The Nightingale Center

How to Choose an Acupuncturist

Acupuncture involves the insertion of very thin sterile, stainless steel needles into points on the surface of the body to a dept just below the surface of the skin. Acupuncturists are most often sought for treatment of pain, fatigue and as an adjunct to traditional medical treatments. Most acupuncturists use disposable needles. For some people the insertion is hardly noticeable, for others there is a small pinch, sometimes followed by a sensation of numbness, tingling, warmth heaviness or relaxation. There is a fast growing body of research supporting the benefits of acupuncture and Chinese medicine.

There are an estimated nine to twelve million patient visits per year to acupuncturists in the United States alone. Most of these are for treatment of pain symptoms after patients have found unsatisfactory results form Western medicine. There are between nine and ten thousand practitioners of acupuncture, including about three thousand physicians who have received training in continuing education programs through American medical schools.

Chinese medicine includes acupunctures, herbal medicine and a philosophy of the body as a whole. Where most Western medicine is practiced as though the person could be reduced to parts (i.e., Internists, Podiatrists, ENTs, Hematologist, etc.) or with a focus on illness (Oncologist, Rumitologist, etc.) Chinese medicine embraces a philosophy that the patient has a flow of energy (called chi) through meridians (unseen lines along the body). If this energy is flowing freely and balanced, then the body automatically heals itself. If this energy is blocked or out of balance then physical, emotional and other health problems will arise.

This philosophy is strange to us in the West, so choosing an acupuncturist can be a confusing if not an outright intimidating task. Even without completely understanding the philosophy behind this 3000 year old art there are important things to know in choosing an acupuncturist.

There are 35 schools of Chinese medicine in the United States with programs lasting between 3-4 years. 23 states restrict the practice of acupuncture to physicians only, while the other states have regulations for non-physicians.

Traditional Chinese Medicine (TCM) is the most common type of Chinese medicine taught and practiced in the United States. It is based on eight principles that are actually pairs of opposites that describe patterns of disharmony in a patient to be treated. TCM places a heavy emphasis on herbal medicine, which is supplemented by acupuncture.

There is also Five Element Acupuncture that is the longest established form of Chinese medicine in the United States. This philosophy states that acupuncture (without herbs) is a complete medical system in itself. In this medical tradition the life energy (chi) is seen as influenced by a sequence of elements, which support each other, and organ systems are thought to correspond to these elements. Promoting harmony in the function of all the organ networks is the desired outcome.

Medical Acupuncture performed only by physicians (MDs and DOs) has an emphasis on the neurophysiologic and bioelectric terms used by Western physicians. Much research is coming out of this tradition to explain the function of acupuncture in the physical and statistical terms of our Western culture.

Many practitioners of acupuncture were trained in their native countries and bring with them the unique herbs, philosophies and traditions of their regions. The limited English of some practitioners can leave some patients feeling uneasy about their treatment and they worry about being understood. This is a personal consideration. In many forms of Chinese Medicine the relationship between patient and practitioner is seen to be an important element of healing.

Japanese Acupuncture does not include herbal remedies and uses thinner needles. There is an emphasis on the practitioner's diagnostic skills and the mildest intervention possible is the ideal. Auricular acupuncture treats acupuncture points on the ears exclusively. It is popular for pain control and to assist from drug and alcohol addiction and eating disorders.

Along with the insertion of tiny needles into specific acupuncture points and the recommending of certain herbs, many acupuncturists use Moxibustion (the burning of mugwort herb) on an acupuncture point. It is applied as a fluffy wool-like material and rolled up to about the size of a pea, placed on the point and then lit, usually with incense. It is removed in just a few seconds when the patient is able to feel the warmth. This process is much older than the use of needles and considered by some superior to all other treatments. Massage is also incorporated by many acupuncturists.

Some acupuncturist stay with patients during treatment, others leave a patient resting while the needles stimulate the acupuncture points. Most patients find this part of treatment very relaxing and soothing. During the time when patients are resting with needles in place, many acupuncturists use heat lamps to further the action of the needles, and relax the muscles of the patient. Most people find this a very relaxing and rejuvenating time.

Most acupuncturist consider themselves Eclectic and draw from several of these traditions. If one or more of these traditions sound interesting to you make sure you bring them up when interviewing an acupuncturists. As with any professional, an acupuncturist works for you and should have a good understanding of your likes, dislikes, goals, medical conditions and any concerns you may have. Having an understanding of the basic concepts can give you ideas for questions you may have for a practitioner you are considering.

In California acupuncturists must be licensed to practice.

Some questions to ask

1. Does the practitioner have a current license? (You might want to ask about continuing education to expand knowledge and keep up with current findings).
2. Has he/she passed the National Commission for Certification of Acupuncturists (NCCA) exam? The NCCA conducts a certification exam with both written and practical portions, including clean needle techniques. Practitioners who are certified are designated "Diplomate in Acupuncture" or Dipl.Ac, and are listed in the annual Directory of National Board Certified Acupuncturists.
3. Does he/she belong to the American Association of Acupuncture and Oriental Medicine (AAAOM)? This is the largest membership organization for practitioners with over 1600 members. A member must have achieved diplomate status with the NCCA or is licensed by a state using equivalent criteria.
4. Did he/she graduate from a program accredited by The National Accreditation Commission for Schools and Colleges and Oriental Medicine (NACSCAOM)?
5. How many years has she/he been in practice?
6. Is he/she active in any of the organizations in their field?
7. Has he/she done any internships/trainings in traditional Oriental settings (China, Japan, Hong Kong, Taiwan, etc.) Training abroad can be intensive and create a broad base of techniques and knowledge to draw from.
8. Does he/she use disposable needles?
9. Is there an OCEA approved waste container for these needles?
10. Does he/she wash hands between each patient?
11. Does he/she change the linen/paper on the table between each patient?
12. Does the office setting look professional and instill an overall sense of competency and pride in his/her work?
13. Has he/she written any professional articles you might read to get a better understanding of philosophy and focus of treatment?
14. Is any part of treatment covered by your insurance carrier? Are there referrals you might be able to get that would insure third party coverage?
15. Does he she have experience treating someone with your ailment? How many patients with this disorder have been treated, with what outcomes?
16. Does he/she have any testimonials from satisfied patients?
17. Does he/she have any specialties?
18. Does he/she make you feel understood and comfortable?
19. Are you comfortable with his/her style, energy and professionalism?
20. Do you have confidence in him/her?
21. What do other people tell you about his/her work?
22. Does he/she take the time to answer your questions, and make you feel cared about?

As with choosing any health care provider, use your intuition and ask the important questions. If at any time during treatment you feel uncomfortable or have new questions, don't hesitate to bring them up. A caring practitioner will want to know how you are feeling and if you have any concerns. Remember they went into this field to be of service to you.