In my last article in the February 2002 issue of Acupuncture Today, I addressed the therapeutic value of doing less: not over-treating your patients and giving the gentle-yet-powerful effects of acupuncture a chance to heal. In this article, I'd like to discuss how to extend this strategy to the care your patients, specifically those with neuro/muscular/skeletal conditions, receive from other healthcare providers. Of course, many of these same principles could apply to other conditions. One note: the following advice addresses physical care only, not prescription medications.
Quite often, acupuncturists see patients who are also being treated by chiropractors, osteopaths, physical therapists, etc. Even if these patients are not under someone else's care, they may have been prescribed exercises or other practices they continue to perform on their own. While these additional therapies might be helping, there is also a chance they are damaging or complicating your patients' condition. It does little good for you to be so careful with your treatments if your patients are doing something else that may aggravate their condition. How do you advise your patients about the possible risk other therapies pose without overstepping the line of professional courtesy? While each patient needs to be considered individually, I have found some basic approaches helpful.
First, I avoid telling patients outright that I am concerned about the therapy they are receiving from another healthcare provider. Instead, I try to steer them to realize this possibility for themselves. During the initial consultation, I explain that while all therapies have their own benefit-to-risk ratio, most carry a greater risk than acupuncture, which supports the body's natural healing ability and therefore enjoys an excellent benefit-to-risk ratio.
At this point, patients who have been utilizing other therapies for weeks or longer often admit that they've wondered whether it was helping at all, or perhaps even doing some damage. I agree with them that it is difficult to know for sure if the other therapy was having any negative affects, and point out that since they had tried that therapy so long and continue to experience problems, it makes sense to try another approach. Of course, they already suspect this, or else they wouldn't be coming to see me. I tell them the decision is theirs alone to make, but that they might consider suspending the other therapy and giving acupuncture a chance for a few weeks.
I try to frame the above discussion as a common-sense approach that gives the lower-risk therapy (acupuncture) an opportunity instead of mixing it with higher-risk therapies. If the lower-risk therapy does not take care of the problem, they can always add the higher-risk ones again. I describe this as practicing a "First, do no damage" approach to healing. Most patients are comfortable with this, and will decide to suspend the other therapies and allow acupuncture a chance to heal.
When I see patients who are convinced other therapies are helping them, I do not force the issue, as they may be right. I still discuss benefit-to-risk ratios, however, so that I can bring it up again if the patient does not progress with acupuncture as I hoped. If that happens, I explain that it is difficult to judge exactly what my treatments may be doing because of the other, higher-risk therapies. Acupuncture may be taking them a few steps forward, only to have the other practices push them a few steps back. The only way to accurately measure what acupuncture is doing is to eliminate anything that may set the patient back. I never insist on this -- I merely recommend it as making sense.
I have seen dozens of patients who only realized the full benefits of acupuncture after they had suspended other therapies and allowed their bodies to heal. When it comes to exercises, I tell my patients that once their injuries have healed and they are back to normal, they can then slowly begin doing exercises again if they wish. The point here, just as with my last article, is not to think that "more therapy equals more healing." Acupuncture, rest and time comprise a powerful healing combination.
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.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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