Acupuncture: A Clinical Review

Victor S. Sierpina, MD; Moshe A. Frenkel, MD

Disclosures

South Med J. 2005;98(3):330-337. 

In This Article

The Practitioner and Training

There are approximately 17,000 acupuncturists in the United States, with most having been trained as Oriental Medical Doctors, Doctors of Oriental Medicine, or Licensed Acupuncturists. The National Certification Commission of Acupuncture and Oriental Medicine (NCCAOM) maintains a database of 13,000 practitioners distributed in every state in the United States who have completed their certification process (http://www.nccaom.com).[26] Training here and abroad is usually a 3- to 4-year process, including all aspects of TCM, which includes not only acupuncture but also herbalism, massage, dietary therapy, and exercise programs such as tai chi and qi gong. The herbalism aspect of these programs is intense, since TCM formulas are often a mixture of 9 to 12 herbs and other substances meant to balance the system in a complex way. Most schools provide 500 hours or more of Western medical science focusing primarily on identifying conditions, which need referral to a medical doctor, for example, myocardial infarction, cancer, or significant weight loss. They also teach familiarity with biomedical terminology, the referral and consultation process, and the diagnostic and therapeutic tools of Western physicians.

Physicians may elect a different pathway of acupuncture training. Although weekend courses and CMEs may offer some limited training for physicians, the most long-established course is that offered by the University of California at Los Angeles and the Helms Institute, which includes approximately 300 hours of training in medical acupuncture. Nearly 4,000 physicians in the United States have been trained as acupuncturists, and more courses are now available. Because of their medical background, courses designed for these MD or DO physicians are abbreviated from the lengthy TCM training. These medical acupuncture courses do not include learning or prescribing the extensive pharmacopoeia of Chinese medicine. The training is scheduled to accommodate the practicing physician's needs with an initial introductory weekend, several months of review of books and training videotapes, and a 10-day, intensive seminar on point location and therapeutics. This training is typically aimed at primary care physicians, anesthesiologists, and pain management specialists and is considered adequate by the majority of state medical boards. Despite its shorter period of training compared with other schools of acupuncture, medical practitioners with this degree of training are quite competent to perform safe and effective acupuncture for most indications. Physicians practice acupuncture under the scope of their medical license. They should inform their insurance carrier that they perform acupuncture, though this does not generally involve any change in risk and rate of insurance. The American Academy of Medical Acupuncture (AAMA) is the professional association that supports physicians doing medical acupuncture with CME, research, publications, and lobbying, as some nonphysician acupuncture organizations seek to limit the extent of practice of physicians trained in acupuncture. They also provide a list of physician acupuncturists by region, which is available at (www.medicalacupuncture.org),[19] along with pertinent rules and regulations and training information. This organization also sponsors a national certifying board examination for physician acupuncturists.

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