Why You Should See An Acupuncturist for Acupuncture

In recent years medical doctors (MDs), osteopaths (DOs), physical therapists (PTs), and chiropractors (DCs) in North Carolina have all written acupuncture into their scope of practice, giving themselves legal permission to offer this therapy to their patients. Unfortunately, some of them require no additional training to do so while others only require very little. As it stands, though there are certification classes available for them, physicians are not required to have any additional training at all to practice acupuncture (www.ncmedboard.org). Physical therapists must be certified in acupuncture to practice it, though they are only required to take 54 hours of class (www.ncptboard.org). Chiropractors are required to have more education than that, but they still only need 200 hours of class to be certified and that's only if they were licensed after 07/01/2008. If they were licensed before 2008 it's 100 just hours (www.ncchiroboard.com). Neither MDs, DOs, PTs, nor DCs are required to have any clinical training or additional continuing education to practice acupuncture. In contrast, licensed acupuncturists must attain a post-graduate master's degree from an accredited college with a minimum of 1,800 class hours, 650 of which must be supervised clinical training, must take the Clean Needle Technique course, pass three national board exams, maintain a state license, and complete forty continuing education credits every two years (www.ncalb.com). As a Doctor of Acupuncture and Chinese Medicine, I have fulfilled all of the above requirements for licensure plus I have an additional 1,100 class hours.

 

Acupuncturists are licensed to practice acupuncture, while MDs, DOs, PTs, and DCs are only certified in it. What's the difference? A license is a mandatory credential issued by a government entity verifying that an individual has met the minimum educational requirements needed to practice a particular profession within a designated scope of practice. In many professions, like medicine, it is illegal to practice without a license. A certification, on the other hand, is a voluntary credential issued by a private entity verifying that an individual has completed a certain training. Certifications are not regulated by government entities and do not have minimum educational requirements. This means that legally, because they are only certified, MDs, DOs, PTs, and DCs are not allowed to use the titles Licensed Acupuncturist or Doctor of Acupuncture and Chinese Medicine, nor can they refer to themselves professionally as an acupuncturist. Since MDs, DOs, PTs, and DCs are not required to study acupuncture to practice according to their licensure, it is only an additional voluntary certification for them. Confusing this further is the use of certain terms, like "medical acupuncture" by physicians or "dry needling" by physical therapists, the former incorrectly suggesting a special level of expertise and training when the opposite is true, and the latter suggesting that there is a clinical distinction between acupuncture and dry needling when there isn't one.  

 

As an acupuncturist, it is very interesting for me to see how many other types of medical practitioners have added acupuncture to their legal scope of practice. In some ways, it is a welcome acknowledgment by mainstream medicine as to the efficacy of this wise and ancient healing art. In other ways, though, it is a complete dismissal of the underlying theoretical foundation of Chinese medicine. This is especially so when you look at how little training MDs, DOs, DCs, and PTs are required to have to practice acupuncture. For example, there are over 350 acupuncture points, each with a specific anatomical location and correct depth and angle of insertion. Just this critical basic information took me 60 class hours to learn. Another issue is that they use acupuncture needles, put them in acupuncture points, and use this therapy clinically for the same reasons that acupuncturists do, namely as a treatment for pain. So what's the difference, other than in the term they use to describe it? I would say nothing, though in court the North Carolina Physical Therapy Board argued that it's because physical therapists use it according to a different theoretical background. In response, I would say that it is impossible to correctly use a tool if you do not understand the underlying theory of how it works and that acupuncture points still have the same actions and contraindications whether they are used by acupuncturists or physical therapists. It is not just the needle that is the cure, it is the whole philosophy of Chinese medicine and its alternate paradigm of chi, energy channels, yin and yang, and the five elements behind it that makes acupuncture so effective. To reduce this medicine to the simple mechanical application of a needle where it hurts, to adopt the tool but not the theory that it came out of, is limiting at best and dangerous at worst. In fact, the practice of dry needling by PTs is illegal in six states and counting and there is more than one physician group that has published a formal position paper against it because they do not have enough training.

 

Please click here to read the AAMA (American Academy of Medical Acupuncturists) physician's group position against the practice of dry needling by physical therapists.