Acupuncture in the American Medical Industry
By Austin B. Hahn
Originally published: March, 2014
Updated: October 11th, 2015
I. My Story
Imagine the worst abdominal pain you’ve ever felt while experiencing a burning urinary tract infection and neither of them will go away. I was nineteen years old while working in retail and going to school. In August of 2012, I developed interstitial cystitis from a UTI after avoiding treatment for nearly a year due to humiliation. The cause of interstitial cystitis, or IC, is unknown, but this condition is associated with bladder pain and the urge to frequently urinate (”Diseases and Conditions”). I also contracted salmonella from eating recalled peanut butter. Several brands from New Mexico, including Trader Joe’s, were contaminated (“Peanut butter”). August to December of 2012 were the worst months of my life, and little did I know about how long the healing process would take.
I hardly slept for four months straight. I felt almost as if someone was poking me in the gut with their thumb. Meanwhile, the burning sensation in my bladder kept me tossing and turning in bed. Sometimes I would have to get up and go to the bathroom four times a night. I was miserable! My health became progressively worse, and it began to affect my academic, personal, and professional life. I lost my job as a sales associate, and I failed a class for the first time in my education. I consulted my general practitioner in October, then I had a colonoscopy at Hillsboro Gastroenterology PC in January of 2013. I even saw a naturopathic doctor and visited a urologist, but none of them could give me a prognosis. No one could offer me treatment or relate to my problems, so I became depressed and frustrated. Thoughts of suicide were starting to settle in.
I decided to take matters into my own hands by researching online for medicinal alternatives. I stumbled across a website called Interstitial Cystitis Success Stories and read about a woman named Camille and her medical success story after having acupuncture. Her story gave me hope, so I looked for an acupuncturist in Portland and found Dr. Beth Griffing, a licensed traditional Chinese medicine practitioner. I was treated by Dr. Griffing from March until August of 2013 before being referred to Dr. Guohui Liu, a professor at the Oregon College of Oriental Medicine and author of Warm Pathogen Diseases: A Clinical Guide. By early 2014, after ten months of acupuncture treatments and taking acidophilus pearls, my gastrointestinal pain was gone, and my cystitis had subsided. Acupuncture gave me my life back. My experience and research on acupuncture led me to wonder: why isn’t it integrated into the American medical system?
Acupuncture originated in China 5,000 years ago (Chon and Lee 1). The practice was first described in The Yellow Emperor’s Classic of Internal Medicine, a document dating back to 100 BCE (White and Ernst 662). As Dr. Benjamin Rho, a professor at the Council of Colleges of Acupuncture and Oriental Medicine states, “acupuncture is a process that enables the body to heal itself by balancing the flow of Qi energy which is found along certain surfaces of the body that are used as acupuncture points” (Rho). Traditional Chinese medicine practitioners associate this energy with well-being. When a person’s Qi energy is out of balance, the body is more susceptible to illnesses and diseases.
Acupuncture was first introduced by Jesuit missionaries in Europe during the 17th century (Chon and Lee 1). This helped to integrate Eastern medicine into Western civilization. Although physicians continued to spread knowledge about acupuncture from China to the Arab trade routes, making it an established practice among the east, modern-day Western societies wouldn’t become familiar with it until the late 20th century (Ehrlich). In 1971, James Reston, a New York Times reporter, “had a considerable amount of postoperative pain and bloating” after undergoing an appendectomy in China. Chinese doctors administered acupuncture, and, to his amazement, his pain subdued without experiencing any recurrences (Chon and Lee 1). Reston wrote and published an article about his experience in the newspaper, introducing the United States to acupuncture (Chon and Lee 1).
Today we know that numerous conditions can benefit from acupuncture. Carpal tunnel syndrome, fibromyalgia, and osteoarthritis pain are some medical conditions listed by the National Center for Complementary and Alternative Medicine, (NCCAM), that acupuncture can treat. While acupuncture becomes increasingly approved within the medical community, consistent evidence has indicated that it may help manage migraine and tension-type headaches (Chon and Lee 5). The World Health Organization also lists acupuncture as an efficacious remedy for various diseases and symptoms, such as depression and gastrointestinal spasms. In addition, the Acupuncture Massage College states that acupuncture supports the immune system, alleviates emotional issues, prevents the common cold, and helps reduce post-surgical nausea. Moreover, unlike “conventional treatments for overactive immune system disorders such as allergies and autoimmune diseases such as arthritis … which is useful for symptom management but does not result in a cure,” acupuncture stimulates the immune system, resulting in no side effects (”Chinese Herbs”). These discoveries have prompted the advancement of acupuncture in the United States.
Michele Andrews, a reporter for the Los Angeles Times, claims that hospitals are offering more alternative treatments due to patient demand and profit. The American Hospital Association and the Samueli Institute, a nonprofit research group, states that “42% of the 714 hospitals that responded offered at least one such therapy in 2010; five years earlier, only 27% of hospitals offered such treatments.” Furthermore, the National Health Interview Survey estimates 3.1 million adults underwent acupuncture in 2007 (Chon and Lee 1). Other statistics confirm acupuncture’s acceptance among the American public, and various sources continue to prove its efficacy. As mentioned by the Health Medicine Institute, an online division for continuing education in acupuncture, the Translational Andrology and Urology revealed in a study that acupuncture has been proven effective in aiding anesthesia for penile surgery. Local nerve block and several acupuncture points along the arm reduced the effects of postoperative pain (“Acupuncture Assists”). These findings have led to further research on the advantages of integrating acupuncture into the American healthcare system.
Although the NCCAM claims that “few” cases of serious side effects have been reported in the United States, making it a safe alternative to prescription medication, acupuncture is currently not covered by insurance (Chon and Lee 4). For patients and outpatients alike, this means paying more out of pocket. The cost of treatment may vary according to the type of medical condition. Lara Salahi, a writer for Boston.com, also notes the lack of scientific evidence to prove acupuncture’s efficacy. Clinical trials on osteoarthritis “have demonstrated modest therapeutic efficacy” (Weiner, et al.). In addition, states have different regulation laws. For example, in California acupuncturists are required to have 950 hours of clinical practice (“Title 16”). In Alabama, only a doctor, an osteopath, or a chiropractor can perform acupuncture; however, there is no training required in order for a doctor to practice acupuncture (“Alabama Laws”). Because licensure requirements vary with each state, there is no consistency in regulation to ensure the quality of treatment and safety of patients. Without proper training, acupuncturists could injure a patient by penetrating the skin too far, resulting in infection.
Patients should take caution when considering acupuncture. Daniel Hsu, a doctor of acupuncture and oriental medicine, lists bleeding, immune and skin disorders, metal allergies, and valvular heart disease as contraindications. What’s more, Edzard Ernst of the University of Exeter, a leading expert on the evidence-based evaluation of alternative medicine, states, “If a patient has trouble breathing after treatment and the acupuncturist does not suspect lung collapse … the patient can die.” Ernst continues, “studies … have revealed 86 deaths after acupuncture between 1965 and 2009, most of them from lung collapse.” Additionally, while acupuncture facilitates pain management, no research has concluded that it can cure diseases. When considering acupuncture, people should research the risks and consult a certified practitioner to find out if complementary medicine is right for them.
V. Lack of Coverage
Acupuncture is becoming more recognized as a medical practice by hospitals and health insurance companies. Chinese medicine practitioner Phil Veneziano anticipates that acupuncture will become vital to the future of hospitals’ financial stability. “The Information Age has catapulted this exquisitely-elegant medicine into the spotlight, under the microscope and on the radar of an estimated 8.2 million Americans” (Phil 1). Furthermore, Ankita Rao, a staff writer for Kaiser Health News, reports that the medical community is now reviewing health laws, such as Section 2706 which states that “insurance companies ‘shall not discriminate’ against any health provider with a state recognized license.” By 2014, the Bureau of Health Statistics may have to recognize acupuncture as a profession under Section 3502 of President Obama’s health care reform (Phil 1). Health insurance companies, such as BlueCross BlueShield, already offer plans that cover acupuncture, but are limited to “24 visits per calendar year” (Breskin). According to Health Affinity System, a regional healthcare system, most insurance companies currently do not provide coverage for acupuncture, including Medicare and Medicaid.
In 1996, Tom Chi, a NYS Licensed Acupuncturist, contacted the medical director of Empire BlueCross BlueShield of New York at the time, Dan McCrohn, to get coverage for acupuncture. McCrohn then complied with Chi’s request. However, Chi claims that once Empire had gone for-profit and “gave the state a billion dollars for the privilege,” Dr. Steve Willensky, another Empire medical director, stopped covering acupuncture. “One wonders why a vital system of proved medicine is largely excluded from our national healthcare insurance system” (Chi 1). Willensky had ordered Chi to send peer-reviewed studies proving acupuncture’s effectiveness. After sending fifty peer-reviewed studies, Chi recalls Willensky’s response saying, “I wish you hadn’t called my bluff. We just don’t want to pay for acupuncture even if it works.” Moreover, over the last 15 years since 1993, Congressman Maruice Hinchey has continuously reintroduced the Federal Acupuncture Coverage Act (Chi 1). Because this law has not been passed, Medicare and Medicaid are unable to reimburse for treatment (Chi 1). Workers Comp and No-Fault are also not legally obliged to pay for NYS Licensed Acupuncturists (Chi 1). Chi urges for reform “or we’ll continue to choke on healthcare costs.”
Acupuncture needs to be federally regulated in order to assure the same quality of treatment and safety for all patients in the United States. Every state should hold medical acupuncturists and licensed acupuncturist services up to the same regulation standards which would include completing a number of hours of clinical training and obtaining a degree of certification. As Marshall Sager points out, the Founding Chair of the American Board of Medical Acupuncture, insurance companies need to be informed about the cost effectiveness of acupuncture. From my point of view, using financial projections and statistics to educate insurance providers on acupuncture’s economical value would be equally effective. If acupuncture prevents patients from undergoing costly surgical procedures, then this could mean less medical expenses for insurance carriers.
Incorporating acupuncture into the American healthcare system will enable researchers and scientists to more accurately assess the potential advantages of it on human health. As Stager proposes, “we [should] undertake a cost/benefit statistical analysis of various specific medical conditions and their treatments, both traditional Western therapies and acupuncture.” Acupuncture is inspiring new research, leading to medical advancements. While patient demand increases and public interest grows, regulations will have to be imposed, education will be crucial for funding, and laws will have to be implemented to ensure the safety of patients and the ethical practice of acupuncturists.
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