I have had so many students over the years tell me that they ran out of time trying to squeeze one more local treatment into a session that I am going to go on record stating Zach’s First Law of Local Treatment. It says: “Any local treatment you do in a clinical setting is most likely going to take you 15 minutes. If you think you can fit two local treatments into 15 minutes of clinic time, you are probably wrong.” (And yes, this is all meant tongue-in-cheek, but there is some good advice to follow).
I should define here what I mean by “local treatment.” I am using the term to mean any group of needles that you add after your core, root, or systemic treatment is in with the goal of focusing the treatment effect on a specific area of the body; and also any adjunct technique other than needles, such as moxabustion, gua sha, massage, cupping, etc.
This Law is meant as a guide for students and new practitioners. If you are planning on doing two local treatments and you only have 15 minutes planned, do not be surprised if you run 15 minutes over. Getting around this Law usually requires that you be well practiced at a local treatment. By “well practiced,” I mean that you do the specific technique many times a day for several years until you get your time down to 10 minutes or, if you work very hard on a few forgiving techniques, 5 mintues.
So when you are in the clinic, and are faced with only 15 minutes of time left and you want to address your client’s arthritic thumb AND treat a scar on her abdomen AND burn some moxa, my advice is to take a breath, pick the local treatment that you think is most important for today, and do only that one treatment. If you only have 5 minutes of time left, skip the local treatment for today or make peace with the fact that you are going to run late. If you find that you are running late often, I would suggest three possible remedies…
One: change your schedule so you have the time you need at this point in your career to do your best work. If you need an extra 15 minutes to get your best treatment in, take it! And don’t just sneak it in. Book your clients so you have that 15 minutes for every client. Structure your practice so you can more easily do your best work. When you have enough time, you will not be stressed or rushing, your clients will get better faster, and your practice will flourish.
Two: practice! If you enjoy using moxa in the clinic, for example, make time to improve your speed and technique. If you have a cancellation or an empty slot (which has been known to happen from time to time in a new practice), use the time to make cones and burn them so you train your hands and get more efficient. Figure out what you will need to work more quickly, where you need water placed in each of your rooms, which incense or lighter works best for you, how much moxa you want on hand and how it can be most easily accessible, and so on. Be sure to always set out your moxa equipment at the start of each clinic shift, so you don’t have to waste treatment time setting it up. As I said before, with a lot of practice over several years you can really cut down on the time you need to perform specific local treatments. Being able to shave 5 minutes off your average treatment time is a big deal! So if you have one local treatment you like and want to use more often, start practicing now.
Three: consider streamlining your systemic treatment. There are several ways this can be done, and I have touched on a few of them here. If you get faster and more efficient at balancing the organ-meridian system as a whole, you will have more time to add in whatever local treatment you wish. Again, every 5 mintues you can take off your treatment time while still doing your best work is something to be celebrated.
