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             (role down and learn)              

Is acupuncture considered alternative or experimental treatment in the U.S.?

Unaware or misinformed, some people (doctors and not doctors) still mistakenly think of acupuncture only as an alternative, or considered acupuncture an experimental treatment. The truth is that acupuncture is a medically approved procedure recommended by the medical authorities in this country.    

Since 1996, the FDA has approved acupuncture needles as "safe medical device", and the National Institute of Health (NIH) promotes the use of acupuncture for various medical conditions, including low back pain and inflammation, postoperative dental pain, inflammatory diseases, and in nausea due to chemotherapy. Furthermore, the National Institute of Health (NIH)'s Consensus on Acupuncture (1997), states the following:

"While it is often thought that there is substantial research evidence to support conventional medical practice, this is frequently not the case. This does not mean that these treatments are ineffective. The data in support of acupuncture are as strong as those for many accepted Western medical therapies.  

One of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same conditions. As an example, musculoskeletal conditions, such as fibromyalgia, myofacial pain, and tennis elbow, or epicondylitis, are conditions for which acupuncture may be beneficial. These painful conditions are often treated with, among other things, anti-inflammatory medications (aspirin, ibuprofen, etc.) or with steroids injections. Both medical interventions have a potential for deleterious side effects but are still widely used and are considered acceptable treatments. The evidence supporting these therapies is not better than that for acupuncture." (These words are extracted from the official text of the Consensus on Acupuncture by the National Institute of Health of the United States, 1997).

The World Health Organization promotes the use of acupuncture to treat many illnesses. And millions of Americans receive acupuncture treatments every year. The number of people seeking acupuncture and Traditional Chinese Medicine is increasing rapidly. Presently, Oriental Medicine is one of the fields of more rapid growth in health care in the United States.  

Acupuncture may be the most familiar name associated with Traditional Chinese Medicine, however,  traditional Chinese herbal remedies and many other procedures are integral parts of this healing system. Herbal medicine in particular is very well accepted in the West, and even a large number of Western conventional medicine (e.i. aspirin, coumadin, ephedrine, digitalis, vinblastin, taxol, etc.)  directly derivate from herbs or were first discovered in herbs and are now made synthetically or chemically modified.  

While acupuncture and traditional Chinese herbal medicine can offer an alternative to the Western patient, TCM can also enhance the effectiveness of Western medicine when used as integrated treatment to deal with many chronic and difficult diseases. Traditional Chinese Medicine should also be consider as a priority choice "no as an alternative" to resolve illnesses and medical conditions for which conventional medical therapies have shown to be uneffective or for which TCM has been traditionally and clinically proven to be more effective than Western medical treatments.      

When analyzing many aspects like those mentioned above, one can get to the conclusion that Traditional Chinese Medicine or its most known modality "acupuncture", is not experimental. However, as Traditional Chinese Medicine differs from Western medicine in many ways, it brings an alternative to the patients, either by itself or in combination with Western conventional treatments.       

Does acupuncture hurt?  
No, it does not hurt. If the needles are stimulated by hand manipulation vs. electrical stimulation, some times the patient can feel a burning or light sore sensation on the needle spot,  but no pain. Acupuncture does not hurt. On the contrary, acupuncture is used to control pain.   

Are the needles sterilized? 
Yes, the needles are sterilized and labeled disposable (for a single use only).   

Is there medicine in the needles? 
No, there is not medicine in the needles. Acupuncture needles are surgical instruments that acupuncture physicians insert and manipulate in points along the body's meridians (precise anatomical locations in the body) used to induce a particular biological response or to stimulate a physiological function.

Is acupuncture always used when treating a patient with Oriental Medicine? 
No, acupuncture is only one form of therapy among many other procedures that an acupuncturist may use in clinic. Herbal remedies are traditionally used in the forms of infusion, pills, tablets, capsules, intramuscular injections, granules, oral liquids, enemas, suppositories, poultices, plasters, creams, and skin solutions. Other typical TCM procedures are moxibustion, thermotherapy, hydrotherapy, massage, joint manipulations, therapeutic diet, life style counseling, etc.

If the patient has been diagnosed with an incurable illness, can he or she be treated successfully by Traditional Chinese Medicine? Yes, usually the patient has received a diagnosis by Western medicine and if the conventional doctor have said that the illness is incurable, he means that the condition is not treatable successfully with Western medicine. Sometimes better results can be obtained with Traditional Chinese Medicine or with an integrated approach of therapies from both systems.

Why some conventional doctors do not recommend acupuncture and or herbal medicine?  Some doctors of Western medicine do understand the benefits of acupuncture and herbal medicine, and they do refer patients to doctors of Oriental medicine. However it must be understood that conventional doctors, themselves, are also a product of Western culture which for the most part have not been aware of Traditional Chinese Medicine until very recent.

Western doctors have been trained exclusively in Western medicine, and unless they have traveled to China, Japan, Korea, and other countries where the use of Oriental medicine is common, it is then logical that they would be unfamiliar with this healing system. Many Western doctors do not even know that Oriental medicine is a complete medical system with Universities, hospitals, clinics, and scientific research centers. I believe that this lack of knowledge plays a big role and is a major factor on why some conventional doctors still provide incorrect information about Traditional Chinese Medicine and its benefits to the patients.

Even though when acupuncture is recommended by the World Health Organization (WHO) and the National Institute of Health (NIH) in the United States, and Institutions such as HarvardMedicalSchool, many Western doctors still do not recommend it, or what is worse, some of them mislead their patients about the possible benefit of receiving this medical procedure.

These are facts that lead me to believe that they do not understand the benefits of acupuncture, and they are also unaware of the possible legal consequences that may imply misleading a patient about obtaining potential benefits from a legitimate medical procedure such as acupuncture.

I believe that physicians of Western medicine  are good, honest, and dedicated professionals. Some of them simply do not have the pertaining information for a proper referral to acupuncture and Oriental Medicine. 

Do health insurance companies pay for acupuncture? 
Yes, most health insurance plans with free access (PPO), and accident insurance programs such as PIP, liability, and some worker's comp., would cover medical examinations and acupuncture treatment by a licensed acupuncturist. Health insurance coverage for acupuncture varies according to State Laws, insurance company, and type of policy.

My health insurance pays for acupuncture, but the agent says that only if it is provided by a doctor of Western Medicine. Is that true? 
Insurance coverage for acupuncture varies according to State laws, insurance company, and type of policy or group policy.

In Florida, under Florida State law, it is illegal to deny payment for acupuncture to an acupuncturist, if the insurer would pay for acupuncture by another health care provider (Law Reference: Florida Statute 627.6403). Bear in mind that the insurance agent, adjuster, or representative, may not be familiar with Florida law on acupuncture and Oriental Medicine. Therefore, your explanation on this respect may be necessary.

If there is no insurance coverage for acupuncture, what is the usual fee to visit an acupuncturist?  
The cost varies among acupuncturists, but usually it is in line with other health care providers. The fee is slightly higher for the initial visit than for the follow ups.

How can I know if a physician is qualified to perform acupuncture? 
In the United States, the practice of medicine is strictly regulated by State Law. In Florida, the practice of Oriental Medicine is regulated under Florida Statute Chapter 457. 

In the same manner that a cardiologist is the best choice to treat heart diseases, a licensed acupuncturist is the most qualified person to perform acupuncture procedures. It is recommendable to verify if the provider is licensed by the State Board of Acupuncture (Florida Satutes Chapter 457). Florida law also strictly prohibits the identification as acupuncturist or doctor of Oriental Medicine (DOM or OMD), or any other professional title denoting the use of acupuncture and Oriental Medicine, unless the practitioner is a licensed acupuncture physician (Florida Chapter 457). 

Are there specialists within Oriental Medicine? 
An acupuncture physician is a licensed primary health care provider and usually performs general practice in Traditional Chinese Medicine. However, there are several post graduate courses in different specialties and a practitioner may specialized or have experience in treating a determined condition (if you have any question regarding the specialized knowledge, area of practice, an experience of your provider, do no hesitate to ask).

I have a prescribed medical treatment with herbal medicine, but my conventional doctor told me to discontinue herbal medicine.  What should I do? 
Excluding in emergency cases, changing or withdrawing medications (including Chinese herbal medicines) without first knowing the patient's medical history and or the purpose of the treatment, may be detrimental to the patient's health and should never take place without consulting with the patient's health care provider that prescribed the treatment.

Therefore under normal circumstances, a Western conventional doctor should not unilaterally alter the patient's prescribed treatment with traditional Chinese medicine. Ethical conduct as well as professional communication are very important, specially if the doctor of Oriental Medicine is the patient's primary care provider, and when the doctor of Western Medicine is not familiar with the prescribed treatment (this must also apply vise verse). The doctor may not be fully aware of the risks (medical as well as legal). Therefore, the patient should always inform the doctor of Western Medicine if he or she is undergoing treatment with Traditional Chinese Medicine, as well as the purpose of the treatment and whether the doctor of Oriental Medicine is his or her primary health care provider.  It is wise to establish professional communication when the patient is receiving treatment from multiple providers (a common trend in today's health care). Therefore, unless the patient is unconcious, the patient should always inform his providers of any herbal medicine he or she is taking, and encourage communication before discontinuing a treatment or beginning a new one. This rule is even more relevant in today's world, where international traveling is frequent. I know of cases in which the patient has been placed in danger; essential medications (especially prescribed herbal remedies) have been disregarded because the attending physicians is unfamiliar with it or simply thinking that those remedies are inappropriate. Many people in this world use herbal based remedies that are essential or vital for their health. 

Can I receive acupuncture in a hospital? 
As Traditional Chinese Medicine becomes more and more common in the United States, some hospitals are beginning to have licensed acupuncturists listed in their staff. However, the majority of hospitals still do not have acupuncture providers.

Usually, when a hospitalized patient wants acupuncture, he or she must request it from a licensed acupuncturist who in turn has to properly inform the patient's attending physician and the hospital.

The acupuncturist should inform the patient's attending physician about the patient's requested acupuncture service and the nature of the procedure(s) and purpose of therapy, as well as post treatment results and progress. 

When treating a patient at a hospital, my office first submits a request signed by the patient or the patient's guardian plus all the pertaining information to the patient's attending physician at the hospital. The process is relatively easy and quick when the acupuncture provider, the attending physician, and the hospital's administrative staff are familiar with the procedures. However, it may turn difficult if the acupuncturist (as a consulting provider), the attending physician, and or the hospital's directives are not familiar with the process. It must also be understood that for the most part, the denial is based on concern for potential lawsuits. Therefore, the acupuncture provider must also show verification of carrying malpractice insurance.

In Florida, the patient's access to medical treatments of his or her choice (including alternative and or integrative treatments) is intended by law. Ref.: Florida Statute 381.026 (d) (3) "Patient's Bill of Rights" and Florida Statute 456.41 "Complementary and Alternative Health Care Treatments".

If the patient is hospitalized and unable to travel to the acupuncturist's clinic, then he or she may be able to receive acupuncture treatment at the hospital, should proper communication take place. My experience in most cases, is that after proper communication has taken place and the nature and purpose of the acupuncture treatment has been informed and any other question clarified, the patient's access to acupuncture is allowed without objection. However, sometime receiving acupuncture treatment while still in the hospital can turn to be an impossible dream.  

Up to what I know, unfortunately so far there are no TCM hospitals in the United States. And while some known hospitals have started departments or programs of so called "alternative medicine" or "integrative medicine", so far, there is not a fully integrated medicine hospital in the United States.

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