Please support discrimination?!?

Another entry in our Hypocrites with Double Standards (HWDS) files?

I’ve been reading about the importance of Section 2706 of the Affordable Care Act for our profession. It wouldn’t be right for insurance companies to cover acupuncture only if performed by an MD, right? The concerns within our community, according to the press, are that the section might be undermined by the actions of the AMA (this makes us angry!) or not strongly enforced.

Okay, non-discrimination good.

Wait a second — AOMSM, the Massachusetts acupuncture association, is pushing legislation that discriminates.  Section 7 of S1107 and H2021 reads “The use of needles on trigger points, Ashi points, and/or for intramuscular needling for the treatment of myofascial pain will be considered the practice of acupuncture” (does it matter what type of needles?) and Section 8 reads “Only licensed acupuncturists or medical doctors shall be reimbursed for acupuncture services.” Is anyone surprised that “political agents for PTs in MA have taken measures to prevent “An Act Relative to the Practice of Acupuncture” from advancing”?

So — discrimination is good if it works in my favor, bad if it works against me?  How does this reflect on our profession and the future of integrated health? Not well, in my opinion.  What do you think?


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7 thoughts on “Please support discrimination?!?

  1. As always, provocative question here. I feel in my Zangfu the usual fear about, “Oh my gosh, they’re taking something from me!” I keep arriving at the same place. The good news is it’s turning more and more into a bogey-man. The focus should be on developing the art and practice of acupuncture. Whenever my focus is on the other guy’s (gal’s) plate, I’m probably coming from a place of fear. Fear that my piece of pie is not as big, or god forbid, contains only crumbs. That hasn’t been my experience. Sure, the practice-building issues are much harder than I like. The insurance parity issue is another big challenge. The medical system is often about money rather than health. But in reality, how much of my support of keeping needles away from other clinicians is just plain ignorant, fear-based and short-sighted. It’s been said here before, “Why not use this to educate people, clinicians and otherwise.” Not, “you can’t do that, not you suck at that and are dangerous to all the clients I so care about, not how is this fair?” Etc…. If it truly is safe for a MD, or PT or DC or any other alphabet soup credential too insert a needle, then what does that mean? Do we really believe in our clinical skills and efficacy or are we going to just keep fighting with people that actually want to know who we are and what we do. Let’s place nice with others. Let the big power sort out what comes. Sure, call something dangerous that is, but don’t on one hand scream about all those dangerous clinicians and on the other ignore our own backyard. Maybe too heavy-handed here….Wouldn’t be the first-time that the soap-box got comfortable, but sincerely, positive moves toward clinicians and clients might work much better. I refuse to attack anyone.

  2. As I see it, it’s not an issue of discrimination but of training and scope of practice. Just as it’s not discrimination to require that someone who cuts someone open during surgery be qualified, it seems very reasonable for people who insert needles into the body have adequate training. Are non-surgeons being discriminated against when they can’t start cutting into people?

    • I assume the state has already determined that these non-LAcs and MD’s are qualified to use a needle. If it hasn’t, then there is no need for legislation that would prevent reimbursement. I get the impression that the acupuncture community isn’t satisfied with the decisions of the state boards re. dry needling and now is trying a back door method of regulation. I’d be very surprised if the legislation went anywhere — do you think the D.O. will be okay with having his trigger point injection re-defined as acupuncture?

      Likewise, if the AMA says the reason they are against section 2506 is because it allows unqualified practitioners to treat people, do we agree?

      • Regardless of the statements of the boards, the bigger question is one of training. It’s possible in some states that with less than 300 hours of training an MD can advertise that they practice ‘medical acupuncture.’ In contrast to the 3000+ hours that many current graduates get in Chinese medicine (acupuncture and herbs), what indicates that these MD are qualified to insert acupuncture needles? In some states, PTs can literally take a 3 day, 24 hour course and start ‘dry-needling’. With this is in mind, should acupuncturists be able to take a three day course and start practicing some form of PT and start advertising as such?

        • There would be a lot of answers I’d need before I could answer your question — what form of PT? What’s the training of LAcs in my state? Do they have a good safety record? Do I have any jurisdiction over their practice. Tui Na is a form of PT under another name, and there are LAcs who do that with no training at all specified. I’ve written a lot about these issues — you can look for the tags TPDN or Dry Needling if you want to see more. If PT’s are advertising that they are doing acupuncture perhaps that is our own fault for insisting that dry needling is acupuncture? I remember fighting for acupuncture licensure and having to persuade the MD’s that we were qualified — they got to do acupuncture before we did.

          I respect the right of health professions to self regulate, and of health professionals to use good judgement in determining the limits of their training. Of course, in all fields there are people who don’t — that’s why we have reporting and disciplinary boards. Personally, I think most PT’s are good at finding trigger points and probably can learn to use a needle safely to release them without extensive training. I support acupuncture boards working with PT Boards or Medical Boards to assist them in establishing safe practice. I don’t support a profession that, when unhappy with the way things are going, tries to redefine the practice of others and promotes discriminatory reimbursement practices to get its way. After all, what’s good for the goose is good for the gander — and I wouldn’t be understanding if other professions tried this with us.

  3. Just another crappy move. We, licensed acupuncturists, need to stop focusing on others and focus on the best of our medicine. The medicine behind our needles is the strongest asset we have, something PT and drs don’t have.

    It’s crappy to discriminate against others. We keep digging ourselves deeper into a hole of no return.

    • It certainly bums me out. Our fight against Dry Needling has, imo, done far more to harm us than Dry Needling itself. Next time another profession treats us in ways we find disrespectful or demeaning, well, chalk it up to karma. We should know that what we do is so much more than the needle, but somehow that has become our line in the sand.

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