As an MD considering training in acupuncture at the Helms Institute, I’m very interested in this discussion. I’ve been in practice for 5 years now, and I’m often frustrated by the limitations of Western medicine, by the tendency to rely on prescription drugs to solve problems. This is what led me to consider learning more about alternative therapies. Because the majority of my patients still have some skepticism when it comes to alternative therapies, I was hoping that in my own education, I could further educate my patients to see that sometimes there is a bigger picture to healing than what just one side can offer.

In all honesty, I am not well-versed in the insurance issues regarding acupuncture. Nor could I fully appreciate the frustration that many licensed acupuncturists may have in seeing their expertise being impinged upon by others who they feel are radically undertrained. I may feel similarly about an individual who graduated from medical school, but decided not to take the traditional residency training, but instead went directly into practice. Nonetheless, I still do think it’s possible to come to some level of skill and effectiveness with experience.

The last thing I want is to learn something that would be ultimately detrimental of even dangerous to my patients. If anyone is willing to share, I would like to hear about specific examples you’ve seen of MD’s certified in acupuncture performing “terrible treatments.” I’ve tried to look into the pneumothoraxes caused by acupuncture needles, but could find little information about who was performing the treatments and really what the details around it were.

Thanks, and I hope to keep discussion going,
Sohee

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Mike Bowser Reply:
December 15th, 2008 at 1:11 pm

@Sohee Bidol-Lee,
Many doctors share your frustrations about practice, which is why finding a good program is important. One really good option is to enroll in any one of the accredited acupuncture/OM programs and take evening classes. The school will most likely have you take only the necessary acupuncture/TCM courses (about 2 years worth).

There are many programs in the LA area, not far from UCLA and the Helms program. I would suggest you look into Yosan, Emperor’s college, SCUHS, South Baylo and Samra. All of these programs have websites. For example, Emperor’s college has many good offsight internship ops, which include the Freeman Memorial hospital, for their doctorate students (DAOM).

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This really seems like a disingenuous attempt to divide our professional community rather than find common ground so that patients can receive the very best health care services. The idea that there is a “turf war” between MDs and LAcs is perpetuated by limited thinking, misleading information, and NOT getting the facts on BOTH sides.

I have presented the facts about medical acupuncture for anyone who really wants to understand this issue.

I know my view is unpopular and it is easier for LAcs to point fingers and blame rather than look at the deeper complexities surrounding practitioner training. I hope you tone down the rhetoric and offer not only real facts, but creative ideas designed to strengthen the entire acupuncture profession.

After all, acupuncture belongs to the people, not the practitioners.

Lisa Hanfileti, LAc
Insights-For-Acupuncturists.com

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Drew Reply:
April 30th, 2009 at 10:19 pm

@Lisa Hanfileti,
I couldn’t agree more Lisa! Thank your for a logical point of view that focuses on moving forward and providing comprehensive care.

Also, I often put out the unpopular viewpoint of letting practitioners know that I know several Medical acupuncturists that I consider fantastic practitioners…

Drew Taylor MS, LAc, ATC

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Nice of you to run to the defense of M.D.’s. Now can you get health insurance companies to pay for our treatments? Most of them will pay M.D.’s to do acupuncture, but not L.Ac.’s. How does that “strengthen the entire acupuncture profession”? It not only discredits us, but essentially renders us unable to earn a living in a professional that we dedicated 3000 hours and $40,000 to learn.

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Lisa Hanfileti Reply:
January 10th, 2009 at 11:53 am

@Joyce Avimeleh,
Hi Joyce,

I am not running to anyone’s defense, just sharing what I have learned. I think we all still have a lot to learn (including me) if we can remain open minded.

I am trying to help us ALL understand the facts, rather than rely on rumor. You do not have your facts correct and that is a problem, especially when you are repeating them as facts to other acupuncturists and everyone gets “fired up”.

It is not true that “most [insurance companies] will pay M.D.’s to do acupuncture, but not L.Ac.’s.” By far the majority reimburses for licensed acupuncturists, but there are several that require an MD. (This can be challenged if you are diligent.) But the bigger problem with your anger is that you are lumping insurance companies and MDs together and then blaming all MDs for the actions of the insurance companies. MDs as a whole hate dealing with insurance companies as much as we do and do not set their policies.

If you could just step back for a moment and look you might see that MD acupuncturists are fighting some of the exact same battles we are: reimbursement, acceptance (by their colleagues who laugh at them and by hospitals who prevent them from practicing it for “liability reasons”), and earning “a living wage” as you call it.

Can you for a moment see that there is SOME common ground? Perhaps if we communicated with these MDs we might be able to make changes that benefited us all? Where this is being done (OCOM and OHSU for example), amazing things are happening. I am not saying we put our heads in the sand (Joyce Edwards, below, makes a good point), just that we take notice of all the complexities and be smart.

The biggest mistake I think LAcs make is to complain western medicine doesn’t accept acupuncture, then some MDs come along and really think it has merit and want to learn it to help their patients, so they go through the accepted training (good or bad, it’s what they have), and then we attack them for not doing enough and “stealing our medicine” and taking our money… As MDs struggle against narrow minded administrators to get acupuncture accepted in hospitals (please read my personal report on my website under the heading of “The Economics of Medical Acupuncture: Financial, Social, & Political Implications”), do you really think MDs are going to try to help us get hospital privileges too if we are complaining about how bad they are? Again, what if we stepped back and looked at what we have in common and tried to join forces in order to advance the acupuncture profession as a whole? I think it’s worth considering.

As LAcs we still have so much work to do! We need to stand on our own two feet, get acupuncture legalized in every state, get a national credential (instead of LAc, RA, CA, OMD, DOM, my gosh no wonder the public is confused!), get a national certification exam (the NCCAOM exam is not accepted in CA), and standardize our own training (some programs don’t teach herbal medicine.)

We have an amazing profession and unbelievable value to offer people. This world has never been more in need of practitioners of mind-body medicine and holistic health care practitioners. I believe we can OWN this field if we put our heads together and our best efforts forward.

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Mike Bowser Reply:
January 9th, 2009 at 12:53 pm

@Lisa Hanfileti,
Defense might not be the right term, but certainly you have gone out of your way to sell us on the idea that abbreviated programs in acupuncture should be accepted.

I have not heard why you think a MD/DO should be allowed this and a DC not but for me that is splitting hairs. You mention facts and that is always a good place to start.

Fact, the legislation that started licensing acupuncture for MD/DO, did so for research sake and not independent practice. The issue of setting up professional standards has not been undertaken by the allopathic community and until they decide to include this in their basic education you will not have this acceptance. Maybe they need to take up this issue within their own profession.

Fact, these abbreviated programs are unaccredited except by continuing education dept at various colleges. There is no scrutiny or standards within these.

Fact, there is no supervised clinical practice.

Fact, the predominate theories are based upon TCM and not western medicine. This further underscores the importance of having a solid theoretical TCM education.

Fact, there is no requirement for continuing education with these abbreviated programs. If a provider is going to use any medical therapy, they need to keep up with developments in the profession.

Fact, the acupuncture profession once operated from a position of unaccredited programs but we are far from that now.

What you are asking us to do is reverse our profession and the gains we have made in order to take in doctors that do not want to operate within their own established practice norms.

Lastly, I have not heard you say why our profession should be the only healthcare profession to allow for lesser training. In the interest of improving the acupuncture profession, let’s raise the bar, not lower it.

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I’m not really sure what is meant by “acupuncture is for the people…” Whould that mean that Chiropratic and conventional medicine are “for the people” as well? If this were the case the there would be no need for any formal educational – which does not seem like a good solution.

The solution is clear – unification within our profession and raising (not lowering) the standards of Acupuncture and the Oriental Medicinal.

This is the first time I have ever heard of an acupuncturist defend the Helms’s program – that in and of itself is concerning.

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Yummy! Real vs. Hobbyist Acupuncturists. There are a handful of “medical acupuncturists” who deserve much respect for doing extensive work with acupuncture. The rest sadly, due to lack of training and lack of practice, quack.. This is along post but way fun and packed with… uh.. poignancy!!

Here’s a press release I issued when some chiropractors recently wanted certification in New York.
I received this (below) letter from a chiropractor. I answered (my answer follows her letter). I hope this makes the point. P.s. I never heard back from her but was glad I took the time to answer.
best wishes and please do enjoy the press release and the two followup letters,

tom chi, l.ac (NY) Dr.Acu (RhI).

———Press Release 3 days prior to the vote on Chirporactors doing Acupuncture in New York State——————–

SNAP! CRACKLE! POP! Untrained Chiropractors Doing Acupuncture!
Insane or Just Plain Fraudulent Asks Top Acupuncture Physician
SOUTH FALLSBURG, N.Y., April 8, 2008 — Just when you thought it was safe to get acupuncture yet one more group of medical practitioners fights for the right to be shamelessly under qualified. This time it’s chiropractors.

For licensed acupuncturists it’s relatively ordinary to “cure” asthma, ADD, hot flashes, post-stroke injury, digestive problems, acne, difficult and chronic pain, shingles, autism and more says Master Acupuncturist Tom Chi, a Doctor of Acupuncture (RI) and NYS Licensed Acupuncturist.

Chi, who has practiced for 25+ years and done over 120,000 treatments, says acupuncture is the new medicine and will become the first choice for non-emergency medicine within the next 5 to 10 years.

“Real acupuncturists have a minimum of 4000 hours of training and must qualify for National Board Certification to become licensed,” says Chi, “and every year we see a new group of irresponsible practitioners who want to become pretend acupuncturists and have the lobbying power to accomplish it.”

This year it is New York State chiropractors that are seeking the right to practice acupuncture with just 300 hours of training. Bill #S590 incredibly would allow chiropractors to call themselves acupuncturists, a possibility that sends chills down the Licensed Acupuncturists spine!

Members of ASNY, the NYS acupuncture association, say it is the power of lobbyists to promote greedy unqualified practitioners from podiatrists to chiropractors who want to follow the example of allopathic doctors who lobbied for the right to practice acupuncture with just 300 hours. “My patients who’ve been treated by medical doctors complain about lack of results and lack of disclosure about their incomplete training. Many consider it outright fraud,” says Dr. Chi.

Chi has treated over 100 medical doctors, members of congress, even a chief medical officer of Pfizer Pharmaceuticals; the largest drug company in the world. He has performed acupuncture anesthesia while on staff at Catskill Regional Hospital and his patients have come from as far away as Lichtenstein and Venezuela after having tried western medicine and many other therapies.

His view is that a medical revolution is taking place and that acupuncture is emerging as the preferred therapy. Press coverage such as the 1998 Discovery Magazine article showing brain scan evidence which clearly validates acupuncture continues to support claims of amazing results for a broad range of health care problems.

Unfortunately say acupuncturists, those with the power to manipulate the legislature want to skip the real training and hang up a shingle. Chi exclaims, “This is unacceptable and borders on criminal. Our efforts need to go into making Medicare and Medicaid pay for acupuncture. It’s time! It’s important! Let your representatives know that essential standards must not be bypassed for the enrichment of unethical practitioners. We are in an evolving Healthcare Revolution,” relates Chi. “Acupuncture repeatedly delivers results and HUGE healthcare savings! On Wednesday the legislature needs to say NO to poorly trained healthcare practitioners posing as real acupuncturists!”

Media inquiries:
DrChi@FixPainNow.com
845.798.9995
Dr. Tom Chi

——-Here is the letter from a chiropractor to me following the issue of the press release——————

Dear Dr. Chi,

In the interest of creating harmony, I would like to open dialog with you concerning collaborative education and patient care.

Just read your article on line. As a practicing chiropractor, who has enjoyed using acupuncture for 15 years of my 25 year career, I am curious if the hostility you have is generated by your own personal territorial issues; or if you have some substantial claim to the fact that 300 hours of training for a trained physician is not “enough”? The standards of licensure for acupuncture are relatively new in the US and Canada. Having searched high and low for a program in which to train and gain more proficiency, I have had to turn to training courses outside the US as the current educational structure for any physician who is interested in incorporating acupuncture into their practice is non existent, except in our own turf, (ie: chiro and medical schools). The supposed “keepers” of the acupuncture knowledge are self appointed, as is true in all new paradigms being integrated into any culture. The history of chiropractic, as foiled against the wave of the allopathic consciousness over the last century, might serve as a lesson for the “Licensed Acupuncture” community.

When MDs started getting certified to do manipulation in weekend classes there was a huge uproar in the chiropractic community. What time has borne out is that those MDs doing manipulation actually have given greater credence to the efficacy of structural realignment and the importance of finesse and focused training.

I think you will find your fire would be more creative in the long run if you created alliances rather than pointing fingers and creating divisions.

I am curious…….where did you get your training? How would you like to see acupuncture integrated into the American health culture? And is fear running your life or is your Liver yang just flaring?

Sincerely and with kindest regard!

(name witheld)

———–Here is My Reply————————-

Dear Dr. J,

You are indeed a thoughtful being and your letter is greatly appreciated, your conjecture about the liver could be a natural conclusion

The good news is, I’m not angry, nor is my liver fire flaring. I’ve been one of those fortunate ones to have great health throughout life and to enjoy a natural contentedness

Hard to cover all the territory, let me try….

My experience with both allopaths and chiropractors practicing acupuncture is one of patient disappointment. The results are not there in most cases. It’s unfair to a patient to not understand pulse diagnosis, TCM medical theory etc. This does not come in 300 hours. Beyond understanding is assimilation and mastery.

When I speak to those with this miniscule training they routinely have a “gimme those needles I’m already a doctor” attitude and don’t even realize that it’s a detriment not a bonus that they use their other medical training when doing acupuncture.

Hobbyist acupuncturists are a nuisance. People need immediate tangible lasting results. In the clinic a patient with reflux can usually count on that being gone within 1 to 3 treatments. I’ve had autistic children speak after 6 treatments with one needle each time (and acknowledge other people as existing, give a high five, etc.).

Children with asthma who use an inhaler everyday then go an entire year and throughout soccer season without needing it once after just 4 or 5 treatments.

Post-stroke patients aphasic and losing hearing/vision on one side, dragging one leg, same 4 to 6 treatments, dancing in the waiting room.

These are not the results of minimally trained practitioners.

As to training I am particularly ignorant about what is available. I do know that Bastyre and others have brought together a number of disciplines under one roof. It’s also quite possible to go to acupuncture school and CLEP out on bio/phys courses. The other courses are not and should not be optional. There is no magic understanding that comes from practicing another form of medicine because acupuncture is a complete medical system in itself with very little overlap to allopathy or chiropractic.

The “keepers of the acupuncture knowledge” to my understanding are actually people who’ve studied the knowledge and based the real training programs, testing, etc., upon that knowledge.

As to my training I am a graduate of a 3-year acu school and also a 2.5 year acu school. I did advanced acupressure type techniques though using the esoteric hand-sensitization techniques from the Ving Tsun Kung Fu (created by a Chinese nun and made famous by Bruce Lee.) I have evolved something which I call Soft-Tissue Reprocessing which eliminates the adhesions/injuries which cause most back, neck shoulder, knee pain etc.

So, for a patient with or without disc problems who is ambulatory and suffers intense pain throughout the day, this patient usually will have immediate (or near immediate) tangible, lasting results with difficult and chronic pain. The injury will not come back as it will no longer exist. This is a huge leap from what we normally see with therapy.

As someone who has dedicated herself to learning I’m certain you have pursued your understanding of the acupuncture well beyond what we normally see with allopaths or chiropractors. There is also a Medical Acupuncture society with a number of very dedicated allopaths who’ve filled in the pieces and done good work.

Still, these are the exceptions. It’s not okay to wing it and self-train after the fact of licensing. If I was making the legislation anyone could become licensed simply by passing the national boards with a caveat!

No One would become licensed just by demonstrating a knowledge of the point location and theory but would have to Prove results in a clinic treating patients and through evaluation show that they can indeed accomplish a meaningful level of actual healing. NCCAOM feels differently. They feel one is not qualified to take those boards without the 4000 hour training.

There are a lot of poorly performing acupuncturists even with the schooling and this would remedy that problem.

People come first so if you’ve read Overdosed America or through your chiropractic training you may know the sham of most allopathic non-emergency treatment.

Chiropractors performance by my experience from Fla (100 hours training and allopaths 0 hours) is just poor. People who say they tried acupuncture and it doesn’t work have most often been needled by allopaths or chiropractors.

Though it’s in answer to your questions it’s way long-winded and I will pause here.

As to creating harmony. Not necessary, I felt that you simply brought your personal harmony to my door. Very nice.

And living in fear? It’s a funny thing. I’ve done over $300,000 in unbilled or severely reduced treatments over the last five years since I moved to the mountains (a poor rural area). I just can’t say no. It wouldn’t hurt if insurers paid for medicine that works.

If I didn’t have other sources of income to pay for my patient’s health care, I’d be in big trouble.

Here’s my recent press release (one page) where I tried to stir up a reaction about insurance, you may get a kick out of it. And yes, it’s hypey concerning yers truly. (the URL is just below this letter)

Finally, I love that you wrote to me. You are great. Thoughful without b.s.

I’d love to hear from you anytime.

tc

——-This is a Fun Press Release about Acu & Insurance——-
http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=109&STORY=/www/story/02-20-2008/0004758980&EDATE=

( Warning! Doctors, Insurers Hold Patients Hostage!
While drug companies act like an occupying force, doctors and insurers run a dysfunctional cartel, often intentionally denying effective treatment to patients!)

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I must say I enjoy all this dialogue about training. I absolutely love Tom’s term “hobbyist acupuncturist.” I recently watched a youtube video of a chiropractor in Florida performing acupuncture because he is “certified.” Now I know why we get their patients! If the act of sticking needles in a person is the definition of acupuncture, then this chiro makes the clear case for professionally trained acupuncturists. I’ve seen tailors with better needle technique. I have also had several patients come to see me who had MD hobbyist acupuncture.

In one particular case this hobbyist doctor used a very interesting technique. Six needles in total (all local, no distal points), and the patient was in-and-out in 15 minutes. Brilliant! The patient was exponentially worse after the treatment.

We need to continue to educate, and promote our profession to public; this is the only way to minimize this nonsense. Unfortunately, the hobbyist DCs and MDs with their “Acupuncture Hobbyist Certifications” will never go away.

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