[00:00:00] Dr. Nell: I think it's just such an underutilized tool that entire process of onboarding a patient from the forms that they're filling out what they're required to do.

[00:00:09] Dr. Jess Reynolds: Welcome to Aim and Practice, the podcast that helps acupuncturists and massage therapists shift from technician to transformational guide so you can create a purpose driven practice that brings lasting change to your clients and yourself. I'm your host, Dr. Jess Reynolds, And today I am chatting with Dr.

Nell, a seasoned acupuncturist and allied health advocate. Now in today's episode, you will learn how to set clear expectations and foster trust with your patients from the very first interaction, the power of informed consent and how intake forms really are an amazing tool for transparent patient communication.

And why effective advocacy in allied health can make a real difference for practitioners and clients alike, and much, much more. Now, Dr. Nell combines her clinical expertise with a true passion for patient centered care, offering [00:01:00] communication strategies that really do help practitioners engage more effectively, elevate the quality of care, and create a practice environment where clients really feel safe you and valued and understood.

Her insights really are a roadmap to not only improving patient satisfaction, but also fostering a more sustainable, fulfilling practice. So let's dive into our conversation with Dr. Nell.

Today's episode is sponsored by Jane, a clinic management software and EMR. Now the Jane team knows that when your work day is spent providing care to your patients and clients, it can feel like there aren't enough hours in the day for all the rest of your admin tasks. This can mean that scheduling appointments becomes an after hours task, turning what should be a restful evening into extra long work days.

That's why Jane has designed a user friendly online online booking system so you can give your patients the freedom to book their appointments at their own convenience, whether that's after hours or on weekends, [00:02:00] patients can also manage their appointments, fill out intake forms, and even enable SMS and email reminders from their secure online portal, which saves you from having to manually do all this work.

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Well, Dr. Nell, welcome. And thank you very much for taking the time to have this chat with me. I'm excited to talk to you. We met at a conference not too terribly long ago, the FOSOMA conference. That's the Florida State Oriental Medicine Association conference, I believe, down in Florida. And you did a really interesting presentation on communication.

And I mean, it was interesting not only because of the content, but I found it interesting because I go to a lot of conferences, as I'm sure you do as well, and it's, it's very rare that there are presentations or [00:03:00] workshops on something like communication or soft skills in general. So I'm curious if we could start by, by just jumping into, out of all the topics that you could have taught and do teach, what, uh, what inspires you to teach about communication, particularly from the perspective that you do?

[00:03:16] Dr. Nell: Yeah. Well, thanks, first of all, for having me, and it was great to have you in that class. It was nice to see someone who is also speaking in that space and really sees the value in effectively communicating with patients. Um, you know, I've spoken at F SOMA a few times, as well as other conferences in this space, and so I always try to do a little bit of a different iteration to get to kind of the same point, because People need to hear things differently, right?

Uh, and that was really the basis of, uh, the communication class that a lot of times when we're communicating, we're focusing on ourselves as the communicator and how, you know, we're, we're making ourselves look or, and [00:04:00] not really thinking that our communication needs to be about the person that we're trying to reach.

And that starts. And extends through every aspect of practice. So that is from when someone sees your website or when they first call your office to when they come in and nonverbal communication, what is that saying to them? Um, people, you know, we hear about the golden rule and I was at a conference recently that someone said their biggest learning in business and in leadership was that it's really not about treat others how you want to be treated.

It's treat others how they want to be treated. And so that's very similar with communicating and when you're working with. Patients, because we are diverse beings and have different ways that we want to be spoken to. And if you're trying to get the end result of a great clinical experience, a great experience for them, uh, with acupuncture or with herbal medicine, or just meeting a new practitioner, being in a doctor's office, um, they need to [00:05:00] feel comfortable.

And so I think the reason I picked that topic for that moment was that you can be incredible with your physical craft, if that's needling, if that's chiropractic care, if that's, you know, dentistry. Um, but if you're not able to connect with people and make them comfortable, uh, they're not going to want to come back and they're not going to feel like they're in that safe space.

[00:05:23] Dr. Jess Reynolds: Yeah, I would. I would definitely agree with that. Um, as far as where does the communication begin? I appreciate that you mentioned everything from your website to what happens before the session. So what do you, what do you suggest? Like when you, when you think about how we can communicate more effectively to start to create and foster that safe space, what are some of the pre appointment things that you consider?

[00:05:50] Dr. Nell: Um, I mean, look and feel so, and, and that can mean different things to different people. So I think if you're thinking about who do I want to attract [00:06:00] into my practice, that is your website for sure. It's how you're carrying yourself when you meet people. Um, I've met people who are afraid of coming into medical providers.

And when I had my main, uh, location in Beverly Hills, California, that was much more, um, spa like, cozier, comfortable. Um, I wore a lab coat. I wore professional attire. But there was still a different feel to the office. So people felt comfortable in there coming and sharing. Uh, when COVID happened, I stayed open.

I had to shift a lot of things to make people feel comfortable. The, the distance you're sitting from someone in a treatment room, um, that can be a sign of intimacy or not, or how comfortable are you sharing? But when people are looking at all of your marketing materials, when they're speaking to other patients who've come into your practice, who are sharing that experience.

You want all of those things to come [00:07:00] through beyond the actual modality that you're practicing or the medicine that you're practicing.

[00:07:06] Dr. Jess Reynolds: Mm hmm. Yeah. Yeah. When, when I think about people coming into. medical clinics versus coming into more of a spa setting. I find it so interesting. And this partly comes from a workshop I took recently on interior design for wellness spaces. And I think that's such a powerful form of communication because while there may be some listeners that are really trying to create the persona of this is medicine.

I think the majority of us in the complimentary and integrative medicine world, we've got a bit more freedom to be like, yeah, we're practicing medicine, but also, We can do it with heart and we can do it in a way that really fosters this sense of comfort and ease. I think we can communicate that with how we decorate our office and with how we set up our chairs, you know, like all of these little things really send that message.

As you said earlier, the nonverbal thing of, Hey, it's okay. This is a safe place to be. Yes,

[00:07:58] Dr. Nell: Well, and [00:08:00] you know, what's interesting about that is I feel like as I started out and I'm still very much this way because I work with a lot of medical doctors, um, Um, where I'm like, Hey, like I want this to be medicine. This needs to be respected as such. Uh, but at the same time, there's a difference between professional, clinical and then cold.

And so I think there's definitely a line that you can walk, whatever messaging you want your, your practice or your, or your place to send. Um, My place was always super clean. It was very clear that, like, you know, you're coming in here. You're getting a professional experience. Like I said, I still wore a lab coat and then actually switch to scrubs during coven just because it was easier to swap those out.

But, you know, the, the aesthetic of the space, like, no insane colors that would get people amped up, like that type of thing. I did have a mentor who had, like, all different colors in his office. Each room was representative [00:09:00] of a different one of the five elements. Um, and so depending on what conditions people had, he would place them in those rooms and that would help with their experience.

Because again, people need different things to me. That sounds like a scheduling nightmare, but it's a great idea.

[00:09:16] Dr. Jess Reynolds: it sounds

[00:09:17] Dr. Nell: So not something I ever felt like I, you know, had the fortitude to take on. Um, but I think making people feel that they're in a professional space that is still welcoming, clean, um, Can really make a very big difference.

And I do think it needs to be cohesive with what your overall brand, your beliefs and like you said, kind of having that flexibility, um, of what area you want to play in.

[00:09:45] Dr. Jess Reynolds: One of the parts of your presentation that I appreciated is the attention and emphasis you put on the intake and the consent form. So in your experience, how can practitioners better utilize this pre appointment thing that is essential? [00:10:00] Everybody's got to do it. How can we shift that a little bit to communicate a little bit better and again, sort of continue to foster this, this sense of, uh, more comfort and ease.

[00:10:11] Dr. Nell: Yeah, I, I almost, uh, laughed when you said the thing about the consent form because I know informed consent came up and I was like, this is the sexiest, most exciting topic ever. Um, but I think it's just such an underutilized tool that entire process of onboarding a patient from the forms that they're filling out what they're required to do.

You know, like homework wise before coming into the appointment. Um, It helps set an expectation, and that was really like the basis of everything I said. Like, if you can understand maintaining or setting expectations, you like saved yourself three hours of my class. Like, that's really what it's about, is like, what do you want the expectation to be?

Um, that helps with patient compliance. But when I was talking about, uh, the [00:11:00] consent forms specifically and the intake forms, it's like people shy away from some of those things as if They don't have value, or they're a hindrance, or ugh, it's like stuff I don't want to talk about, like the risks that could happen.

But what's great about that is if you talk about it on the front end, not only are you getting that out of the way, but anything that could possibly come up is not a surprise to a patient. And so they're prepared for things, and they feel like they're involved in that process. Like I mentioned that With informed consent, the first paragraph is the patient requesting care and saying, Hey, I want this treatment.

Um, I'm actively engaged in this. This is not something that's been forced on me. And Hey, I understand everything else that's on this form. So it really is our obligation to not only go through that and make sure the patient understands, we can really utilize it to our benefit to explain the benefits of treatment, why it's different than, um, other [00:12:00] types of care, what their alternatives are.

And then, really importantly, what's the patient's expectation, um, with that and what's their obligation. So they need to let us know if they change medications, if they change herbs, if they become pregnant. So then as you go through this, you see, it's not just you as the practitioner saying, Hey, this is a passive process.

You're just going to lay on a table and I'm going to treat you. This is really a collaboration to help get the patient to a blood or place with their health, with their care. And they need to be bought into that.

[00:12:34] Dr. Jess Reynolds: You know, as I hear you describe this, and between now and when I was in the workshop, it's, it's an interesting and unique area to be passionate about and care about. So I'm, I'm kind of curious about what story led you to this. To this point where you're, you're passionate about it to, to talk about it at conferences and speak about it publicly.

And, and that's, yeah, I'm curious. How did, how did you get to be this passionate about it?

[00:12:58] Dr. Nell: Um, I think [00:13:00] initially, I had to find ways because I had developed a cash practice. I did insurance when I was first starting out. I also worked in like workers compensation and so done a lot of different practice models. Um, but when I really leaned into practicing full time, what is this going to look like?

This is going to be a cash practice. We're focused on primarily post surgical patients. So I'm working with a lot of surgeons and networking there. Um, but I really needed to figure out how do we maintain a certain experience for patients that is replicable, um, but also high touch. And, um, In looking for ways that are not potentially to our detriment.

Like sometimes, you know, like I'm, I'm not a big hugger, like, you know, some people hug their patients, that's not a thing for me. So how are you creating an environment where you're interacting with the patient in a meaningful way? Um, beyond ways that could be confusing or get you in trouble, or that are like [00:14:00] just needling or body work with the patient.

And so it really seemed like there's all these opportunities leading up to them coming in the clinic. Um, and so kind of just looking for opportunities there because I love educating patients. I love patients who've never had acupuncture before. That was like most of my patient base. And a lot of people shy away from that.

And they're like, I want the people who already love acupuncture. So it was for me another opportunity to educate without like talking someone's head off in a treatment room every time you do a treatment and they're like, I don't care what these needles mean. I just want to feel better. So I liked that aspect of it.

And then I actually got an opportunity to work. With a risk management group in the allied health space, uh, to do business development for them. And so I had kind of scaled down practice in order to take that on full time and relocated to Scottsdale, Arizona. But I saw like this other side of things in learning about malpractice insurance.

Like I had always just thought [00:15:00] Practice insurance and not really thought about all these different risk management pieces and in learning about all of these different pieces that make up your potential risk in practice and things that can protect you. Also benefit the patient experience. Then I was like, wow, like that is such a win.

If you can help protect yourself and your practice, maintain that professionalism and enhance the understanding that the patient is going to have of the experience and you know, what. What they're going to have for their entire process with you. That's how I kind of fell into informed consent. And we would do a lot of presentations for the schools, um, in the U S and that was always this topic that just kept evolving and.

People were oddly interested in, but more from a, this is scary, I don't want to talk about pneumothorax perspective. Um, but I got really excited about it because I'm like, no, it's an actual opportunity. You sign this thing at your doctor's office all the time and you don't even [00:16:00] read it. So like, Let's read it and, and let them know like, Hey, a little bruising on the hand.

That happens sometimes, like this is the deal. Um, and it just took a lot of the intimidation away. And I got excited that students got it, new practitioners got it. Um, and they felt like it was this added layer of protection that also allowed them to communicate well with their patients.

[00:16:23] Dr. Jess Reynolds: Right. Yeah, I remember at one point in time, during the workshop you did there, there was a quite large tangent into understanding lawsuits and how to protect yourself. And that seemed like a pretty, pretty major preoccupation. Yeah.

[00:16:39] Dr. Nell: scheduled in the presentation and I, I told you guys like, yeah, ask, you know, ask me what comes up with this. We've built in time. Um, yes, there was definitely a tangent that happened with that. And yeah, it's clearly on people's minds.

[00:16:52] Dr. Jess Reynolds: Yeah. And I think not only educating the practitioner, which my experience is, there's not a lot of education as far as all [00:17:00] the things that can actually go wrong in a session, particularly when you're doing a semi invasive procedure like acupuncture, right? There's, there's a lot of. A lot of things that can go wrong, but even with something like massage.

But also, as you mentioned, having these discussions in, in a, I suppose, conversational, but a less clinical way with patients, I really think it builds trust. You know, they're like, okay, this is a person who's telling me, here's what can happen, but not in a way that's leaving me as a patient scared. Right.

But that requires quite a bit of skill, I would imagine.

[00:17:31] Dr. Nell: I mean, that's why, that's why I teach the class. That's why I think it's, um, it's a thing we all work on. Like my communication is not perfect. It will never be perfect. It's continuously evolving. Um, and I think that's important for us to just be mindful of that. It's not like when you memorize your acupuncture points and you know, like depth and angle, and you're like, okay, I got it now, like, bodies still have variability.

You know, there's like still adjustments that need to be made. [00:18:00] And so that's the same with your communication. We need to have a personalized approach with that, just like we do with everything else in practice. Um, and I think sometimes it's important just to check in with like where reactions or, um, initial feelings about things are coming from, because as allied health providers, I think sometimes there's a little bit of this.

Chip of, uh, like people think this isn't really medicine or I'm always having to explain myself and nobody asked these questions of an MD. And like, Hey, that's not entirely true. Um, I asked my MD a lot of questions. I understand that there is like maybe more historical built in trust there for people with that credential.

But that is the reality. And so if we really want, again, the intended result of people having a great experience working with us and having great treatment outcomes, we have to recognize that it's still our [00:19:00] responsibility to be good at that education and communicating and not just say, like, this is not right.

I'm not going to have to say X, Y, and Z because nobody else in the medical field does. Um, A lot of the patients who come to us have tried a lot of other things, or working with multiple providers, or either trying to optimize their health, or they're like super sick and it's last resort. So a lot of times it's complicated stories, and complicated stories have nuance.

People are much more likely to share those things with you, and like you said, build trust. If you have that open line that still maintains a professional boundary, um, and maintains a certain expectation for what things will look like, but is open and not closed off.

[00:19:46] Dr. Jess Reynolds: Mm hmm. There's one thing that you, you touched on in there a few times, which has to do with this idea of allied health professionals, sort of having the sense of, you know, I'm going to say lack of credibility, and this is something that I've [00:20:00] seen come up very often in the workshops of the people I teach, and I send surveys out and ask questions about challenges practitioners are experiencing, and pretty much across the board in the allied health world.

This is an issue of people feeling as though they're looked down upon by the, the other medical professionals, or the public thinks that it's maybe not the same, and it's a last resort thing. So I also understand that amongst all the other amazing things you do. You work within advocacy for allied health.

Can we dig into that a little bit about what, what, what's that process like and what got you into it?

[00:20:34] Dr. Nell: Um, yeah, I think I always wanted a piece of that. I, when I started practicing, I really had this idea that I wanted to do well enough in practice that I had time for advocacy work. Um, because that's, you know, by and large volunteer and that's not just our industry. I mean, you know, a lot of, a lot of other, um, [00:21:00] Advocacy organizations are of course non profit, but in acupuncture, things are built a little bit differently.

Like the national association in the U. S. doesn't have a paid executive director. When I was on the board, we're all volunteer. Um, I was president of one of the state associations in California. Um, and again, same thing across the board, everybody's volunteering their time. That was literally like a full time job at one point.

So it's. For me, it was about leaning into skill set and what made me feel like I was making impact. And I do have this rule that if I don't feel like I am Making impact to the best of my ability, or I'm not capable of doing that, then like, I'm not doing it anymore. So there have been, you know, like I completed my, uh, two year term on the board for ASA and didn't renew, um, my term.

I'm doing other things in allied health space. There's like new fresh blood in there, which is great. Um, and I [00:22:00] think we need that because the profession allied health in general is evolving so much. Um, the utilization is going up. The way that we even present our medicine, let's say acupuncture, compared to like 30 years ago, where it was illegal in a lot of places.

Um, it's very, very different to have a conversation now with somebody and be like, Oh, hey, you know, acupuncture is in the VA. Like, veterans are demanding acupuncture and, you know, you have licensed acupuncturists there. Like, I worked with surgeons in LA. Like, it's very well respected. And you need people who are willing to speak to that and not take it super personally when someone does not agree with you.

Um, realize that everybody who's working is generally a good person and is Like trying really hard in a volunteer arena and so That was like the passion. I felt like it was a good spot for me, skillset wise. I do like speaking. Um, I enjoy [00:23:00] like a good debate and, um, and seeing like where we can actually make progress.

Uh, public policy is really exciting. There's just been a lot of change, a lot of change in allied health in general. Um, you know, insurance covers things in the U S and so there's so little involvement, um, If you look at the different state associations, it's such a small percentage of practitioners in the state who are actually involved.

And then to get to the national level, and then for people who are doing like day to day work, it's a, it's a very small crowd. So I think, If you have the skill set for it and you can build in the time for it, it's a really important thing to do. Like, if we look at physical therapy in school, they're all joining, you know, APTA.

Um, there's a reason that organization is so strong, that organization developed, um, You know, specialties. And so that's what allowed PTs to become part of standard of [00:24:00] care, whether it's like sports medicine or cardiology. So there's just a lot of work that needs to be done in some of these other professions in order for patients to fully have access to care and not having it be like always us in the industry who's having to educate that like this should be part of your health repertoire.

[00:24:19] Dr. Jess Reynolds: You know, and, and looping this back to communication, I'm curious about how you communicate acupuncture, uh, In sort of the more Western medicine context, because when I think of allied health professionals, you know, let's, let's take, you know, massage or chiropractor or physio or something relatively easy to explain.

We can say, here's the physiology behind it. And here's the scientific studies and so on and so forth with the acupuncture. It's like, so listen, Qi. And yet, you know, like, how do you communicate this in a way when so much of the language surrounding acupuncture and East Asian medicine is still rooted in these more [00:25:00] esoteric principles and philosophies,

[00:25:02] Dr. Nell: Yeah, so I do keep it very simple. Um, and I also liken it to this, like, I think a lot of times, like, we think we have to be able to explain this at like a graduate school level to an MD. I do not, like, a surgeon doesn't expect me to understand, the nuances of like every cut he's going to make in a procedure.

Like you can talk me through at high level. I should be able to do the same thing with like the specialty that I practice. And so I come at it from that confidence because like, no, I'm not going to overload you with information just so I can feel like I'm, you know, putting all the credibility out there.

I generally relate it to the nervous system. or the circulatory system. There's a lot of overlap there and a lot of research there, um, and inflammation and stress in the body because 20 years ago, nobody was talking about stress as a very credible physiological thing. And now they are now every MD understands that [00:26:00] stress causes inflammation.

There's an HPA axis that causes all these issues in the body. So I link it to that and I say, you know, Research shows that it mostly impacts the nervous and circulatory systems. There's like a 96 percent overlap with our channels. And if you look at a map of the nervous system, so people understand a map of the nervous system, we know it's a little more complicated than that.

And there's, there's different levels and different functions and channels versus organs. But they don't really care about that. Like, nor do they need to understand at that depth in order to understand like this could help one of their patients.

[00:26:37] Dr. Jess Reynolds: and then with your personal journey as a practitioner, I mean, the I'm sure the education that you went through and the education. I went through are similar in enough ways that we could probably both, um, both remember similar stories. The first year about learning these esoteric principles. So I'm curious within your personal practice.

What's your style? Do you hear more towards like the [00:27:00] traditional Chinese medicine? Or? I mean, I know that you're, you're kind of. practicing functional medicine. So how do you, how do you go about doing this? Are you thinking nourish Qi or are you thinking balance HPA?

[00:27:13] Dr. Nell: So, I would say for acupuncture and herbs, I am certainly thinking more traditionally. I still do labs, even if I'm just prescribing herbs and not like more functional medicine supplements, because I like to show patients, like, look, there is a change that's happening here. Um, There are a lot of, like, if you look at like thyroid issues and overlap with like spleen and kidney, there's not always a perfect translation, but there is usually a pattern explanation.

Right. And so I definitely think more in terms of patterns. When I first started out, I was like very, I think like a lot of practitioners, especially if you were educated in the U S like most schools are TCM schools, like [00:28:00] boards are geared towards TCM. So it's very like protocol, like. And I have found that to be, and as you like dig into the classics, it's like more accurate.

It's more accurate for herbs. It's like not as accurate for acupuncture. Um, but I think when you're first starting out, you're like, Oh yeah, like this point is for nourishing in and like this. So I think I started out very much like that. I got really into electro acupuncture very early. Um, Maybe two years after I was licensed.

So Dr. Jeremy Steiner, he's out of New Jersey. Um, I think I've done like every class, uh, he's taken as well as like Pony Chang, uh, studied with him a little bit as well. And that for me was like a great overlap because there was like such a respect of the medicine, but also this understanding that there was some language that needed to be like translated and modernized.

For people to buy in and [00:29:00] understand. Right? And so, I don't think in communicating with a patient to tell them this helps lower the inflammation in your body is somehow doing our medicine a disservice. I think it's like you're so Speaking to a patient in a way that they can understand. Like, I don't want to go into a medical practice and be spoken to with medical jargon.

And so if we're talking in terms of like chi and blood and yet, like we understand that the patient doesn't understand that. And sometimes it can even become a detrimental thing when like, we're talking about a liver issue from our perspective. And they're like, holy crap, I have to go to my doctor because this acupuncturist told me something's wrong with my liver, and like, I quit drinking 20 years ago, and they're saying I still have this issue, but it's been checked out.

So we just have to be mindful that like, it is jargon. Even though we have like a heavy respect for the tradition and the history of [00:30:00] that jargon, now it's jargon with patients. And if we believe that this is medicine, which it is, we need to treat it as such and be able to communicate that effectively.

[00:30:10] Dr. Jess Reynolds: Yeah, I really appreciate that. I remember when, uh, it was about two years after I graduated from acupuncture school. I'm, and I mean, just like most of us in the West, I grew up very Western minded. So for me, learning the traditional Chinese medicine, like the traditional part. I swear it was like putting my brain in a blender.

And then I remember coming out the others. Yeah. It's like, I don't know. And then you come out and you're like, like almost like you're, you're brainwashed. You're like, I don't understand what you mean that you've got like an iron deficiency. Don't you mean blood? You know, so there was like this. Diseducation, re education, and then about two years after I decided to go to the Institute for Functional Medicine, and I went through the functional medicine training. And I remember within like the first month, I'm like, this is, this is literally just TCM. Like, this is exactly the way we are taught to think.

And that was the aha moment where I'm like, okay, [00:31:00] there's magic. There's, there's, there's magic. And I, I just, I'm going to call it magic because there are things that happen in TCM. We don't really get it as far as physiological processes. It's like, okay, great. We don't have the terms for it yet. And I'm okay with that.

But there is so much within the world of TCM that is literally the exact same thing as functional medicine. So it's so cool that we are taught how to think in this functional medicine way. And we're also taught, keep your mind open, because it turns out there's a bunch of things that we can't explain.

So that transition from sort of the TCM to functional medicine combination I think is so beautiful.

[00:31:35] Dr. Nell: It's amazing because you also see so much overlap in that functional medicine world with different types of providers, which is what I think is really cool because it's like this umbrella where You know, there are MDs who practice functional medicine, there are chiropractors, there are acupuncturists, like, there are naturopaths, um, and so we can all have this, like, one lens that we're seeing things through, but like you [00:32:00] said, that, like, how to think, there's still a pattern approach.

There's still a like, okay, how do we like dig a little bit deeper? Like, what are we looking at first? Um, I did a lot of, uh, Apex Energetics training as well, like even when I was a student. And it was fascinating because you do see an overlap. Like, I've, I've talked to Ayurvedic practitioners and I'm like, wow, this is like very similar as well.

Like, it's like a lot of overlap here too. So. It's not just our one, you know, aspect of allied health. Um, there's definitely something to all of that when you're really looking at like what ties all that together. And it's, it's root cause, you know, like root cause medicine.

[00:32:41] Dr. Jess Reynolds: Mm hmm. Looping back to an earlier part of the conversation, you were saying that you were, you were working in Beverly Hills, you had a practice in a clinic there, and then you moved to Scottsdale, Arizona. It sounds like that was a pretty big transition. And in the meantime, from my understanding of what you do, you do [00:33:00] clinical practice, And you do a whole bunch of what I call off the table work.

Um, I'm curious about your experience with that balancing, maintaining a practice and doing these other things as well. What's that been like for you?

[00:33:15] Dr. Nell: Um, so when I, Was in Beverly Hills. It was initially, of course, like all of us, like primarily me. I was at one point in a multi specialty medical suite, primarily neurology, but there was also neurologists, PAs, chiropractor, uh, naturopathic doctors. And that was kind of how I got my start in Beverly Hills.

Absolutely loved that. Um, and was there for several years and then COVID hit and I got a little nervous about the shared space because. You know, it was different everywhere. In Beverly Hills, you could literally get a ticket for walking outside without a mask on. Like, it was very, very stressful. So, you know, that risk in my mind with [00:34:00] staying open, um, I was like, All right, well, what if one of these other providers were sharing a waiting room?

They're not doing temperatures. Like, what if something happens? And my lease was coming up, and everybody was trying to get rid of medical leases at that time because they had all this extra space. A lot of, a lot of my friends were shutting down. Um, and then went and actually took over what used to be a really high end skin spa that had a smaller waiting room, but much larger treatment rooms.

And that was perfect for COBA because I was like, I don't need a lot of waiting room space. So it was 100 percent my space. Um, and then when I got the opportunity in Scottsdale, I was like, Oh, this is really going to take me relocating. Um, We had started bringing on other practitioners and had switched to more of a, uh, concierge and travel model.

Cause like our, our margins were like, it's like 80 percent of our revenue was from in home anyway, doing post surgical care. So I was like, why am I paying Beverly Hills rent? This doesn't make any sense. So, um, we had a model while I [00:35:00] was in Scottsdale where I would come back, uh, one to two times a month.

Um, I was also pregnant at the time we moved when I was five months pregnant. Uh, so we were initially flying, then we started driving and I did that trip up until basically my son was born. I think like the week before he was born was like my last LA trip. Um, and at that point was like, And I'll just like give this little anecdote, cause you're talking about off the table work.

My son's due date was September 10th. I was speaking at the ASA conference virtually, cause this was 2021, on September 11th and 12th. And so I was literally telling my son in my belly, could you please like just hang on for a couple days, cause mommy didn't share with anybody that I'm pregnant, because people only see me on Zoom.

And it'd be great if I could just do this conference, it's kind of a big deal. And he was four days late. So

[00:35:56] Dr. Jess Reynolds: Okay.

[00:35:57] Dr. Nell: listen. Um, so I think, like, [00:36:00] the off the table work only works if you have, like, if you're in a partnership, if you have a great partner, who's very understanding of that. Um, and if it's like, really fulfilling mission and vision of what you're doing at that time, because that.

Wasn't sustainable forever. You know, we did hire other practitioners. I wasn't having to go back as much. Um, I was doing once a month after my son was born, and then that got down to quarterly and it was really me doing initial consultations virtually and then developing a treatment plan that one of our practitioners would fulfill in la.

Um, and then kept scaling that down more. I had some patients in Arizona. Uh, and then we moved to the East Coast about a year ago. And so I was like, I just can't do this California trip anymore. I was picking up a few patients here. Um, and so if I do travel, like I'm still licensed in multiple states, so I will see patients when I'm there.

But right now I do a lot of referring [00:37:00] if it's not local here. And primarily what I'm doing now is actually looking to acquire a multi specialty clinic to run it. Because in this. Off the table work period. Also did my MBA. And I realized that like, this is a powerful way to help clinicians who do not want to be business owners who are like growing something great, um, to be able to then say, okay, Hey, like I have the business document.

I love this stuff. Like you keep doing what you're doing and like, let me help you. Um, and I had done that on a coaching and consulting level for the last few years. And so now it's more like official. My, my main capacity is like finding. The right partnership, um, so I can help grow this industry even more because there are some really cool businesses out there and there are some phenomenal practitioners and some of them don't really want the business part of it.

Right.

[00:37:57] Dr. Jess Reynolds: And I mean, many parts of it, but what I [00:38:00] find so cool about getting into this industry and staying in it, because as we know, a lot of people, they, uh, they, they opt out relatively early, but after one's been in the allied health world, regardless of your modality for, I'd say, 8 to 10 years ish, you start to get to this point where it's like, Okay, what else can I do in this world leaving it?

And that's what sounds so cool about what your story is, is like, turns out you really enjoy doing the business thing, and you really enjoy being in the wellness world. And on top of that. The number of clinics that shut down because some practitioner was like, I like to help people and I'm going to start my own business.

And it turns out that it's like primary. I like to help people. And that's super way down on the list. It's like, I guess I'll start a business and they fail because running a business is super hard,

[00:38:52] Dr. Nell: So hard. So hard for, for like people who go to business school and like [00:39:00] do all the right things. Like in the U S more than 90 percent of practitioners are sole proprietors. So they just basically like fell into small business. Like you come out of school, we don't get trained for business. You get like two little practice management classes.

There's really like speaking on like, you know, you and I both spoke at FSOMA. Yeah. They've been really great because they do their, um, you know, building better business webinars. They try to figure out like, how do we get this to be a course that can be approved that people can also learn some acumen from, but that's another issue in the industry.

Like most states are not, um, putting the same value for continuing education on business courses. Even though that's, by and large, like why people are failing, it's not because they, like, forgot a magic point for ankle pain. Um, and, you know, I do a lot of great clinical courses too, but the that whole setup from, like, lack of training, [00:40:00] people not really wanting to be business owners, being pushed into business, not having a mechanism with continuing education to be properly trained in business, not having any resources from any of the different entities on, like, who can help me with this?

It's really problematic. And so to go back to your original question about like why I teach that class, it's because how do we find a way to bring business acumen into things that people will be interested in and they can see an immediate ROI on?

[00:40:28] Dr. Jess Reynolds: Yeah, just recently, one of the associations where I live, they said, okay, we're going to try something new because we're getting to the end of the renewal cycle. People are needing their continuing education credits. So they said, we're going to do a two month long business course where it's like every three weeks, we're going to do a three hour workshop on business.

It's all going to be zoom based. So they asked me if I'd facilitate it because I'm really passionate about this. And it

[00:40:52] Dr. Nell: Cause you're the guy.

[00:40:53] Dr. Jess Reynolds: I'm the guy.

[00:40:54] Dr. Nell: Yeah.

[00:40:55] Dr. Jess Reynolds: And, uh, uh, I'm really excited about it. But the interesting thing is [00:41:00] there's, there's a need. We know there's a need, not only because, as you just mentioned, but also practitioners know it.

They know they need this. Like the number of people who asked me marketing questions or basic business questions are like, should I be a sole proprietor? Blah, blah, blah. It's countless. So there's a need. But there's no demand because when people take continuing education, they want this hard skill, right?

They want to learn this new technique. And it's such an interesting and challenging balance knowing that there's a need, but no demand.

[00:41:30] Dr. Nell: It's like fascinating to me. And. I, you know, I'm sure I've been like outspoken about it numerous times because at this point I'm like, I've done this long enough, like, I don't really care if people, you know, find that offensive or I'm not, you know, giving way to everything. I think there is like so much great continuing education out there.

And like I said, like, I really value my clinical courses. I just think like, if you know that you're having an issue with something, Like, why are we complaining about it if there [00:42:00] are fixes out there? Um, and it's like, no, I just, like, rather do this. I am more interested in clinical. I find that more fun.

Like, yeah, like, I don't find P& L fun. Like, I, like, I don't, like, it's not fun for me, even though business is fun for me. Like, there are always going to be aspects of what you do when you're doing clinical. That are not the most fun part some of those things you can outsource and like some of them you can't always Um, but it is very interesting to me because i've seen this at a student level I've seen it at like a new practitioner level I've seen it at like a i've been licensed for 15 years and i'm still complaining about the same thing But I don't want to Invest in anything to help with that So I find it Really interesting because I like you get those off handed questions all the time You Like all the time the only reason I even developed like online courses was because people would ask me stuff And I was like, I have no other resource to give them.

So All right, like let me do a few classes so that they're there and [00:43:00] available Um, but yeah, it's it's it's very interesting to me and I wonder as like Standardization continues to unfold as, like, schools continue to close, consolidation, um, starts to happen, like, there's going to be a new lens through which, like, people are looking at education, um, Yeah, I just wonder if we'll see some changes with that, whether it's like on the curriculum side or like the type of person who's coming into the profession as well.

I think that's really interesting to look at, because that's different than it was 10 years ago, 15 years ago. And I think that'll continue to evolve. And there's different, like, wants, needs and desires there, too.

[00:43:43] Dr. Jess Reynolds: Yeah, I'd be curious to see where the change occurs as well. I've worked at a few different colleges and, uh, as we know, that's, that's really where most of the misinformation begins and where the lack of education begins. So, I'd really like to see curriculum change within [00:44:00] colleges, but that's, that's a big job.

[00:44:02] Dr. Nell: It's a big job. And, you know, people think it's as simple as like this school needs to like, no, it's not. It's like in, in the U S we have a calm above them. It's like department of education. Um, you have like for profit and not for profit and competing things there. You have the doctoral program and many different doctoral programs.

So there's a lot of changes in that. Um, So it's not as simple as like, the school you're in, like, why are they not teaching business? Like you said, there's just a lot of, a lot of steps to that. And, you know, to your point about that misinformation happening, I think something we can learn from because I, I have had like supervisors in clinic when I was a student be pushing this narrative of like, you can't be financially stable or successful by doing this medicine, or you have to take what you can get, or like you have to put up with this and that.

[00:45:00] And that's really damaging because words matter. And when you are in a position of power, like whether you're in grad school or not, like this is still a teacher. This is someone who's experienced in the field. That can be really powerful for someone to hear. And so I think for those of us who are doing well, um, and who do still really enjoy what we do, and do have strong opinions about what we've seen, and look, I will always say, like, this is my opinion.

It's like, everyone's free to have a different one. Um, I think it's important that we speak, and we share our experiences, and that we're also very open, To others experiences and other thoughts and feelings around things. Um, I recently had written an article in acupuncture today, just about the, the misalignment in how we seem to value our own profession versus how outsiders, um, like if you look at, you [00:46:00] know, private equity or investors, like.

See opportunity in this market. And so for us to sit and be like, Oh, what was me like, this is so hard. Um, I basically was like, look like other people do see value in this. So this story of like, we're not accepted or like, we can't continue that narrative and I had an old supervisor, like reach out to me and.

Like, basically tell me, like, our medicine should never be included in mainstream healthcare and they're, you know, gonna, you know, lose all the magic from it and I'm like, okay, like, that's one person's opinion for, like, everyone who, like, hates something I say, there's like plenty of other people who love it and are inspired by it.

Um, and I think, like, we need to just be really mindful in, like, a position of leadership, whether it's like you speaking or your podcast. We can have impact that like we don't even realize that we're having. So it needs to really be coming from like, like [00:47:00] our true heart and mind and soul, what is coming out of our mouth and what we're showing, what we're communicating.

[00:47:07] Dr. Jess Reynolds: As you say that I find myself curious about how much of the continuation of this. we're not respected, woe is me mentality is self propagated. It's just this, this collective sort of story that we're all continuing to perpetuate. Whereas if we were to just stop the story and act as if we were part of the, the entire medical system, I'd be really curious how much faster the, uh, uh, uh, adoption would occur.

[00:47:33] Dr. Nell: Yeah, I, that was really like the point of my article, not to shame anyone for just being like, Oh, I'm going to continue to perpetuate this. I think. You know, there's a lot of like reasons why that narrative is there. I definitely think it's an issue. I certainly think it causes problems. Um, but I might've shared this in my class.

Well, nobody else has heard the story, but you, if I did, but I had gotten invited to a [00:48:00] dinner with some consultants, um, at a big consulting firm in Chicago, and it was one of my classmates, uh, from my MBA. And I already felt a little intimidated. Cause I'm like, okay, like these are like these big hotshot guys.

It's like, All right, cool. Like, of course I'm trying to network and meet people. Um, and my classmate was like, Oh my gosh, this Dr. Nell, like, she's so great. She has acupuncture. And, and, you know, it's like four other guys. And they're like, does that even work? Like, Oh, like, you know, I think my chiro does acupuncture.

Like. And I know a lot of people, myself included a long time ago, like you could immediately just go on the defensive and be pissed off that you're at dinner with these people and they're being rude or, you know, not respecting you. And I just was like, wait a second. Like, this is just coming from a place of ignorance and not knowing it is not malicious or if it is like I get to choose how I'm interpreting that and definitely how I respond to it.[00:49:00]

And so we ended up having a conversation and like dove at one of the guys, like works with benefits in corporations and works with MDs. And I was like, well, do you see like more MDs doing acupuncture? And he's like, yeah, it's crazy. I feel like everybody wants to do acupuncture now. And I was like, so what did that track that, like, obviously there's efficacy there.

Um, and literally like all four of those guys walked away with acupuncture referrals and three of them actually went. Yeah. And, and, and shout out to Aligned Modern Health in Chicago, because I refer a lot of people there. They have like 14 locations. They're great when I don't understand where people live in Chicagoland.

But I think we all have had moments like that. We all have moments where it's like, this could be a little offensive and rude. And if we just decide to respond. I don't even want to say like compassion, but just like being willing to educate people and understand that like they simply do not know. [00:50:00] Um, I think it would change a lot if it was like just that little attitude switch.

Because I have so many stories like that. Like students who come to me and tell me things and I'm like, Do you think that that's what was going on there? Do you think because that person didn't call you back for those medical records that they actually don't respect you? Like that was something I got in like a doctorate program And I was like, no, have you ever forgotten to call somebody back?

Maybe we try again see if we can have a different conversation. So I I do agree with you. I wonder If we switched that just a little bit If it would make a really dramatic difference and it would stop that pattern

[00:50:41] Dr. Jess Reynolds: I, I suspect it would. Um, I think, I think most, most of our reality comes from how we choose to perceive things. And if we have a collective perception in one direction, that will likely dramatically skew reality into that direction. So maybe that's, uh, maybe that's the next, the next project to work on [00:51:00] changing the collective perception of the practitioners, not of the rest of the public.

Yeah.

[00:51:06] Dr. Nell: Yep.

[00:51:07] Dr. Jess Reynolds: So I have a

[00:51:08] Dr. Nell: with us.

[00:51:08] Dr. Jess Reynolds: I ask virtually every exactly. Yes, a question that I ask virtually everybody, which is this in your experience, both as a practitioner and somebody who I'm sure has received a lot of different sessions and being involved in business. I'm particularly curious. What do you think makes a practitioner successful?

[00:51:27] Dr. Nell: Oh, there's like so many things. I think being able to understand the needs of the person in front of you, and that goes to like their motivation, their roadblocks, um, And be able to problem solve that. And I keep it that general because for some people, like I love when I go in and I get a five minute adjustment and I like barely have to talk.

It's like the best thing in the world. Some people need something [00:52:00] different than that. Um, some people wanna be on the table forever. Some people need to talk more. One patient I like, did telehealth sessions with her and she wanted to talk for most of the time. And then we did some acupressure. So I think when you're really seeking to understand needs roadblocks, like where is there any friction to then solve for that within your professional boundaries, um, I think that's when you can be successful.

[00:52:29] Dr. Jess Reynolds: Beautiful. Love that answer. Thank you. And as we tie a bow on this awesome conversation, is there anything else you'd like to add? Any, any tangents we went on that didn't feel fully concluded or anything else?

[00:52:43] Dr. Nell: Now, I think the only thing I would really like to add, because this has been, and I talked about this in my class as well, this theme of your why, Like why you're doing what you're doing is so critically important [00:53:00] because not only does it ground you in what you're doing on your day to day or help you plan with your long term, but it also evolves.

And I think if you are really honest with yourself about like how that's evolving, example, it would be really easy for me to be like, Hey, like I spent all this time like doing my master's and doctorate and like. I should be practicing six days a week and not doing advocacy half the time and like not doing this business stuff.

And I'm like, no, like that, that is where I can be most impactful. And the fact that I've had this education and I can still treat patients, but I'm primarily going to be helping other businesses grow so that more people have access to this type of care. Feels very fulfilling and right on point with like skill set and why.

So I think we just need to be mindful to consistently check in with our why and make sure we're still headed down that path. Um, [00:54:00] and it's okay if it deviates a little bit. My friend calls it the GPS road plan. Like you have your destination and you might get rerouted, but you're going to need to come back.

Um, and I think just being very intentional about that is, is critical Um, and realizing that, like, that can look really different for a different people and that's okay. It's a really beautiful thing.

[00:54:26] Dr. Jess Reynolds: I really, really appreciate that. I just got back from this four day long retreat style workshop where it's it's annual every year, and it's largely sort of a business development thing, and we spend a full day every year going through why, and I think the why is so much more important than the how. You know, the why I want to help people.

How? Well, right now, the how is I'm going to become a doctor of traditional Chinese medicine. And if you reinvestigate that why a little bit later on, how might be, I'm going to be a business owner. And then two years later, if you go back to that, [00:55:00] why the how is likely going to change. So that, that real investigation, I'm so grateful you brought that up and beautifully said,

[00:55:06] Dr. Nell: Great.

[00:55:09] Dr. Jess Reynolds: and thank you very much for taking the time to chat. Uh, it was a great conversation and I'm grateful for our time together.

[00:55:15] Dr. Nell: Thanks so much for having me. It was wonderful checking in and so much alignment and hoping your listeners got some good value.

[00:55:23] Dr. Jess Reynolds: Um, I'm confident they did. Thanks.

[00:55:27] Dr. Nell: Thanks. Bye.

[00:55:28] Dr. Jess Reynolds: As always, thank you so much for spending your time with us today. I know time is precious, and I am truly grateful that you chose to spend yours with us. Before we go, I want to share three key insights from our conversation with Dr. Nell that you can take with you. One is How setting clear expectations and fostering trust from the very first interaction can really transform your patient relationships.

Second, the power of informed consent and intake forms as tools to not only protect your practice, but also empower and educate your patients. Your [00:56:00] patients. And finally, why effective advocacy in allied health is essential, not just for professional growth, but for ensuring patients have access to comprehensive, holistic care.

And a huge thank you to Dr. Nell for sharing her knowledge and expertise with us today. If this conversation resonated with you, please subscribe. So you never miss an opportunity to learn, grow, and grow. Build a purpose driven practice. You can connect with Dr. Now through her advocacy work or her speaking at conferences.

You'll find all of her information in the show notes below.

Your journey matters and I am very honored to be part of it. Until next time, be well, my friend.

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