A House Built on Shifting Sand

About eighteen years ago, as we were advocating for a practice act in Virginia, a big upset was that MD’s, DC’s, and DO’s (and podiatrists within their scope) could practice acupuncture with only 200 hours of training.  Time and again, acupuncturists complained (and continue to complain) about this — after all they say (and we said to the legislators and staff at the Department of Health Professions) acupuncture is far more than sticking a needle in the body.  Acupuncture is a complete system of healing, a theory, a philosophy, a paradigm, a system of diagnosis.  A doctor may be able to safely stick a needle in a point (though these are, after all, very special needles, nothing like a crude hypodermic), but they aren’t doing “acupuncture.”  Mention MD’s and DC’s “with limited training” doing acupuncture to most LAcs today and you’ll get anger and complaints.

What gets LAcs (or OMDs or CAcs) even more incensed today — Physical Therapists (or DC’s) sticking a needle in a point and saying it isn’t acupuncture.  After all, we say to the regulatory boards (and even more loudly to each other), they’re sticking an acupuncture needle in a point.  We don’t care whether the PT is thinking only that a trigger point causing pain could be released by this needle.  Or that they know nothing of the theory of Chinese medicine.  All we know is that if they are sticking a needle in a point they are doing acupuncture, they darn well better not call it anything else, and they ought not be allowed to do it.

I’ll save the in-depth conversations about TPDN, scope of practice (it doesn’t mean what you think it means), and coalition building for other days.  For today, I just want to ask that our profession show some consistency.  Consider the implications of insisting that acupuncture is defined as a needle in a point, or the implications of insisting it is far more than that, and especially consider the implications of changing the definition to suit a short term need.  Consider the implications on what you do in your treatment room, as well as the impact on our battles with other professions, our interactions with regulators, our involvement with third-party payer systems, and perhaps most importantly, on how we build our brand.  Above all, remember that like a house built on shifting sands, a profession built on shifting definitions is unlikely to stand the test of time.

Copyright —

© Elaine Wolf Komarow and The Acupuncture Observer, 2013-2017. Unauthorized use and/or duplication of this material without express written permission from Elaine Wolf Komarow is prohibited. Excerpts and links are encouraged, provided that full and clear credit is given with specific direction to the original content.

5 thoughts on “A House Built on Shifting Sand

    • Some future post will explore a Traditional Diagnosis for our profession. No doubt a Water imbalance plays a big role. I think about Metal too — this whole underlying angst about the respect we do or don’t get, and the various things we try to do (increasing education requirements for example) to try and get that respect.

      The really crazy thing is that so much of the fight about labels comes from the mistaken belief that, if we call something acupuncture we get to control it. While that argument seems to have worked in some states, I think it is a temporary victory at best. Our Boards have a say in what our licensees do, we don’t get to control what other professions do, even if we call it acupuncture.

  1. Elaine: I totally agree with you – we need to be consistent in how we define acupuncture, and honestly, it works much more in our favor as professionals to stick with the original complaint – that sticking needles in a body without full training in acupuncture theory, in the technique of how to use intent to move Qi, and in the intricate understandings of the entire paradigm of Chinese medicine simply IS NOT acupuncture. We need to solidly stand behind our knowledge, wisdom, and energetic skills and abilities as practitioners who are highly trained in our chosen profession.
    Other modalities may gain some popularity – maybe we should spend more time in educating the public more, so they will understand what acupuncture really is, and what the benefits are – perhaps there will still be many who will be attracted to the “quick fix” or to practices that are better covered by their insurance, but the well-educated consumer will continue to seek out acupuncture when they realize the broader benefits to their overall health. So let’s put more effort into educating the public and do something pro-active about attracting customers, rather than commiserating over how other professions may be taking away our market share.

    • And I agree with you! It may be that even some well-educated consumers choose to receive dry needling from a PT if it serves them. I would, if I had a trigger point begging for release, and was in the office of a PT I trusted. And some of my clients have as well. They are still my patients, and they understand the difference between what they got from the PT (which they found helpful) and what they receive from me (also helpful). We have argued when seeking licensure or third-party coverage that the consumer should be able to choose what sort of care they want. Seems like we should support that even when they are choosing someone other than us, and, focus our efforts on giving them enough information to help them make a good choice.

      • Yes! Yes! Yes! There is a time and a place for everything. Nothing wrong with our clients, as educated consumers, choosing other modalities as needed. And there are times that my patients leave my practice for a little while as they do other things, because it helps them at the time – they come back when they want acupuncture again. I also encourage them to take full advantage of multiple modalities when I see they would benefit. They can tell when a practitioner is sincerely looking out for their welfare as a higher priority than the bottom line ($$). In the long run, it brings them back.

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