from them) imply that acupuncturists are certified the way yoga teachers, personal trainers, and health coaches are certified. We are not. We are licensed. If you’d like to learn more about our credentials and our board exams, there’s a blog post about the biomedicine board exam (here) and the full panoply of boards (here). We are licensed.
If you want to work with an acupuncturist or get referrals from one, do go into the introduction knowing our background on a broad level (our credentials) and being aware of the individual in terms of specifics. Is this a solo practice? Then this is a small business just like yours. Don’t just ask for referrals. Be ready to show that you have something to offer the acupuncturist too. Have you tried acupuncture? Are you willing to come see me for an acupuncture or a tui na treatment? There are lots of benefits to tui na and other forms of traditional Chinese bodywork, as you can see, here, and if I’ve treated you and I know you, I am much more inclined to send someone to you. I’m not the acupuncturist or health coach for everyone, and if I’m primarily treating someone with in-office bodywork or acupuncture, I am inclined to refer out. I also do not treat married couples. When the happy, healing spouse wants their partner to start acupuncture or bodywork too, I find someone else to do that work. My patients trust me and for good reason. I will only refer to people I know and when I refer, I do so because I sincerely believe that the referral will benefit my patient.
~~~If I want to work with you…~~~
If I contact you and ask if we might refer to each other, it’s because I’ve looked at your web site. I am not going to ask a busy doctor to drop everything and chat with me but if you have something to offer that many of my clients or patients need, I will reach out and see if you have time for me to come by your office for a brief introduction. If you are a personal trainer or a health coach or a bodywork therapist with a specialty different from mine that’s useful, or you are a yoga instructor or a psychotherapist? I will only refer to you if I’ve spoken with you and gotten a good feel for whether or not I can in good conscience send my clients to you.
Here is a tip: my name is Paula pronounced the Spanish way (Pa-U-la, emphasis on the u) and that’s a great test of your listening skills when I meet you. If you can’t pronounce it, that’s no problem. Most English-speaking people can say the word “pow” and if you can say “Pow-la” that is close enough. If you don’t bother, and I will repeat my name again to you so that you get a second chance, that tells me that you’re not a good listener and not very culturally aware. I met a group of therapists at their open house recently. I will not ever send anyone their way because not a one even tried. A therapist needs to be a good listener. I don’t insist that clients and patients pronounce my name correctly. I don’t even insist on that for personal trainers or yoga teachers or bodywork therapists (although I appreciate it). But with psychotherapists? Being a good listener and respecting someone’s identity is the sine qua non of psychotherapy. They lost me at the introduction because they were not good listeners and they demonstrated a lack of intercultural awareness. Whatever you purport to do on a professional level, I look and listen to see and hear how consistently and well you do it before I send my treasured clients and patients to you for whatever it is. (And I assume that you do the same with me if you reach out to me).
Long story short: little things do count.
For personal trainers, health coaches, bodywork therapists, and yoga teachers? There is a difference between me sending someone to you as a complement to the primary strategy vs. me sending someone to you because I think that what you offer benefits the client or patient more than what I have to offer. A client is someone I work with as a health coach or wellness educator. Patients come to me for traditional Chinese services and that can come in the form of wellness coaching combined with acupuncture, herbs, and/or hands-on treatment. There can be some overlap but I don’t mix the metaphors past a certain extent. (Note: I am always mindful of scope of practice; that there is an MD up the line from me often factors in, or I refer to Western practitioners if something I see is out of my realm).
Know your place in the spectrum. I have sent a bodywork patient to to a yoga instructor because ongoing instruction is what the person needed; bodywork is good for this individual but their situation was best served by gentle exercise. I have someone else who wants to be able to bend and pick up a grandchild. This person derives great benefit from acupuncture and bodywork from me combined with functional fitness training from a personal trainer who works with elderly clients. However, keep in mind that when it’s an ongoing treatment plan (as in the second case), I am the authority in this situation. The personal trainer is not. When I have questions, I ask my mentor or give the patient questions to ask their orthopedic specialist, an MD.
This doesn’t always work out the way I would wish. Example? I have someone who is very gifted and I’d love to continue working with them. Unfortunately, they tried to hijack the treatment plan and managed to do it in such a way that it called my attention. I no longer trust this person’s professionalism. I have others to whom I will refer.
Long story short? I know my place along the firmament and am well aware of the limits of my scope of practice. You need to do the same.
I’m really good at finding where people hold trauma in their bodies when I give a bodywork treatment. My specialty within Spanish literature was national trauma and how it filters through literature and art. I have a scholar’s knowledge of trauma and a peer-reviewed publication record to show it. As such, I’ve had patients ask me why I don’t get a therapist license and practice both bodywork and therapy. My answer? It’s too much. That would violate boundaries, to both physically and emotionally touch a patient this way. It’s healthier if I can help someone find the trauma in their body and then send them to make meaning of it with their licensed therapist. As a health coach, I can help someone to become a great critical thinker about an important subject (themselves and their health). I’m not a duly-credentialed nutritionist and, though my acupuncture license and additional certificate in sports nutrition qualify me to educate, I will send a diabetic client to someone who really can help them…meantime, I can do a lot of other things for that person. I love working with EDS and hypermobility syndromes but in no way would I ever think I’m replacing the MD in such cases.
Long story short? I know what I’m good at and legally, ethically, and morally qualified to do and I know when I need to refer. This is how it should be for everyone involved.
As a patient or client, you deserve the best. Ask the questions! Insist on clarity! And anyone looking for referrals (either to give them or get them)? Ask the questions! Insist on clarity!
A person’s health and wellbeing is their individual greatest investment. When we are professional, open, and clear, our value only grows. I love to refer out and I’m so happy when someone trusts me and makes a referral to me.
You, the patient or client, deserve the very best. As we say in Spanish, “cada olla tiene su tapa” (each pot has its top, though this is usually in the context of finding the right romantic partner). There’s someone for everyone, in other words. Finding just the right person to help you achieve and maintain your very best level of health can be a challenge, but the benefits are endless. You are your most important investment. And those of us who go into healthcare professions are here because we care about you and your health. You come to us because you care about your health. We’re all in this together.
Ask the questions and insist on clarity. In so doing, you will reap the rewards.
Paula Bruno, Ph.D., L.Ac., is a licensed acupuncturist and herbalist, an AOBTA-CP traditional Chinese bodywork therapist, and a wellness educator. She maintains an active and growing practice at her Austin, TX offices. Dr. Bruno is also available for distance appointments for wellness consultation or coaching.
In her first career, she was a Spanish professor.
Dr. Bruno’s specialties as a traditional Chinese medicine practitioner include: • Musculoskeletal health (acute or chronic pain relief; Ehlers Danlos syndrome & hypermobility support) • Digestive support, gut health, and weight loss • Aesthetic treatment, including scar revision • Men’s health • General preventative care and immune support for all persons.
When you are ready to discover what traditional medicine plus a vibrant and engaged approach to holistic health can do for you, either contact Dr. Bruno or book an appointment online.
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Note: Material on this web site site is not intended to diagnose, prevent, treat, or cure any disease, illness, or ailment. A TCM practitioner in Texas identifies syndrome patterns but does not diagnose illness. Material on this web site does not purport to identify syndrome patterns.