One of the biggest misconceptions in our profession is that hospital-based acupuncture programs fail because there isn’t enough funding. My experience taught me otherwise.
I developed three separate acupuncture program proposals for three different hospital departments within a large academic medical center. As I navigated the process, I quickly realized there was very little guidance available for acupuncturists interested in creating hospital programs from the ground up. Most existing hospital acupuncture services were established through donor-funded initiatives, not by acupuncturists who designed programs, built business cases and secured institutional support.
To bridge that gap, I invested additional time and resources to develop skills in program development and change management. As part of that process, I conducted a qualitative research study to better understand what hospital leaders perceived as the barriers to implementing acupuncture.
The study consisted of individual semi-structured interviews with leadership from the medical, surgical and bioethics departments at a large academic medical center. Interviews were independently coded and analyzed using thematic analysis.1-2
I expected funding to emerge as the primary obstacle. It did not.
Instead, the dominant theme was a knowledge gap among physicians and surgeons. Although acupuncture has a growing body of evidence supporting its role in pain management, most physicians receive no formal education about acupuncture during medical school, residency or fellowship training.
This finding has important implications for our profession. If the primary barrier is physician knowledge rather than funding, then generating more research alone will not automatically increase hospital adoption. Likewise, expanding insurance coverage, while important, will not by itself lead to widespread implementation of inpatient acupuncture services. Education must accompany evidence.
Interestingly, the study also challenged another common assumption. Funding itself was not viewed as the limiting factor by hospital leadership. Once a program demonstrated clinical value and aligned with organizational priorities, identifying financial support was not considered the greatest hurdle.
The research also highlighted another opportunity for our profession. Compensation models accepted by acupuncturists working in donor-funded hospital programs should not define the value of every hospital-based position. During my own program development, negotiating a higher hourly rate than those commonly accepted in existing donor-funded programs was not the barrier.
Perhaps the most surprising aspect of the project was that acupuncturists, including practitioners from other institutions and those with prior hospital experience who were invited to participate, did not contribute to the study. As a profession, we have relatively little published research examining the operational and organizational challenges of implementing acupuncture within hospital systems.
If we want acupuncture to become a routine part of evidence-based hospital care, we must expand our focus beyond clinical efficacy. We need implementation research, and leadership from acupuncturists who are prepared to build programs, and fight for appropriate salaries and recognition.
References
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