In New Jersey, USA, where I currently live and practice Chinese medicine, the most common way that scheduling occurs for acupuncture and conventional medical visits is through online, patient-directed scheduling. In my own practice, I personally schedule and reschedule every patient. Here is why:
Chinese medicine, practiced authentically, requires individualized consideration. It is certainly more convenient to have set hours, a nice relaxing lunch break, and fixed appointment slots. Chinese medicine, however, does not work that way. I receive texts, emails, and phone calls from current and new patients all day and night. I don’t think that ten minutes ever pass without these. There are constant minor or major emergencies of sickness, pain, and injuries. Chinese medical ethics dictates that if someone needs help, you help them. No one wants to be sick or in pain and then have to wait three months for an appointment. This is the model of conventional, modern, Western medicine; but not Chinese medicine. The current response to this in the United States seems to be the idea of “concierge” style practice. In this approach, a patient essentially pays out of pocket to have access to their doctor when they need it. While good in theory, this should not be an add-on that requires extra payment. This is a basic responsibility of being a doctor. The famous 7th century Chinese doctor Sun Simiao wrote that we should feel the misery of our patients as if it were our own. That we should treat all people equally, and attend to them when in need, regardless of our own situation or desires. This is compassion practice. It seems it is for the other person, and on one level it is. But it is also for the one who works to cultivate this. The Chinese term that describes this is the virtue “Ren” (仁), which means compassion, or benevolence. In modern times this can be tricky, but the basic point is clear. The practice of medicine should not be a 9 to 5 job with no direct contact with the doctor.
There are practical considerations about running a practice that necessitate some structure and guidelines; but they do not need to be set in stone. One person may need more time for dietary counseling, another for muscular therapies; some people need fifteen minutes with needles retained and others need thirty minutes. Some people are routinely late, some early. One person may change and leave the treatment room quickly, another may emerge twenty minutes later. Every variation from the norm that I seek to establish, affects everything else. When I schedule one person according to their needs, and they cancel last minute; I cannot necessarily use that time for someone or something else.
In this way, there is mutual responsibility. It is my responsibility to attend to my patients’ individual needs and circumstances; but likewise it is their responsibility to recognize the effort that goes into this and act with consideration. I sometimes imagine an acupuncture fantasy world where every person schedules, shows up on time, moves through the treatment process with ease, and does not text me ten times to reschedule before the next appointment. I have occasional days like this. However,I know my practice is made up of people, not time slots. I do my best to speak with patients about all of this, so they hopefully understand better the way this particular practice operates and why. This is also why I write articles and post signs and establish rules with the intention of keeping the schedule flowing smoothly during the day. But I am ultimately unable to control all of it. This then, becomes one’s personal practice. I do not mean practice as in a number of people visiting the office. I mean practice in the sense of one’s personal, spiritual practice and cultivation. How we work on ourselves, to use what we encounter and how we react and respond to align ourselves with the Dao, with the natural flow of things. This is the fundamental premise of Chinese medicine in the first place.