Acupuncture & Oriental Medicine
Acupuncture is a health care technique that involves the insertion of filiform needles into specific points on the body in order to elicit therapeutic responses. The term is also used to refer to the broader field, or system of medicine, of Acupuncture and Oriental Medicine (AOM), that encompasses a wide range of medical practices used over many centuries together or independently for healing purposes. (Chinese medicine as a distinct field dates back as far as 1400 BC.)
While distinct from Western medical practice, the field also emphasizes early disease detection and fosters changes in patient behavior as the primary means of minimizing disease burden, areas of important focus in contemporary American medicine for health improvement and reduced costs of care.
The majority of certified acupuncturists work in independent practice settings, but the integration of the practice and Oriental medicine into mainstream hospitals, clinics, integrative centers, teaching facilities, and the military has increased significantly since 2000. Research evidence continues to establish its effectiveness for important categories of ill health, especially pain.
Licensure of acupuncture in the U.S. as a separate and distinct profession began in 1973, when the first practice acts were established in Maryland, Nevada, and Oregon.
Professionals working in the US: 30,000
States where Acupuncture is licensed: 44
|Examples of Use||Education & Certification||References|
|In US health||Insurance|
Examples of Use
Acupuncturists maintain and restore the health of patients through the diagnosis and treatment of a wide range of health conditions, by employing a combination of Chinese medicine theory and modern biomedical science. Acupuncturists apply numerous modalities that may include manual therapies, tool-assisted techniques, moxibustion, auricular (ear) therapy, lifestyle and diet counseling, herbal medicine and supplements, exercise therapy, Tai Chi and Qi Gong.
The practice is based on a complex, highly structured system of observational biology. This system is rooted in an explicit view of how humans interact with and within natural and man-made environments and within their social systems. (This framework is also used in the treatment of animals.) In diagnosis, acupuncturists first determine states of balance and imbalance in patients, by using unique groupings of signs (i.e., facial observation, and tongue and pulse diagnoses) and symptoms that are described in Eastern traditions, in conjunction with standard Western biomedical diagnostic techniques.
Conditions Treated by Acupuncturists
Treated conditions include a wide variety of disorders that are often categorized under the domains of internal medicine, musculoskeletal and physical medicine and rehabilitation, mental health, gynecology and fertility, endocrinology, and neurology.
In 1997 the National Institutes of Health issued a consensus statement on acupuncture in which the treatment had been shown to be effective in treating adult post-operative and chemotherapy-induced nausea and vomiting, and postoperative dental pain. Additionally, the statement reported that acupuncture can be a useful adjunct treatment or an acceptable alternative when treating the following conditions:
low back pain
carpal tunnel syndrome
Acupuncture has proven to be a safe and effective form of health care when performed by a trained, certified and licensed professional. Complications from clinical treatments are extremely rare, and side effects are very limited.
A 2001 World Health Organization (WHO) statement declared acupuncture treatment safe when performed by a licensed and well-trained practitioner. WHO suggested that the popularity of acupuncture for chronic and acute pain in many countries may be attributed to the absence of side-effects from its use when compared with pharmaceutical alternatives.
Education, Training, Certification and Licensure
Degrees and certifications have been established for both Acupuncture and for Oriental Medicine. The curricula for both are almost identical, with Oriental Medicine (minimum of 2625 hours over four years) covering greater integration of therapies, especially herbal therapies.
Candidates for certification from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) must successfully pass four examinations. Both these series include biomedicine. This is an essential competency, designed to assure that professionals know when to refer a patient to a medical doctor or other healthcare practitioner and more fundamentally be equipped to discuss care and treatment knowledgeably with conventional physicians and other care providers. (All NCCAOM certification programs are accredited by the National Commission for Certification Agencies (NCCA).)
Scope of Practice
The scope of practice for acupuncture and oriental medicine varies by state. In general, acupuncturists maintain and restore the health of patients through the diagnosis and treatment of a wide range of health conditions, employing Chinese medicine theory and modern biomedical science. They may apply numerous modalities, including acupuncture needle insertion, manual therapy, tool-assisted techniques, moxibustion, lifestyle and diet counselling, herbal medicine and supplements, exercise therapy, Tai Chi and Qi Gong.
Regulatory and Licensing
State licensure has been established in 44 states and the District of Columbia. Initiatives are under way to include licensure in the six remaining states. Licensure activity has steadily and significantly increased since 1973. Early standards for licensure were set on a state-by-state basis. Since 1982 national standards have existed that verify the entry-level knowledge and skills required of professionals. The map shows the status of acupuncture as a licensed therapy in the U.S.
Acupuncture in US Health and Wellness
Since its first U.S. accreditations and licensing in the early 1970’s acupuncture has steadily grown to take a place as a powerful therapeutic tool in US healthcare. Because the question about it (and many integrative interventions) — “How does it work?” — is not easily answered, acupuncture’s historic track record of positive outcomes has helped to expand the thinking of physicians, medical researchers and policy makers: about the nature of the healthy body and its own internal mechanisms for restoration, re-balancing and recovery. The advent of imaging technology has gone a long way to illustrate the positive effects of acupuncture, notably as a treatment for pain, and, in a way, to “catch up with” public demand for the therapy.
Although this growth has come almost entirely from the encounters between patients and independent licensed acupuncturists (LAcs) outside the healthcare system, you will now find the treatment available in hospitals and in a growing number of independent MD-led regional medical clinics.
The experience of the US Army since the wars in the Middle East is perhaps the best example of institutional acceptance of outcomes attained before clinical trial evidence is certain. Soldiers and veterans suffering from traumatic brain injury, PTSD and the often crippling side effects of addiction to pain killers have found relief from acupuncture.
Because pain in general – from chronic illness and disease, from injury and in post-operative recovery — is so pervasive throughout the U.S. population, significant initiatives have been created by the National Institutes of Health and by the US Military Health to broaden solutions, including the use of non-opioid pain management tools, including acupuncture.
The following video describes the use of acupuncture in military health and development of treatment on the battlefield.
Acupuncture when it is not affordable
Because acupuncture remains unaffordable for many, providers in many cities and towns have developed a “community acupuncture” model that provides the therapy in group settings, at a lower per-person cost. In a 2014 report from Portland, OR, researchers said community acupuncture “fills a gap for the uninsured, under-insured and medically under-served population.”
Although acupuncture has gained substantial licensing presence throughout America and a growing therapeutic reputation in mainstream hospitals, clinics, integrative centers, teaching facilities, and the military, its practitioners and patients experience very uneven insurance coverage. Where it is covered, it is often when it is used in lieu of another therapy for a covered condition such as pain control in surgery or dentistry.
This imbalance between public and patient preference for acupuncture and its exclusion from the insurance plans, despite its extensive national licensure, is a good example of the marketplace correction that Section 2706 of the Affordable Care Act was enacted to bring about.
References for Acupuncture
Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM)
Acupuncturists Without Borders
American Association of Acupuncture and Oriental Medicine
American Organization for the Bodywork Therapies of Asia (AOBTA)
Council of Colleges of Acupuncture and Oriental Medicine (CCAOM)
National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM)
National Guild of Acupuncture and Oriental Medicine (NGAOM)
People’s Organization of Community Acupuncture (POCA)
Articles and Studies
A 2014 summary of acupuncture research presented at the International Research Congress on Integrative Medicine and Health (IRCIMH) in May 2014.
A link to an article published by JAMA Internal Medicine, by LTC Wayne B. Jonas, MD, USA (Ret.) and LTG Eric B. Schoomaker, MD, PhD, USA (Ret.) offering alternatives to the excessive use of opioids in the U.S. military: a call to action to integrate medical practices that have proven to alleviate the symptoms of chronic pain. Jonas is CEO of Samueli Institute, the nation’s leading research partner with the Department of Defense on integrative health care treatments.
University of California at San Francisco one of a very few academic medical centers to offer acupuncture to both inpatients and outpatients.
NCCAOM’s Find-a-Practitioner Directory