“The origin of Acupuncture and Moxibustion as a written down subset of the many therapeutic techniques appeared about 4,000 years ago by Fu Xi’s creation of stone needles. Fu Xi and the Yellow Emperor (Huang Di) actually were the more modern representatives of the clan commune of China’s primitive society. Activities in China first appeared about 1.7 million years ago, while clan commune activities appeared about 100,000, years ago.”
Biophysical modalities affecting the acupuncture points, the channels/meridians, tissues, extra cellular fluids and the organs have always been varied. These in part have included the use of needles but certainly have never been limited to them. This group of modalities consists of but not limited to:
What has occurred over the ages regarding Acupuncture/Oriental Medicine is its continuous evolution and the realization of the ever more encompassing truths to its philosophical roots.
Proof of this evolving nature to Acupuncture/Oriental Medicine is the appearance of a synergistically merged set of non-needle Acupuncture therapies called BA GUA FA (use of both fascia friction and suction cupping). “The history in more modern times of Acupuncture/Oriental Medicine followed the Opium War in 1840, which the Revolution of 1911 ended the rule of the Qing Dynasty. This is when western allopathic medicine was first introduced into China. The Chinese government for a while denounced and defamed, it’s traditional medicine until they realized that their people’s health care needs could not be met with allopathic medications due to the costs. In 1950, Chairman Mao Zedong adopted an important policy to unite doctors of both western and traditional oriental medicine in school settings. Since that time much work has been done in China and around the world in research and attempting to sort out the ancient legacy.”
The major perspective systems in which to draw symptom and pattern diagnostics and apply any number of the varied biophysical modalities of acupuncture are:
These systems are based upon the philosophical beliefs, theories and understanding of the human being, the internal relationships of the organo-systems and tissues and their relationship to the environment. Acupuncture points and channels/meridians are the entry into the body and the varied biophysical modalities are the ways to create an effect through them. The use of acupuncture needles and moxibustion are but only two of the many biophysical modalities. In the reality of ‘Acupuncture’ there are other non-needle bodywork modalities that for many maladies, illness and injury are much superior to the use of acupuncture needles. These non-needle modalities cannot be separated from the umbrella concept of ‘Acupuncture’ in it’s fullest of meanings.
Terminology is of critical importance to accurately communicate. Adopting or attempting to force the concept of Acupuncture into medical language prevents correct analysis because the underlying belief systems embodied in western and oriental medicine are completely different.
The term ‘Acupuncture’, as it is used by medical acupuncturists, is misunderstood. For example, ‘acupuncture’ with the small ‘a’ has been mistaken for ‘Acupuncture’ with the capital ‘A’. The small ‘a’ acupuncture pertains to the application of needles while the capital ‘A’ pertains to the entire system of modalities underlying oriental medicine as applied to acupuncture points and/or channels. The use of acupuncture needles is the outermost and most invasive form of ‘Acupuncture’. A well-trained Licensed Acupuncturist uses whichever modality within the group that is most appropriate for the patient but not limited to needles.
It is interesting to note that ‘acupuncture’ with the small ‘a’ spread to the United States and became popular during the 1970’s. Unfortunately, the full meaning of ‘Acupuncture’ with the capital ‘A’, in the United States, was limited to needles. Many of the inclusive modalities within ‘Acupuncture’ such as ‘bodywork’ modalities (TuiNa, GuaSha, NiuSha, BaGuan, Amma, AnMo and now BaGuaFa) went unnoticed under the therapy called ‘Massage’.
A limited number of allopathic physicians have received cursory training in acupuncture. These MDs call themselves ‘medical acupuncturists’. Their following definition describes their understanding of acupuncture:
“Acupuncture is a method of encouraging the body to promote natural healing and to improve functioning. This is done by inserting needles and applying heat or electrical stimulation at very precise acupuncture points.” (This definition creates artificial subsets of Acupuncture by implying a specific limitation to the application of needles and needle stimulation.)
The World Health Organization recommends that Medical Doctors receive training in acupuncture equal to a non-MD acupuncturist, prior to treating patients. The W.H.O. further recommends a minimum of 1,500 hours of didactic and clinical training coupled with successfully passing a national standard test. Medical acupuncturists sometimes have less than 300 hours of training.
Except for these CME trained medical acupuncturists, ‘Acupuncture’ competency in the United States is tested by the National Certification Commission of Acupuncture and Oriental Medicine (NCCAOM) and prior to sitting for their comprehensive exam an applicant must have successfully completed a minimum of didactic and clinical training equal to 1,725 hours which is primarily ‘Acupuncture’ theories and practices.
This educational standard is intending to upgrade to 4,000-hours of didactic and clinical education. The degree and title, ‘Doctor of Oriental Medicine,’ is planned for those that pass competency tests based on this training. Increased modules will be part of this educational track in order to fully integrate Acupuncture/Oriental medicine along side Western medicine treatment.
One might ask – but isn’t it true that ‘Acupuncture’ with the small ‘a’ (needles) is what the majority of Licensed Acupuncturists use? The response would be in the affirmative with several clarifications:
These standards along with the approval of ABCcodes as a National Standard Code-set should be implemented as soon as possible.
Many federal programs already reimburse for ‘Acupuncture’ services with the small ‘a’ when administered by Medical Doctors (while these same programs deny payment to more highly qualified Acupuncturists). MDs are billing for services using conventional evaluation and management coding and that data is getting lost and is not accurate. Insurance carriers, and many self-insured operations discriminate against Licensed Acupuncturists in large part because of a lack of coding. We ask that NCVHS solve these unfair practices by naming ABCcode as a National Standard code set to enable members of the Acupuncture profession to be able to legally bill for their services. Without ABCcodes, we either must use inappropriate CPT codes putting us at risk of fraud or not collect fees for our services. We doubt that this was the intent of Congress in passing HIPAA legislation.
We would like to thank NVCHS in advance for their attention to this important public healthcare issue.
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