So a new patient comes in and s/he has the smelliest feet you've ever experienced. And, since 30 of the 60 command points are below the knees, it is a rare acupuncture treatment that does not require us to use a patient's feet. So what to do in this situation?

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1. Depending upon what else is going on with this patient and the nature of their pattern discrimination, we might be able to see this as a corroborating symptom of damp heat and make sure whatever herbal formula we use takes this into account.
2. That's all well and good, but in this situation in the moment, we can actually wipe down this patient's feet with alcohol or first water and then alcohol, telling the patient that we need their feet to be clean before we can put in any needles. This deals with the issue at hand pretty directly and instantly.
3. If the problem persists, we might ask the patient to wash their feet in our washroom prior to their treatment. Tell them that this issue or problem is part of their diagnosis. There is no fault no blame and you do not wish to embarrass them, but that in the interest of other patients who will use the room after them, you make this request. Do not make a big deal out of it and be as matter of fact as you can.
4. You might put up a sign in your bathroom that says "Cleanliness prior to treatments in greatly appreciated. Please feel free to use the supplies we have provided in this washroom." Then make sure you have nice handsoap, hand towels, mouthwash, tampons, anti-bacterial disposable or deodorant wipes, breath mints, paper cups, air freshener, and ultra-soft toilet paper in your washroom. People should get the message.
5. If you have to have a talk with patients about their foot, mouth, underarm, or-any-other-bodypart odor, keep it medical and for their ears only. Remind them that it is a symptom and, though perhaps embarrassing, it gives you more information about treating them. Be sure they know that supplies are available for them to freshen up before each treatment.
6. Make sure that you are fresh and clean all day as well. Keep a toothbrush at your clinic for after lunch, perhaps a change of clothes in the closet, and use all those other supplies as well if and when you need them. Even just a stressful encounter with a patient complaint on the phone, or with a patient's family member, or arguing with an insurance company can make you sweat.

If you have advice for practitioners on dealing with these sensitive issues, I hope you'll email me at honora@bluepoppy.com. Thanks for reading!