The Diagnostic Interview By The Acupuncture Practitioner
To the experienced acupuncture practitioner, establishing rapport with the patient is very important. Just imagine, who in this world would let someone whom they do not trust to stick needles onto them. The confidential relationship between the patient and the practitioner cannot be overestimated.
The practitioner starts by recording basic biographical information and asking the patient to describe in his or her own way the problem over which help is being sought. The practitioner must then organize this information in a coherent manner within the framework of Chinese medicine. As we have described, this is achieved by undertaking the four examinations:
- looking + hearing and smelling + questioning + touching.
The information revealed by each of these four areas is then synthesized into a comprehensive picture. "Looking" involves observing all aspects of the patient's physical appearance and demeanor, including the very important
observation of the tongue. "Hearing and Smelling" can reveal important clues as to whether a problem is one of excess or deficiency, although it is fair to say that there is a limit to the extent that Western practitioners actively smell their patients! Even Chinese medicine must adapt itself to the cultural norms and mores that pertain in the West. "Questioning" allows the practitioner to explore a whole range of issues that will build up a fuller picture of the patient's disharmony. Finally, "Touching" enables the practitioner to identify painful areas through palpation, to sense body temperature and skin condition, and, most important, to take the patient's pulses.
At the end of the diagnostic interview, which may take anything from thirty minutes to an hour, the practitioner has a mass of information that can be organized in terms of the Eight-Principle patterns of Yin/Yang, Interior/Exterior, Cold/Hot,
Once the practitioner has completed the interview, he or she will have formulated a diagnosis and have a treatment strategy in mind. At this point it is important that information is shared between the practitioner and the patient.
The practitioner will normally take care to explain the nature of the problem, and the suggested treatment, as clearly as possible, in terms that the patient can understand. There is an obligation on the practitioner to make his or her understanding of the disharmony accessible to the patient, and the patient should expect and accept no less.
In all but a few cases, it is very unlikely that one acupuncture treatment will completely resolve a problem. More than likely, especially for longstanding, chronic conditions, a series of treatments, spread over several weeks or months, will be necessary. The practitioner should make it clear to the patient in what way acupuncture can be expected to help with the