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Listen to patients’ stories. Treat them as friends. They may need a dose of the strongest drug of all: the doctor.
Michael Balint, Hungarian psychoanalyst, 1957
Having been in clinical practice for a few years, it is inevitable that some of the simple joys of the profession are lost in the midst of the job. Our time is spent just keeping ahead of developments and new ideas, managing an ever-increasing workload, targets and demands, and managing the clinical conundrums presented in every day practice by our patients. Little time is left to reflect over the more enjoyable aspects of our careers, namely the contact we have with people and the privileged position this affords us, in all walks of medicine.
Although this book is targeted at those setting out in the clinical practice of acupuncture only, much can be gleaned from its pages for those in all areas of medicine, not just acupuncturists.
The author, an experienced acupuncturist, has written this book to try and alleviate some of the worries and teething problems that may be encountered with the ultimate aim being to save the new practitioner from unnecessary worry and years of striving for an ideal method of practice. John Hamwee is a practitioner of Traditional Chinese Medicine (TCM), hence the clinical detail included may not be applicable to all acupuncturists. However, this does not seem relevant. This is not a textbook with the aim of providing detail on treatment and practice. For example, the chapter on pulses, while obviously aimed at TCM practitioners from a clinical prospective, can be read by all types of practitioner. The message is more related to how you touch a patient to take their pulse, and the effect this can have on the patient and their response to treatment. In this respect, it makes it a pleasurable read, with different types of learning point to those found in more standard texts. Most chapters focus on areas of practice that are not clinical, but more pertaining to the relationship we develop with our patients. This is shown from the patient's point of view, and the practitioners, and while often described in terms of ‘energy medicine’ and the effect that we can have on the patient's energy and therefore response to treatment, this could be interpreted with a more ‘Western’ understanding. For example, do we influence a patient's energy with our own, or is it as simple as whether we get on with our patient, and they us, making it a more pleasurable experience for all involved and, hence, more likely to have a good outcome? Does it matter? It is just refreshing to read of this in a positive light, and something to be encouraged and improved upon as a part of the patient's treatment, rather than something to be avoided within a clinical trial as it negates the ‘science’ behind the results obtained from acupuncture. Though many of the principles and anecdotes presented can be interpreted from a TCM perspective, they can also be applied to traditional medicine, such as the impact of the sick role on a patient's response, and, at the other end of the spectrum, the patient who attends for ‘a dose of the doctor’ to make them feel better. This is frequently acknowledged and accepted as part of treatment and response within this book, and rightly so.
Throughout the book the author provides an honest and frank glimpse into areas of his practice with which he has struggled, and how he overcame his problems. There are case reports and anecdotes to highlight the issues raised, which inspire the reader to strive to achieve better results and relationships with our patients. There are enlightening and open discussions regarding how best to run a practice regarding time for appointments, and how much to charge patients, with acknowledgment of the difficulties this can sometimes evoke.
As discussed, this book is aimed at those starting out in their acupuncture careers to guide them through potential pitfalls and perhaps speed up their path to better practice. In reality, I don't think a book can achieve this. We all need to go through the learning experience and difficult phases at the start to allow us to learn from our mistakes, and hone our skills and understanding. This allows us to develop our own style and methods for developing our clinical skills, and also how we interact with our patients and develop relationships. This is a necessary learning curve, and it is only with time and experience we can become better practitioners, in whatever area of healthcare we work. There are no short cuts to achieving this. That is what makes it rewarding when we get there.
Hamwee's book does however offer a wonderful insight into an experienced practitioners’ career pathway, with a very honest account of the ups and downs along the way. It has advice and anecdotes which we can all relate to, and perhaps serves to remind us of the simple joy of just being with our patients and doing something effectively quite simple to aid their recovery, namely listening and responding. Any treatment added to this may be just the icing on the cake!
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.
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