Over the last few years theres been a considerable upsurge in Acupuncture awareness. It seems to be everywhere: Acupuncture for anxiety, acupuncture for insomnia, acupuncture for immunity, acupuncture for fertility! This is fabulous. Its really very exciting that Acupuncture has started to become much more mainstream in consideration for so many aspects of health, because thats really what its all about: better benefit and recovery for every health condition, more accessible for everyone.
However, one rising issue that has also occurred with this awareness and popularity is the unfortunate and confusing – some might say unethical – promotion of Acupuncture as a service by those who aren’t actually trained or registered to provide it. The practice of Acupuncture for any of these conditions above is restricted – according to AHPRA (the Australian Health Professionals Regulation Association) to those who are actually licensed – and Registered – as Acupuncturists.
This, unfortunately, has not stopped any number of practitioners who are not Acupuncturists from doing advertising and attempting to practice it.
Why not, and how, you ask?
Unfortunately, unlike every other registered profession, such as Nursing, Psychology, Physiotherapy, Chiropractic, etc – AHPRA have decided that the title of Acupuncturist is restricted, but not the use of the word Acupuncture. Confusing, yes? (Don’t ask me, I don’t get it either.) This loophole, unfortunately, creates a great deal of confusion, and also places a certain amount of pressure and expectation on the general public to do the research themselves to discover what level of training, and in particular, what is the reasonable expectation, for a practitioner to be registered and/ or practising Acupuncture.
In the current situation, someone not registered as an Acupuncturist can advertise acupuncture – the practice of needles in skin for therapeutic effect – with a weekend course of training – but they cant advertise Chiropractic, or Physiotherapy, or whatever else, because the use of the related word is considered to be ‘holding out’ to be a qualified practitioner in that practice. Which is fair enough.
You have a right to assume that someone using the associated word, be that advertising materials or facebook or whatever, has actual training in that modality.
But its not currently the case with Acupuncture.
And while you can probably easily identify your mechanic advertising Acupuncture as being a little odd, its a little more difficult when someone is actually a health practitioner in another modality, say, for example, physiotherapy. Because you, as a member of the general public, have an absolutely reasonable right to assume that the person putting needles in you has full training in that practice. Acupuncturists have to go to university for 4-5 years at Undergraduate level and often do additional post graduate qualifications, as well as our required professional development – in Acupuncture. We do many hours training every year to keep our skill base up to date. We are specialists in Acupuncture and needling, whatever form it may take. Ive explained it here previously.
While its a great thing that so many other practitioners are interested and learning the potential benefits of Acupuncture, its very concerning to Acupuncturists (those trained, registered professionals in needling) that there appears to be so little concern regarding what may or may not be appropriate for treatment by them, as practitioners in another field, without this specialised training. Would you consider surgical procedures from someone with ‘an interest’ who then did a short course in it? I hope not.
Passionate and interested in something? Great. Show the world how passionate you are – get qualified.
And although it would be wonderful for many more people to know, for example, that Colon/ Large Intestine 4 (that point everyone knows between your thumb and forefinger) is great for colds and flu, headaches and pain, or that Pericardium 6 suppresses the Vagus nerve and does wonders for nausea, there is also the issue that Spleen 6 – low down on your calf muscle – dilates the cervix and is contraindicated for pregnancy, or that Gall bladder 21 (that big painful one up in your shoulders) stimulates oxytocin and stimulates birth. Other points are contraindicated in high blood pressure and should be avoided. (The list goes on.) I really don’t know if I should have to suggest that if a practitioner doesn’t know which points do what, where and when they are inappropriate – then perhaps they shouldn’t be needling, or perhaps they need to consider referring on to a trained specialist, as they would for other conditions. In this situation, that means an Acupuncturist.
Acupuncture points affect more than just the muscle being activated – they stimulate hormones, modulate brain activity, and regulate circadian rhythm, among other things. Acupuncture has been listed as the most holistic and comprehensive modality, recommended by the World Health Organisation for treatment of everything from musculoskeletal and neurological disorders to mental health conditions (see here for a complete listing) and it has that effectiveness through a broad and complex range of physiological and biochemical interactions, and a body of knowledge with is both broad and deep.
One of the many reasons Acupuncture is such a long and challenging degree is because, like all medical techniques, there is a time and place when anything may be fantastic and do wonders – and a time and place for other, equally wonderful techniques and tools. Different techniques are appropriate at different times for different people, with different conditions and requirements for care. Your doctor won’t randomly prescribe warfarin for a person with a bleeding disorder. We as Acupuncturists don’t just randomly put pins in you either. The reason we ask all those questions about health and sleep and energy (and on and on) aren’t just for fun. They’re for accurate diagnosis to get the best and most accurate treatment for you. We select them based on constitution, condition, and however other many mitigating factors there may be. Acupuncture is a complex, holistic and precise medicine with a systematic approach to health and healing, based on specific diagnosis and clinical expertise.
Like every other Acupuncturist, I’m deeply disturbed by stories of people needled through their jeans weekly for six months without results, or the stories I have heard of ‘anxiety/ fertility/ facial and cosmetic dry needling’. Because those practices, the skills and the evidence, don’t exist outside of Acupuncture, and are highly unlikely to get positive results. Claims for dry needling are restricted to musculoskeletal conditions only – although you are still better off seeing an Acupuncturist for anything involving needles, for obvious reasons. Its also considered fraud by health fund providers, as well as practising outside of Scope of Practice as defined by governing association bodies, for those who are not registered as Acupuncturists.
I’m concerned because these practices are profoundly damaging to Acupuncture, as a practice and profession, but also for another reason: I personally consider this to be past simply the legal aspects of fraud or scope of practice – which are troubling enough – its actually an issue with that other term we all get hammered with in training, which is Duty of Care.
As a Health Professional, I have Duty of Care – legally and ethically – to refer on for something not in my scope of practice or best capacity to treat. Whether that be directing someone back to their GP, to another therapist for something more specific, or to a specialist for clarification on an issue, I am responsible for doing the best I possibly can to ensure my clients recovery and best health. All health professionals are held to this standard.
I’m a long way from being convinced that someone who has completed a weekend course and then read a few acupuncture books or watched youtube videos* is the best practitioner available to do ‘acupuncture’ on a patient. Period. And even further from treating fertility, anxiety, immunity, or insomnia, because these are issues which are complex, comprehensive, and unique to Chinese medical diagnoses and require a specific understanding and training to be effective. This has actually been shown to be the case with musculoskeletal conditions as well.
And in case you were wondering, is this training available for other practitioners to upskill and learn Acupuncture properly? Yes, it is. RMIT University have a Masters in Acupuncture available exclusively for health practitioners: its full of GP’s, Osteopaths, Chiropractors, Nurses, Physiotherapists and Paramedics who have made the considerable investment of time and money to learn Acupuncture comprehensively and well. Its been going since the early nineties – so no excuses. (Congratulations and shout out to my fellow post grads at RMIT! 🙂 )
Here in Australia you are actually very fortunate as its easy to be sure the person sticking needles into you has more than a short course of ‘training’: you can simply go on the AHPRA site here and check, or look for the title of Acupuncturist – before you let someone put needles in you. Had a bad experience or misled witht his issues? Get in touch with AHPRA here – its what theyre here for, to protect you!
*This is if you’re a very lucky patient – this is the most training they can do. As non-Acupuncturist’s they cant go to Acupuncture seminars, which are restricted to registered Acupuncturists.