I am writing to applaud an article you published by John Scott, DOM, called "What Are We Doing Anyway?" in the July 2006 issue of Acupuncture Today.
Dr. Scott's summary of where our current American health care system developed from is enlightening. Out-lining the multiple advances in medical technology and the direct result of rising costs to individuals is very important in understanding how our dependence on managed care has grown. We are a society that depends heavily on our managed care systems, so much so that many people live in terror of losing their health benefits. It is important for complementary providers to understand the "other half" of our patient's health care needs, since it informs their decisions regarding complementary care.
The "where are we going?" of Dr. Scott's article, I think, is how we can integrate acupuncture and Chinese medicine into regular medical care: using acupuncture for pain, nausea, hormonal balancing, and so on, in the low-cost setting that has developed in our country, namely, managed care clinics and hospitals. Part of our mandate as practitioners is to work with doctors and nurses to show how effective and cost-effective acupuncture can be; to dispel misconceptions of AOM as voodoo medicine; and to continue presenting ideas about how to work together for the best and most cost-effective health care answers for all Americans.
As a student, I worked in hospitals and clinics in the Seattle area and saw the excellent effects that were brought to populations normally denied treatment: immigrant, low-income and other special-need groups. Now that I am in private practice, it is frustrating to see only a slice of the local population who could be helped by acupuncture.
Dr. Scott's discussion of the stagnation of new acupuncturists entering practice was accurate and insightful. Students come out of school with debt similar to medical students, but there are no internships available, no debt forgiveness for working with underserved populations, almost no opportunities to join a thriving clinic. It is a tremendous leap to take, and Dr. Scott is correct in pointing out that many do not make it.
Bringing acupuncture and Chinese medicine into the same stream of care as conventional medicine is probably not every acupuncturist's goal. Many practitioners are very independent and do not want to communicate with MDs and RNs. What each of us needs to see, I think, is that there can be many types of practice: the spa-like setting, the multi-bed clinic, the hospital rotation. This multi-pronged approach occurs in China, England and Germany, and should be where America is headed. Providing the opportunity for many types of practice is the answer to the issues of practitioner attrition and service to all sectors of the population.
It is my great hope that individual practitioners, schools, and state and national AOM organizations all focus on moving our profession forward through personal discussions with conventional providers, creating internship programs at hospitals, and innovative participation in current health care systems. It is time for us to grow as a profession, not shrink back into the fringe when our medicine is criticized by those who feel threatened by our work.
Marian S. Hughes, LAc Petaluma, Calif.
I would like to respond to the article in the July 2006 issue by John Scott, DOM. The risk of becoming Medicare providers, as the Hinchey bill alludes to, would be economically disastrous for those of us who practice acupuncture. We would get paid poorly, and not in a timely fashion, and put ourselves subject to great fines and penalties for inadvertently treating a Medicare patient (as this is the way it is for DCs). Professionally, we do not need to be part of an already flawed medical system.
Instead, the states need to get their laws to mandate that "acupuncture must be covered by insurance" and get their practice acts in order to take this to their state legislators and change the laws.
The Hinchey bill will not help acupuncture providers. The turnover time, and little remittance and the potential for the inadvertent liability, is not a good economic decision. I do not support the Hinchey bill and have urged my state legislators not to support this bill.
Patricia McKay, DOM Albuquerque, N.M.
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