You Can Make a Difference

Many LAcs do their best to ignore the “politics” of acupuncture. The experience of participating in professional dialogue can be disheartening and discouraging. It isn’t easy to participate even when we want to — things are happening at the state level, with schools and ACAOM (the coming FPD), or with credentialing (proposed changes at NCCAOM), for example. All too often the debate gets heated and divisive. It is hard to get the whole story and figure out the possible consequences of a change or know what action might be effective. When the licensure legislation was developing in DE few outside of the state were involved. Some of my colleagues in DE had concerns, but they eventually gave up what felt like a fight for a better bill.

Five years after the DE legislation went into effect, there are approximately 35 LAcs serving a population of over 900,000 people and many of those practitioners were either grandfathered in or granted a waiver. Two years went by without a single non-waivered approval. Clearly, the legislation is not giving the people of DE access to qualified LAcs. As I wrote about in my last post, I know of two excellent practitioners who have recently been denied licensure even though their credentials surpass those of many practitioners in the state.

In the long run, the Delaware legislation should be changed. Rules that exclude the majority of NCCAOM credentialed Acupuncturists make no sense, especially when acupuncture can be done by other professionals with far less training. In the short run, the Acupuncture Advisory Council should acknowledge the record of safety of NCCAOM AC practitioners and consistently grant waivers to those with that credential.  In the very short term, the Council should grant waivers to Virginia LAc Sharon Crowell and Maryland LAc Sue Berman.  To facilitate those short term goals I ask that all of you write to the Acupuncture Advisory Council expressing your support of such a waiver.  Please mail your letters by August 22nd!  Feel free to post a copy of your letter in the comments section to inspire others. Email a copy to That will help if further action is necessary.

You can see the letter I sent (and borrow from it if appropriate) —  DE Observer Letter.  I’ve also generated a DE LAc sample letter that you can personalize. You could add some of these Possible concerns or your own concerns (please share any additional concerns in the blog comments). The letter can be modified for clients or others who are interested. If you’d like an excuse to visit Dover, DE, the next Advisory Council meeting is September 12th. It should be lovely at that time of year – but don’t count on being able to find an LAc in town :).


Imagine, or, How I Learned to Stop Worrying and Love the Bomb.

Trigger Point Dry Needling — develop a way to harvest Liver Yang rising, bring the topic up in a crowd of acupuncturists, and reduce our dependence on fossil fuels. I’ll save my full critique of our current response for another day. Today I will paint a picture of what could have been, and could still be, if we were to respond to this issue with healthy Wood.

Imagine, if the community’s response to the topic of dry needling went like this —

  1. Similar to Mark Seems’ response, described in his 1993 book A New American Acupuncture, we recognized that the independent identification of types of physical dysfunction by different modalities can provide fruitful opportunities for integrated medicine.
  2. We made sure that all acupuncture students and practitioners had the opportunity to develop expertise in the needle techniques, point identification, and point selection that is necessary to effectively release stagnation at A Shi points.
  3. Our discussions with Physical Therapists and other professionals were respectful, making clear that we understood their interest in serving their clients. (Just as ours is when we explore our own scope of practice, right?)
  4. We had, in advance of hearings and public statements, carefully explored the consequences of insisting that this technique be described as acupuncture. Might it be easier for the public to understand differences in techniques and training if PT’s and others were encouraged to use distinct terminology? Could our insistence that it be called acupuncture actually set the stage for the slippery slope that we fear?
  5. We honestly and forthrightly identified the amount and type of training we considered sufficient to use this technique.  (For instance, if we practice in a state that allows medical extenders, and if we had a spouse who was also a PT assisting in our office, what would be need to teach them before we felt they could use this technique?  How long would it take?)
  6. We were consistent in our arguments — for instance, expressing concern over the pain this technique can cause, while later suggesting that we could accept a situation in which the PT’s used a syringe to stimulate the point is not consistent.  Likewise, arguing that we already do this technique undercuts the discomfort argument.  Another example — we have often argued that patients should have the right to choose their providers, yet here we have argued that patients must be protected from the risk of a poor choice.
  7. We proactively educated the public about our training and experience.  (No need to denigrate the training of others in the process.)
  8. We explored employment opportunities at PT offices — illustrating how the hiring of LAcs would enable the PT to avoid altering their practice flow or having to deal with related insurance and paperwork hassles.  This would provide employment opportunities for acupuncturists and give clients convenient access to TPDN and full acupuncture treatments.
  9. All providers of TPDN knew the location of LAcs in the area and referral relationships were encouraged as appropriate.
  10. We offered appropriate training to PT’s, DC’s, and others interested and legally able to use this technique in our jurisdiction, building relationships of mutual respect while addressing our concerns about existing training, and, adding a source of revenue for our schools and teachers.
  11. We educated ourselves about the regulatory process, making sure that every LAc understands that our regulatory boards regulate people (LAcs) not techniques, and not the activities of other professions.

This list could be longer, but I bet you get the point.  Without resorting to the old canard about the Chinese character for crisis, I will say that this whole TPDN “situation” had (and in some cases still has) the potential to be a huge opportunity for us.  Instead, it continues to suck up a lot of time and energy and burn rather than build bridges.  What a shame.  We have indeed turned potential opportunity into a dangerous crisis.