• How Dry Needling Can Grow Your Practice with Dr Frank Gargano

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    joe-and-frank

    Joe: Welcome everybody to this episode of the Private Practice Business Academy. This is your host, Dr. Joe Simon. On the phone with us today is Dr. Frank Gargano. Dr. Gargano is the president at Integrative Dry Needling Institute. We really wanted to get Frank on this call because there’s so much talk about dry needling, between physical therapists and acupuncturists. A little turf war going on, per se. I know we have a solid base of acupuncturists and physical therapists that listen to this podcast. Don’t worry, we’re going to get both sides of the story, but I want to make sure I get on and hear from the horse’s mouth what the controversy’s all about, and what is dry needling.
    But, Frank, before we jump into all of that, thank you for being on the show, and please introduce yourself to the audience.

    Frank: Thank you, Joe, for having me. I’m Frank Gargano. I’m a physical therapist in practice for about 24 years now, primarily doing outpatient orthopedics. I do a little bit of neuro, but I’ve got kind of a specialty area in the upper cervical spine, where I do a lot with headaches, migraines, and dizziness. Back in 2009, I got with Dr. Ma and did his course, actually. Ever since then, it’s been changing my practice. It’s been changing how I look at people how they look at pain.
    So, Dr. Ma and I got together a few years back, and we started to make a plan. That plan was for me to eventually take over his teachings, and that’s what’s happened. So I’ve taken over the concept for him. We’re going to be moving forward with integrative dry needling in the US.

    Joe: Excellent, Frank. I’ve been on the website for DryNeedlingCourse.com. The information about Dr. Ma is on there, as well, and the courses and logistics. But we have a bunch of people listening to this podcast right now that do not even understand what dry needling is exactly. So, let’s go all the way to the beginning. What is dry needling?

    Frank: Dry needling has been around for quite some time. Really, I think the beginning of it came from Janet Travell. She described myofascial trigger points and she described areas in muscles that had nodules. So she went after those areas and she listed things called local twitch responses. And those are just actually muscle twitches, sort of a spinal reflex that goes on and that, she found, was a way to clear some of the myofascial muscular problems that patients were complaining of.
    It’s progressed now, there are other developers, early developers. Dr. Gunn is another one — intermuscular stimulation. And he really looked at it more of a neural radiculopathy matter. So, he looks at the cervical spine, maybe if you had an elbow problem, he’ll look at the cervical spine all the way down into the arm. That’s another form of dry needling.
    Then as we moved forward. Dr. Ma, along with some of his mentors, came along with the idea of integrative dry needling. That essentially looks at the body in a more systemic way. Instead of looking at it purely as a muscular source of pain and dysfunction, we look at it more as an irritated or inflamed peripheral nervous system. We believe that certainly, there are muscular problems that go along with it, but we think that the root of all this is this nervous system is really generating some of that inflammation and some of that dysfunction that we’re seeing within the muscles themselves.
    So, in general, what dry needling does is several things. The first is, it can literally disrupt these trigger points. It literally has a mechanical effect on them. The second thing that it does, it has a way of improving the circulation to an area. We believe that a lot of pain is caused by a loss of circulation. By utilizing the needling, we set forth a number of physiological process, from the immune system, the endocrine system, the cardiac system, for that matter, the nervous system. So, when you create this lesion, with these small monofilaments, essentially you’re putting the body in motion to start to heal.
    There’s another neurological aspect to this that’s really starting to come out a little bit more in the literature, as well. It has a strong neurological effect, both with the spinal cord and actually with the central processing within the brain. There’s a lot more research coming out, looking at the effectiveness of dry needling as a whole.

    Joe: Frank, how accepting is the medical community when you bring this up in conversation with them, or if you are promoting your clinic, or just promoting your services for dry needling? How accepting is the rest of the medical community about this?

    Frank: Early on, what I would do is I would go to the physicians and I would explain it. The first thing they would say to me, “Oh, you mean acupuncture.” I’d say, “No, we’re not doing acupuncture. We’re doing a Westernized model of needling that utilizes the central nervous system and utilizes the muscular system. Those are the target points. We’re only looking at musculoskeletal dysfunction.”
    So, when you sit down with them and explain to them exactly what the point here is, is that we’re trying to base it on that neurology, on that muscular structure, they get a better understanding of what we’re talking about. I think the acceptance really is in the understanding more than anything else. I know a lot of doctors that refer for acupuncture and they believe in that. They believe in needling as a whole. So, when you bring this concept to them, most of them have been pretty receptive to it.

    Joe: I’ve done some research myself. Obviously, for those who are listening, please check with your state boards to see if, as a physical therapist, you’re allowed to do dry needling. Going across the board, and I’m based in Northeast in New York and in New York you’re not allowed as a physical therapist to puncture the skin in any way, as I read the state boards. I read that carefully, but I didn’t look at the rest of the country. I was just taking a quick glance. But, in your state, Frank, I’m assuming it’s accepted and it’s fine. There’s no issue with physical therapists doing dry needling?

    Frank: Right. In Ohio, we’ve had it for quite some time. As I said, I’ve been needling since 2009. There are only a few states now that do not allow it. Unfortunately for you, New York is certainly one of them. Pennsylvania, California, and there are a few others. It’s a matter of going to your State Board and educating them. I think a lot of times, the licensure boards themselves have a misunderstanding of what’s going on. There are some states out there that just don’t make an opinion. They don’t have a comment one way or the other.
    On IntegrativeDryNeedling.com, I have a whole list, of the United States, of all the states that have, and some of the regulation stuff related to that. So, that’ll be a resource for some of your listeners, as well.

    Joe: Excellent, Frank. What’s the kick back from acupuncture? I see what you’re saying why a physician or another healthcare practitioner would say, “Hey, it sounds like acupuncture.” I understand what you’re saying, that’s it’s not acupuncture, we’re looking at the musculoskeletal system. Is there a kick back from acupuncturists? Do they find this like you’re kind of encroaching on your turf a bit?

    Frank: Yeah, I think there is. I’ve never had a personal issue with that. In fact, I welcome acupuncturists into my course, because I would like to show them, and I’ve got one coming to my next course. I would like to explain to them and show them that what I’m doing is completely different. I’m not an acupuncturist. I couldn’t begin to teach anyone acupuncture. In fact, it takes somewhere around 1800 hours to truly learn acupuncture. The differences that are there are significant between the PT doing dry needling and an acupuncturist.

    Joe: Well said, Frank. Not to take anything away from acupuncturists, because I’ve looked into their course of study, and it is very in depth. It’s a lot more work. Exactly what you said. Very well said.

    Frank: Let’s expand on this one second, too. On the other side of this too, Joe; part of the controversy is that are we qualified as physical therapists — I guess you could lump in chiropractors or anybody else doing needling — are we qualified to do the needling? You look at the undergrad; I’ve got, as you do, I have hundreds of hours in each of my undergrad anatomies: physiology, neuro-physiology, those types of things.
    I think I read recently in a post-graduate course of PT, we get somewhere around 2600 hours in and around those types of subjects. A PT coming into a course to learn needling is very, very well prepared to understand the anatomy and physiology of what’s going on.
    And then, the actual needling process is not that difficult to teach. How to set a needle is not that difficult to teach, particularly with these manual therapists that are coming in. It really goes back to taking what you know, knowing your physiology, knowing the needling mechanism, and knowing why you’re needling. And how to needle, how to use needling for bio-mechanical changes in things. All related to neurology and musculoskeletal care.

    Joe: Excellent. I’m glad you mentioned that. Obviously, I’ve seen acupuncture, I’ve had acupuncture done. But, I’ve not seen dry needling. I was very interested and, obviously, to the listeners out there, I already spoke to one of my therapists that is based in New Jersey, and we’re getting ready to sign up for the course. We looked at the other courses that are available besides yourself, and it’s only like, the three big companies that actually do this. I’m not sure if there are more — to be honest, I’ve only been researching for about week.
    I urge anybody to take a look at your website. You give so much good information on here. It’s not just promoting your course only, but just to explain everything. It was very well explained on DryNeedlingCourse.com. Explained very well. To someone like me, before I even saw the debate of this, I was trying to figure out: “What is dry needling?” I, like everyone else, was not educated on it, and I assumed it was just a form of acupuncture. So, very well said.
    What I want to bring up is, let’s talk about the reimbursement aspect of this as a physical therapist. Besides the angle of going the cash payment route, and this might be an excellent revenue stream for somebody thinking of going a cash-based practice, this is an excellent way to go. Before we even get into that, let’s talk about, can this be reimbursed through your insurance?

    Frank: Medicare does not recognize dry needling as a code. Typically, if you’re going to do needling on a Medicare patient, they’re not recognizing it as a code. What we do in our clinic, and again, some of the experts are smarter than me in reimbursement. When you read their stuff, some will say that you have to do it as an untimed code, because it’s not reimbursable. Other experts will say, “Look, it’s a manual therapy procedure. You’re using a monofilament and you’re using it as a tool, so it should be billed under manual therapy.”
    I’ve never had a problem with reimbursement for providing it, so I will put it into my notes that I’m doing it, and I use it as an adjunct to my other manual therapy techniques. Because, again, it’s not where we’re going to go in and needle somebody for a straight thirty minutes. You couple put in three needles, you could put in fifteen needles. It really depends on what that patient needs.
    As you get proficient with needling, the time it requires is usually very small. So, it’s an adjunct to what you’re already doing within your manual therapy care. But every state has a different requirement. Every payer will look at things differently, and I’m sure at some point, we’re going to have a code for needling, for physical therapists or chiropractors that is going to be reimbursed at some level or another.

    Joe: That is a good point, as well. I assume, with ICD-10 coming in October, there very well may be a code for dry needling that’s in there. I’m not sure of that and we will ask and see if I can get that information, as well. It might be a really good day if we can bill separately for dry needling, because obviously, it’s a different skill set altogether. And I agree with what you said that it is a tool that’s used for manual therapy.
    So, reimbursement-wise, you’re billing it as manual therapy. It is another technique that you can add to your toolbelt, definitely. The reason I asked, because I was looking at the fees, and not only your course, but the other courses out there — all about the same ballpark, but they’re expensive. I’m going to say, it’s about double the price of an average course. Now, I see the benefit in it, I see the coursework is there and it’s a skill that has to be learned, so I can see the price justification for that.
    But, that’s why my question came up about the reimbursement. I was hoping the reimbursement would be higher for this. I was like, “Maybe that’s why not everyone’s doing it. Maybe they just don’t know the reimbursement’s higher.” But now, knowing that it’s just a manual therapy code, it’s part of treatment that is being rendered already, it brings back that, okay, this is part of the manual therapy reimbursement. That’s something I did not know and I’m sure it’s something our listeners didn’t know, but that’s good.
    Let’s talk about the cash revenue on this. Is this an easy sell for patients?

    Frank: I’ll tell you, since I started needling, and again, I’ve been in a private practice setting for my whole 24 years, really; there’s been nothing that’s changed. I’m a Mulligan instructor as well, I teach movement. That was a huge change in just my practice patterns and how I did things. I saw major changes when I started to apply spine Mulligan’s concepts. But, I’ll tell you, nothing has changed my practice, not only in treatment outcomes — because the question really isn’t about dry needling if it works. That’s not even the question. Dry needling works. You have to have the ability to modify your treatments to different patient types. That’s why it’s important to have different skills for dry needling.
    You talked about the different concepts and courses that are out there. Dr. Ma’s and mine are completely different than all of these standard trigger point courses that are out there. We give you lots of options to perform trigger point dry needling and integrative dry needling. Going back to the patient concept is that, the number of patients that I’ve gotten that I don’t think I would have gotten before.
    What I mean by that is, we see people with fibromyalgia or some of the other chronic conditions that are really hard to treat with traditional physical therapy. Adding in some integrative dry needling type concepts, these people do quite well. I’m seeing mothers and fathers and kids, and it’s starting to bring that whole buzz to my practice, that is really interesting to see. A lot of people are coming right off the street and asking for integrative dry needling.
    I’m a direct access state so that’s a huge benefit to me. I can take people right off the street and they can come in and get their needling done. I don’t use needling as a standalone process, I don’t think many therapists do. But, it’s one of those additions that can get you there quicker, faster. “All roads lead to Rome” type concept, but some of them are quicker, faster, maybe more efficient. I think that’s really what dry needling does to the physical therapy practice.

    Joe: Excellent, Frank. That’s excellent stuff. There was a point that I was going to bring up next. I wanted to know if you could do needling as a stand alone. Would that be just a treatment? Someone coming in just for the dry needling only and not for “standard physical therapy?” Do you see that? Are you treating only a certain body part or are you doing the entire body part? Obviously, depending on diagnosis. Could you do dry needling as a stand alone treatment for the patient for that time frame?

    Frank: It’s very rare in my practice. If I saw 100 people, there may be four or five that it’s all I do with them. The only reason that would be is if they just don’t tolerate anything else. A good example is Ehlers-Danlos. I’ve seen a couple of those. I’ve got a lady who’s got Ehlers-Danlos and fibromyalgia. She can’t exercise, she can’t do some of the standard PT stuff. I can’t manipulate her. Just trying to mobilize her joints is very difficult for her. And the thing that she finds the most relief with is when I’m doing what we call our systemic dry needling, or using homeostatic points. I needle her in these key points and when she leaves, she feels fantastic and she’s able to function at a much higher level. I see her probably once a month, and I just continue to try and maintain her. It really is maintenance along those lines.
    In that case, that is a stand alone treatment, other than education and some other things that I can provide for her, but I’m not doing manual therapy on that type of patient.

    Joe: Good point. It really is a tool that is used part of every other treatment that you’re adding in. What’s the time frame on dry needling? Is it a ten-minute procedure? Is it a five minute procedure? Thirty seconds and the patient’s done? Take us through that time frame of an average treatment.

    Frank: Sure. Let’s use a cervical patient for example. Obviously, I see a lot of those. A patient will come in and a I tend to clear the joints first. I’m kind of a joint guy, I’ve been that way all my life. I tend to really check the joints and see. I’ll do things to the joints and then I’ll re-check the soft tissue. If what I just did cleared that soft tissue, I don’t tend to need to do much with the needling aspect. But if I’m seeing that there’s continuing to be problems along those lines, that’s when I start to bring in the needling. If those problems continue to persist, then I start to look even further down the chain.
    I really look at the body as a whole. That’s really what our concept is. It’s looking at not just a local area, but looking at the whole region, the whole body, because the body really is vertically integrated. You can’t treat a neck without looking at a thoracic and a lumbar, sometimes even a foot. Neurologically, there’s research out there showing that both neurologically and chemically that the body is interrelated and systemic in its being. So, we need to be able to address that appropriately.

    Joe: Okay. So by the time you’ve finished the clearing and you assess, and you know that you’re probably going to be doing dry needling for this patient, the cervical spine, the setup is fairly quick, I assume. But, how long does the actual treatment with the dry needling take?
    Frank: I think that goes back to the amount of time that you have the needle in there is part of that question, too. If you’re a traditional trigger point therapist and you want to go for the local twitch response, and you see that upper trap sitting right there and you want to go ahead and ┬áin on that and really get as much local twitch responses as you can, it doesn’t take very long to do that. It can take literally thirty seconds to go ahead and hit the traps.
    If you have a lot of muscle guarding its path, you want to put that needle in and you want to let it sit for a bit. There’s some controversy on how long it sits. The osteopathic literature talks about thirty seconds to three minutes. Some would say you want to keep it in there for ten or twenty minutes. It really depends on what the patient needs and what your theories are. I tend to keep it in more in the minutes range than I do into the tens of minutes range. The lady I talked with you earlier about the Ehlers-Danlos; I’ll leave that in a bit longer, because it has that calming effect on her. So, when it’s all said and done, the needling itself can be literally under ten minutes. It’s anywhere from a few minutes up until ten minutes in an average patient.

    Joe: Excellent, Frank. That’s what I was looking for. That cleared it up. I wanted to draw a picture for everyone that’s listening, so they can kind of see as they go through the treatment themselves, what that time frame would be, once you’ve assessed and once you know that you’re going to be using the needling, what that actually setup is going to be. Obviously, each person is different, the time frame’s going to be different for each diagnosis. If you’re a manual therapist and you’re releasing a trap, it all depends on the patient, it depends on how bad that spasm is, rotations involved, etcetera, etcetera. Obviously, thirty seconds to a few minutes. Great point.

    Obviously you’re saying it’s systematic. I’ve spoken to other people and I’ve actually read some literature of doing dry needling to remove wrinkles. Have you heard of this?

    Frank: No. Not really. Relaxing a muscle will release a wrinkle.

    Joe: Yeah. That’s what I was reading literature on. The reason why is, I was trying to get enough research before this podcast so I could hit on a few points, but I wasn’t sure if this was something that was common in the dry needling world. I just wanted to bring that up. So, it’s not common.
    I understand you work with cervical and more head and neck and that’s a specialty, but could this be used on a lot of athletes? Younger athletes — high school and college aged level — for certain injuries?

    Frank: In that patient population, they do so well with dry needling. The young, the healthy bodies. Needling has such a strong effect. In our course, when we go through a quantitative assessment looking at a person’s ability to respond to dry needling. That quantitative approach gives us a really good understanding of how many dry needling sessions they’re going to need. That’s a unique part of our course.
    When you look at someone that, say, is a 20-year old athlete, they’ll fall, more than likely, into our A-group. Our A-group are people that need few visits with long lasting relief. In a sports community, there’s really nothing I’ve found that’s better for A) getting them ready for an event, and B) helping them with that onset muscles soreness that’s going on. Again, that’s a lot of muscle injury. When you exercise, there’s a lot of loss to circulation. That’s where that ends coming from.
    So, as we talked about earlier on in the interview, one of the main things that we do, is that needling helps with improving circulation. So if you can get circulation going in a muscle, a lot of those chemicals and that biological milieu, if you will, that’s inflammatory starts to leave the area and, these people feel better pretty quickly.
    It’s one of those things, where if you use it with your athletes, you’re amazed and so are they. Currently we’re using it a lot in my clinic with crossfit athletes. Those guys are pretty intense people. Usually in pretty good shape, and usually hurting themselves all the time because of the level of intensity that they’re putting into it. So, we’re doing a lot with crossfit and getting some really nice results.

    Joe: Excellent. That’s a great point. That would be a great aspect to bring to the local crossfits, which are basically nationwide at this point. So, wherever you are in this country listening to this podcast, that is a nice little revenue stream to niche target, a crossfit, and say this is a benefit you can offer. Through dry needling in your physical therapy practice.

    Frank: Yeah. We deal with several crossfit clinics and it’s been fantastic for our business. You can’t imagine how these guys are referring friends and different things into it as well for that competitive edge. So, yeah, I would highly recommend in private practice that they go and take a look at those crossfit gyms because those guys are definitely in need of what we do.

    Joe: I’m going to bring this point up as well, because I’ve done this before with a few clinics. The crossfit mentality is not really a mentality of rehab. They push through the pain. So, standard physical therapy is not something they jump to, even though the need it. I agree to this, they need the chiropractor, they would need the physical therapy, but they don’t really go to it readily. Until they’re really injured. So that’s the downside. But dry needling is something different that helps that sports angle. If the education is done correctly, you could really pull them in as Frank has done here with his clientele.
    The reason why we wanted to get this interview out was there was a big article that just came out with acupuncturists and physical therapy with dry needling. You’ve explained that, which makes a lot of sense. As I put that out on LinkedIn, we had a lot of people jump on board and want to know more about it. They listed a lot of different companies. The three companies that I spoke about before. Everyone has said the same thing. Everyone has said it’s taken their clinic to the next level. That is the one common thread I wanted to share with the audience is that dry needling has taken their clinic to the next level.
    You’ve heard Frank talk about this in many ways, giving a great example in crossfit. Frank, I’ve got to ask: what are the cons? Are there any cons for dry needling? Besides the fact that my home state of New York does not allow it. But I partner up in clinics in other states, so I’m happy that it works there. Besides the fact that your state does not allow it, which is four like you said, are there any downsides on dry needling?
    Frank: I’d like to give you a couple, actually, to give you a balanced view here, but I really don’t know of any. There are people that just don’t tolerate dry needling. Certainly, a lot of them don’t tolerate the twitching aspect of dry needling, so you have to do a different technique. We show you how to deal with those people that just don’t tolerate the needling effect, the needling sensation itself. At times, it certainly can be uncomfortable. I guess that’s a downside to some patients. That’s a very small percentage of the patients.
    There really aren’t any safety issues with this. In skilled and educated hands, there really isn’t a danger factor at all. There’s a little bit of mysticism, it’s dangerous and everything else. Some patients get a little nervous, but the majority of patients afterwards will go, “Is that all it was?” I’m like, “That’s all it was.” “That wasn’t bad at all?” I’m like, “I know. It really wasn’t.”
    As a private practitioner, I couldn’t see this not being in my practice. I just couldn’t see not doing needling as a service for my clients.

    Joe: Do you have patients or treating therapists that are scared of needles? Have you come across that?

    Frank: I think inherently, most people are scared of needles initially. When I’m teaching my courses, I always start out with a little half inch needle in the forearm. You see the look in these people’s eyes when you first start going, “Okay, we’re gonna do some needling.” I think there’s always that initial apprehension. With therapists, they get over it quickly, because by the afternoon, they’re just banging in needles and they’re having a good time.
    With patients, it’s really all about how you present it. As you get better at needling and you do more of it, you understand how to present it to them in a really non-threatening way. And you make sure it’s their decision.
    That’s another big part of needling. It’s got to be the patient’s decision. You can’t do a sales job on them, you can’t talk them into it. They either do or they don’t want to do the needling. Ninety-nine percent of the time they come around and they do it. But you get those few people who are just scared of it and they won’t do it, and that’s okay. Everybody on this call has a bunch of other things they can do with their patients. They’re already successful. What dry needling does for them, is that it maybe just takes them to a little bit higher level in their practice, that’s all.

    Joe: Excellent. Let’s talk about the course, Frank. As I’ve been looking at the other courses -; the reason why I got you on the phone call is because your course, as stated by many others , this is not just my opinion, I’m going by others that have regarded their opinions from my e-mails that have gone out, and Dr. Ma’s courses and yours as well has been rated the best. I don’t want to say the best, but has gotten the most recommendations. That’s the fairest way I can say it.
    You guys have gotten the most recommendations about your course for dry needling compared to the other two that I . . . the other two, I don’t want to take anything away from them. That’s why I’m not mentioning their names. But, they have a great setup as well, they teach the points like you mentioned, but you guys give a lot of information on your website.
    Let’s talk about the course. How many days is it? How many levels of it before you get certified? Walk me through that.

    Frank: Sure. And thank you for that, by the way. Dr. Ma is absolutely brilliant. He’s a guy that just gives you those ‘Ah-ha!’ moments. And I’ve spent a lot of time with him in training and going over things. He’s really just a brilliant guy, and he brings a different skill set to the needling. I take what he’s brought, and I take my physical therapy background and we put those things together.
    The course that you mentioned, it’s not really his course, my course. It’s really the same course. We just continue to change it. The course is three days. It is intense. Really intense, actually. We start in the morning at eight, we end at around six, and we go for three days. There’s a lot of mechanism, there’s a lot of research we put into it in regards to what the needling mechanisms are, what we think they are based on available knowledge now.
    So, we try to get our therapists to obviously be skillful in the needling, but they have to understand why. They have to understand the mechanisms of why you needle. What does the needle do?
    To regress a little bit to the controversy, is this acupuncture or is this not acupuncture? When you put a needle into someone, once it breaks the skin and gets into the body, the physiology of that needling, of that healing, is the same.
    And I don’t care if the paradigm, that I’m an acupuncturist or a trigger point dry needling therapist or an integrative dry needling therapist. All that kind of goes out the door, because it’s the body’s response to the needle that really is making the difference. There’s different applications and different techniques to be able to needle, but the physiology is the same. That’s really what we try to get into with it. Looking at what that is, and why you needle and the clinical decision making of why you needle. Not just the ability to needle.

    Joe: So it’s an intensive three day course, basically for level one? Are there a few levels that you have to go through?
    Frank: Yeah. The first course is 27 CEUs and 33 CCUs, so we’ve got quite a bit of, obviously, lab portion involved with that. And then there’s an advanced course that is another 27 hours. So there are some states that require upwards of 54 hours before they can practice. Other states require 50, and then, in other states, after the first course, you essentially can go out and start to practice. So it really is based on your state and what they requirements are in your state.

    Joe: Excellent. The state requirements obviously will let you know. Besides the courses, are there anything extra that somebody could get or read about or is there anything that people that are listening right now, they could say, “Hey, I want to know more about dry needling. Can’t take a course right now. What else could I do?

    Frank: Janet Travell’s books, obviously. She’s absolutely brilliant. I use her books all the time, as many of us do. Jan Dommerholt has a great book out on trigger point dry needling and he also talks about in his book several other techniques of needling. So he goes over those in different chapters, so I think that’s a great book for people who are just starting out into it.
    Dr. Ma has two books out currently that give that different viewpoint that we’re talking about. We have a third book coming out that Dr. Ma wrote. Many of us put chapters into that book. That’s going to be a little bit more of an integration book, looking at clinical effects and things like that. There’s five, six books I just mentioned there that I think the listeners would be able to go out and get some good information from.

    Joe: Excellent. I just want to recap that because I’m reading it off the screen right now. Dr. Ma’s textbooks are, “The Biomedical Acupuncture for Pain Management,” and the second book is for sports and trauma rehabilitation. I will make sure I have a link for both books on our resource page at PrivatePracticeBusinessAcademy.com. I’m assuming they’re for sale through Amazon or through your website, but I’ll make sure we have the links that will take them to the right spot for those books and those resources.
    Again, the website is very detailed. Besides talking about Dr. Ma and why he’s so good at what he does, and the schedule and the registration and the new developments that are happening, it’s very well done. A lot of great information is on this, which is great for someone like myself, who has about zero knowledge of dry needling, this was an excellent website to learn from. So, I urge everyone -; obviously don’t do it right now if you’re driving, or running on the treadmill listening to this podcast. When you get a chance, dry needling course; very easy to remember: DryNeedlingCourse.com. Great website.

    Frank: IntegrativeDryNeedling.com is my website. Dr. Ma’s and mine are two different websites.

    Joe: I’m sorry. Okay.

    Frank: They’re sharing the same thing. The same information. So, IntegrativeDryNeedling.com is my website.

    Joe: IntegrativeDryNeedling.com, right, Frank? That’s okay. I’ll make sure I have that as the link for the resource as well on this post, so we know exactly where we’re sending everybody to. But it’s the same course, correct? That everyone goes to? If they sign up for the course.

    Frank: Yeah. Dr. Ma’s going to be doing another couple courses this year and then he’s going to be done teaching. So, everything will be coming through IntegrativeDryNeedling.com

    Joe: Got it. Okay. This was a lot of information, Frank, and I have to say, this was a lot for me to take in a small period of time. But, this answered a lot of my questions, though. And a lot of questions that other PTs had, and other chiropractors had about this. The chiropractors are basically saying, “Well, I can just hire an acupuncturist and bill it out the same way.” So I’ve spoken to a few of them about this. PTs, obviously, are the ones that are really pushing the dry needling, which is great. I think this is a great aspect to have in your practice. I think it’d be a great niche cash revenue practice that you can create with this, along with your physical therapy services, as well. This is a lot of information. Again, I urge people to check out the website. It’ll answer a lot more questions than what we’ve done on this podcast.
    Frank, I want to thank you for being on this podcast today. It was great to have you. I really appreciate it. There are going to be questions, and I know they’re going to come asking more questions. I think we covered the basic questions that everyone has posted centered around the reimbursement and centered around, ‘Are we allowed to do this as physical therapists?’ So, we’ve answered the majority of the questions. You gave some great feedback about why you’re getting so many referrals, which I think will be a reason why you’re going to see a shift of people jumping over to dry needling, as well.

    Frank: Yeah. I agree.

    Joe: Frank, thanks once again, thank you for your time, and I just want to let people know that we went back and forth to get Frank on the phone because I really wanted to get this interview in and get it out to you guys immediately, because we had so many people talking about this. We kind of worked our schedules and we’re squeezing this in on a Saturday morning. Thankfully, my kids have not screamed in the background.

    Frank: I’m shushing mine off right now, so we’re . . .

    Joe: [laughs] So, we’re done. We’re done. Again, thank you, Frank. If someone wanted to contact you, what’s the best way to get a hold of you?

    Frank: Frank@IntegrativeDryNeedling.com

    Joe: Excellent. Again, we’ll have that as a resource on our resource page. I thank everyone for listening to this show. Have a great day. Again, this is Dr. Joe Simon from the Private Practice Business Academy. Thank you.

    Frank: Thank you.

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