The threat to acupuncture from dry needling is like the threat to “traditional” marriage from gay marriage. That is, the real threat is our obsession with the issue and our willingness to make any argument, no matter how ridiculous, to keep people from connecting with the provider of their choice.
Despite thousands of years of experience and a big head-start, we didn’t establish ourselves as the undisputed experts of this method of pain relief. Having failed to convince the PT Boards that PT’s performing dry needling is a danger to the public, or that LAcs should get to determine the appropriate training for this technique, we are now arguing that we’ll accept it, as long as it hurts.
The November 2013 issue of AcupunctureToday included Dry Needling: Averting a Crisis for the Profession, here is my response to AT —
Dr. Amaro’s “obvious solution” to Dry Needling, that PT’s be judicially mandated to use a hypodermic needle, is awful. Has it come to this? Despite our 2,000+ year head-start our plan for success is to require other providers to use a tool that causes tissue damage and pain? There is no non-political reason for a board to require its licensees to use an unnecessarily harmful tool. To present it as a possibility is an embarrassment to the profession.
While some auto insurance and worker’s compensation will reimburse for dry needling, for the most part Trigger Point Dry Needling is not a billable service when performed by a physical therapist. It is considered “experimental and unproven” by Medicare and major medical insurance companies. And, if it were true that PT’s were getting rich on reimbursements for this technique, is that an argument against allowing them to perform an effective procedure? Don’t we support people getting relief from pain, regardless of who is paying the bill?
It would be tragic if we were successful in requiring everyone using a filiform needle to use the term acupuncture while losing the battle to prevent non-LAcs from performing the technique. Given various rulings of state AG’s, and of the regulatory boards responsible for other professions, this is a strong possibility. Then, we will have lost our ability to distinguish what we do from what others do. (And, ironically, would help PT’s obtain reimbursement.)
We had decades to establish ourselves as the experts in this technique. We didn’t, and, frankly, many of us are unpracticed with it and uninterested in making it a major part of our clinic offerings. Addressing unfair reimbursement scenarios is reasonable. Respectfully presenting evidence-based concerns about risks to the public is part of our civic duty. Our ongoing panicked response to TPDN, with arguments based on misinformation or a misunderstanding of such basic topics as scope and the regulatory process, culminating in the argument in Acupuncture Today – that it’s okay as long as it hurts – is the real threat to our reputation and our future.
I encourage you to read all of my posts on this topic (you can get them via the categories or tags on the homepage) and on scope of practice. It is time for the acupuncture profession to stop shooting itself in the foot.
Cross-posted on https://www.facebook.com/groups/pocacoop/
You should get ready for some marriage proposals, or at least a lot of love.
A nice change from flaming bags of poo, right? Thank you, Lisa for your hard work, and for not getting bogged down in words. I hope to change the conversation, and you and all of the 600+ punks who are members of POCA are changing the lives of thousands of people every week. Helping people feel better — that’s why most of us became practitioners. POCA has never lost sight of that bottom line. Thanks for the inspiration.
Woohoo! Well said!
I was wondering if you were going to respond to the article. I read the article and thought about how we are digging ourselves into a deeper hole. It’s very sad we are wasting time, energy and money on this dry needling stuff.
So question: do you think acupuncture should be a doctorate degree? Thus we can be doctors of TCM or 5 element which then could be seen as a speciality of a medicine? Would that change insurance reimbursement?
No, I don’t think acupuncture should be a doctorate degree —
1) Insurance companies don’t make their decisions based on titles. They make decisions based on regulations, what will help them sell policies, what is cost effective, political pressure, etc. We can call ourselves the grand poobahs of all that is good, but that wouldn’t get the insurance companies to cover acupuncture.
2) Getting a doctorate degree would not mean that acupuncture would be a medical speciality. To be a medical speciality we’d need to go to medical school — MCATS, 4 years of medical school, then residency. Sounds long and expensive.
3) The experience of those who have come before us should have taught us that chasing the insurance dollar is not a path to success. In my neck of the woods, the doctors who can are leaving the third-party payer system. And medical practices based on insurance reimbursement — much of the direct patient care is provided by lesser trained PA’s, nurses, etc.
4) Our current level of education seems to be more than enough for competent practice.
Thanks for clarifying the doctorate idea.
Well this is like the tail wags the dog.
I’ve been looking into the poca site and it’s refreshing to see a community of practitioners working together. If anything that’s where we all need to start – as a group and then figure out our next step.
Yup. When we re-focus on what brought most of us here — wanting to use this incredible medicine to help people — it can be maddening to see that all the talk about being valued and respected hasn’t really been helpful to that end. We want to treat people, and there are all kinds of ways to make that possible. For a group that knows the actual medicine of the west doesn’t live up to the hype (though of course it has its very important contributions), we sure have been seduced by the medical system of the west.
I saw Amaro’s article but never made it to the part suggesting hypodermics. SERIOUSLY!!!!?????
It would have taken me three or four posts to address everything that deserves to be addressed in the article. As for hypodermics, yup. That is where it all started for the PT’s — they started using hypodermics and doing injections, then realized the needle without injection anything worked (hence the term dry needling), then realized that, since injecting wasn’t necessary, an acupuncture needle could accomplish the task with less pain and tissue damage. And that’s when the LAcs got involved. (Well, not really then either, it’s when the PT’s asked their boards for clarification.) The argument that we could accept the trigger point release if they just continued to use syringes has been around for a while, sadly, but to see it taken so seriously is concerning.