Self-reflection and Learning Goals 5: Level 3

     From the first tuina clinic with Dr. Fan he kept the feeling of the clinic very calm and relaxed, but as the weeks went on he started requesting more and more physical assessments. I never felt like I was fully committed or confident in my physical assessments during acupuncture rotations simply because it seemed like my findings often wouldn't change the treatment plan anyway. While in tuina, it felt more acutely important to the treatment. On reflection, it would have been a good idea if I had treated those musculo-skeletal acupuncture treatments more like a tuina treatment. I think perhaps part of why they seemed different in my mind was the lack or addition of physical contact with the patient. In a tuina treatment you start touching the patient right away, feeling for ropey, sore or knotted muscles and you don't have to ask very many questions. While in an acupuncture treatment you start with talk only, and it can be easy to forget to use palpation or alternatively difficult to transition from one to the other.
   I think the most important lesson I've learned in reflecting on this, and also my goal for the future, is to always remember touch. Get that patient permission from the beginning so you can easily move from questioning to palpation and incorporate physical assessments that way as well.