Embracing the season of gratitude and thanks, it’s time for The Acupuncture Observer to take a step back and share some of her foundational beliefs about the medicine, the profession, and life.
- Acupuncture/OM works. The unique situation of the patient and the unique skills of the provider influence effectiveness. No single tradition provides all of the answers or benefits.
- Acupuncture/OM has fewer negative side effects and risks than conventional treatment for many conditions.
- Access is a necessary precursor to effective treatment.
- Effective treatment will increase wellbeing and could decrease health care costs.
- Every means to increase access carries trade-offs. Those trade-offs must be understood as we determine our path forward. We should learn from the experiences of other professions.
- Understanding and explaining the mechanism of acupuncture from the knowledge base of modern biology and physiology is useful and interesting, but is not necessary for acceptance by the medical establishment.
- The current “science-based” understanding of health is known to be limited. Insisting that Acupuncture/OM be taught, thought of, or explored only in the language of modern medicine/science is unscientific and risks centuries of experience and wisdom.
- Consumers should have significant freedom of choice in health care. Understandable and clear information about potential benefits and risks, as well as an exploration of the costs (financial and otherwise) is necessary for good decision-making.
- Self-serving thinking leads to hypocrisy. Special attention is needed when an argument for patient protection creates an economic benefit for particular providers.
- Simple, easily learned treatments can be effective and safe.
- There is the potential for growth and success within the acupuncture/OM profession.
- Many acupuncture programs do not provide sufficient or accurate information about post-graduation life and do a poor job of teaching business skills. This can be changed easily and inexpensively.
- The financial and karmic ROI (Return on Investment) of positively promoting our profession is superior to that of engaging in political/regulatory battles with others.
- The future of the medicine and of the profession are interconnected but not identical.
- Thoughtful and respectful analysis can identify areas of common ground.
- Focusing on areas of common ground decreases factionalism, and builds unity, understanding, and participation.
- The profession lacks venues for respectful dialogue on these issues. As a result, many scholars and potential leaders within the profession avoid involvement.
Do we agree on some of these? Can respectful dialogue increase the areas of agreement? What if we read the Tao Te Ching, the I Ching, and The Art of War first? What if we go deeper than our Wei level response to some of these issues? I believe it is possible that we’ll be able to find a new path forward, one we can walk together, with our hair flowing free. After all, I’m an acupuncturist.
Thanks for the comments. Here some thoughts. Enrollment in med schools increased from 77,375 in 2009 to 83,472 in 2013; a 10% increase is hardly a rush for the exits [https://www.aamc.org/download/321526/data/2013factstable26-2.pdf].
How many MDs and others are using acupuncture? Data suggest this is a miniscule number. You have not supported your statement with evidence.
“Parallel tracks” is like comparing a dial phone with a cell phone. Of course the real issue is revenue. Data show the current (bare)foot path leads to 40% earning <$40K.
Business skills work best when there is business to work with. Data (NCCAOM JTA and my own published research) show ~90% of all LAcs work in private practice, half solo. Having been involved with mainstream medicine most of my career I understand that the medical business is about referrals. We need to be on the mainstream team. Until that happens we are in the margins.
This is your website. It represents your opinions and aims to achieve "a deeper exploration of the professional choices we are making." Doing a fine job. I am confident you do not mind if I challenge your opinions with evidence. Sincerely. Maybe you will reconsider your opinions.
I certainly don’t mind the challenges —
1) Increasing #’s seeking the degree is doesn’t tell us much. After all, three new acupuncture schools are opening within 5 miles of my office.
http://www.forbes.com/sites/susanadams/2012/04/27/why-do-so-many-doctors-regret-their-job-choice/
2) I wonder how many MD’s would use acupuncture if, when they did, they weren’t harassed by LAcs. Or would use it if they had time. There is a physician near me who practices, and when an ad for her practice showed up on an acupuncture Facebook group, the screams of outrage from my colleagues were loud and ongoing.
3) Many of us put ourselves on the margins by our disrespectful manner and our arrogance, etc. There are many factors that contribute to our situation, but there are also many LAcs who have excellent working relationships with the establishment.
Nicely done. I find many insights in your list. In particular I strongly endorse #3 – access is arguably the number one problem to be solved, too many LAcs unable to earn a living because of access issues directly tied to insufficient training; #2 – the key to a workers comp practice is the ability to demonstrate equal if not better outcomes to drug based treatments; #5 – the path on which acupuncture finds itself has been traveled by every successful healthcare profession, understanding this is paramount to progress; #13 if you are referring to political battles with “encroaching” professions that use needling therapy, I agree this is a low priority for a profession – acu – with very limited human and $$ resources; #15 # 17 thanks for providing one place for respectful dialogue.
My comments on areas of disagreement include #6: the ability to explain needling therapy in terms of science establishes the common basis for finding our place in the medical mainstream which is where referrals come from; #7 pitting TCM against EBM is divisive; it feeds hubris, wrong lesson; #12 economic success is not a function of “business skills” that are poorly taught in training programs; it is a function of being marginalized in medicine.
“One whose upper and lower ranks have the same desires will be victorious.” Sun Tzu
“Scuze me while I kiss the sky.” Jimi
Have a wonderful turkey day with friends and family.
Steve —
Regarding #5 — I think many of the professions, and certainly the MD’s, are regretting the path they have traveled when it comes to third party payer systems. It is odd that when MD’s are increasingly trying to do everything they can to exit the system, we are trying hard to enter it.
As for #6, we see that MD’s and others are increasingly using acupuncture and referring to LAcs. Also, the mechanism of many western treatments (pharmaceutical and other) is not known. So, as I wrote, it is not necessary.
#7 I’m certainly not pitting one against the other. I’m all for parallel tracks. To insist that TCM be only explained in western scientific terms, as some do, would be pitting one against the other.
#12 – economic success is due to many factors. It’s clear that many acupuncturists are successful, and many are not marginalized. There is great evidence that business skills are not being well taught in schools. I’m sure that wouldn’t solve the whole problem (and I didn’t say it would), but it could be changed.
Happy Thanksgiving!