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Abbreviated Courses In Acupuncture For Physicians Pose A Serious Problem

  • Sometimes, understanding one’s background can clarify their particular point of view. So in the spirit of “full disclosure” I would like to tell you a little about mine.

    I began my medical career in 1979 when I received my MD degree from Albany Medical College. I trained in diagnostic radiology at George Washington University Hospital in Washington, DC. I entered private practice and spent 20 years doing full-service hospital radiology. It was at the end of these 20 years that changes occurred in my life, changes that made me look at my direction and commitments. It was at that time in my career when I discovered acupuncture, and the power this medicine has to heal. Please understand, I was awestruck at the conditions acupuncture could effectively treat —- conditions that from my previous medical training I knew were precisely those no one wanted to get stuck with because there was no effective treatment. I am a fellowship-trained interventional radiologist, and I have put needles into arteries, veins, solid organs, abscesses, tumors, pleural cavities, peritoneal cavities….you name it. But I had never felt the pull of Qi on a needle, I had never intentionally manipulated a needle to achieve a specific energetic effect, I had never contacted the energy of a meridian, nor used needles themselves, as instruments of healing. Here was a whole new science to learn. And the amazing thing is that it has a 3000 year history with millions upon millions of people undergoing clinical trial in China for 30 centuries!

    Medical Acupuncture Training Is Equivilent To A Self-Educated Acupuncturist

    So I enrolled in a course for physicians to learn “medical acupuncture”. I attended two weekend sessions, watched videotapes, and read one book. This course was based on the work of one physician. The book we read was his book – the videotapes we listened to were him talking, and he gave nearly all of the lectures at the 2 weekends of instruction. On the last day of training, I happened to be sitting next to a doctor from San Diego, and I overheard him say, “My wife knows so much more about acupuncture than I do.”

    I subsequently found out this doctor’s wife was a licensed acupuncturist. One thing led to another, and before I knew it, I was enrolled at the National College of Natural Medicine in Portland, Oregon in a Master’s degree program in Classical Chinese Medicine. I will graduate from this same program in June. It is a 4-year program, and I have been able to complete it in 3 years by transferring credits from my medical school training. I feel very strongly that, in order to practice acupuncture at the level of competency which this medicine deserves, one must learn from many professors, observe with many clinical supervisors, and spend at least a few years to learn how to approach a patient in a holistic way with an entirely new set of diagnostic principles.

    Remember, I am a scientist at heart, and this is the finest science that I have encountered. As a physician who has gone through Western medical training and now training in acupuncture and Oriental Medicine, I assure you that abbreviated courses in acupuncture for physicians pose a serious problem. That problem has to do with efficacy of treatment. Without a comprehensive education in the fundamentals of this science, and without appropriate hours spent in learning complex needling techniques, followed by supervised clinical application of all of this learning, it is not possible to effectively treat the list of diseases which the world now recognizes are amenable to acupuncture intervention.

    The World Health Organization recognizes the ability of acupuncture to treat the following diseases: asthma, menstrual cramps, arthritis, sciatica, TMJ problems, allergies, anxiety, depression, bladder problems, kidney problems, childhood illness, colds, influenza, cough, bronchitis, constipation, diarrhea, dizziness, ear-nose & throat disorders, fatigue, gynecological disorders, genital herpes, herpetic neuralgia, heart palpitations, immune system deficiency, infertility, insomnia, numbness, poor circulation, PMS, sexual dysfunction, impotence, skin problems, stress-related illnesses, and weight gain or weight loss…and the list goes on.

    Acupuncture is not a nice, short topic that can be covered during a seminar lasting for a few weekends. Suffice it to say, that it is not possible to treat the difficult diseases listed above after watching videotapes, reading one textbook, and attending two weekends of lecture with needling practice on a few other course participants.

    I would like to give you a brief case presentation now, to try to illustrate in a nutshell why I am writing this letter. A 57 year old man presented 4 days earlier to the OHSU emergency room with sudden and complete blindness in his right eye. He was seen by an ophthalmologist, underwent carotid ultrasound, an MRI of his brain and MRI angiography , and was told that he had occlusion of his central retinal artery and would have permanent loss of vision in that eye. At the time of presentation his medications included lisinopril, metformin, and aspirin. Fortunately, the patient happened to have an appointment with his chiropractor, who heard the story of this man’s sudden blindness and grim prognosis, and referred the patient to the acupuncture practitioner who worked in the same building. The patient was seen daily for 7 consecutive days for acupuncture treatment. On the second day, he could see a small circle of light in the center of his vision in the blind eye. Day by day that circle of light enlarged, and became clearer. At the end of 7 treatments he had 20/40 vision in the previously blind eye.

    This is the power of this medicine in the hands of a skilled practitioner. This is what can be accomplished in Oriental Medicine. Someone in Integrative Medicine has given me a definition of their subspecialty as the medicine that “fills in the gaps”. I think this is an apt definition, and there are many gaps in western medicine which need filling. Please give Oriental Medicine a chance by ensuring that practitioners who enter this field are adequately trained. Let’s up the ante, and see whether we can embrace this amazing alternative healing science with practitioners who have enough didactic hours of lecture from a variety of acupuncture faculty, and enough supervised hours of clinical practice so that they are familiar with treating patients with all sorts of maladies such as cancer, asthma, palpitations, constipation, allergies, menstrual disorders….to name just a few common problems.

    The way forward has been paved by the state of Hawaii. Hawaii requires that medical doctors be trained and tested for competency prior to administering acupuncture to patients. The Attorney General for the state of Hawaii issued a statement on August 18, 2003, declaring that “medical acupuncture” as performed by physicians is not substantially different from any other type of acupuncture, and therefore, physicians performing “medical acupuncture” should be subject to the same laws of licensure and proof of competency as everyone else.

    We in the acupuncture field are at a crossroads. We can condone physicians doing acupuncture under-trained, unsupervised, unevaluated in terms of competency, or we can strive to raise the standard. I feel strongly that this is a public health issue. I feel strongly that allowing medical doctors with minimal training & without oversight by a non-professional organization is a dangerous and foolhardy policy. I’d like to respectfully remind you that we are talking here about a healthcare profession; we are talking about peoples’ health & well-being; we cannot afford to have a double standard. The general public deserves parity in licensing so that competency can be maintained.

    I therefore propose that the American Association of Medical Acupuncture evaluate their own training programs and consider complying with the World Health Organization’s recommendations of 1500 hours of training in acupuncture for physicians interested in pursuing this medicine. The WHO standards for physicians performing “medical acupuncture” include 1000 hours of didactic (including needling technique labs) and 500 hours of supervised clinical training, which ensures adequate training for entry level acupuncture. In addition, I feel that physicians should be required to pass the NCCAOM examinations to ensure their competency in acupuncture evaluation and treatment. If the AAMA is willing to adopt these standards of 1500 hours and NCCAOM testing, I believe the future of “medical acupuncture” in the United States would be shifted from a position of tenuous efficacy to one of competency and powerful healing.

    Dr. Marilyn M. Walkey MD
    www.flyingcraneacupuncture.com

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57 Comments
  1. #1 Dr. Andy Rosenfarb, ND, L.Ac.
    March 25th, 2010 at 7:32 am

    This is one of the best articles on this subject I have ever read. Thanks Marilyn and keep up the great work – you are truly inspirational!

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  2. #2 Kim Knight, MAcOM, LAc
    March 25th, 2010 at 8:30 am

    Great article and thanks for sharing your process!

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  3. #3 Arya Nielsen, PhD
    March 25th, 2010 at 1:08 pm

    The position has merit and yet there is evidence to the contrary. The therapeutic effect of acupuncture is not dependent on a provider’s training. Risk of complications or side effects is associated with training…less training, more problems.
    But the rather confounding notion that even a novice at acupuncture can produce a therapeutic effect…at least for problems such as head, neck, back and knee pain/conditions…is nevertheless, apparent in research for each of these conditions.
    Training in East Asian medicine deepens interactive clinical skills and offers more to the patient from that archive of wisdom, for sure. But we must take into account that entry level providers can be able acupuncturists and that is not necessarily a bad thing.
    Arya

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    Dr. Marilyn Walkey, MD, LAc Reply:

    Dear Arya,
    I have one question….are you a licensed acupuncturist?
    Do you have a PhD in Oriental Medicine. If not, I’m sorry, I don’t recognize you as an expert, despite how many peer-reviewed, double-blind, evidence-based studies you have read!

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    Arya Nielsen, PhD Reply:

    Hello,
    I am a licensed acupuncturist in practice for 34 years. I have an academic research PhD in Philosophies of Medicine with a specialization in Integrative Clinical Science and Health Care.
    I practice at a medical teaching hospital and direct a Fellowship program in acupuncture for inpatient care. I am published and I teach in NY and internationally. And while I agree that physicians would benefit from more training for safety reasons one cannot refute at least the trials and data from existing studies that they can elicit a therapeutic response. Moreover, at least in NY State, the regulation is not likely to change to increase training for physicians. Not sure it will anywhere. But am also not so sure it is as dangerous as the article states…but/and it does not mean the current standard is great.
    Arya

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    Hugo Ramiro Reply:

    Hi Maralyn and Arya: Arya, the issue has little to do with whether a needle elicits therapeutic response – of course it does, this isn’t placebo. However, operator skill is a major factor in terms of where the therapeutic ceiling is. Furthermore, an incompetent acupuncturist can insert needles wrongly, and damage the patient either energetically or organically. In Chinese Medicine we know that an improperly applied needle can harm, often in very subtle ways – this is just one of many reasons that it must be recognised that the only people who do acupuncture correctly are those trained in Chinese Medicine.
    My education is in classical Chinese medicine via a lineage tradition.

    tom chi Reply:

    Less dangerous than irritating. If you’re going to see a bad acupuncturist and receive no results then it’s nice to see one who is properly trained ;-)

    Hobbyist (MD) acupuncturists routinely deprive patients of good results and patients don’t know that the MD doesn’t qualify for licensure and relies on patient ignorance about their lack of training.

    One patient told me her MD acupuncturist said, in reference to our treatments, “why does he get results and I don’t?”.

    The answer? Pin-The-Tale-On-The-Donkey is not really the substantive training that gives the best odds for competency. And deluding the public with minimal training is not ethical.

    The MD’s have the “give me those damn needles and take your pulse diagnosis and kiss off” methodology. Then they prescribe pharmaceuticals rather than scientific Chinese medicinal herbal formulas because they know better and have saved the patient from the “hocus-pocus” of Chinese medicine.

    The beauty of it is that they didn’t have to learn TCM and fall victim to it. Meantime, virtually all of my (our) patients get better fast!

    TCM is the medicine that works for most primary problems. Let MD’s treat emergency and a few specialty conditions or retire like the barbers who did brain surgery in the 1900’s eventually did.

    P.s. At least we nipped it in the bud when chiropractors decided acu was in their scope of practice too. In Florida they need 100 hours of training and MD’s need ZERO hours. Here’s a press release from just before the bill was retracted in NYS.

    SNAP! CRACKLE! POP!
    Untrained Chiropractors Doing Acupuncture!
    Insane or Just Plain Fraudulent?

    http://www.bio-medicine.org/medicine-news-1/SNAP-21-CRACKLE-21-POP-21-Untrained-Chiropractors-Doing-Acupuncture-21-16218-1/

    Reply

    Anon Reply:

    I mostly agree with what you’ve said. The following statement can be argued,…”The therapeutic effect of acupuncture is not dependent on a provider’s training.”

    While novices can indeed treat another person well and help heal their chief complaint, a highly cultivated or better-versed practitioner may do more with more clinical and life experience or approaches given their knowledge of the medicine….(not necessarily and not always, true!).

    As my master always says…”Intention makes all the difference.” If an acupuncturist truly intends to help heal their patient in the best way they know how, then they are worth a try. The catch is…do they truly penitently feel that way? Not all do! It is much safer than seeing an MD or Chiropractor in my book. I am the most finicky health snob and counterculturalist in American society today…hands down, neurotic. Unless I truly want pain meds or my arm re-attached when I saw it off, then my goal is to stay as clear from doctors, hospitals, and sick people as possible.

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  4. #4 Kimo Shotz
    March 25th, 2010 at 8:28 pm

    Woohoo! This is a sensitive subject. And both have valid points. (Arya, thank you, I love that you respond in a non-adversarial way)
    I am a Nurse practitioner in OBGYN for the past 11 years. I am now in my third (of 4) year at the Oregon College of Oriental Medicine (my original path, at last) and can hardly contain myself with the excitement I have for being able to add this powerful, holistic medicine to my healer’s tool belt. As I still work in clinic weekly, I listen even more intently to my patients and am able to see the individually unique, broad patterns of imbalance my women patients have, that account for not just her one complaint of migraines, PMS, postpartum depression, or her dysmenorrhea, etc, but all the other symptoms that frustrate her and adversely effect her quality of life, yet she’s not identifying these until I ask her about them.
    I am optimistic that Chinese medicine is finally being integrated (albeit, painfully slowly) into our mainstream healthcare, and am fortunate to have caught this amazing wave. I work with a MD who was trained through a (6-month) Medical Doctor program. In talking with this doctor (on many occasions) about my excitement in applying Chinese medicine to women’s health care I came to understand that this doctor did not have the theoretical foundational understanding of TCM and 5-Element, etc. that is essential to providing holistic care for the patient. Her scope of healing is dramatically narrowed, to treating one symptom, in very much the way Western Medicine tends to be when approaching a patient’s condition (surprise-surprise). She noticed this as well as we spoke and I relayed all these patterns I see. As a result she is interested in learning more about TCM, 5-E. Yes, she does help her patients with her skills, but she could do much more.
    Yes, western science/medicine and the NIH are trying to reduce TCM to fit the simplified western medicine/science mold and this is scary, frustrating, and inappropriate, and wow! I hope they wise up.
    It is important to open and maintain a colleagial dialogue with MDs showing an interest in this medicine so all can understand its’ power/benefit in so many realms.

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    Hugo Ramiro Reply:

    Hi Kimo; I enjoyed your story and am glad you can add this to your “toolbox”. I run a primary care practice and have only one tool in my toolbox – Chinese Medicine. I hope you work in a hospital, otherwise it means that you don’t understand the depth of Chinese Medicine, perhaps due to incomplete training. My clue is that you talk of integration in mainstream healthcare, when this is likely the worst thing for Chinese medicine, and one of the reasons that this website exists. It can also be said that true integration is not even possible!
    I maintain collegial relationships with the many MDs that I work with, and I am also firm in the boundary I set – Chinese medicine is nto to be pillaged, co=opted or absorbed by western medicine. It must and will stand on its own. Collaboration, NOT Integration.
    Thanks,
    Hugo

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    Arya Nielsen, PhD Reply:

    Hugo: Guess what? The adaptation of Chinese medicine and acupuncture is the very reason it exists outside of China. For this system to be integrated into hospitals and conventional settings does not mean it is being ‘pillaged’ or ‘absorbed’. It means patients are having access to something that helps them.
    No one owns this system; you do not own this system. Like language, it will morph and be adapted in different settings. The very notion that yours is the ‘correct’ way to practice does not appreciate the thousands of years of practitioners, some more adept than others, who used and passed on a variation of practice. Chinese medicine is syncretic by nature. It absorbs whatever is useful…and adapts to serve patients. It has remained viable because it is adaptable…and would not have done so if any one group at any point was able to monopolize it as you suggest it needs.

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    Hugo Ramiro Reply:

    Arya; guess what? Your points of view are outdated. The latest in the literature shows that a process of co-optation and eventual dissolution of the absorbed system is the standard outcome unless the profession is able to defend its boundaries. The process of integration for Chinese Medicine in China, 60 years in, has failed. A similar experiment has led to similar results in India. This is evidence that you are ignoring.
    Your statement that no one owns the system is provably false, as international law is demonstrating. Please see “International law and Indigenous Knowledge” for a primer in this area.
    Your claim that Chinese Medicine is no more than a language is facile, and does not attest to the fact that specialist training is a requirement, and that the people who have that specialist training are the owners, and that the specialist training itself requires Yin-Yang philosophy. These are unavoidable roots(and I doubt that your Yin Yang philosophy is of a very high level as is attested to by your posts – only internal cultivation, as you *should* know, leads to a grasp of the fundaments of Chinese medicine).
    The very notion that you would condescend to a lineage practitioner and attempt to educate them on the history of Chinese Medicine also shows your ignorance regarding the importance of oral tradition and direct transmission.
    Your attempt to paint me as a monopoliser is laughable, since I subscribe to the (Chinese Medical) notion that Chinese Medicine is “plural and heterogeneous” as lead members of our field have stated.
    Once again, the point is that the absorption of Chinese Medicine *into* biomedicine will not work, because biomedicine is not itself a coherent process, whereas Chinese medicine is. There is no room for Chinese medicine in a fragmental worldview, obviously.

    Finally, some of the literature that you have been missing-

    The old stuff:
    Black Skin, White Masks (Fanon 1968)
    Orientalism (Said 1978)
    The Dynamics of Colonial violence (Kabwegyere 1972)

    The Newer stuff:
    Which Medicine? Whose Standard? Critical Reflections on medical integration in China (Fan, Holliday 2008)
    Sushi Science and Hamburger Science (Motokawa 1989)
    Deconstructing the evidence-based discourse in health sciences: truth, power and fascism (Holmes, Murray, Perron, Rail 2006)
    Integration or Collaboration? (Ramiro, forthcoming)

    Of course there are many more; I have cabinets full.

    I think your western degrees cause you to be overconfident and overstep yourself. It is a common result of the western mindset. Your degree itself is an exposition of your bias, apparently. I really recommend you get your hands on International Law and Indigenous Knowledge (Oguamanan 2006).

    Please ensure that you read the brief reply that follows this one where I will include two quotation from leaders in the field to facilitate your encounter with your limitations.

    Now if you would care to speak to me with a little respect rather than as the western coloniser to the mere lineage holder, I would continue this discussion, but otherwise, you have a responsibility to catch up with your research.
    Hugo (no PhD thank god)

    Autumn Yuqiu Jiang Reply:

    “Collaboration, not integration!” — I have never seen anyone putting it better! Thank you so much and by the way, I love your website.
    If the west has no “evidence” or “science” to explain how Qi works, Just as Hugo said — the west has “a responsibility to catch up with your research”! It should not be the other way around, not that the Chinese Medicine has to be butchered and abbreviated so it can fit in the mode of western medicine.
    Thank you for the reading list! Bravo Hugo!

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  5. #5 Tian
    March 27th, 2010 at 12:29 am

    To Dr. Walkey

    I wanted to let you know, just how much I like your post! Thank you for your dedication to our profession and the patients we serve. I have always respected medical doctors. I hope that medical doctors will take your advise. It really is awesome to see a medical doctor who decides to study TCM and takes it to heart, by doing the full schooling needed to really learn this beautiful medicine.

    I hope that in the future, more medical doctors will do the same and hope to see more acupuncturists working along side them. I really enjoyed learning western medicine from the MD’s in school. You guys have so much to offer in knowledge to our profession and we can also offer so much to yours.

    I always hoped that MD’s would speak about this subject. A lot of acupuncturists look up to you guys. Many acupuncturists get sad after seeing other professions practice with little or no training, in what took us so long to learn. Even then, this is a life time of learning.

    I salute you, and hope you will decide to get involved in our national organizations. You would have my vote.

    OCOM is a great college for CCM. I would invite you to also explore the teaching of Dr. Leon Hammer, who is also a MD and one of the best acupuncturists in this country. Dr. Hammers Contemporary Chinese Pulse Diagnosis is one the best books I have ever read. Really nice to see our medicine through the eyes of a MD, as is the case of Dr. Hammer and his long time work with Dr. Shen.

    Best of luck to you sir

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  6. #6 Acupuncture NYC
    April 11th, 2010 at 7:40 pm

    I went through naturopathic school and acupuncture school concurrently and in naturopathic school students would get incredibly limited training in acupuncture and then graduate and (at least in Connecticut where I trained) be able to practice acupuncture. I imagine the abbreviated medical acupuncture courses are equally limited. I can’t say I think that it’s putting patients in any particular danger, because acupuncture is relatively safe. But I do think there is a serious difference in efficacy, practitioners with limited training seem to rely on a protocol for a condition, rather than individualizing the treatment based on pattern. There also seems to be more of a focus on local points – sticking a needle in the problem – which (at least in my experience) tends to be less effective than distal points.

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  7. #7 M. Garcia, MD, MPH
    April 12th, 2010 at 10:18 am

    Those of us who are considered FMGs (trained outside the USA) cannot but think that such recommendations even though valid, might be and can be interpreted as to have the intention to monopolize the field by some of those who are part of the medical profession/system.
    The use of Acupuncture for healing has been in place and with good results for thousands of years by people who probably never had a professional degree or letters behind their names (i.e., MD, DO, PhD, etc.).
    Clearly, this might represent a “move over (“those of you who do not have our degrees”) and let us (“those with them”) take over.” The “we know better” attitude.
    This begs the question, is this really good for the “safety” of all of the people or only for some (specifically those involved in the process of establishing registration/certification/licensure taxes and/or other fees)?

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    Hugo Ramiro Reply:

    Just to clarify Garcia’s points, because it is possible that he/she has not been fully clear: Chinese Medicine should and will regulate itself, as Western Medicine regulates itself. Makes sense, doesn’t it.

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  8. #8 Hugo Ramiro
    May 7th, 2010 at 4:07 pm

    The two quotations Arya:
    International Law and Indigenous Knowledge, p 82:
    “Perhaps the most important provision of the Draft Declaration on the subject of Indigenous Knowledge is article 29: ‘Indigenous peoples are entitled to the recognition of the full ownership, control and protection of their cultural and intellectual property. They have the right to special measures to control, develop and protect their sciences, technologies and cultural manifestations […].'”

    Note the word OWNERSHIP.

    Now a message for you from Li Shi Zhen (do you know who this is?) in his book Study on the Eight Extra Meridians:
    “Inner channels and scenery can only be viewed through the inward reflection in deep meditation”.

    I hope you will be going back to the drawing board.

    Hugo

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  9. #9 Arya Nielsen, PhD
    May 8th, 2010 at 11:59 am

    Hugo,
    We have responsibilities in practice, like our responsibilities to our children and to the earth. But it does not mean we own our children or the earth…or Chinese medicine. While Chinese medicine is a traditional indigenous system, it has been widely adapted outside of China. Your practice of Chinese medicine does not make you an ‘indigenous person’, or a ‘lineage holder’. You learned a system of medicine that you love…good. That no one group can own it is just a statement of fact, an observation. Consider that Chinese medicine would not have survived for you to learn if it were not the case. We all learned it because someone gave it, not because they ‘owned it’.
    Finally, what lineage is it that teaches when someone does not agree with you they are ‘shallow in the yin~yang’?

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    Hugo Ramiro Reply:

    Arya – Indigenous peoples around the world disagree with you (this Indigenous person as well). Please see the references to international laws and treaties that I have provided, otherwise you are providing your personal opinion only – a personal opinion not in line with the standards set by the international community (or our own, see this website, for example). Culture, science and technology *is* owned. If you wrote a book, then you own it, and if someone plagiarised the book, it would be wrong, and *you* would feel wronged – just like I felt wronged when I first learned of the “Graston technique”. Please inform yourself before continuing on with your repetitive and demonstrably false opinions – again, I have provided references.
    Your grasp of Yin Yang theory is weak as is evidenced by your posts. It is BASIC Yin Yang theory that there are boundaries which *must* be maintained in order for health to exist, whether these boundaries are between persons, or between professions – identity itself derives from these boundaries, one of which is the dividing flux between the white and black halves of the yin yang symbol. As a practitioner of Chinese medicine I am absolutely allowed, and even required, to point out your failure. Yin Yang theory is not some little thing we pay lip service to, it is the foundation of our medicine, and it is a DAOIST principle. Your (very insulting) brush-off of my lineage shows me that you do not have one, do not know what is involved in one, and have not grasped what Yin Yang theory itself blooms from. I doubt you are able to follow at this point, so I will move on.

    Chinese medicine is not some corpse to be dismembered, dissected or picked apart. It is to remain whole and growing. And how will it achieve that? By maintaining its own boundaries, just as a healthy individual does. Just as an individual owns themselves and their actions, so does Chinese Medicine. Again, see the international law references which I have provided which expound these principles *in depth*. You are out of *your* depth here, Arya.
    Your concept of “ownership” is naive and surprising, honestly. If I walked into a dentist’s office, got into the dentist’s chair and tried to perform oral surgery on a patient, I would get into very big trouble. Why? Because dentistry OWNS dentistry. If I drive without a license, same problem. If I prescribed anti-biotics, HRT therapy or vaccination, I would also get into grave trouble. Why? Because I have no ownership of these methods, professions, skills or technologies. Why is it that biomedicine can assert it boundaries, but Chinese medicine belongs to anyone who wants to take a strip off? It is a terrible double-standard that I am devoting my life to help resolve.

    Lu Bingkui, former director of the PRC’s Minitry of TCM, 1991:

    `Underneath the bright and cheap glitter at the
    surface, the essence and the characteristics of
    Chinese medicine are being metamorphosed and
    annihilated at a most perturbing rate. The primary
    expression of this crisis is the Westernisation of all
    guiding principles and methodologies of Chinese
    medicine.`

    A repeat from my post no 8, above, which you must have missed:

    ‘Indigenous peoples are entitled to the recognition of the full ownership, control and protection of their cultural and intellectual property. They have the right to special measures to control, develop and protect their sciences, technologies and cultural manifestations […].’

    Thanks,
    Hugo

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  10. #10 David Bent L.Ac.
    May 11th, 2010 at 12:56 pm

    Marilyn,
    Thank you so much for putting this article out there. I am a liscenced acupuncturist, practicing since 2002, and an 18 year practitioner of qigong. Over the years, I have heard many a story from my patients about inneffective acupuncture treatments given by MD’s and chiropractors.
    It would be fantastic if we all stuck to what we do best. I don’t attempt surgery after a weekend course, but given a PDR I could probably write a decent prescription…this doesn’t mean I should, and I’m sure everyone is glad I’m not allowed to by law!
    I know it’s harder to hurt someone with Chinese medicine, but inneffective treatments hurt everyone- those who are competent professionals, the general public who could benefit, and the patient who has to continue to endure their condition with less hope for relief.
    Thanks Again!
    David Bent L.Ac.

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  11. #11 Patrick Fitzsimons
    July 13th, 2010 at 8:53 pm

    I propose here that we translate Ba Qi Mai – called the “Eight Extra Meridians” in this post – differently.

    Ba translates as eight. Easy enough!
    Qi translates as strange or curious, odd even. “Extra”? Is it a bonus that we have these? Add ons? No, in fact they are primordial, our conduits for yuan qi, relate with our autonomic nervous system, cyclical phenomena in the body, and DNA.
    Mai translates better as channels or vessels – they’re like underground rivers. “Meridian”, meanwhile, is a cartographic term – it refers to imaginary lines on a map. Hugo, from your posts, I hardly believe that you’d think the acupuncture channels are imaginary.

    So, how about The Eight Curious Vessels? The Eight Odd Conduits? The Eight Strange Channels? Anything but “The Eight Extra Meridians”!

    Language is important, otherwise our ideas are discordant, and we’re not quite expressing our ideas as they should be :).

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    Hugo Ramiro Reply:

    Patrick, interestingly enough, I agree with all your points and think of the Ba Qi Mai in the exact way you do. I debated briefly whether I should write “Eight Extra Meridians” as my source text did, or write “Eight Extraordinary Vessels” as I would prefer to.
    Thank you for pointing this out. I still don’t know whether I should modify the source (english) text or not when I reference it.
    Cheers,
    Hugo

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  12. #12 Sourmash
    September 4th, 2010 at 10:47 pm

    This is one of the most balanced articles I have read on the subject of medical acupuncture. I am a recent graduate (graduated yesterday) of the Oregon College of Oriental Medicine and have thought about this subject from many different angles. Ultimately I believe the obligation of the medical community as a whole is to establish a system in which the greatest number of people have the greatest access to the best care possible. I also believe that as our western culture moves towards a system where CAM practices are more integrated it is vital that we strive to maintain the spirit and uniqueness of each modality, especially acupuncture. To me the idea of a two weekend course in acupuncture is paradoxical by it’s nature (and not the good kind of paradox). That is, it attempts to co-opt a modality that is fast becoming one of the most popular in health care while simultaneously dismissing that modality’s roots and profundity. It is indicative of a pompous and superior attitude that western medicine would be wise to grow beyond. That said I am in full support of MD’s taking greater interest in our modality and support the idea of allowing them to gain licensure through the NCCAOM after a sufficient level of training in technique and theory (1500 hours seems like a fair expectation considering I have devoted more than twice that to obtain my masters degree).

    As far as integration is concerned. I think an integrated health system is the next important step in the US, we must strive to achieve this in a way that respects the unique history and power of each modality (and those who have given their lives to the study and practice of those modalities). I cannot stand acupuncturists who dismiss western medicine any more than I can stand western practitioners who dismiss what I have come to understand as a deep and profoundly healing art.

    Thanks for your contribution to this discourse.

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  13. #13 kimo shotz
    October 4th, 2010 at 11:15 am

    Hugo, Your response is full of assumptions, condescending and offensive, to both me, and I would expect Arya, who has dropped out of this discussion, possibly as a result. this is exactly what we don’t want, to ostracize different view points via lassumptions and ack of understanding.
    What I am saying by integration is not what you understand me to be meaning. It is indeed “collaboration” I am talking of. But it will help to have some practitioners be physically integrated into hospitals or nearby, as that is how a huge portion of patients will be able to access us. Integration also means practitioners on all sides developing a deeper understanding of each medicine modality. I have the benefit of having a couple amazing Chinese faculty-professors who are both Western physicians or scientists and TCM practitioners. They have chosen to work as TCM providers/profssors for various reasons, one being that they feel TCM can offer more for patients. However they have a deeper, more expansive understanding of western anatomy/physiology/disease processes/allopathic treatments, risks, side effects that they can really work with patients to collaborate with allopaths offer what is best for that patient.
    TCM must not be co-opted, absolutely. But fostering mutual respect between modalities is essential for the growth of TCM in this country.
    over and out.

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  14. #14 Hugo Ramiro
    October 4th, 2010 at 1:24 pm

    Kimo, glad I got to you, and under your skin. I am doing my job.
    In other news, my post is no more full of assumptions, condescension etc than yours – or Arya’s for that matter.
    It is interesting that the people who find my posts offensive have heavy training in western disciplines.
    *That* says a whole lot.
    Take a harder look at your foundational biases.
    Furthermore, unless you have some kind of human-rights complaint, don’t bother bringing your “offense” into this discussion. You are reading tone and intent into the words on your screen which are fully your projections.
    Finally, there is a big difference between integration and collaboration, which is why I make that distinction.
    Others have been able to understand my point – ask yourself why you yourself are experiencing so much resistance.
    “Over and out”!

    Hugo

    Reply

    tom chi Reply:

    Hugo,

    I’m not trained in western sciences beyond what is required for licensure. I’ve done well over 50,000 treatments and it’s simple as pie to get most patients better because the needles and the patients are able to heal themselves with a teensy bit of help from me. Over and over,.. and over and over. No Big Deal!

    As to integration, I abhor that medical doctors perpetuate the fraud of useless and often destructive medicines and regimens on a daily basis while either saying they don’t know anything about TCM or condemning it. A few make referrals. Others try to create Integrative Medicine practices, usually meaning they rule and pollute the field, collect the billings and give speeches.

    I’ve treated almost 100 MD’s for such things as chronic pain, asthma, hot flashes, gastritis and then endless conditions that they also don’t’ treat well.

    I can’t wait for the medical insurance system to collapse so that only treatments that work will be paid for.

    Take as one small example that arthroscopy is less effective than placebo in published studies. And yet MD’s continue to perform this $8 Billion dollar per year procedure and I have to hear the MD medical director of BC/BS Anthem tell me they are rejecting yet another study on acupuncture and that they threw out WHO’s recommendations entirely.

    I am also an advocate for third-party independent clinics that newbie acupuncturists must go to and prove results to that staff prior to being allowed to be licensed in any state. They can receive mentoring until they get it right, then go and change the world, so to speak. That’s just to ensure that in the regulated industry the results are excellent.

    MD’s need to come down to earth, they waste time, money, faith and allow suffering to continue with their blinders on. It’s not justifiable.

    As to Arya, please note she has been a tireless advocate of acupuncture practice and service to acus and patients.

    To disagree with her is fine. I’m enjoying your scholarship and hope you will continue to speak out about your viewpoints.

    Please note that I as a non-scholar but nonetheless high-performing acupuncturist do believe it would be thoughtful and constructive to pay more attention to your excellent points while bypassing the personal attacks. I suspect you don’t think of them that way so perhaps the feedback will cause you to reconsider.

    Thanks for considering this.

    tc

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  15. #15 Patrick Fitzsimons
    October 4th, 2010 at 8:43 pm

    I agree with the author of this post, abbreviated courses in acupuncture for MDs (and chiropractors by the way) do in fact pose a serious problem.

    It is a disservice to the great physicians of the past that bring us this great medicine to reduce it to an abbreviated course. Even a 4-year training is but scratching the surface! I’ve heard stories of apprentices of acupuncture not practicing for ten years or more in China in the not so distant past. Why should now be so different, especially when schools of acupuncture are graduating so many practitioners each year?

    It seems there is a divide, a distrust even, that acupuncture performed by an MD or western-trained practitioner is more desirable than one trained in a more “eastern” setting. I don’t think it’s far-fetched to say that western science is regarded as the pinnacle of science in the world. In many people’s eyes a health practitioner practicing outside of this system is flaky. I, personally, often think of these people as “dinosaurs”, because they just ain’t with it! :) There’s so much more to quote-unquote, reality!

    While I think it is VERY useful for an acupuncturist to understand the body through the lens of western biology, I do not subscribe to the idea that this is a prerequisite for a good acupuncturist. The microscope is, afterall, a relatively new invention. The great physicians of the past lived without it. Their knowledge of the body, and of nature, transcends what we know today. Not unlike the Mayans, the Egyptians, and many of the great ancient peoples of the world, they had an understanding of things that we’re just now trying to reconnect with. What this brings up is that there are yet different perspectives through which to view our reality, none better, none worse. I think that Arya’s analogy of different languages is a good one, because you’d know once you speak another language the world shifts a little bit. You see the world from a different vantage point. Reaching fluency in that language ensures that the paradigm shift truly takes place. If we don’t reach fluency in Chinese Medicine, why should we be practicing acupuncture?

    Acupuncture is a holistic modality. Many practitioners will say that they “specialize” in certain areas. This is often a marketing approach. The truth is, if they don’t understand the whole picture, their treatment efficacy will suffer. More often than not, I like to believe, they know that, and they practice acupuncture true to form – treating the patient and not the disease.

    For those of us trained strictly in Chinese Medicine, there are challenges that come from “within”. The world of Chinese Medicine is becoming more fragmented, more “schools of thought” are emerging, more so called “systems”. This does not help the situation. We have acupuncturists arguing about what is the true medicine, bragging about their so-called “lineage”. We are arguing amongst ourselves. Perhaps we could instead learn from one another, at best distill out what is the best of what we’ve got. The infighting is working against us.

    Acupuncture is a powerful medicine. In able hands it does wonders. In clumsy hands it sometimes does wonders. But in clumsy hands it can actually cause negative side effects. These side effects, not unlike those of pharmaceutical medicine, could go unnoticed, unconnected from their origin, for being practiced in a context (western medicine) that does not view the body holistically. Forever we’re chasing symptoms which morph from one thing to the next, perhaps more serious than the last. Think of what steroids so often do, but suppress the symptoms, until they rear their ugly head as something more hideous. Attracting a superficial pathology to the yin organs IS entirely possible.

    So…. instead of creating short courses so that acupuncture is more available to the masses, let’s step back and reflect upon the immensity of this great science. Doesn’t it deserve more? Only scratch the surface and you will know, or otherwise fool yourself.

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  16. #16 John Pirog
    December 2nd, 2010 at 6:09 pm

    I have no objection to requiring more clinical training, not just for MD practitioners, but for all Western practitioners. Nevertheless, I don’t see any evidence that medical acupuncturists are hurting the acupuncture profession, and plenty of evidence that they are helping it. Here in Minnesota, medical acupuncturists helped pass the insurance parity law, which allows equal access to third party coverage for the services of acupuncturists. Many acupuncturists working in hospitals and integrated clinics owe their jobs to medical acupuncturists who helped pave the way for the acceptance of this therapy in conservative medical settings. And I have seen medical acupuncturists publicly defend the profession when it is under attack by allopaths, often responding with a better sense of professionalism and attention to credible evidence than acupuncturists are generally capable of. I have known many MD practitioners, some trained in weekend CME courses and some in regular Master’s programs. They all tell me the same thing: there is far more money to be made practicing regular medicine than practicing acupuncture, even when the insurance companies pay them a higher rate than us, and physicians practicing even on a part-time basis typically take a pay cut. I know of one physician who was forced out of her her clinic because her acupuncture practice wasn’t producing as much revenue as the other internists. These people are not opportunists, and if we were wise we would be trying to make allies of them. Bashing them on forums such as this–even implying that they are injuring their patients–just makes us look greedy and protectionist in the eyes of the public.

    Reply

    Hugo Reply:

    John, as far as I can tell you are misreading the posts. In any case, just because in your area MAs seem to be benevolent, I don’t see why you would believe that your situation holds true for everyone else. Here in Ontario the OMA nearly succeeded in outlawing the practice of Chinese Medicine. That is obviously was not benificent of them.
    Taking our allies where they present themselves is always wise, however, losing our integrity just to have allies is not. Our true allies are those who respect our integrity. Allies who do not respect our integrity will betray us, eventually. Some of the people you mention will respect our integrity (perhaps even viewing it as their own), many will not.

    Hugo

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  17. #17 melanie silver
    December 4th, 2010 at 9:01 am

    hi,
    good article. i spent over a year in acupuncture school (was unable to finish at the time)but i will go back soon i hope. mds really need the proper training just like any other acupuncturist. this just isnt sticking little needles in someone like a voodoo doll, this is a highly speciallized technique developed over millenea to treat and cure people. it is used in every hospital in china and is starting to be used here more too.in my class we had several mds and nurses and it was a 4 year program. i went to pcom in chicago and loved it.i also use it for myself. i highly recomend it.

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  18. #18 Jose Torres, L.Ac.
    December 4th, 2010 at 11:32 am

    I assume when you are talking about the “abbreviated course of acupuncture for physicians”, you are referring to the Dr. Helms course through UCLA, it is in fact the most popular and longest running.

    Has anyone even looked at the Helms material? It is an exact duplicated of CAM book everyone used in acupuncture school. MD’s are not learning anything new or different, they are just learning it faster.

    I agree with Arya Neilsen, that anyone with proper training, regardless of “total hours”, can learn to use acupuncture effectively in the clinical setting. That is to say, anyone with proper training can puncture the ear, to affect the vagus nerve’s parasympathetic response.

    I disagree with Dr. Marilyn Walkey, MD, LAc, when she says that if you do not have a PhD degree in Oriental Medicine, you are not a worthy expert… mainly because there currently does not exist such an academic degree or an institution that offers it. The current “Graduate” degree in TCM falls short of a true GRADUATE education, leaving little if any room for students to be exposed to writing and research methodology and training.

    There are many academic researchers in History, Anthropology and Literature here in the US, that are far more versed in 文言文 or Classical literature, and that are far more knowledgeable of the complex history of China. Retired Professor Nathan Sivin is such a person. He though, has never picked up and used an acupuncture needle, yet he knows more about the topic than all of us combined.

    I hope you all have a chance to read this article from my colleague Ben Kavoussi: Astrology with Needles

    http://www.sciencebasedmedicine.org/?p=583

    Reply

    Hugo Reply:

    Jose, there are so many misreadings in your post that I am shocked. Nathan Sivin, for example, knows a lot, but cannot treat patients. It’s not his job, just like it is not ours to be as well versed in historiography. The fact that you bring up the vagus nerve shows how your western training impinges on your Chinese medical training. Discerning patterns and treating them according to the 8 principles, six divisions etc is what is necessary, not “affecting the vagus nerve”.
    Furthermore, has not one of your teachers told you what happens when you learn something fast? My teachers had me go over my basics until they were satisfied, and that took time. I certainly did not have the hubris to think to myself “This is simple because it looks simple, I can learn this fast, no problem”.
    Finally Ben Kavoussi commits the same error that so many westerners commit when they approach CM which is to mentate and believe that mentation will take them anywhere other than their own well-trammelled paths.
    Thanks,
    Hugo

    Reply

    Jose Torres, L.Ac. Reply:

    The fact that a “PhD”, “OMD”, etc etc from a privately owned Graduate school of Oriental Medicine, lets say for example in Oregon or California… does not transfer and is not recognized as a legitimate degree in the University of California system, is grounds for being a bit of a sketchy business.

    A real graduate studies program, at a real research institute, teaches its students about research and writing. This is something lacking in the current private school TCM programs, and it is exactly this divisive outlook that most administrations have, ie Western vs Eastern… it is holding back the profession.

    Personally, I want to see acupuncture in all major hospitals. I assure you I know more than a few friends, recent graduates with no employment opportunities. More than 50% unemployment rate here in the USA.

    氣 breath

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  19. #19 Eugene
    December 4th, 2010 at 8:10 pm

    I am a DO physitrist practicing osteopathic manual medicine along with the usual stuff (opioids,injections, emg/ncv, brain trauma, ) I see a lot of pain patients to sum it up. In Osteopathy, besides the usual classes in manual medicine those of us who choose to integrate it into the more common concept of “western” practice spend a lot of time refining our skill. We do sense and work with energy fields (some of us anyway) and get criticized by our collegues who never bothered to try to feel them and work with them. I spend a lot of time working with “guru’s” in Osteopathic manipulation and evolve as I do so… when the student is ready the teacher will come sort of thing. I would hate it if an MD, or L.Ac. for that matter would take a couple of weekend courses and some text book texts and say they do Osteopathic Manipulation… having said all that, I know many MDs and DOs who do medical accupuncture and have worked with TCM docs as well… what i saw was a wide wide array of knowledge and talent, from those who put in a few needles and hook em up to a stim to those who actually do tongue and pulse Dx in conjunction with their “western” knowledge and do so very well. I have been treated by med accupunturists and TCuys/guys/gals… school helps, but i do have to say, self learning through reading and taking time to listen and diagnose counts for more.

    regards
    Eugene

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  20. #20 Cherie Santasiero, Ph.D.
    December 20th, 2010 at 3:45 pm

    Wow. At first I thought this would be an educational and interesting place to learn more about the world of acupuncture. However, it is full of anger and resentment, Hugo. What’s with the name calling? How much healing is there in that?

    I work with Medical Acupuncturists, Traditional Acupuncturists and 5-Element Acupuncturists at our center. They are all effective. NO treatment, allopatthic or alternative medicine, is perfect for everyone. Our doctor trained 300 hours at UCLA with Joe Helms, MD, author, and OM at University of Toronto. Besides CME in acupuncture, he’s also got 25 years of FULL TIME experience. He is well-known for his positive outcomes. There is benefit in all forms of acupuncture. Over the years I have seen all three acupuncturists learn from each other. Perhaps that’s because they’re not of the nothion that it’s their way or the highway; they are real healers. That is also why they are so good! What can get through a closed door… or a blocked meridian?
    I am not an acupuncturist, but I’ll bet that all that anger represents a blockage that is not being taken care of.

    Reply

    Hugo Reply:

    Hi Cherie, 4 points:

    1. Have you not realized what this whole website is about? “Not all acupuncturists are created equal” is the by-line.

    2. “Hugo’s anger” may just be your subsumed projections (“My anger”). You have no way of verifying my emotions, and I would ask that you be careful, especially in the dangerous world of type-written conversation where no facial or tonal expression exists. Try and stick to the facts. This is simple netiquette.

    3. Please review the nature and structure of ad hominem attacks here: http://philosophy.lander.edu/logic/person.html You will find that you are ignoring my commentary and factual presentations in favour of focussing on your perceptions of my emotional state.

    4. For a good primer on this topic, please review a citation I have already posted above:
    Which Medicine? Whose Standard? Critical Reflections on medical integration in China (Fan, Holliday 2008)

    Thanks,
    Hugo

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  21. #21 tom chi l. ac.
    December 21st, 2010 at 3:56 pm

    Here comes a rant, run while you can!
    Hope you enjoy it. :-)

    A Ph.D. has no relevance to acupuncture results. Writing papers has no relevance to treating patients.

    Most primary medical conditions are so easy to treat it’s ridiculous.

    The hard thing is having insurance suck peoples resources dry and making them believe that if it’s not covered they should choose bad medicine (by which I mean that (mostly) garbage called allopathy.

    I don’t want to work alongside MD’s even though I like them as people. Why? It’s ethically horrifying to not speak up when they give for example, Previcid, instead of simply telling the body to adjust acid production and all the other good things that happen when the spleen – digestive complex is tweaked along with balancing all systems in the body with acu.

    Oh yeah, I forgot, first you send them to a specialist who only deals in stomachs and intestines.. Ha! A specialist? Dear doc, it’s a spleen def, damp heat or other phenomenon you’ve never heard of. And while you were reading this we fixed it. It’s all Whack-A-Mole to them.

    Most of the drugs suck and worse cause severe side effects. Patients come in having not had peristalsis for two years after taking Effexor (just one of many examples).

    For others their insurance pays $ thousands each month for Imitrex injections and yet 3 treatments with acu (and advanced hands-on tissue reprocessing) and there is no pain (typical). And it stays gone!

    Oh yeah, thanks a bunch for addicting so many people to Oxycontin and failed surgeries. When I get to L.A. I’ll be treating a woman who had metal rods installed from hip to cranium and then.. had “the hardware replaced” and continues to have the same original pain it was meant to fix. Why? Because most pain comes from soft-tissue and most back and neck surgeries fail miserably, largely for that reason. Surgeons already know this but they can do what they like. How lovely. (Yes I’ve digressed but you saw this coming)! And that’s just one case, if you saw the video of these fifty patients coming up it’s horrifying what they’ve been through, medically!

    Years ago when I treated the chief medical officer for Pfizer (and he said I can retell the story) he had a notepad that said “Feldene, for when your arthritis hurts”.

    I said why not just say “Feldene for when you want a bleeding ulcer” and he replied “Tom you should know all the allergic deaths we’ve had”.

    Allopaths prescribe whatever crap the pharms feed them. Many thanks to the most ethical of them however most only refer to acus after they’ve trashed the patient for a few years. Others pretend acupuncture capability and don’t deliver results. The very most ethical allopath would never treat asthma, hot flashes, digestion – GURDS, reflux, post-stroke, etc.

    NEVER. Because their medicine is garbage for most primary medical problems and acupuncture properly performed works fabulously.

    With their poor results, MD’s wouldn’t practice primary western medicine at all. So perhaps it is the most benevolent who try to practice acupuncture but for most their results are not good and their patients are not told of their deficit – lack of expertise and training.

    By the way, I didn’t dream this. After well over 60,000 treatments I’ve heard the patients and they are frustrated by all this, it’s based on their experiences.

    Why would practicing a poorly performing medicine (allopathy) pre-qualify an MD to become an acupuncturist?

    Western doctors could do a good job of screening for serious medical conditions that must have urgent intervention and then back off and let (most) acus easily eliminate health problems rather than turn them into years of pharms and b.s. results.

    How often does someone come into my office and say they’ve had years of drugs, tests, operations and therapy with no results? Every clinic day.

    How often do they marvel at the results we achieve with acu and advanced hands-on? Every clinic day. I have a ton of videos of before and after as videos speak much louder than oral claims or studies using “technicians” to do the needling.

    We need a medical revolution with MD’s playing a tiny role as screeners and doing specialty meds. By that I don’t mean removing gall bladders and tonsils unnecessarily but monitoring and treating malignancies, saving accident patients in ER’s and other conditions/treatment that prove themselves by a real standard… results!

    Please read Dr. Abrams – Overdosed America where he points out that most drugs don’t do what they say and most are incorrectly and/or over-prescribed per the actual supporting pharm studies. Yum!

    Other than that I have no opinion.

    P.s. In my upcoming series I’ll have an MD in the coat closet bound and gagged and I’ll say “hey, we told you, first do no harm” and then I’ll send in a face-painter to keep things delightful!

    And for the person who was not an acupuncturist who visited here? Good news. You’re almost as qualified as a “Certifed MD Acupuncturist” to treat patients… do you have a video player? Well in a few weekends…..

    So thank you for making this site available to us all, even when acupuncture schools have started “training” MD’s and people get angry because they hit the lotto and have MD “friends” that they are afraid they may lose if one reads these posts. Here’s your emoticons so you’ll know I”m not angry, just animated: :-) ;-) <:-0~

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  22. #22 Jody Eisemann, L.Ac.
    January 18th, 2011 at 8:18 am

    Interesting discussion, I very much appreciate this forum, thank you.

    Many Licensed Acupuncturists I have spoken with feel the way to solve this issue would be relatively easy: simply require MDs (and other healthcare providers) who want to incorporate acupuncture to sit for the 2 day NCCAOM exam (as we have), pass it and the “problem” would largely be resolved (although not addressing possible oversight and continuing ed issues).

    Here is a video example of what is being taught as a medical acupuncture treatment strategy: “Advanced Functional Assessment of Musculoskeletal Problems” http://www.acupunctureacademy.ca/

    However, as mentioned in earlier posts, such superficial treatments may help, but if an underlying imbalance and/or blood stasis condition is not addressed, chances of resolving musculoskeletal problems will decline markedly. Not wanting their patient to continue to suffer, and probably very frustrated, an MD might feel the only possible further solution would be pharmaceutical and/or surgical (I imagine not even thinking to refer out to an L.Ac.!).

    Those of us who are trained to think in TCM terms have many other tools to treat musculoskeletal problems (as in this video), for example: traditional acupuncture diagnosis, cupping, direct and indirect moxa, tui na, Chinese medicinal herbal formulas, bleeding techniques, gwa sha, various electro-acupuncture, topical herbal salves, auricular acupuncture, intradermal tacks, Japanese ion pumping cord techniques, hara palpation and much much more.

    The Three Stages of Traumatic Injury
    http://www.acupuncturetoday.com/mpacms/at/article.php?id=32231&no_paginate=true&no_b=true

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  23. #23 tom chi l.ac.
    January 18th, 2011 at 9:54 am

    Very thoughtful Jody, thank you.

    IDIOTS WITHOUT OVERSIGHT
    I don’t see having MD’s sit for the NCCAOM exam as a solution and here’s why.

    Any non-MD should then be able to take an A&P course and sit for the boards. No need for a digested TCM theory that provides the background of understanding the paradigm that for instance explains the connection between the kidney chi and the lungs and what the process entails.

    They’d have no practical or basic understanding of applied pulse diagnosis. No established basics on needling technique.

    No, it is test-taking and that plays into the brain/ego concept that MD’s already use and doesn’t allow them to create new neural networks that lead to how to use TCM expertly and as a default for effectively treating most healthcare problems instead of mugging the system and “improving” it by adding trash pharmaceuticals.

    Either they train and practice acupuncture clinically or they have no business pretending to be acupuncturists without any legal or apparently, ethical standards, to force disclosure that they are idiots without oversight. In many cases, thoughtful idiots. Imagine how pissed they’d be if we sat for some sort of surgical application boards and began doing brain surgery. It’s just about being able to thoughtful cut a bit here and there with finesse. I feel I could do it. Barbers did it in the 1900’s. Seriously I could be a “certified” brain surgeon rather than licensed cause I don’t think it’s all that complicated! Right? Hand me a clamp.

    If western medical sucks, and 50% of it does, practice that or dig ditches or do whatever that says “I’m an ethical contributing human” rather than “I’m charging your insurance, let ME worry about the results” and then provide none.

    Other than that I have no opinion.

    By the way, I have personally experienced cows laughing. I mean really laughing. !!!!! I didn’t know they could do that but they can. Really. But I digress.

    :-)

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  24. #24 Acupuncture is not Allopathic Med
    December 30th, 2011 at 12:51 pm

    Finally…an enlightened and appreciative MD! Force those divine right MD money-mongering machines to take the NCCAOM Boards at the very least and prove their competency first!

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  25. #25 Dr Debasis Bakshi
    January 14th, 2012 at 11:24 am

    I am an Indian Acupuncture Doctor practicing for more than 40 years, fully agree with your viewpoint.
    We also proposed to our national Govt. for the same.
    Pl. keep contact.
    Dr. Debasis Bakshi
    drdebasis56@gmail.com

    Reply

    tom chi Reply:

    Shukriya!

    Reply

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  26. #26 Anna Kelly, MD
    January 17th, 2012 at 11:59 am

    As both a physician acupuncturist and licensed acupuncturist, I feel qualified to speak to the issue. The tone of many of the responses here is less than helpful to a profession that is already divided. My interest is in bringing the profession together, for the sake of both its usefulness in our culture as well as its survival.

    My extensive experience is that the training for both licensed acupuncturists and physician acupuncturists is in no way complete, rooted in depth or 4 quadrant/integral theory. Both are a start to hopefully what is a lifelong open book process, as we remain more interested in what we don’t already know than in making declarations which are divisive and unhelpful to the practice of CM in the west.

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  27. #27 Tom Chi L. Ac.
    January 17th, 2012 at 3:43 pm

    There may be some confusion here. If you are an M.D. and a Licensed Acupuncturist, that typically denotes a fully trained multi-year schooled acupuncturist rather than the 300 hours of mostly video training that is a concern to most of us.

    So this is apples and oranges. There is no “bringing together of the professions”. There are MD’s who practice allopathy and think that magically makes them an acupuncturist with 300 hours of training. And no, it’s not okay to say “you may not be well-trained but I bet you’ll get the hang of it in a few years of defrauding patients”.

    I’m sure this is not the case with you however, some MD’s call themselves Licensed Acupuncturists and don’t even realize that they are Certified Acupuncturists (the hobbyist certification). That’s bizarre. Plus they aren’t required to tell their patients they aren’t really fully trained acupuncturists but instead perhaps hope to play one on tv.

    So, no bringing together of the professions, there’s no real connection. And now the physical therapists are doing “dry needling”. Surprise, that’s acupuncture! Chiropractors in Fl “do” acupuncture with 100 hours. MD’s there are able to practice acupuncture in 100 hours.

    If you went to NCCAOM accredited acupuncture school and studied and applied acu for several thousand hours, you deserve a lot of credit and earned a place in the acupuncture profession.

    Everybody else is playing at the patients expense.
    As Ted Kaptchuk said in Web That Has No Weaver, give a lay person a needle with antibiotics in it and (s)he may be able to do a lot of good. It doesn’t make them an MD. Same with acupuncture needles. A monkey could get some results but not the same as a properly trained acupuncturist.

    Perhaps we should just drop the educational training and recruit heroin addicts since they are great with needles.

    I appreciate your thoughtfulness. However my comments aren’t divisive they are fact. A teensy bit of training is not just as good as several years that are “in no way complete”.

    This is VERY helpful to TCM in the west. I will understand your complete veracity if you stand behind this statement by agreeing in theory to allow acupuncturists to do surgery with 300 hours (more than enough!).

    Wishing you a Happy New Year and thanks for what I believe is a genuine concern for a great outcome.

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  28. #28 calgaryacupuncture
    June 19th, 2012 at 1:47 pm

    Great story! I treated the same case of the blindness patient, and she recovered completely!
    for such case that caused by “Liver Fire up,urging”, it is very easy fix. but unfortunately, MDs always thought they are the GOD and miss the chance.
    Let’s work together for everybody’s health. not for money only.

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  29. #29 Shifu Ramon Careaga
    August 10th, 2012 at 11:08 am

    I just want to point out 2 things.
    #1 Med Acupuncturists are not going away unless you change laws and we don’t have that kind of power. ALSO with 73% of Doctors thinking of leaving their profession and the shortage of health care opportunities already and complex disorders, that isn’t likely to happen. Very soon I predict that Med. Acupuncturists may outnumber us, which means you need to learn how to play along and touch niches and markets they cannot touch. They are not TCM, they are Med. Acupuncture and they would probably love to LEARN TCM from us if we werne’t such a judgmental, and defensive group. We have a lot to learn from the western world, as well, IMO.
    #2 Thanks for the article, I think the debate that follows has more to provide than the article itself, even. It takes a lot of courage to write it, and it’s an important topic. IMO, integrative medicine is the future, the only question is how much independence we retain for our craft and profession as the insurance monster tries to gobble us up (and so many of us willingly and naively accept its loving hydra-tentacles).
    Maybe people should stop and realize that Med. Acupuncturists are flattering us (and becoming competition, yes) but they want to learn from us and validate us… and without them maybe we wouldn’t be as strong in the future. So let’s conduct ourselves appropriately and not become overly hot and judgmental. They know they aren’t TCM – it’s 100-200 hrs vs. 2500-3500. They know this. It’s the PATIENT that doesn’t, so focus on educating them. IF you want to fight politically, then get rich. That’s the bottom line. Your opinion doesn’t count as much as your bank account in matters of public policy and law.
    Sincerely,
    Shifu Ramon Careaga, C.Ac., MSTOM, Dipl OM
    http://www.bluelotushealth.com (clinic site)

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  30. #30 Attilio D'Alberto
    April 13th, 2013 at 4:19 am

    A great article. I wish more healthcare professionals saw medical acupuncture this way.

    I’m fighting my own battle in the UK with physiotherapists practising acupuncture after a day’s training, see http://www.chinesemedicinetimes.com/article.php/265/alied_continue_to_offer_day_courses_in_acupuncture_to_non_acupuncturists

    We need to spread the word, form action groups and lobby our associations to lobby the government. Only then will change occur.

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  31. #31 Lonny Jarrett
    April 15th, 2013 at 7:28 am

    The fact that physicians can practice with significantly less training represents an unnatural hierarchy predicated on social and cultural realities that exist for historical reasons that aren’t anybodies fault.

    Having said that let’s assess the facts with a degree of humility:

    1. Chinese medicine is new in this country and is only even beginning to live up to its potential. Practitioners with a sophisticated capacity that honor that potential are only just starting to emerge. In fact, the average physician who graduates from Helm’s class has not much less training than many of the founders of the first schools of acupuncture in America had in the early 70’s.

    2. Most physicians who take abbreviated courses never go on to practice substantially and they run up against their limitations fairly quickly (I’ve be been in the field 34 years and I run up against my limitations daily). Of course, some continue to delude themselves that they “know acupuncture.” Yet others go on to do advanced study. For instance, Anna Kelly who posted previously, went through an abbreviated training, studied sufficiently to pass the NCCAOM exam, took 28 weekends with me, not to mention her numerous studies with other teachers, and her continued pursuit of French energetics. I’d trust her with a patient over most of the practitioners I’ve met in the profession, including some of those who have posted here. Suffice it to say, I’m glad she was able to get the introduction she did in the original course she took.

    3. There are MD’s with depth and acupuncturists with depth and people with both degrees who are superficial and ignorant. Practicing CM effectively requires a soul depth that can’t be bought. And that is actually the more substantial basis of qualification than information acquired. Neither educational system addresses this in any serious way. In general, the acupuncture schools accept every single student whose check clears and has completed the prerequisites. And, they graduate every single student who can pass a test regardless of how frivolous or immature that student might be. I’ve been at conventions of “medical acupuncturists” where I felt far more at home due to the seriousness and depth of the participants than I have at certain similar gatherings of practitioner acupuncturists. Which leads me to…….

    4. The impulse to study Chinese medicine arises within a physician from the same motive and dimension that it arises within the non-MD practitioner. It arises from the impulse to seek for greater wholeness and that should be ultimately respected. Licensed Acupuncturists who are not MD’s resent MD’s who practice largely out of economic fear and out of ignorance. The only reasonable response is to (1) devote one’s life to becoming a master of the medicine so that ones accomplishment speaks for itself and (2) pull on the best in others and make alliances wherever possible. I can tell how far a person who practices CM has gotten by how much humility they have. We are all just getting started and, in fact, Chinese medicine is just getting started (The classics weren’t the last words on the medicine, they were the first) and the possibility exists now for a greater emergence and synthesis than was ever attained, or even possible, previously in history.

    5. Chinese medicine is a science of integrity and an individual who is a living manifestation of the medicine is one whose life naturally brings people together. Creating separation is an expression of ego and undermines any medical degree a person might happen to possess in terms of credibility in the context of a science of wholeness.

    6. The best way forward now is for physicians and licensed acupuncturists to realize that we are All In This Together and to forge alliances for the good of the medicine. Physicians who practice CM have done so in the face of scorn from their own community and we should honor them by taking their sacrifice seriously. There are certain liabilities entailed by being a physician that no sane practitioner of Chinese medicine would want to embrace (legal liability, and a bureaucratic and insurance system that is invested in illness and not health).

    8. There is a movement within CM to make “buckets out of ming vases” and to deconstruct this beautiful medicine to the point of triviality. I only mention this to highlight that the greatest threats to the integrity of the medicine lie within and not without.

    Conclusion:

    We should forge alliances wherever we can and build strong relationships with those in the “Medical Acupuncture” community. We should be emissaries of the type of wholeness that we purport our medicine to be about. There are much greater threats that face humanity now that should form an overarching context for us all to come together and stop this immature petty squabbling. I’m interested in personal and professional relationships with people who are awake to the urgent call toward unity regardless of what degree they possess.

    Lastly, I will suggest that it is their seriousness and commitment to integrity that has made Anna Kelly and Dr. Walkey the practitioner/physicians that they are. It is in following our impulse toward wholeness that we form the type of synthesis that expresses itself through us and inspires others. It is our job as healers to encourage that, by example, in all relationships we have the privilege to participate in.

    Regards, Lonny Jarrett

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  32. #32 tom chi
    April 27th, 2013 at 10:21 pm

    That’s mostly horseshit.

    It’s not petty squabbling to believe the public deserves well-trained practitioners.
    I don’t want to forge “alliances” with under-trained persons, that’s just guilt by association.

    Being an MD does NOTHING to make one a better acupuncturist so either we eliminate standards for ALL acupuncturists (training) or we hold to a high standard.

    Stop with the Kumbaya, If you don’t think your ego is just as present as anyone else you have been completely fooled.

    A great master said “the ego is like a black ant on a black rock on a moonless night. Just when you think you’ve beat it it’s got you!”.

    My being offended by fraudulent practitioners who don’t tell their patients that they are hobbyists with elementary training is an asset to the public. Most of the MD “acupuncturists” I know call themselves Licensed Acupuncturists. You know why? Because they don’t even know that they are Certified Acupuncturists because they don’t qualify to be L.Ac’s.

    My making nice would be a sellout to the nirvana of compromise that you sell. And by the way of the 100 MD’s I’ve treated not one wished that they were with a hobbyist.

    They came for a real cure for pain, reflux, hot flashes, asthma, post-stroke and more. And they got it. Period.

    ALL of my patients get better, fast! So don’t worry about my ego, my patients love me but.. I look like Mr. Potato-head so it may be both the results as well as some sort of fetish thing (on the likability front).

    If someone passed the NCCAOM that means they went to acupuncture school as the NCCAOM will not allow the abbreviated MD “training” and then sit for the boards.

    The immaturity is anyone who believes they can happy-face away the patients right to a qualified acupuncturist.

    Your heart is appreciated. Your thoughts though, in this particular context, sadly, are mush.

    P.s. My patients are PISSED with the MD’s who never told them why their “acupuncture” sucks and their results are non-existent. Yes, there are some very serious medical acupuncturists who pour themselves into the work and deserve kudos. But most started with crap for education and it’s not okay to just say “poke em hard” and throw them out on the street to fend for themselves knowing a few will excel while the others disillusion the public and steal resources.

    Practice western medicine or practice real acupuncture but stop waving your MD degree around and asking for unity. MD’s who practice acu with virtually no hours of training are jackasses and frauds.

    If only the public knew the difference.

    Other than that I have no opinion.

    With love and respect,

    tc

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  33. #33 Dr. Tony Zayner
    August 6th, 2013 at 12:43 pm

    Agree with Jon Pirog on yielding(taoism) and allowing others like MD’s and PT’s to do their “DRY needling. Would prefer them to be on our side than against us…PT’s have 12,000 practitioners in Illinois. Acu’s are about 2,000. So gotta respect the bull in the room. Especially if we want their support in the future for our scope to be expanded to the LEGAL use of Tui Na and Herbs with state and federally(Obamacare) mandated insurance coverage. The elephant in the room is the TCM schools which are 95% privately owned and appear to not care less about spending any money on promoting, elevating, or marketing our art. The schools just advertise to acquire new students to increase the bottom line. The schools give students unrealistic thoughts of vague opportunities they will never be able to acquire. Heard the National rate of failure for TCM students is now 85%(I believe the failure rate is higher after 2 years of struggling unless you have a trust fund or a rich partner). A MSOM degree is now costing a student $125,000 and job prospects anywhere are next to nil. Sorry, but thats criminal. Until the schools begin working together(putting away petty differences)pooling their money for lobbyists and political contributions we will go NOWHERE as a profession…Schools need to be heavily promoting and donating money to State Acupuncture Association. I’ve taught at 2 schools where encouraging membership in Acu assoc. was either frowned upon or rarely encouraged. Owners and administrators(some commented above) of schools should be ashamed of themselves. Students are sent out there ill-prepared, lost, and starving. Don’t know how they sleep at night……

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  34. #34 Diane
    August 8th, 2013 at 10:48 am

    I am a former ICU charge nurse who then went on to become an anesthetist which I did for 20 years. Because of personal experience with acupuncture and also that of my dog receiving it I am currently in a 4 year acupuncture school also learning herbs, bodywork and dietary counseling.

    Every day I leave clinic with my head spinning because I see results (one also involved clearing diabetes induced blindness) that based on the western medical view of the body simply should NOT be happening.

    After 3 years of school, I concur wholeheartedly that the abbreviated weekend training in the popular MD program cannot even scratch the surface of this medicine. There is currently an ER physician in my school who took the program mentioned in the article-she also felt that it wasn’t nearly enough training in this field.

    My goal is to hopefully get both western and eastern medical practitioners understand and communicating with each other more fully in order to effect the best outcome for our patients

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  35. #35 Robert Burton M.D.
    August 8th, 2013 at 5:06 pm

    Dr. Wakley,

    I’m a physician with who was exposed to an abbreviated acupuncture training program and agree with the essence of what you are saying. But that course only increased my desire to learn more. I agree that one should be well trained but one should also understand their limitations. I’ve seen how acupuncture has filled the gaps and have sought to expand my knowledge base just recently finishing a 2yr 5 element course. If an exam or training pathway is established I’ll be the first to jump on board. Until then, lets not demonize each other and keep the avenues of communications opened. Those enlightened will see the wisdom of allopathic medicine and TCM able to discuss things openly.

    Robert Burton M.D.

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    Anna Kelly, MD Reply:

    I agree, Robert, that the level of discourse in discussions like this (as evidenced by numerous posts above) is shockingly low and cuts off all reasonable conversation. Sad really that out of self-centered fear we act this way. I for one am embarrassed.

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  36. #36 jeanie mossa kraft l.ac
    August 9th, 2013 at 10:52 am

    Thank you for writing this article! A few weekends of training is not enough for any profession. Even hairdressers are required more than 1000 hours of training. Why should MDs, PTs and veterinarians be allowed to do acupuncture without proper education? It is dangerous and misrepresents true Traditional Chinese medicine.

    I cannot take a weekend course to be a chiro, PT, MD or vet and practice, and that is a good thing.

    jeanie mossa kraft L.Ac.

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    Jessica Zerr R.Ac Reply:

    Very well said Jeanie. I am always trying to educate people about the different types of training that various health professionals must complete in order to practice acupuncture. It varies so much between each profession and I think it’s important for people to understand and know what their options are.

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  37. #37 James J. Maguire
    December 19th, 2013 at 12:17 am

    This issue has been going on for the 35 years that I have been an acupuncturist. The purpose of state acupuncture licensing regulations is to provide a STANDARD OF MINIMUM COMPETENCY in the practice of acupuncture for the protection of the health, safety, and welfare of the public. ANYONE practicing acupuncture (state laws usually define acupuncture as the insertion and removal of a FILIFORM needle) with less training than that of a Licensed Acupuncturist is therefore doing so at a level BELOW MINIMUM COMPETENCY.

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