Not gonna lie, I'm frustrated.

17 years of practicing Chinese medicine in Beijing. No. 1 private Chinese hospital experience. But here in San Francisco? I'm barely making minimum wage. The system doesn't even recognize me as a "real doctor." Finding work feels impossible. I'm forced to launch my own practice.

So I called my friend Rita Chen. She studied TCM in Beijing like me, moved to the US in 2011, and built a thriving clinic in Atlanta. I needed to understand how she did it.

What We Talked About

Rita and I were classmates in Beijing. We're both from Taiwan, studied traditional Chinese medicine together, and then took very different paths to the US. She's been practicing here since 2014—first in San Jose, now in Atlanta. She's built something real.

I needed to hear how she did it because right now, I'm stuck in a system that doesn't make sense.

The Numbers Don't Add Up

Here's what I'm dealing with: Job offers in San Francisco pay around minimum wage plus 30% commission. That's it. For someone with 17 years of experience. For comparison, in Beijing's public hospitals, patients pay $7 to see a TCM doctor (reimbursed down to $1 out-of-pocket). At the private hospital where I worked, consultations were $200 and treatments ran $200-400.

In San Francisco, the most you can charge is about $200 per session—and that's in one of the most expensive cities in America. Meanwhile, getting my ear wax removed here costs $100.

The economics are broken.

Why This Keeps Happening

Rita explained something important: TCM still isn't considered primary healthcare in America. Insurance only covers pain management—that's it. So most patients you'll see are either dealing with pain, or they're paying out of pocket for other conditions like insomnia or infertility.

In Beijing, I worked across six different hospital departments. I collaborated with specialists. I saw complicated cases that required real problem-solving. Here? The cases are limited because the awareness is limited.

And there's another issue: education.

In the US, you can become an acupuncturist with a 3-year master's degree. In China, we went through 5 years of training plus extensive hospital practice.

The foundation is just different. It's not a knock on anyone, it's just reality. And when patients get inconsistent experiences, they don't know what to trust.

But There's Hope

Rita said something that stuck with me: "It is still pretty bright because people are more open to different ways to help them."

She's right. Things are changing:

• People are researching alternatives when conventional medicine doesn't work. They're finding TCM.

• Rita gets referrals from orthopedic doctors and fertility clinics. Why? Because they can see measurable results—like egg retrieval counts doubling after acupuncture treatment.

• More people are trying herbal medicine. Even the needles—which scare people at first—become something patients look forward to. Rita jokes with her patients: "Are you ready for today's torture?" And they laugh and say yes.

In Georgia, there are only 500 acupuncturists total. That's a tiny group. But the demand is there. People need help.

What I Learned

Rita's been in and out of the US for 15 years. She's tried and failed to establish practices before. Five years ago in San Diego, she struggled with marketing and had no network. But she kept going. She moved to Atlanta, built relationships, and now she has a thriving practice.

Her advice? Enjoy the moment. Keep learning. Keep moving. The way forward reveals itself when you don't stop.

She also reminded me why I do this work: TCM changed her life. It changes her patients' lives. She practices on herself too, not just on others. That's the whole point.

Why This Podcast Exists

American patients deserve better access to holistic care. But pushing for education and legitimacy? It's an uphill battle.

I'm starting this podcast: Puzzle Exchange. Because I want to have honest conversations with doctors from different traditions. We'll talk about what's broken, what's possible, and what we're building despite the differences.

Rita said something else that resonated: We need people who can really teach TCM here. Who can build strong educational foundations. Who can help raise awareness and quality.

I don't know if I'm that person yet. But I'm going to try.

This is bridge-building through honest conversation. It's going to be a hell of a journey.

I hope you'll join us.