The Florida State Oriental Medical Association (FSOMA) took on the Board of Physical Therapy, allegeding that "physical therapists are not adequately trained in the insertion of filiform needles into the human body and carries the potential for harm to patients and the profession of acupuncture."1
An argument to this effect pointed to a policy statement issued by the American Medical Association (AMA) at its 2016 Annual Meeting stating that dry needling is "an invasive procedure and ... should only be performed by practitioners with standard training and familiarity with routine use of needles in their practice, such as licensed medical physicians and licensed acupuncturists." The press release announcing the AMA policy specifically mentioned physical therapists in terms of "lax regulation and nonexistent standards" surrounding the invasive practice of dry needling.1
FSOMA sent out an email to members announcing the win and posted a statement on their website, "An Administrative Law Judge at the Division of Administrative Hearings issued a final order today in favor of the Florida State Oriental Medical Association (FSOMA), declaring the Board of Physical Therapy Practice Proposed Rule pertaining to Dry Needling invalid."2
Although this ruling is only for the state of Florida the precedent has been set—with hope that other states will soon follow with similar rulings.
References
Florida State Oriental Medical Association vs. Department of Health, Board of Physical Therapy Practice and Florida Physical Therapy Association, 2018; 11-22.
Florida State Oriental Medical Association, fsoma.org, 2019.
A student stands over a patient, needle poised. They have a “perfect” prescription: a textbook combination of points harvested from a lecture slide on chronic lower back pain. But as the needle meets the skin, the student hesitates - the symptom of a quiet habit that has taken hold of our profession. We routinely say we “prescribe” points. It sounds efficient. It echoes the authority of biomedical culture and fits neatly into the insurance field. But vocabulary is never neutral; repeated long enough, it dictates behavior.
Acupuncture can be highly effective in cases of nasal congestion so common in allergy presentations; so much so that I often treat such issues using acupuncture protocols alone. In cases of seasonal allergies with highly predictable causes such as obvious elevations of environmental allergens, I use a skeleton acupuncture prescription that can easily be fleshed out to target potential underlying patterns and effectively customized to the patient.
The field of acupuncture in the U.S. continues to grow in visibility, patient demand and clinical effectiveness. Yet behind the curtain, many acupuncturists are quietly struggling to keep their doors open. While the profession is rooted in centuries of healing tradition, modern economic pressures – particularly those driven by insurance limitations, low reimbursement rates and job-market saturation – are making it increasingly difficult for licensed acupuncturists to thrive.
