Restructuring American Acupuncture Practices
Restructuring American Acupuncture Practices
a proposal by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon
Institute for Traditional Medicine
Four times each year, I receive an issue of the Journal of Traditional Chinese Medicine, and each issue has several acupuncture articles. The articles include clinical reports of acupuncture therapies given to patients in China. In virtually every report (see Appendix), acupuncture therapy is administered daily, for several days in a row, typically 5-10 days consecutively, followed by a short break of 1-3 days, and then another course of 5-10 days of therapy, as needed until the symptoms have been alleviated. In some cases, acupuncture is administered every other day rather than daily. I do not recall seeing any report where acupuncture is administered once per week (other than a follow-up to a successful treatment where acupuncture had previously been done every day or every other day). There are quite a few protocols where two sets of acupuncture points are chosen, with one set given one day, the next set the next day, and then continuing this alternating pattern. This is a means of addressing two sets of therapeutic concerns or two approaches to the same basic therapy without losing momentum in the treatment of either pattern. The alternating treatments also reduce the possibility of irritating the patient by repeating the same pattern each day.
By contrast, most American practitioners I have spoken with-many hundreds of such practitioners over the years-routinely recommend to their patients a schedule of once per week acupuncture. Further, they have become accustomed to having patients miss a weekly appointment here or there, so that a course of 10 acupuncture treatments can easily take 3 months, compared to 10-20 days in China. In many instances, the weekly acupuncture appears adequate to address the patient's needs. However, it is frequently reported to me that an acupuncture treatment helps the patient notably, but the apparent effects wear off in a day or two. If I point out the therapeutic method used in China, with daily acupuncture rather than weekly acupuncture, the response is uniformly that patients cannot afford to get acupuncture daily; additionally, daily or every-other-day acupuncture may be restricted by either the patients' or practitioners' schedules. As a result, the concept of weekly acupuncture has become entrenched here.
In a survey conducted among practitioners who applied for inclusion in ITM's Practitioner Reference Guide, it is clear that many, if not most, American acupuncturists work less than 5 days per week, may spend an hour during each standard patient visit (initial visits are typically longer), and may see fewer than 30 patients per week. Thus, even if patients had the time and money for daily or every other day acupuncture visits, the way practices are set up now, it would be almost impossible for them to schedule it. On average, with current schedules, a practitioner might be able to treat about 7 patients daily for four days per week, limiting the number of patients far too much.
In this proposal, I would first like to point out the reasons for promoting the use of daily (or nearly daily) acupuncture (at least for some patients), and then indicate how such a situation could be attained by practitioners who are willing to provide this kind of service. It is my proposal that by restructuring acupuncture practices, many patients could avail themselves of frequent acupuncture in an affordable manner. In making this proposal, I recognize that there are many styles of providing Chinese medical services, and many personal factors that a practitioner may face influencing what they can offer. However, I believe the model offered here needs to be elucidated so that practitioners can consider it as an option.
WHY FREQUENT ACUPUNCTURE?
It has been reported to me informally that many acupuncture patients seen here (in the U.S.) will note an improvement in their condition after about 5-6 weekly acupuncture treatments. Further treatments may then be needed to gain the full effect of acupuncture. A course of 10-15 treatments in total is not unusual. Some patients opt for prolonged treatment over several months or even years, ...
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