Category Archives: acupuncture
Here’s an article from Apple News outlining the superior efficacy of acupuncture over morphine carried out in 300 emergency departments. This adds to the building evidence supporting the efficacy of acupuncture in the treatment of acute and chronic pain.
“Many people are quick to dismiss the power of alternative therapies to cure pain and suffering, as is the case with acupuncture. But with science now saying otherwise, people may have to reevaluate their opinions.
An excellent case in point is a new study published in the American Journal of Emergency Medicine. The study, which was published in July of this year, compared acupuncture against morphine in the management of acute pain.
Researchers randomly selected 300 emergency departments and split them into two even groups. The first group was subjected to acupuncture in order to treat their acute pain, while the second group was given morphine.
The results were even better than researchers imagined. Patients who were treated with acupuncture experienced a whopping 92 percent reduction in their pain, while the morphine group experienced a 78 percent reduction. Not only that, the acupuncture group had a much faster pain recovery time. While the morphine group took an average of 28 minutes to recover from their pain, the acupuncture group recovered from their pain in an average of 16 minutes.
So, the alternative treatment was both more effective in reducing pain and faster. So what’s the catch? There doesn’t appear to be one! Not only did acupuncture blow the conventional medical treatment out of the water on those fronts, it also had fewer drawbacks. Of the one in three patients who experienced adverse side effects from the treatment, 57 percent of these were in the morphine group and just 2.6 percent were in the acupuncture group.
The study went on to suggest that acupuncture “should be considered, especially in today’s increasingly complicated and polymedicated patients, to avoid adverse drug reactions.” Let’s dig a little deeper and find out whether acupuncture really is the better choice for pain treatment in hospitals and ERs.
Morphine and common side effects
M￼orphine is an opioid (meaning opiate-based) medication used to treat moderate to severe pain. If you’ve ever had to go into the hospital for surgery, chances are you were placed on a strong dose of morphine post-op. After getting my tonsils out when I was 19, I was eased back into the world of the living with a blast of morphine, which left me feeling pretty whacky but largely devoid of pain.
While morphine is undoubtedly effective in alleviating pain, it’s potentially lethal side effects make it a very dangerous drug indeed. In 2014, more than 28,000 Americans died from opioid overdose, with 14,000 of those deaths involving prescription opioids. According to the California Department of Public Health, prescription opioids like morphine were only prescribed for relieving acute pain. Today, however, they’re increasingly being used to treat chronic pain, such as back pain or osteoarthritis. Aside from the addictive nature of morphine, this is putting many people at risk.
The United Kingdom is no better. This article is one of many which highlights the unprecedented number of deaths associated with morphine overdose or side effects under expert supervision in hospitals. The article indicated that three elderly patients in a Portsmouth hospital were killed due to a prescription of lethal doses of morphine, while two other patients in the same hospital died after being administered “suitable” doses of the drug.
More common side effects
When you look at the statistics around morphine, none of this should come as any real surprise. Side effects associated with this opiate are staggering. They are so numerous that I’ll only list a small fraction to give you some idea of just how risky morphine is:
Bulging soft spot on the head of an infant (I didn’t even know it was legal to prescribe morphine to babies!)
Loss of color in vision
Pounding in the ears
Swelling of the eyelids, lips and tongue
Shortness of breath
Sweating or chills
Loss of consciousness
Unusual bleeding or bruising
Wow. I for one will never be using morphine again. With such a horrifying list of potential side effects (and that’s certainly not all of them!), I almost think it’d be better to deal with the pain than put that into your body.
What is acupuncture?
Acupuncture is a popular traditional Chinese medicine where thin needles are lightly inserted into the surface of the skin. While it has probably been around for far longer, the first documented utilization of acupuncture dates back to around 100 BCE in ancient China.
Today, acupuncture is receiving something of a revival in the Western world. While many Asian cultures have consistently used acupuncture throughout the past 2,000 or more years, acupuncture was quickly pushed aside in Western cultures with the rise of modern medicine. People began to cast off such traditional treatments in favor of “more effective” aggressively-endorsed medical drugs.
But with an increasing body of evidence showing the dangers and drawbacks of using prescription drugs to treat anything from back pain to migraine headaches, many people are beginning to see the merit in less invasive traditional methods. Acupuncture is now commonly sought out for pain relief, lower back pain, shoulder stiffness and knee problems. Some American physicians prescribe acupuncture treatment in conjunction with conventional medical treatments for improved recovery.
How acupuncture works
T￼heories as to how acupuncture actually works vary considerably. One major school of thought is that acupuncture operates via neurohormonal pathways. Needles are placed on specific points of the body in order to stimulate certain nerves. These nerves send signals to the brain, which then releases neural hormones such as beta-endorphins. This contributes to feelings of happiness and alleviation of stress, which reduces the pain a patient is feeling.
Another hypothesis is that acupuncture reduces pro-inflammatory markers in the body. Certain studies suggest that acupuncture results in a significant reduction in pro-inflammatory proteins in the body, which decreases inflammation and alleviates pain.
Whatever the reason, the potential side effects of acupuncture are considerably less scary than those of morphine. Listed “side effects” of acupuncture are limited to:
Some people may experience soreness after acupuncture for the first time, but that soreness is from most accounts almost unnoticeable. Both organ injury and infection can occur if the acupuncture practitioner pushes in the needles too deep or doesn’t use new needles each time, respectively. But because the acupuncture practitioners in the United States are closely monitored, this is unlikely to happen.
More acupuncture studies
Aside from the study referenced earlier in this article, there is a huge range of scientific literature validating the claims that acupuncture can alleviate pain. Here are just a few passages from those studies, chosen at random:
“Acupuncture has an intrinsic analgesic (pain relieving) effect in the clinical treatment of tennis elbow pain.” – Journal of Rheumatology, 1993
“Several Cochrane reviews of acupuncture for a wide range of pain conditions have recently been published. All of these reviews were of high quality. Their results suggest that acupuncture is effective for some but not all types of pain.” – Chinese Journal of Integrative Medicine, 2011
“Acupuncture was superior to conventional physical therapy (with regards to chronic back and neck pain).” – Acupuncture and Electro-Therapeutics Research, 1978
“Acupuncture is effective for the treatment of chronic pain and is, therefore, a reasonable referral option.” – Archives of Internal Medicine, 2012
As with everything, keep an open mind and why not give it a go? You might be surprised by the results!
— Liivi HessStruggling with weight problems? Find out why acupuncture might just be that miracle you’ve been hoping for!”
Acupuncture is an effective low impact therapy that accesses self healing aspects of the bodies neurohormonal system.
Due to increased research in recent years acupuncture has an evidence base greater than many conventional medical treatments.
The efficacy of acupuncture does not depend on the style used. In other words contemporary acupuncture taught in a short course based almost solely on modern anatomy and physiology works as well as traditional approaches taking 3 or 4 years.* This is a game changing point – acupuncture can be taught in a few weeks to qualified medical professionals.
Most contemporary acupuncture schools subject students to unnecessary ideology and traditional detail resulting in the dual burdens of high debt and low income. Essentially students are being inducted into the belief systems of their teachers at great cost to them. As I have shown previously this has financially ruinous consequences and is an ethical travesty.
Most traditional acupuncture training is of low quality with respect to real world application. Most acupuncture education is at least covertly anti-scientific and anti-evidence. Hence the lack of evident change.
Personally I would dissuade a prospective acupuncture student from attending the usual acupuncture education unless they have another medical license such as NP, PA, MD, PT. Or they have another income source or are independently wealthy. If you have one of the above licenses and live in a State which legally sanctions it then I would recommend a short course such as –https://integrativedryneedling.com/
Finally I’m not in the business of telling others what to believe nor am I personally a capital S skeptic nor by inclination or evidence a materialist. If you are interested in natural medicine find a way to do so that is practical and feasible. Be careful thinking you are going to be different from the others; be super successful and pay off a student debt of $60,000 to $100,000 by practicing acupuncture. If you can, get a standard medical degree and learn natural medicine through continuing education.
Don’t divide medicine into Eastern/Western, Traditional/Naturopathic etc. The best medicine is whatever works with the least amount of toxicity and side effects. Natural medicine is not more spiritual than allopathic medicine. All medicine has the potential to be a practice of compassion. Don’t let yourself be indoctrinated by other people’s beliefs, be your own guide.
* Researcher Andrew Vickers quoted in – Medscape Medical News – Neurology. Acupuncture Superior to Placebo, Usual Care for Chronic Pain, Pauline Anderson, September 10, 2012
See also – http://www.wellnessclarity.com/?p=283
The following article by Dr.Lorenzo Cohen, Ph.D., Professor and Director of the Integrative Medicine Program at the University of Texas, MD Anderson Cancer Center appeared in Huffington Post on December 7th, 2013. The article confirms many of the clinical uses for acupuncture in the area of Oncology. These uses are certainly confirmed by myself and other colleagues who have been working in this field utilizing acupuncture and herbal therapy for the past 20 years. Also medical treatment for cancer can easily feel ‘industrial’ and depersonalizing and the care received in acupuncture clinics can help people going through treatment for cancer feel re-empowered, nourished and supported.
In the article the author states that the “mechanisms are not well understood”, this however is not true any longer with several writers/researchers outlining much of acupuncture’s modes of action in modern scientific understanding. See for example – http://www.amazon.com/Biomedical-Acupuncture-Pain-Management-Integrative/dp/0443066590 and http://www.amazon.com/Introduction-Western-Medical-Acupuncture-1e/dp/0443071772/ref=sr_1_1?s=books&ie=UTF8&qid=1386465583&sr=1-1&keywords=western+acupuncture
See also – http://www.ncbi.nlm.nih.gov/pubmed/23341529
The systematic review, published in the Journal of Clinical Oncology, searched the worldwide literature for randomized, controlled trials evaluating the use of acupuncture for symptom management in cancer patients. Forty-one studies were found for the treatment of eight symptoms (pain — 11, nausea/vomiting — 11, postoperative ileus (constipation) — eight, xerostomia (dry mouth) — four, hot flashes — seven, fatigue — three, anxiety/depression/mood disorders — five, and sleep disturbance — three), and were rated for study quality and whether outcomes were positive or negative.
One well-designed large study undefined for the treatment of chemotherapy-induced nausea and vomiting, found electroacupuncture worked better than anti-nausea medications or sham acupuncture (minimal needling) in women with breast cancer. Although less clear, the evidence also suggests acupuncture is helpful for pain control. None of the identified studies were classified as having a low risk of bias due to study weaknesses, but nine of the 11 pain studies had positive results favoring its use. For the other symptoms assessed, the quality of the studies was lower, but there is reason to believe that with larger more rigorous studies, acupuncture may be found beneficial for some of these conditions as well.
The use of acupuncture for symptom control in oncology is important to consider. Findings from this review and others indicate it is an appropriate treatment alongside conventional care for chemotherapy-induced nausea/vomiting, although additional studies are needed to better understand how it works and which patients might benefit most. For other symptoms, the specific effects of acupuncture remain undetermined, primarily due to weaknesses in the studies. As a low-risk, cost-effective treatment option, acupuncture may be helpful when combined with conventional care for patients suffering from uncontrolled treatment-related side effects or in those for whom other treatment approaches have failed.”
1. Garcia MK, McQuade J, Haddad R, Patel S, Lee R, Palmer JL, Yang P, Cohen L. “Acupuncture in cancer care: a systematic review.” Journal of Clinical Oncology (Published online before print Jan. 22, 2013). doi: 10.1200/JCO.2012.43.5818)
2. Shen J, Wenger N, Glaspy J, Hays RD, Albert PS, Choi C, Shekelle PG. “Electroacupuncture for control of myeloablative chemotherapy-induced emesis: A randomized controlled trial.” JAMA 284:2755-61, 2000.
A small study comparing outcomes for moderate to severe depression in three groups; standard care, counseling and acupuncture was published last this week in PLOS Medicine.
In this pragmatic randomised controlled trial conducted in the North of England, patients with depression were randomised to receive 12 weekly sessions of acupuncture plus usual care (302 patients), or 12 weekly sessions of counselling plus usual care (302 patients), or usual care alone (151 patients).
Both the acupuncture and the counseling groups resulted in significant improvement in depression scores over standard care alone. Improvements were stable at 3 months post treatment. All study groups continued with standard medical treatments such as antidepressants.
Commentary given considered the study as validating acupuncture as an evidence-based treatment for depression in an integrative environment.
A frequent side-benefit of acupuncture treatment for a variety of conditions is improved wellbeing. The study demonstrates this effect to be robust enough to improve moderate to severe depression scores. It seems reasonable to expect an even greater treatment effect in mild to moderate depression.
Clinically I have seen good success in managing bouts of mild to moderate depression combining acupuncture with an Albizzia based Chinese herbal formula.
Thomas Martin LAc.
Sixty-eight of 111 patients from the Kansai region of Japan who were diagnosed as having COPD and were receiving standard medication participated in a randomized, parallel-group, placebo-controlled trial. COPD is considered a non-reversible condition that can severely reduce lung function. It is predicted to be the third leading cause of death worldwide by 2020.
In both groups patients were treated with real or placebo needling at the same acupoints once a week for 12 weeks.The placebo needling involved an apparatus that looked like a real acupuncture needle but only pressed the skin surface.
The primary end point, or study result was the modified Borg scale score evaluated immediately after the 6-minute walk test. This is a scale used to evaluate shortness of breath after exertion.
After 12 weeks, the Borg scale score after the 6-minute walk test was significantly better in the real acupuncture group compared with the placebo acupuncture group. Also improvements in nutritional status, body mass and over-all quality of life was seen in the acupuncture group.
We demonstrated clinically relevant improvements in DOE (Borg scale), nutrition status (including BMI), airflow obstruction, exercise capacity, and health-related quality of life after 3 months of acupuncture treatment
In clinical practice I have often seen improved breathing and voice strength following acupuncture treatment even when the lungs or chest was not the primary focus of treatment. Acupuncture can be a valuable adjunctive treatment for chronic asthma and I have seen it to be of considerable help with breathlessness in people with a cancer diagnosis. Improved wellbeing and functionality is another non-specific outcome often seen following a course of acupuncture.
Thomas J Martin LAc.
A significant number of breast cancer survivors develop a long-term, difficult to treat, symptom called lymphedema. This involves swelling of the arm, shoulder or breast on the side in which breast tumors and lymph nodes were removed and or radiation treatment performed. The swelling is due to changes in flow of the fluid within lymph vessels in the area, though the exact process is unknown.
Results from a small pilot study led by Barrie r. Cassileth, chief of Memorial Sloan-Kettering’s Integrative Medicine Service, and Clifford a. Hudis, chief of the Breast Cancer Medicine Service, was published April 10 in The Journal Cancer
Study participants received acupuncture at Memorial Sloan-Kettering twice weekly for four weeks, using a regimen developed by the Integrative Medicine Service.
Researchers measured the participants’ upper-arm circumference before and after the treatments. They found that among the 33 patients who received acupuncture, 11 had a significant reduction in swelling and another 18 had at least a small reduction. When contacted several weeks later for feedback, patients reported lasting improvement in swelling.
Dr. Cassileth stated the study showed that acupuncture as a treatment for lymphedema is safe and well tolerated with no serious side effects.
These results confirm what I have seen clinically treating this condition in women diagnosed with breast cancer with acupuncture for the past 18 years. One of the main effects of acupuncture being improved blood and lymph flow.
Thomas Martin LAc.
“Your time is limited so don’t waste it living someone else’s life. Don’t be trapped by dogma – which is living with the results of other people’s thinking...” Steve Jobs
I was speaking with a colleague, a fairly recent graduate of a local acupuncture/Oriental Medicine school. She graduated 5 or 6 years ago and told me that she is abandoning her acupuncture career and training for an alternative career. She also told me she knows five other acupuncturist friends from the same class all of whom are looking for work elsewhere.
None of these acupuncturists are surviving on the income from their practices. My colleague, now in her early 40s, stated she has not been able to buy a house and “will never be able to pay off her student loan” because of her career choice. As I will outline below, this is by no means an isolated experience but a widespread phenomenon amongst a majority of acupuncture school graduates. I will show that to make matters worse the very opposite — that acupuncturists are doing well — is being actively promoted online.
It has long been rumored in the profession that a high percentage of acupuncture graduates fail in their practices in the first few years. Over 50% is a number that has been suggested for many years now.
Unemployment and underemployment among acupuncture program graduates is as alarming as it is under-reported.
It’s surprising that the acupuncture profession as a whole does not collect income data. Chiropractors and massage therapists have Bureau of Labor Statistics data, acupuncturists don’t. The only serious professional attempt to ascertain an approximate income picture are these two papers:
The U.S. Acupuncture Workforce: The Economics of Practice by Steven H. Stumpf, EdD, Clifford R. Carr, EdD, Shauna McCuaig, MAcOM, LAc, Simon J. Shapiro, DO, DAOM, LAc and
Unveiling the United States Acupuncture Workforce, by Steven H. Stumpf, EdD,Mary L. Hardy, MD, D. E. Kendall, OMD, LAc, and Clifford R. Carr, EdD. Both papers are posted in full below with the approval of Dr. Stumpf. Unless otherwise indicated all the italicized quotes are from these papers
Despite the existence of national organizations representing the training programs, licensed members, regulatory boards, and an accreditation body recognized by Department of Education, the acupuncture workforce remains outside the healthcare mainstream (Stumpf et al., 2010). For example, valid longitudinal information describing the acupuncture workforce is simply unavailable in the U.S. A recent review by Stumpf et al. (2010) describes a handful of published studies that provide a minimal depiction of how licensed acupuncturists (LAcs) practice e.g., how many hours they work weekly, their annual earnings, and employment arrangements. As a result, it is nearly impossible for aspiring practitioners to acquire accurate information about practice characteristics and, thereby, forecast their potential to practice successfully.
In the surveys analysed in these papers the majority of acupuncturists are earning a gross income of $20,000 to $50,000 per year. But to emphasize how painfully low these numbers are we need to remember that up to half of this gross income will be taken up with tax, liability insurance, rent, practice expenses, continuing education, health care insurance, loan repayment and so on. That’s a take-home income for the majority of practitioners of close to $10,000 to $25,000 per year.
Three states together—California, New York, and Florida— account for approximately 15,050 or 52.8% of all LAcs in the nation (Zabik, 2009). Approximately 37.7% of the LAcs in these three states earn less than $20,000 per year (Acupuncture Today, September 2010). For these graduates the reality of paying back their student loan debt may be viewed as beyond their reach.
For a health-care profession seeking attention as a serious player in today’s increasingly integrated medicine this is shameful, reflecting poorly on the nation’s acupuncture schools that continue to churn out unsuspecting graduates.
Generally speaking, the respondents to these independent surveys charge fees between $20 and $65 per patient visit; work approximately 30 or fewer hours per week; and generate median gross incomes between $20,000 and $50,000.
50% of the licensed acupuncture (LAc) workforce is working less than 30 hr weekly; 50% are earning less than $50,000 on average; and the number of LAcs working independently in practice, either in their own office or sharing one, has increased from approximately 75% to 90%.
It would be reasonable to assume that the situation regarding the financial viability of the acupuncture profession is worse than is outlined in this already dismal picture. Income data gathering of the independent groups within the acupuncture profession referenced in the above papers, most focusing on a treatment style, is likely to contain numerous biases in favor of higher numbers of clients seen and income received for their favored treatment approach.
Self reporting, a significant factor in the surveys reported, is likely influenced by “professional shame” in lacking success, and other psychological factors. Independent data gathering is the only sure path to statistical clarity but such scientific and transparent data seem absent in the profession.
Graduates of the prominent acupuncture training program who completed surveys for this paper averaged $86,979 in student loan debt in 2009. At present, ~65% are enrolled in programs that “kick the can down the road.”
I would submit that most acupuncturists can’t support themselves without either taking a day job, getting health-care insurance and financial support through a spouse, not having children, indefinite student loan debt deferment, living in rental accommodation long-term, relying on financial resources accumulated from prior employment, and many other creative or luck based factors.
Acupuncture schools to this day remain stubbornly entrenched in teaching hopelessly archaic and metaphysically-based programs, indoctrinating students into an anti-modern medicine, or at least separate but equal mindset. “Alternative paradigm” and “Eastern Doctor” are labels often used, though oriental medicine is in fact a diverse mix of different theories and practices, not a relatively unified field — such as is biomedicine. Which, by the way, is the largest , most culturally diverse, globally collaborative medicine in history. The term “Western Medicine” is simply not accurate. Chinese, Korean, Japanese biomedical researchers and doctors are major contributors to modern medicine. Either join this global ongoing scientific revolution or remain in increasing obscurity. It’s hard to see it any other way.
It is important to note that the elaborate theory of energy meridians that acupuncture students must learn has no scientific evidence despite a decades long research effort. (Many acupuncturists/researchers have discussed this fact, Yun-Tao Ma Phd. LAc. for example. See also http://www.ivis.org/proceedings/aaep/2000/220.pdf)
Surprisingly, there is excellent scholarship indicating that the theory of “energy flow” and energy meridians was not the basis of ancient Chinese Medicine, but instead a recently added Western metaphysical concept, with blood flow being the central dynamic feature: http://www.tedpriebe.com/documents/Kendall_SJIM_meridians.pdf
There are strong sub-beliefs within the profession of certain acupuncture styles working better than others. The evidence of treatment efficacy however does not support this apparent diversity, showing no appreciable difference in outcomes between traditional, neo-traditional, new age contemporary and modern medical acupuncture such as Dry Needling. Fads, charismatic teachers, novelty and reference to ancientness continue to generate new acupuncture styles, in effect creating a kind of surrogate evidence of efficacy.
Acupuncture school graduates enter the workforce set up for isolation in the contemporary medical milieu. Questioning and critical thinking is actively discouraged in acupuncture schools, and graduates are often equipped with a New Age attitude that their success or failure depends on their “energy” to attract success, and not on socioeconomic factors and the inadequacy of their training.
Over 90% have no alternative but to develop private practices in a time when increasingly, standard medical practitioners are finding it unviable to do so. Only 4% of acupuncturists are employed in contemporary medical facilities. The few employment opportunities available within the profession often entail low hourly rates, no benefits such as vacation pay or health-care insurance, or other types of professional support. In such low-paid acupuncture industry situations, clients are usually treated in clinics by groups of acupuncturists, thereby diluting the practitioner/client relationship. Treatment of a particular client is often repeated at length with little or no consistent treatment plan.
Insurance reimbursements to acupuncturists are continually being reduced and client deductibles continue to rise. Medical spending is at its lowest rate in five decades.
There is a very limited job market for acupuncturists, with the only significant employers being acupuncture schools and drug treatment programs . . . Opportunities for acupuncturists to participate in the health care system in the same way other providers do are limited
The future, IMHO
We have a profession whose central defining practice (acupuncture) can be just as effectively utilized in a simple, fairly easily learned way, in a form entirely integrated within modern biomedicine. Oriental medicine is not the primary reason clients seek out an acupuncturist, they just want to get better and have heard that acupuncture might help. If they go often enough they may become suborned into the mindset of energy and meridians, but the original motivation holds; desire for improved health. The question arises, is an independent professional future even realistic for acupuncturists?
The status quo means increasing marginalization and a “99%” type scenario, with a few practitioners doing well and the majority struggling or failing. Income by acupuncturists will decline further as will professional standards. Getting acupuncture may become like having a chair massage. As the above income data becomes more commonly known, acupuncture schools will likely see a fall off in enrollment.
Simple acupuncture techniques like Dry Needling, and Biomedical Acupuncture based on contemporary science and physiology, will be increasingly appropriated by other medical professions. These approaches, sensitive to evidence-based updates, have shown the same outcomes as traditional styles in studies, yet can be taught in a short time to appropriately medically trained individuals.
Many researchers have pointed out that the type of acupuncture doesn’t make a difference in outcomes: To quote Dr. Andrew Vickers, a longstanding acupuncture researcher:
The type of acupuncture didn’t seem to make a difference to the results, said Dr. Vickers. “Some acupuncturists will tell you not to go to such and such a person because that person doesn’t put the needles in the right way, or they don’t use the right theories, or they’re not as well trained, but the particular type of acupuncture you get doesn’t seem to make a large difference.”
A Possible Alternative
The acupuncture profession as we now see it may well become an obscure historical entity harking back to a proud isolated alternative medicine mindset of the 1970’s.
Acupuncture colleges that have the foresight and freedom from current metaphysical dogma could develop primary care programs similar to those of NP’s and PA’s and teach modern biomedical acupuncture and functional medicine based herbology and nutrition. If they did this, high quality students would be attracted and new jobs for graduates would become available within the medical establishment. Current practices and products could be sifted by the transparent clarity of modern scientific medicine, brought into the 21st century through critical review and evidence.
Such colleges could also teach short acupuncture courses to other medical professions, having some play in what is inevitable anyhow.
These colleges would have an ethical responsibility to link success of their programs to the ability of graduates to pay down their loan debts in a prescribed period of time, thereby linking curriculum to actual job markets and the contemporary medical ethos. This responsibility, it seems, is currently evaded by most acupuncture schools.
The colleague I mentioned at the beginning of the article stated that although she enjoys the work, she would not choose to be an acupuncturist if she had her time all over again. Another colleague who has been in practice 15 years expressed the same sentiment. One wonders how many others among the nation’s practicing acupuncturists would concur?
Misinformation abounds on the web…
“A licensed acupuncturist after one year out of school can expect to make $45,000 a year and up. After five years in practice, one’s income should approach $100,000.
$200,000-300,000 a year is not unrealistic within 10 years in practice.”
“The starting salary of individuals in this profession averages $49,844 annually. Salaries after 10 years of practice peak at $133,700 annually.”
This website actually places ‘acupuncturist’ as a job receiving the highest salary among nine other medical professions.
“Average annual salary for a Licensed Acupuncturist is $51716 based on statistics in the U.S. as of 2013.”
Note the over-sell, the casual misinformation, the confusion of ‘salary’ with business revenue, and the attractiveness of it all for the unsuspecting applicant prepared to put themselves into major debt. A debt they are likely not to pay off in over 10 years in practice, or even in another career.
Even the Council Of Colleges Of Acupuncture and Oriental Medicine (CCAOM) happily perpetuates this deception. Note the following FAQ from their website –
How much can an AOM practitioner expect to earn?
There are approximately 20,000-25,000 AOM licensees throughout the United States. A recent estimate, which is based on job postings, reports an annual income range between $30,000-$60,000 and notes that gross annual income can be as much as $105,000.
CCAOM must know that there are very few “job postings” for the 20,000 to 25,000 acupuncturists mentioned. What is the hope for honesty and transparency if a major professional organization prefers to present myth over truth.
Occasionally one can find clear criticism of the confusing presentation of income data, deliberate or otherwise, as with this post questioning the Oregon College Of Oriental Medicine’s graduate data by Lisa Rohleder LAc – OCOM Redefines Acupuncture as a Hobby for Girls –
That would be “the Sugar Daddy business model”, in which an acupuncturist asserts that he or she is successful in his or her practice, because in reality he or she doesn’t need to earn a living, since his or her partner/husband/ wife has a real job and supports their household. Plenty of acupuncturists, regardless of gender, claim this kind of success. https://www.pocacoop.com/prick-prod-provoke/post/ocom-re-defines-acupuncture-as-a-hobby-for-girls
A Decision Based On The Facts
Remember the quote above from Steve Stumpf et al. “it is nearly impossible for aspiring practitioners to acquire accurate information about practice characteristics and, thereby, forecast their potential to practice successfully.”
So if you’re thinking of going to acupuncture school here’s how it probably shapes up. Not inevitable, but likely, based on the experience of the majority.
For the first few years after graduation it’s touch and go if you are even able to stay in practice – most likely you will be struggling to set up a private practice outside the support employment offers. If you survive that, statistically speaking you need to have a spouse to support you and to get health-care insurance through. Or you will need another source of income such as another job, an inheritance, savings, something. Frugality is good!
If you gain employment in the industry, such as detox clinics or low cost public health facilities, you will be part-time, without benefits, often treating the same individuals over and over with a vague or no treatment plan. There will be no union watching out for you.
In some measure you will be deferring your $80,000 to $100,000 loan debt, so forget about buying a house and treat your old car well. You will feel the need to learn new acupuncture styles and do business development courses. There are plenty of people ready to bill your credit card for these.
You’ll need to keep up with CEU’s, and pay Liability Insurance. You’ll find yourself with a whole set of beliefs that other medical practitioners don’t seem to care about. You’ll wonder why the Law Of Attraction isn’t working for you…
Or you may be one of the lucky ones – your acupuncture program would have quietly encouraged that feeling all through your training.
But, for sure, you are a good person, sincerely wanting to help others, and life is indeed an adventure of endless learning, not a bank account. Stay flexible, be creative, jettison most of your acupuncture college training, re-discover your own thinking. Learn from your clients: they, your real teachers will be paying you! Change direction if needed. Enjoy making small differences, as in real life; they are the differences that count. Good luck.
Thomas Martin LAc.
The following is a letter from a recent Acupuncture School graduate who read the above post. The statistics outlined in the post reveal that Michael’s difficult journey, which by no means has yet ended, is shared by a great many. Their plight, in most cases, is not from personal lack of talent or hard work but from deliberate and passive misinformation disseminated from professional schools and organizations.
Thank you for your blog entry “Acupuncture Profession in Crisis”.
I had a rough two years after graduating from Tri-State Collge of Acupuncture in 2011. I simply couldn’t make any money in acupuncture (I lost money, actually). With that, my confidence dropped and eventually had such a problem with anxiety and panic attacks that I stopped practicing. I have $140K debt (including personal) and was so optimistic that I would pay the loans back. But working in acupuncture in NYC means community acupuncture, which was half of what I made as a waiter.
It’s very sad, but I knew that if I didn’t leave, I would be wasting precious time that could be used to find a profession where I could make better money.
While it makes me angry, to think the school promised so much, I kick myself for not looking further. I don’t want acupuncture to go away, but I think people need to know the facts.
Thank you again. I hope more people thinking of going into acupuncture will read this entry!
Thomas Martin LAc.
A pilot study using acupuncture to treat PTSD – Post Traumatic Stress Disorder was published in the Journal of Nervous and Mental Disease, 2007 jun;195(6):504-13. http://www.ncbi.nlm.nih.gov/pubmed/17568299
Acupuncture was compared with a no-treatment wait list and with treatment using cognitive-behavioral group therapy. Acupuncture resulted in significant symptom improvement comparable to the group therapy outcome. Results were measured by comparing self-reported symptom improvement before and after treatment and at a three month post treatment followup.
One of the most frequent effects of acupuncture experienced by clients and seen in the clinic is relaxation and improved sense of wellbeing. This is often accompanied by an altered response to symptoms whereby they seem less to intrude on wellbeing. Realtime MRI studies often confirm such subjective changes objectively. Reduction of sympathetic nervous system hypersensitivity (flight or fight reactivity) is also a proven acupuncture effect.
Though this small study does suggest the usefulness of acupuncture for a difficult to treat condition, it is unlikely that PSTD could be cured by acupuncture treatment. It does support the adjunctive use of acupuncture which may well enable reduction of medication and so of side-effects and enhancement of other therapies. As with any chronic medical condition treatment would need to be intensive at the beginning, tapering off to every 2 or 3 weeks then perhaps with occasional booster treatments at larger intervals.
Thomas Martin LAc.
A unique study was presented September 24, 2008, at the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting in Boston titled Acupuncture for the Treatment of Vasomotor Symptoms in Breast Cancer Patients Receiving Hormone Suppression Treatment
It involved 47 breast cancer patients undergoing estrogen suppression treatment with Tamoxifen and Arimidex, drugs that frequently result in the debilitating side effects of hot flashes, night sweats, and excessive sweating (vasomotor symptoms)
Patients were divided into two groups, one group used the antidepressant, venlafaxine (Effexor), a selective serotonin reuptake inhibitor,which is one of the most common drugs used to treat these hot flashes. The other group was given acupuncture only.
The acupuncture group showed similar reduction of hot flashes, night sweats, and excessive sweating but without the antidepressants side effects and with improvement in the sense of wellbeing and of energy. These results remained stable with followup.
“Our study shows that physicians and patients have an additional therapy for something that affects the majority of breast cancer survivors and actually has benefits, as opposed to more side effects. The effect is more durable than a drug commonly used to treat these vasomotor symptoms and, ultimately, is more cost-effective for insurance companies,” Eleanor Walker, M.D., lead author of the study and a radiation oncologist at the Henry Ford Hospital Department of Radiation Oncology in Detroit, said.
Similar results have been shown with men experiencing hot flashes, sweats and other symptoms resulting from hormonal suppression for prostate cancer. These were reported in International Journal of Radiation Oncology * Biology * Physics Volume 79, Issue 5 , Pages 1358-1363, 1 April 2011 and titled Acupuncture for the Alleviation of Hot Flashes in Men Treated With Androgen Ablation Therapy
It was noted that “Acupuncture provides excellent control of hot flashes in men with a history of AAT (androgen ablation therapy) . The absence of side effects and the durable response at 8 months are likely to be appealing to patients.”
The breast cancer study confirms efficacy of acupuncture frequently seen in complementary cancer care with women undergoing breast cancer treatment. Fewer men undergoing hormonal suppression appear to use acupuncture but reduction in vasomotor symptoms seen in the prostate cancer study may involve a similar mechanism.
Thomas Martin LAC
The following article titled – Acupuncture: Role in Comprehensive Cancer Care—A Primer for the Oncologist and Review of the Literature by Andrea J. Cohen, MD, Alexander Menter, MD, Lyndsey Hale was published in – Integr Cancer There, June 2005 issue,vol. 4 no. 2 131-143
It outlines efficacy or likely efficacy in reducing side effects of cancer treatment. Symptoms improved were, dry mouth, hot flashes, nausea/vomiting, fatigue, shortness of breath and emotional issues such as anxiety and depression.
Having used acupuncture in an integrative cancer care clinic since the mid 1990’s I can vouch for this efficacy. Over-all acupuncture (and medical herbalism if appropriate) appear to provide a valuable support for people going through the significant challenge of cancer and it’s treatment.
Thomas Martin LAC
In recent studies, patients have reported an increased use of complementary and alternative medicine (CAM). Acupuncture is a popular complementary therapy for patients with cancer. This article will provide current cancer treatment providers with information on acupuncture as well as the research conducted on cancer symptoms and side effects of cancer treatments. Antiemetic studies are the most prevalent and contain the most promising results. Several studies have found that acupuncture significantly reduces the number of emesis (vomiting) episodes for patients receiving chemotherapy.
While studies on pain control vary due to the heterogeneity of pain, there are few studies investigating pain caused from cancer and the removal of cancerous tumors. These studies, while promising, provide basic results that need further investigation for more definitive results. Although relatively few studies have been done on anxiety and depression, several researchers have found acupuncture to be just as effective as or more effective than antidepressants for patients without cancer.
Studies on breathlessness, while small, have shown acupuncture to have a significant positive effect on chronic obstructive pulmonary disease, breathlessness associated with end-stage cancer, and asthma. Researchers studying xerostomic individuals who have received salivary gland irradiation found significant positive results in salivary flow rates compared to baseline. Patients with hot flashes due to hormonal imbalance may benefit from the use of acupuncture. A recent pilot study showed improvement of chronic postchemotherapy fatigue following acupuncture treatments.
Many individuals with cancer have turned to acupuncture because their symptoms persisted with conventional treatments or as an alternative or complement to their ongoing treatments. Despite the immense popularity in the community, few large randomized trials have been conducted to determine the effects acupuncture has on cancer symptoms and side effects of treatments. A majority of the current studies have shown beneficial effects that warrant further investigation with large trial sizes.