Comments Abstract Background and Objectives: As evidence establishes the efficacy of medical acupuncture, more family physicians and family medicine residents may receive medical acupuncture training and need to know how to effectively communicate about the treatment option with patients. By identifying how physicians talk about acupuncture treatment with their patients, we aimed to develop a model for physician training that could enhance their ability to integrate and practice medical acupuncture in conventional clinical settings. We conducted interviews with 17 family physicians and 15 patients in a US family medicine clinic that has integrated medical acupuncture into its practice.
Dietary or nutritional counseling from the perspective of Chinese medicine and exercise were the most common recommendations, each occurring in about one third of the visits in both states.
DISCUSSION This study reports unique data on the demographic and training characteristics of licensed acupuncturists, on the patients they treat, and on their diagnostic and treatment methods.
Unlike previous studies, our data derived from specific patient visits and not from practitioner estimates. The main limitation is that we collected data from only 2 states.
Acupuncture statutes and their interpretation vary widely among states, with some permitting only acupuncture needling and others allowing modalities that extend beyond the boundaries of traditional East Asian medicine.
Massachusetts requires acupuncturists who prescribe herbs to have special certification in herbology, but Washington does not. Acupuncture training, however, is similar across the United States, largely because of the requirement by most states that applicants pass the national certification examination administered by the National Commission for the Certification of Acupuncture and Oriental Medicine.
Generally, these are conditions for which Western medical care is often unsuccessful. Moreover, the list overlaps substantially with the most common conditions for which Americans seek CAM care in general.
Nevertheless, at this point acupuncture appears to hold the most promise as an adjunct antiemetic for surgery and chemotherapy 32 and for the treatment of headache.
Although results of studies of acupuncture for back and neck pain have been inconsistent, 39— 41 there is growing evidence that it might be helpful.
In fact, Kaluaokalani et al 46 found that patients with persistent back pain who were randomized to receive the therapy they preferred ie, acupuncture or massage were more likely to improve than those who received their less desired treatment.
Fortunately, several large-scale randomized controlled trials are in progress that will soon provide more definitive answers about the effectiveness of acupuncture for common chronic pain conditions.
Chinese herbs were also often used, although no details were collected on the type of herbal preparations prescribed eg, whether they were patent formulas or customized herbal formulations; whether patent herbs were manufactured in the United States or in China, or whether the herbs were imported directly from China or grown in the West.
Although needling and heat are relatively safe as long as sterile needles are used, 51— 53 herbal medicine presents a number of potential risks for patients, 12, 54, 55 including inappropriate dosages, herb-herb or herb-drug interactions, substitution of different herbs as a result of inaccurate translation, 13 the contamination by or addition of toxic compounds and pharmaceutical medications, 15— 17, 55, 56 and the potential for delay of therapeutic options known to be effective.
Communication Between Acupuncturists and Physicians Acupuncture is an increasingly popular form of care used by patients who, about one half the time, are being treated simultaneously by a physician for the same problem.
Yet we found that acupuncturists and medical doctors did not routinely communicate with each other about the care of their patients. Possible barriers to such interdisciplinary communication include our observation that most patients who see both a physician and an acupuncturist for a particular condition were not referred to acupuncture by the physician, and that acupuncturists are trained to treat patients using a non-Western medical paradigm but are not always sufficiently trained to communicate their findings and treatment outcomes with conventional providers.
In addition, we suspect that most acupuncturists, who are typically solo practitioners, lack office staff and appropriate record systems to assist with administrative tasks, including routine and written communication with other health care practitioners.
We believe that patients will benefit from increased communication between physicians and acupuncturists. Physicians can contribute to this process by asking patients about the type of care they are receiving from an acupuncturist, especially Chinese herbs.
To better understand potential safety risks, including those that are due to adulterated products, dose-dependent toxicity or herb-drug interactions, physicians will benefit from conversations with acupuncturists about the nature of prescribed herbal formulas, especially when patients are taking concurrent prescription and over-the-counter medications.
Some patients will want to try acupuncture only after consultation with their physician. In these circumstances, physicians can use the framework recommended by Eisenberg 58 to guide patients through the process of selecting a well-trained acupuncturist, jointly negotiating the treatment plan, and monitoring the effects of the treatment over time.
CONCLUSION While substantial barriers still exist to the full integration of acupuncture into the health care system eg, variability between states in licensure and practice regulations, variable reimbursement practices by third party payers, lack of solid studies on efficacy for many frequently treated conditions5 the information provided herein should be useful to physicians and other health care practitioners interested in advising their patients about acupuncture.
Acknowledgments We thank the 35 members of the original acupuncture study team for data collection and Kristin Delaney for help with data analysis. Notes Conflicts of interest: In-kind support was provided by the Centers for Disease Control and Prevention.The first medical description of acupuncture by a European physician was by Ten Rhijne, in about , who worked for the East India Company and witnessed acupuncture practice in Japan [6, 11].
Acupuncture is an ancient practice that seeks to treat disease or relieve pain by piercing the body with needles in specific locations. Acupuncture is purported to have outcomes well within the realm of the natural world, and since science deals with natural phenomena, it can study these effects.
Scientific study of acupuncture is challenging due to the multifactorial nature of the intervention, variability in practice, and individualization of treatment. There has been much discussion in the literature on the ideal control condition for studying acupuncture.
Acupuncture is considered cumulative in nature, meaning one may need to undergo a series of treatments. The first session will include a private conversation with the acupuncturist. Allow at least one hour for the first appointment to accommodate your consultation and session.
Acupuncture practice acts: legalized quackery. Jann Bellamy on August 23, ‘Practice acupuncture’ means the use of oriental medical therapies for the purpose of normalizing energetic physiological functions including pain had no clue about oriental medicine’s true nature when they voted for these practice acts.
In fact, I. Acupuncture is an alternative therapy that involves inserting thin needles into targeted areas of the body.
Some believe that this balances a person’s vital energy, while others point to a.