Last month, I was so honoured to be noticed by a Michelle Grasek who is also an acupuncturist who is passionate about marketing and practice management. She contacted me through my Instragram @kanpobliss and wanted to find out more about Traditional Chinese Medicine (TCM) and acupuncture in Singapore.
So here’s the interview from her blog here.
Welcome back everyone!
I have a really unique interview for you today and I can’t tell you how excited I am about it.
Recently I stumbled across a really fun and unique Instagram account, @kanpobliss, run by Jun Negoro, an acupuncturist in Singapore.
I love how she uses emojis to teach people about acupuncture points. It’s so clever and engaging that I just had to reach out.
When I learned that she’s practicing in Singapore, I had a MILLION questions for her about everything from marketing to TCM education to insurance for acupuncture in Singapore.
Jun graciously answered them for me, and I was pretty surprised to learn that acupuncture is not entirely accepted in Singapore the way we Westerners might expect it to be.
I know that I personally assumed that acupuncture is a respected and accepted form of medical care across all Asian countries. I’ll totally admit my ignorance about this.
Jun explains that acupuncturists in Singapore (and some other Asian countries) often struggle with the same issues we do here in the US: helping people understand that it’s a legitimate form of medicine that can help them, and integrating it into Western medical practice.
Who knew that our goals of patient education were reflected in many parts of Asia as well?!
I think you’ll find this interview to be a fascinating peek into the world of acupuncture in Singapore: a world you might assume is very different from our own, but that turns out to have some startling similarities, struggles, and triumphs.
I hope this interview broadens your understanding of acupuncture on a global scale. I know it did for me! As I always discover when I travel and speak to people from other countries, our differences are fascinating, but what we share in common is so fundamental and powerful.
Many thanks to Jun for helping unite and educate acupuncturists across the globe with her thoughtful and articulate answers!
Today Jun and I talk about:
What it’s like to practice acupuncture in Singapore (hospital vs. private clinic)
What marketing works well for private clinics there
How Western medicine is actually the most common, accepted form of medicine in Singapore, and how TCM is gradually being embraced (much like in the US)
And much more
Let’s dive in!
Are you originally from Singapore?
No, I am Japanese but grew up in Singapore. (Hence the word “Kanpo” which refers to TCM in Japanese.)
I studied TCM in Singapore which comes together with two years internship in Beijing. I have been practicing in Singapore for a few years.
What kind of clinic do you work in? Is it in a hospital, or privately owned?
I work in a privately owned clinic targeted mostly at weight management, gynaecology and pain management.
In Singapore, most TCM clinics are privately owned. There are some acupuncture clinics within the hospitals but they are usually not used in conjunction with Western Medicine. The purely TCM hospitals operate heavily on donations.
Singapore only started the registration of acupuncturists in 2001 and TCM physicians in 2002. The medical industry is still very Westernised. For example, TCM insurance and medical certificates are sometimes not recognised. (A medical certificate is a document issued by a doctor confirming that you are ill and thus unfit to attend work/school. It’s like a “sick note.”) But things are changing over time, one step at a time!
Why did you decide to study in Singapore instead of Japan?
I was born in Japan and came to Singapore when I was 6 years old due to my parents’ jobs. Since then, I have been educated in Singapore from primary school (Grade 1) all the way to University. I had no plans of going back to Japan and liked living in Singapore (I would even call it my hometown actually!) so I decided to study in Singapore.
You mentioned that the program in Singapore was five years plus two years in clinic. Can you describe the course of education in Singapore?
In Singapore, there is only one university (Nanyang Technological University) that offers a 5 years double degree course – TCM and Biomedical Science. I studied there. TCM is taught in Mandarin and Biomedical Science is taught in English***. The first 3 years is in Singapore, the final 2 years is in Beijing University of Chinese Medicine (inclusive of internship at their affiliated hospital).
Upon graduation, we need to clock in about 400 hours of clinical practice at specific institutions before we are eligible to take the TCM Physician Registration Exam(conducted once a year). Only after passing the exam, then we get to practice in clinics/hospitals. All these clinical part is compulsory!
If university is not their preferred choice, then they can study a 7 years part time course or 5 years full time course in some of the approved Singapore’s TCM institution. They’ll also have to take the Registration Exam before practicing.
It’s a really long journey!
The above mentioned is for a full licence, meaning that you can prescribe herbs AND do acupuncture. If you only wish to practice acupuncture, only locally registered doctors (western doctors) and dentists are eligible to register. In Singapore, we cannot call ourselves doctors as this refers to Western Medicine trained doctors only. We are called TCM Physician/Practitioners.
***Singapore is a multi racial country and has a bilingual education system. All subjects are taught in English and we have to choose a 2nd language. For Chinese people, most of us choose Mandarin, whereas Malays choose Malay, Indians choose Tamil.
What made you decide to become an acupuncturist?
I never really had a concrete idea of what I wanted to be when I grow up. But thinking back, I grew up around TCM and was taking herbs since young. Plus I enjoyed biology class in school, especially the human body. So when I saw biological science and TCM (which includes acupuncture), I thought “Ah, nice combination, let’s try this,” and here I am today!
You also mentioned that in Singapore, acupuncture and TCM were only recognized as medical professions in 2001 and 2002. I think this will surprise a lot of our readers since many of us in the West assume that acupuncture has been accepted and integrated in healthcare across Asia for a very long time.
Yes, it’s funny how an Eastern Medicine is not totally accepted in Asia right? When I was interning in Beijing, the doctors would do surgery and do post treatments using TCM. I had to remove stitches and then discuss herbal formulas for patients. In paediatrics ward, children had TCM IV drips. It was truly fascinating! It’s something we don’t see in Singapore. Medical system is so integrated and that is what I wish for the future of medicine. It is not West or East (or North or South for that matter), it shouldn’t matter what medical techniques we use as long as it treats the patients. Of course this will take time to implement.
Why was it not an integrated part of the healthcare system before this? What changed that made them decide to accept it at a profession in 2001?
First of all, Singapore (perhaps like most other countries) is very much Westernised. Singapore was colonised by the British for many years before gaining independence 52 years ago (yes! Singapore is that young) and has established its Western healthcare system then.
In the olden days, TCM was only offered by older physicians or through word of mouth passed down from generations and generations in Chinatown. TCM did not have much credibility, some viewed it as witchcraft, no scientific evidence… etc, perhaps that’s also another reason why the government did not make it part of the healthcare system. This is still instilled in people’s’ mindset even up to today. 🙁
It was only when Nanyang Technological University started offering TCM course in 2005 when we had an influx of fresh blood new generation physicians. I guess, Singapore decided to take actions to distinguish between newer generation physicians (who went to university or institution) and senior generation physicians (learnt from grandparents/self-study). TCM became more recognised as a healthcare treatment and a clear structured was needed.
Is this particular situation unique to Singapore, or is it something that also exists in other areas of Asia?
Other than China, I do not know any other countries that truly integrates the Western and TCM in hospitals like Yin and Yang.
I think that the licensing and registration play a big part. As far as I know, TCM is not offered in universities in Japan. Most doctors who practice TCM are Western trained doctors or pharmacists who take extra classes about TCM. For example, I can work in Asian countries like Malaysia where their TCM registration is not enforced, but I can’t practice in Thailand unless I pass their board exams (in Thai language which I have no clue!).
Every country has its own rules and regulations (plus political issues?). Nonetheless, things are slowly changing. Here’s some good news happening in Singapore.
Singapore government has offered additional S$10 million grant in TCM sector in August 2017: http://www.channelnewsasia.com/news/singapore/s-10-million-additional-funding-to-support-develop-tcm-sector-9084212
Also, our Prime Minister Mr. Lee said TCM “will continue to supplement the medical system” as the population ages, during the National rally speech in September 2017: http://www.channelnewsasia.com/news/singapore/traditional-chinese-medicine-to-play-important-role-as-singapore-9244600
What made you decide to work in a private clinic instead of a TCM or integrated hospital? I know you mentioned the TCM hospitals exist largely based on donations… Is the pay less at TCM hospitals? Are the opportunities better if you work for a private clinic instead?
This depends from clinic to clinic. In private clinic, you get to learn other aspects of the operation and business, which can be enjoyable at times. However, in the future I would like to work in a Western hospital with a TCM department after I gain more experience, to get more exposure.
I’m also surprised to hear that the healthcare coverage for TCM is not accepted in all places. Again, I think I assumed that TCM insurance coverage would be accepted everywhere in most Asian countries.
Not all TCM is insured. Some insurance companies require Western doctor’s referral letter or you need an “add-on” to your insurance package to claim TCM at a capped amount. Medical certificates (which are like sick notes) are not 100% recognised as well, but more companies are starting to accept it today.
You mentioned that in the clinic you work at specializes in weight loss, gynecology, and pain management. Would you consider these conditions, or one of these, to be your specialty?
I wouldn’t say that any of them is my specialty but I’m leaning towards gynecology and pain management. I didn’t go to school to specialise in any of these areas. In Singapore, specializing in TCM is up to you to decide and so called “certificate” is not necessary. There are courses and conferences that we can attend, so we can choose which ones to go to and learn about the topic of your choice.
In the coming years, Singapore is going to implement a Continuing TCM Education (CTE) where we have to accumulate points through attending courses. Currently, CTE is still voluntary, but soon it may be a requirement for the renewal of practicing license, which is done every 2 years.
Do you have to do any marketing to bring in your own patients? Or is marketing unnecessary?
Yes, marketing is definitely needed to some extent. As I do not own the clinic, I don’t do much marketing directly but I am constantly looking for ways to communicate and educate patients better. Business marketing is important but I feel that self-marketing is also crucial in this field.
I totally agree that individual marketing for acupuncturists is very important. What kinds of activities do you do to market yourself?
Not sure if this is called marketing, but just being attentive when treating patients and offering customised advice and giving them lifestyle tips works for me. Keeping in touch via SMS or email (like an email subscription) works too.
What kinds of marketing does the clinic do to bring in patients? Is there one kind of marketing that seems to work the best to bring in patients?
The clinic brings in patients via Website, Facebook, WeChat, Instagram, roadshows and newspaper ads. Facebook and website seem to work well. Roadshows and setting up booths at events works sometimes if there are free trials/products, but it is not very sustainable. Few years back, newspaper ads worked well but I feel that Instagram is the best way to get the public to notice you.
(WeChat is similar to WhatsApp but there are groups, blogs, business/personal accounts that you can follow for updates. It’s almost like WhatsApp plus Dayre [an online blog] and Instagram all in one. It’s catered mostly to China or the Chinese speaking community.)
Can you describe the clinic for us? How large is it, how many acupuncturist or conditions of other kinds work there, how many patients do you see a day, etc.?
Located in the city centre of Singapore, the clinic offers herbs, acupuncture, cupping and tuina (or massage therapy). There are about 15 beds, 3 physicians, 3 to 4 massage therapists and 2 receptionists working on rotating shifts. During busy times, I see around 25 patients a day (those who just come for massage not included).
How frequently do you treat your patients?
In Singapore, we treat 2 times a week then slowly pace it out to once a week. Example for weight loss, it’s about 3-4 months treatment, depending on how much they want to lose. Treatment (pain management) can be shorter.
Do you plan to own your own clinic some day or is that not very common?
Currently I do not have plans to start my own clinic but who knows! Perhaps the lack of experience and capital is the biggest concern so I would prefer to work in a private clinic or eventually a hospital where I can get exposure to other aspects of the healthcare system as well.
It is not very common to start a new clinic as a young physician as rental cost can be very expensive in Singapore. Usually most of us will work in clinics for a few years first. As benefits and career progression for TCM can be slow in Singapore, some choose not to practice and work in other healthcare line instead (hospital operations, policy making, regulatory authorities etc).
As for me, I intend to stay in TCM field and inform and inspire others through my Kanpobliss Instagram. I am also currently working on an exciting TCM related project which I will share when it’s ready mid next year (hopefully!).
Thank you so much, Jun! I appreciate how much time and effort you put into these questions. Thank you for helping us better understand the state of acupuncture practice worldwide. I’m glad that ultimately there are important things that unite us no matter where we are 🙂
Make sure you follow Jun’s fresh and fun Instagram account, @Kanpobliss!