00:00
Devesh Chaudhari is a licensed acupuncturist and pharmacist practicing integrative medicine in southern New Jersey and the greater Philadelphia region. He's the founder and owner of AcuPharm, where he utilizes a holistic approach to healthcare that combines conventional and complementary therapies to address a person's physical, emotional, social, spiritual, and environmental health. Devesh, thanks so much for coming in today. So just to start off, can you explain what acupuncture is and a little bit about...
00:29
how it works. Sure. Thank you for the opportunity to talk about acupuncture. Acupuncture has been around for at least, I would say, over 2000 years. It involves inserting very thin needles at various anatomical locations on the body to stimulate nerves, muscles, connective tissue. The effects of acupuncture are complex and there are several theories on how it works.
00:54
From a traditional Chinese medicine perspective, this is like a pre-scientific concepts. It works by restoring the balance of chi or life force that flows through the body's meridians. From a biomedical perspective, acupuncture is thought to work by stimulating the nervous system, which triggers a cascade of physiological changes in the body, such as release of chemicals in the brain, spinal cord, muscles.
01:22
It also seems to modulate the immune system. It also regulates the autonomic nervous system where when the patient's in a sympathetic fight or flight state, it seems to promote a parasympathetic breast, digest, and heal state. There's also increase in blood flow through dilation of blood vessels. And there are a lot of local chemicals released that are anti-inflammatory at the local needling site.
01:49
Fun fact about acupuncture that a lot of people don't know in Japan 20 to 30 percent of acupuncturists are blind and traditionally has been a profession of the blind in Japan. Oh, wow, that's amazing What are some of the common health issues that acupuncture can help with and I'm actually You know patient of yours. I see you probably like once a month, you know, and I come in for lower back pain Is that some of the more common reasons people see you and you know, what are some other?
02:18
kind of just health issues that acupuncture can help? Yeah, so there's several different areas where acupuncture shines, pain being the most common, low back pain is the most common thing, knee pain, shoulder pain, are like secondary things that I see commonly. Most Medicare plans now cover, I think, at least 12 acupuncture treatments a year for low back pain only. So there's growing evidence, and we can talk about the clinical research and the challenges with that. Sure.
02:46
So, musculoskeletal pain, fibromyalgia, osteoarthritis. I've also seen patients for post-op pain, TMJ, carpal tunnel syndrome. Also a significant portion of my practice involves treating women's health issues, menstrual cramps, irregular periods, infertility. I've also done on-site like for IVF before and after embryo transfer.
03:14
There's been a lot of studies showing that it increases the effectiveness of IVF when you combine with acupuncture. A lot of cases of menopausal symptoms and also neurology. So neurological conditions like headache, migraines, rehabilitation per stroke, even like I've seen patients for traumatic brain injuries. One of the other common things that patients seek out acupuncture for is nausea and vomiting, whether it's caused by chemotherapy, morning sickness related in pregnancy.
03:44
motion sickness or any other condition that caused nausea and vomiting. The other things I frequently encounter usually as a secondary complaint is like digestive issues. A patient comes in for some pain conditions and just mentions like, hey, I have a little bit of sluggish digestion, constipation. I also treated IBS, colitis, castritis.
04:09
And there's definitely a psychological component to acupuncture, regardless of what you get acupuncture for, there seems to be a broad effect in terms of you have a relaxed mood, there's a release of endorphins, we feel good. Most people mention like they feel energized, but also feel mentally calm and relaxed. So I've also seen benefits in patients suffering from depression, anxiety, insomnia.
04:33
And then the less common things that I've treated, that I've seen good results with are like respiratory conditions, asthma, bronchitis, common cold and flu. I treat family and friends all the time. And that seems to have pretty good efficacy with that. What can a first time patient expect during their initial visit? I know for me personally, I was scared of the needles. It wasn't as...
05:02
I don't want to say painful, but just uncomfortable as I thought it would be. So if it's a patient's first visit, what can they expect? So typically I start out with a thorough intake. The patient already either has the intake forms filled out or they fill them out when they arrive. And then first 20 to 30 minutes is just thorough going through their current symptoms, what they're looking at, what they're seeking treatment for, extensive medical history, family history.
05:31
And usually I discuss the nature of the problem from a biomedical perspective as well as the acupuncture perspective. I review any medical documents that they might bring, like labs and imaging studies, take a look at their medication list as well as their dietary supplements they might be taking over the counter. Then usually the next step is the traditional diagnostic process which involves collecting data from acupuncture perspective which involves checking the patient's radial pulse above the wrist.
06:01
looking at their tongue, palpating their abdomen, palpating the meridians on the limbs. All these are like traditional diagnostic filters that give me more information about the patient's state from a traditional perspective. And that's my primary data that I rely on for the treatment plan. The biomedical information is really extremely useful, but the main factor determining the treatment.
06:28
and monitoring is based on the traditional data that I collect personally. And then usually I start out with a back massage, like acupressure, and as a dual function it provides treatment, but also gives me feedback on like really important points that are above the organs to kind of give me an idea of, you know, what other areas I might need to address besides their primary complaint that might be as simple as just an elbow pain or headache. Because I try to
06:56
It's a holistic medicine. So I look at what else is going on, try to kind of see their long term trajectory, which way they're trending, their health is trending. And usually patients appreciate the overall broad view instead of just focusing on their chief complaint. Yeah. I mean, I remember you were pretty thorough, but all I could think about was the needles. But I think patients would appreciate the fact that you're looking at it from a...
07:25
holistic approach and not just, you know, trying to treat one symptom. Are there side effects that people complain about? So acupuncture is extremely safe when administered by a trained and licensed acupuncturist or a medical doctor practicing medical acupuncture. Some of the common side effects that I occasionally see is like soreness of the needle site, minor bleeding or bruising.
07:51
We use high quality disposable single use sterilized needles along with a clean needle technique which reduces the risk of infection pretty much. Extremely rare cases of punctured organ or puncturing like pleural cavity or pneumothorax, a collapsed lung. Occasionally, I've heard of situations like that, but those risks are extremely rare.
08:19
Usually I've seen acupuncture schools like will grill you and will do safety first and like most acupuncturists are required to at least to minimum for 2500 hours of hands-on clinical experience. So we treat each other under supervision of like supervisors in the clinic and you treat other patients. So by the time an acupuncture students graduates, the safety is, you know, is not an issue.
08:48
What are some of the common misconceptions? So, like you said, you know, experience of pain, you know, the concept of like needling, usually typically as children, we experience, you know, vaccinations and anytime you see needles, you know, palpitations, you know, just a subconscious reaction. Right. And usually, typically, the more the patient can relax physically, the less they tend to feel. Obviously, the superficial when the needle is inserted, there is a slight pinch.
09:15
Sometimes at the point is really reactive, the patient does feel a lot more like traveling sensation, tingling. There are different styles of acupuncture. So depending on the patient's tolerance, I kind of gauge and see if the patient has extensive tattoos and I know like they're not going to have, you know, they're not going to be needle sensitive. But I typically start out with a gentle needling protocol or style of acupuncture, like traditionally Japanese one.
09:43
There's other like trigger point releases, they're traditional Chinese that tend to be more intense stimulation required to where the patient has to feel certain sensations. The Japanese style of acupuncture, that's not necessary. You can cross palpate, you can check the pulse, you can check the abdomen to see if the points you inserted are having an effect. No, that's very cool. So what inspired you to become an acupuncturist?
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you started off as a pharmacist and you're doing this business as well. Talk to us a little bit about your journey from a pharmacist to acupuncturist. So I actually started around 2001, 2002. I was at Rutgers University Pharmacy School and a bunch of friends in pharmacy school mentioned that they're offering a free
10:39
Rutgers is offering a free six-week course on Shaolin Kung Fu. Watching Bruce Lee movies, let's try it out. Nine of us try it out, a six-week course. Only me and another friend of mine stayed the course and stayed with the school even after all these years. And then over time, reading Buddhist philosophy, Taoism, talk about acupressure and Qigong.
11:06
you know, health preservation exercises. I also had a friend in acupuncture school, she used to get acupuncture, I'm sorry, in pharmacy school, she used to get acupuncture twice a year for allergies, seasonal allergies. And around the same time, I was dealing with the back low back pain issues and I tried, you know, physical therapy, chiropractic, all the medications.
11:31
And pretty much the orthopedic told me I would need either steroid injections or surgery would be an option. And reluctantly, I tried acupuncture with great results. So then completely eliminate flare-ups occasionally every few years. So it requires a lot of self-maintenance continuously, which is a good thing because it kind of keeps me on my toes and requires me to stay active. So that's pretty much. And then I kind of after graduating pharmacy school,
12:00
I kind of felt like as a pharmacist, I didn't have enough impact on direct patient care. I worked in retail pharmacy for a little bit. I worked in nursing home for about a year as a consultant pharmacist. Seeing patients on multiple medications, I kind of felt like there is something missing before the patients get to that stage. Right. What else can be utilized to minimize medication use, reduce dosages?
12:28
We minimize use of certain medications that are high risk in senior citizens. And there was always like this idea of acupuncture in the back of my mind because of the experience I had. And I just said, you know what, let me just try out one semester and see. And then I ended up doing five years of acupuncture school. Got it. Do you see in acupunctures yourself?
12:53
Yes, I usually I was seeing acupuncturists in Philadelphia, but I think he retired, so I haven't been able to contact him. I'm also seeing a colleague up north, but I haven't, typically I haven't been to acupuncturists locally because they're just colleagues. And then I've had some acupuncturists that want to trade treatments, so I'm also, you know, typically do that. And usually I do acupressure, self-care, massage.
13:23
And with Qigong and Tai Chi, typically, the need for acupuncture is a lot less. I usually go like maybe four times a year, every seasonal change, unless there's a need, then I go more frequently. Right. So talking about frequency, how do you determine how often a patient needs to come see you? So typically, most patients end up coming once a week, just based on their schedule, the cost effectiveness.
13:51
In acute cases with severe pain cases where the symptoms are pretty intense, usually typically may require two to three times a week initially, and then you taper down twice a week and then once a week. And then you gradually taper until either the patient is completely symptom free, or if I feel like the patient needs some maintenance for a little bit longer, and maybe like once a month or every three weeks, depending on the patient specific, you know,
14:19
situation on how they're responding, how long they're symptom free, and it just depends on the specific case. Okay. But typically, usually once a week, I've also treated patients at end of life hospice care, like every day or like sometimes even twice a day and last week. So the dosage varies depending on the situation. Right. So if somebody is coming in for preventive care.
14:48
because they have flare-ups constantly or let's say several times a year, how often do you suggest that somebody comes in for just preventive reasons? Typically, I would recommend four times a year, every seasonal change, or not necessarily like right at the change, but you can also do like every three months approximately. That I would say would be the minimum. And if...
15:16
If the patient, I have had some patients who will come every year, you know, every seasonal change and they report like broad effects, better sleep, more energy, a better mood, digestion, just overall, you know, state of being. There's also the diagnostics. I initially thought, you know, those traditional pulse diagnoses and like looking at the tongue is more traditional pre-scientific concepts are not really useful.
15:45
But I'm finding that they're a lot more useful and kind of help identify early issues pretty early on before even before the patient notices any symptoms. So I definitely find, you know, preventative medicine, currently in biomedicine is all about catching disease early, colonoscopies, endoscopies, whatever, screenings. This is preventative and treatment to prevent.
16:14
Right. So there's a dual function with that. Yeah, and I think this is a really great time for people to start taking kind of their, their health care in their own hands, right? The health care system in this country is really motivated by sick care, and not preventive care. And this is a conversation that you know, you and I have had. And the reason for me to like come, not just when I'm symptomatic, but also just in general to come just to come see you.
16:44
So you definitely have a unique background and story. Tell me a little bit about the early days of starting AcuPharm. Even let's go back to how did you come up with the name and then what did you do after that in launching your business? So after graduating in 2012,
17:09
The name, the AcuPharm, just comes from the integrated medicine approach that I utilize. So everything I know as a pharmacist and then everything I know from acupuncture perspective, I try to utilize best of both worlds depending on. So in pharmacy school, there was a really good lesson I learned about pharmacoeconomics. So always be mindful of the patient's financial burden. Try to reduce that.
17:34
And I bring the same thing into my practice. So instead of just kind of retaining patients and just kind of having treatments, more treatments, just to make an extra buck, I try to figure out what is the best course, whether with me or another provider or some other treatment option. Two years back, I had a patient, single mom, working two jobs, struggling financially, wanted to get acupuncture for mild, moderate depression, depression symptoms, anxiety.
18:05
And with her schedule, I said, look, why don't you start by going to a physician and just trying antidepressant? That'd be the most cost effective. You don't have insurance, working two part-time jobs or no poor benefits, helping patients find, okay, these are the drug lists. At the time, they have different grocery chains would have a $4 or generic list or $10 for a three-month supply. So just identifying what the patient needs.
18:34
and then providing different options and then the patient can choose. So I feel like most patients kind of come and say, okay, I'm in your hands, heal me. And my thing is I'd rather have the patient take charge of their health, educate themselves. Yeah, it's confusing. Google, internet, we have so much information at our fingertips. It just takes a little bit of effort, a little bit of involvement.
19:00
There's confusion, usually patients will reach out through email and ask questions and usually respond within a day or two. Just to kind of help them, because it's hard to navigate the healthcare system. You don't really understand how things work. Sometimes patients overpay for certain medications when there are other alternatives. So and then a lot of patients also take herbal supplements, dietary supplements that they don't report to their physician. I kind of try to...
19:28
evaluate and see if it's helping or encouraging the patient to identify how to monitor changes. You feel good, that's not enough. You need to have some kind of tracking system, specific markers to look for, depending on what they're looking for. Your motivation is to take a holistic approach and combine Eastern medicine and Western medicine.
19:58
And as a pharmacist, I can't prescribe or diagnose biomedical conditions. But there's been instances where there are red flags raised and it turns out to be pretty significant finding. And the patients are glad that I was caught. So when did you launch AcuPharm? So I was working full time as a pharmacist. I have three children. And at the time, my wife wasn't working, dealing with complications during pregnancy.
20:27
So in order to maintain health benefits, I was working full time as a pharmacist and also seeing patients anywhere from like 10 to 15 patients a week. And from 2012 until this past year, I was working primarily like 30 to 40 hours a week in pharmacy and about 20 to 25 hours. And pretty much I had like every other Sunday off until
20:56
the pandemic started. And then things kind of calmed down overnight and I was primarily focused on the pharmacy job at the time being most of my patients were senior citizens. There's a lot of confusion about the risk and the safety. So I decided just to kind of slow down the practice until I can be more sure that I can provide safe treatments to patients without risking spreading COVID.
21:25
And now in the past year, I've had some life altering events in the family and sort of midlife crisis to kind of going in a different direction. So I just- Did you buy a sports car? No. Okay.
21:41
I was looking at getting a motorcycle during the pandemic. My wife talked me out of it. I'm glad. Yeah, that's a good thing she did. But now the focus, and my wife is back at work. The kids are older, back in school. So now my entire focus is on acupuncture and integrated medicine. Got it. And then how do new patients find you? So what do you do for marketing? So I've been struggling with marketing. Usually it's through word of mouth, successful cases. Patients will refer.
22:11
I've had some physicians that have referred patients and then when they see results, then they get more referrals. And then currently I've had an acupuncturist I was speaking with, and then we were discussing what she does and kind of considering hiring her as a consultant. Just with the online marketing, I am an introvert. I don't like talking about...
22:37
all the success cases, you know, because for me, it's like, it doesn't matter as long as I can help the patient in front of me at the time. So I kind of working on some ideas on in terms of like online marketing. And I have a meeting next week with the acupuncturist to kind of discuss what she has in mind. Okay. No, that's great. And let's talk about what advice would you give to someone?
23:05
who wants to have a career in acupuncture? So I would say definitely learn and master some business management aspects, marketing aspects. I kind of spend a lot of time on, you know, focusing on clinical skills, results. There was also like an internal conflict between the pharmacist and the acupuncturist within trying to make sense of like how it works from biomedical perspective.
23:33
And then it took me like a few years to kind of harmonize the two aspects within me. And then like took maybe I would say like three to five years treating patients, kind of being skeptical even with positive results, like what else, you know, was the patient, you know, trying or were there other treatments, you know, that might, you know, attribute to the effectiveness. And I can discuss specific, you know, cases and stuff that kind of really opened my eyes to like, okay, this is there something going on.
24:02
I might not be able to explain it entirely from biomedical perspective, but this is not just a placebo effect. Yeah, no, I mean, it makes sense. And I think with any small business, when you're in a large market like Philadelphia, sales and marketing is key, right? It doesn't matter how good you are at your craft when it comes to sales and marketing. It's a different skill set, right? So you could be the best acupuncturist, but if you're not marketing yourself, you might
24:32
in a big city like Philadelphia. So I think it's really important for anyone to learn those skill sets and even the timeframe, it's long, right? It's like three to five years before you can rely on the word of mouth and the referrals to come through. So it's great that you've been able to be successful for so long.
25:00
In talking about this, I can say as one of you know, a patient of yours that definitely works. So if anybody's listening and thinking about acupuncture, definitely they should check out your website. So speaking of your website, where can patients find you? It's acupharmhealth.com. Awesome. Thanks for coming in. Thank you very much.
