This is the fourth article from the ASA Advocacy Committee on the impact of the Acupuncture for Our Seniors Act on our patients, profession and practices. H.R. 4803 will codify licensed / qualified acupuncturists as providers under Medicare who can work and bill independently as "licensed / qualified acupuncturists." Currently, the Centers for Medicare and Medicaid Services (CMS) covers acupuncture for chronic low back pain/cLBP, but licensed / qualified acupuncturists cannot treat or bill Medicare patients because we are not recognized as providers under the Social Security Act.
As an acupuncturist, a professor, and someone who has benefited from acupuncture and Chinese medicine personally, I am deeply motivated to advance the integration of acupuncture and Chinese medicine and allopathic medicine in the United States.
Acupuncture and Chinese medicine can and should play a significant role in improving health care in the U.S. We know allopathic medicine is vital in the treatment of disease. We also know allopathic medicine can focus too narrowly on disease management, and would benefit from a whole-person, health-creation approach. Whether we use the term or not, we as practitioners embrace salutogenesis, or a focus on overall health, as opposed to disease. Acupuncturists play a large role in preventing disease, as well as managing symptoms.
Let's Imagine What Integration Could Accomplish
With acupuncturists more fully integrated into the U.S. health care system, think of what we could accomplish. More patients with chronic conditions and pain would feel heard and experience relief. Surgery patients would recover more quickly, and with less reliance on opioids. Acupuncturists would work side-by-side with our allopathic colleagues to build a new culture around health care – one that centers the patient, gives patients more agency, and recognizes the many options patients have to create health for themselves.
This doesn't mean all acupuncturists start practicing within Western medical systems; it means the work we do in private practice is recognized by allopathic practitioners and adequately reimbursed by payers. In this future, acupuncturists work in emergency departments, on surgical floors, in integrative clinics, and in private practice – and patients seek out our care before resorting to surgery or prescriptions.
We Can Make Small Changes to Help Change the System
To create this future, we need to focus on two things: patient education and patient access. Patients will not seek out our care if they do not understand the benefits, or if regular care is too expensive or difficult to receive.
Of course, there is a long road ahead. For patients to truly understand, embrace and easily access acupuncture, we will need a large-scale cultural shift around health care in this country. I do believe health care is headed toward an outcomes-based, patient-centered model, but we are far from that reality now.
Rather than become discouraged, we as acupuncturists need to push for small changes to achieve a system that brings our patients closer to health optimization, with acupuncture playing a key role. One of the first steps in this process is to pass H.R. 4803: the Acupuncture for Our Seniors Act.
H.R. 4803 would authorize the Medicare program to recognize licensed acupuncturists as Medicare providers, which would expand access to acupuncture for seniors, and establish an acupuncture-coverage model for other payers that often follow CMS coverage policies.
An Important Step Forward Toward Health Optimization
This bill is only one step toward a health care future focused on health optimization. I understand LAcs may feel as though we are being wedged into a small niche corner of health care, and maybe we have always been there; and maybe that's where some want to be. But if we don't support and advocate for these small steps, Americans will continue to go without access to this care.
We know that what we offer makes an incredible difference in the lives of our patients. Many of us entered this field because this medicine changed our lives, me included.
Acupuncturists have so much to offer in the face of the chronic pain and opioid epidemics, along with many other health concerns our country faces. Every step we can take to expand patient access to acupuncture and Chinese medicine is a step toward normalizing our medicine and allowing a greater culture shift to achieve better health for our country.
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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