Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
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"Let us open our philosophic bders and admorit all who are called to our work"
Dear Editor:
All this agonizing about credentialing, turf, and who is the best on the block reminds me of the age-old questions about the number of angels that can perch on the head of a pin. Intelligent people can argue at length about all sorts of issues that are based on shaky premises.
The shaky premise in the current acupuncture practitioners' argument is that the number of hours of training, the institution involved and the letters one post-scripts to one's name somehow describes how well a patient will fare at the hands of the practitioner. If this premise were indeed true, the smart patient would always use these indicators to seek out the best physician, chiropractor or licensed acupuncturist to treat his or her problem. Instead, as we all know, smart patients seek out practitioners who get good results, period. This sort of reputation for good results may or may not coexist with benchmarks of excellence set by other practitioners of that healing tradition (or some other healing tradition).
In other words, market forces will eventually reward good work and discourage the opposite. I feel that the marketplace should have a full range of options for those seeking treatment.
What about basic levels of competence? The answer, my friends, may disappoint. Since our first responsibility is to do no harm, acupuncture and related arts fit the bill perfectly. Even a poorly trained practitioner would find it difficult to harm a patient, even with malign intent. Even poorly chosen treatment tends to help. A good example of this is the acupuncture research protocols that were designed to include "sham" acupuncture points selected to purposely do no good. The surprising results uniformly demonstrated improvement in the condition of patients receiving sham acupuncture above no treatment at all, but not as good as with proper technique.
What is proper technique? I can't answer that, and neither can you. If 10 acupuncturists selected from the phone book were to magically treat the same patient on the same day, would any two give the same treatment? I doubt it greatly. The reason is that acupuncture is a healing art loosely related to science at best. It factors in one's own energy field; intent; experience; mood; the weather; and the hand of God.
I find it impossible to criticize any treatment given by any practitioner with good intent; results stand for themselves!
A word about proficiency tests. There has been a lot of pejorative comment about "weekend wonders" as it relates to MD acupuncture training. Regardless of my exposition above, proficiency counts in the real world. The American Academy of Medical Acupuncture now has a board certification process which includes a hefty proficiency exam. After sitting for (and passing) it, I can relate that it was every bit as comprehensive (and difficult) as the NCCAOM test, which I also passed in 1995.
To summarize, let us open our philosophic borders and admit all who are called to our work. Let the marketplace select who succeeds based on good results, not politics or titles. Let us develop good intent with our fellow practitioners, as well as with our patients, and let the philosophers occupy their minds with the problems of angels.
Richard J. House, MD, LAc
Goldsboro, North Carolina
Acupuncture, Ethics, and the Alliance
Dear Editor:
As a registered nurse and a beginning student at the New England School of Acupuncture, I was very interested in your article on the Acupuncture Alliance meeting (see "Greetings from the Alliance Meeting" in the July issue) for several reasons. First, the program content of the conference in Florida was exciting for a not-yet novice like me. Although acupuncture has been gaining wider acceptance in all settings, it is very good to know there is a gathering of practitioners who seek to elevate the practice and share knowledge.
Second, I received the news of the planning of a codified system of ethics with mixed feelings. Perhaps it is my "Pollyana" perspective, but it seems as though acupuncturists are following the allopathic pattern in this regard, and this is frightening when one considers the implications for the future in sameness of patterning.
On the other hand, it is also very heartening to see that there was a wide acceptance of the project. This shows cohesiveness of thought. Perhaps third party payors are seeking evidence of this kind of thinking, or perhaps it is the state boards and the allopathic medical organizations. I had just completed reading an article in TCM World, in which practitioners of acupuncture were being advised to submit their notes - SOAP notes - with billing to justify treatment. The mention of the development of a formal code of ethics and this article gave me some insight relative to what sort of climate currently exists in the alternative care arena.
In all, I thoroughly enjoyed the article, and thank you for the writing of it. I remain very committed to my new career choice of becoming a licensed acupuncturist.
Olivette M. Aviso, RN
Student, New England School of Acupuncture
"Delighted" to Hear about Qigong
Dear Editor:
I was really delighted to see the article "Qigong for the Heart" in your June issue. For some reason, we in the West seem to be overly focused on herbal medicine as a second source when using the art and science of acupuncture while addressing the needs of those we serve. Chinese philosophy and medical history both show very clearly that the number one method for treating and empowering the people we serve is qigong. Qigong is also more powerful and more forgiving than either acupuncture or herbal medicine. More of us should be learning and sharing its intricacies with patients and colleagues of all modalities. Thanks for the information; here's hoping there is a follow-up.
Walter Hayley, AP, LAc
Bonita Springs, Florida
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