Acupuncture touted for low-cost care
A possible solution to high health-care costs might be coming from an unlikely source -- an alternative form of treatment that's been around for centuries. Joel Rose reports.
Acupuncture (AlternativeApproaches.com)
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KAI RYSSDAL: Whoever wins in November's going to have to do some pretty serious thinking about health care. Surveys consistently show it right near the top of the list of things voters say they're worried about -- the availability of care, as well as the cost. On that latter point, one possible solution might be coming from an unlikely source. An alternative form of treatment that involves lying completely still while they stick needles in you.
Joel Rose reports from Philadelphia.
JOEL ROSE: Philadelphia Community Acupuncture occupies a big, open room on the top floor of a former firehouse. About half a dozen patients doze in reclining chairs with little needles sticking out of their arms and legs.
KORBEN PERRY: Can I see your tongue? And you're sleeping better?
ILIANA PAGAN: I'm going to bed early for me. . . .
Iliana Pagan whispers with acupuncturist Korben Perry. He takes her pulse, inspects her tongue, and then slides tiny needles a few millimeters into her skin, where they'll stay for most of the next hour.
Rose: How does this work again?
Ellen Vincent: Acupuncture? No one really knows. The most important thing is that we see results.
Ellen Vincent started the clinic with Korben Perry just over a year ago. Now it's treating 150 patients a week for a variety of conditions.
Vincent: A lot of back pain. A lot of anxiety, especially panic attacks. I have many people walking in the door in a state of panic and we give them needles, and they walk out the door, saying "Thank you, so much. I feel so much better.
At a typical acupuncture clinic, Vincent and Perry would see one or two patients an hour and charge $80 or more a visit. But Philadelphia Community Acupuncture is organized around the so-called group visit model where up to a dozen patients are seen at the same time. Because of the volume, they're able to keep their fees low. Their sliding scale starts at just $15 dollars a treatment, which means more patients can afford to get treated more often.
Lisa Rohleder: When we say our goal is to take back acupuncture for the working class, we are not kidding.
Lisa Rohleder pioneered the community acupuncture business model at her clinic Working Class Acupuncture in Portland, Oregon.
Rohleder: A large number of our patients have no health insurance at all. And no access to health care. We think that's wrong.
She says this model is closer to the way acupuncture is practiced in China, where it was first developed thousands of years ago. And she thinks group visits for routine health care like this could be applied to more conventional medicine. Kjersten Gmeiner thinks so, too. She's a family doctor in Seattle who's been offering group visits for years for patients with diabetes and hypertension.
Kjersten Gmeiner: It's something that decreases cost -- that's the grail in current medical care -- with increased patient and provider satisfaction.
So far, there isn't a whole lot of research backing up Gmeiner's claims, though one promising study in Denver did show that group visits for seniors lowered their overall health care costs by more than $40 per month. But not everyone is convinced that group visits are the Holy Grail. Deborah Peel heads the organization Patient Privacy Rights.
Deborah Peel: A significant number of people are not comfortable telling anyone but their doctor some of the things that are the most disturbing or troubling or frightening about their symptoms or their bodies. For actually getting the best treatment, one-on-one is far more effective than group treatment.
Even group visit advocates admit they won't work for everyone or every situation. But the idea does seem to be catching on with patients like Jessica Winegar at Philadelphia Community Acupuncture.
Jessica Winegar: You feel like you're all sort of in this together. And, I don't know, I mean, it sounds flaky to say but there is some sort of, like, collective energy that's produced that I think is actually . . . outweighs any of the negative aspects of not having a one-on-one -- an extended one-on-one -- with a provider.
For Winegar, the most important thing is that her back finally stopped hurting.
In Philadelphia, I'm Joel Rose for Marketplace.
Comments
Comment | Refresh
From Philadelphia, PA, 01/04/2009
I have been seeing Ellen Vincent at PCA and she has been treating my various post-partum complications. Because of the treatments, I have been able to walk and workout without the pain it used to cause me. I no longer have intense cravings either! Acupuncture works. In this open setting you still have personalized care and my initial intake(the most private part) was in a separate room. She isnt shouting my symptoms from the rooftops by any means. Most of the people are asleep anyway! In that open space, you see people of all genders,ethnicities, neighborhoods, etc...It brings us all together under one roof, how rare is that? We are all getting the same care at a price that each of us can afford. Unfortunately, in our healthcare system, that too is rare.
From NY, 12/30/2008
Acupuncture has been the major reason for the change in my mental health. Before acupuncture, I couldn't tell you the last time I had felt happy, truly happy. These days, it's one happy day after another. I would highly recommend acupuncture to anyone like me, who suffers from anxiety and depression. And pairing it with a little bit of p*t really puts life way more into perspective.
From Austin, TX, 11/13/2008
It's disappointing to read comments by those who would relegate Oriental Medicine to the same category as treatments by unlicensed persons. Licensed Acupuncturists, or Doctors of Oriental Medicine, depending on what State you live in, are trained in a four academic year Masters degree program. Most programs are between 3000 and 4000 hours, and they are provided extensive biomedical (microbiology, pathophysiology, etc.) training to communicate with western medical providers. At least 1000 hours of clinical training are included in professional internship, and in the best schools, Chinese herbal studies are a core subject. The term Acupuncturist is misleading. In Traditional Chinese Medicine, or TCM, acupuncture is merely a facet of the totality of treatment. Herbs, which are safe if prescribed by a qualified practitioner, are an integral part of treatment, which assist in making the effects of acupuncture long-lasting.
TCM in China is considered a peer to Western medicine. No one in that country sees one side without the other. This system of medicine has a 5000 year history, and although there is only a 50 year or so history of clinical studies, most of which support the effectiveness of oriental medicine, we have at least 2000 years of case studies of individual improvements in health and cures. Compared to less than 150 years of documented success in Western medicine, it at least deserves consideration as a complimentary practice in the future model of integrated medicine. No one model has all of the answers. Over 100 thousand citizens of this nation die each year from properly prescribed Western pharmaceuticals. MDs and DOs aren't perfect, nor are they better trained for their field than we are for ours. Both are first-professional degrees in their respective fields. We don't perform surgery, either. We both have our limitations. In the areas of chronic pain, recovery from stroke, and neurological disorders, oriental medicine offers great promise, as detailed by hundreds of individual cases. Before criticizing a field with which you may not be fully informed, do your research outside of the "quackwatch" hacks that thrive on providing as "evidence" the opinions of practitioners who see us a competitors.
From Gloucester, MA, 10/07/2008
As an acupuncturist having a conventional practice but intrigued by the Community Acupuncture model, I want to clarify an impression implied in some postings. Those acupuncturists adopting the community acupuncture model have full training and licensing. They are no less qualified than acupuncturists seeing less patients per hour time merely because there has to be a private room for each patient to stay in while the needles are in place. Generally, once acupuncture needles are inserted, they stay in place for some period of time while the acupuncturist leaves the room. I tell my patients that it's like putting a battery in a charger until it's ready to use. One of my acupuncture teachers sees 5 patients per hour in private rooms. But she only sustains that caseload because she has apprentices (who are graduated and licensed acupuncturists) performing parts of the treatments after she evaluates the patient. That was how she was trained in Japan. I do everything myself with two treatment rooms and have to set fees to make a living based on that caseload.
From Portland, OR, 09/16/2008
In response to the previous comment, I am glad this issue has come up because it is an area in which community acupuncture sharply differs in philosophy from conventional acupuncture. Rather than equating seeing many patients a day with "HMO acupuncture", we are attempting to emulate the long tradition of Asian master acupuncturists who were and are able to effectively treat dozens of patients a day by relying on the core diagnostic skills of acupuncture such as pulse reading. We do not believe that "complete" treatment for a patient is the same thing as lengthy interactions with an acupuncturist; rather, "complete" treatment represents a complete COURSE of treatment (five, ten, or twenty treatments in a row, once or twice a week). The needles do the real work. In China, someone with a complex or chronic condition would be treated with acupuncture every day for weeks or months. This rarely occurs in America because of the high cost of acupuncture, and as a result, the conventional "complete" model of acupuncture often produces inadequate results, simply because patients cannot afford to fulfill a course of treatment. The analogy in Western medicine would be going to see a doctor who performs a lengthy diagnosis and prescribes antibiotics -- but only a single pill when a ten-day course would be needed to resolve the problem. There is no benefit to the patient if the acupuncturist utilizes "the full scope of acupuncture and Oriental medicine training" when the patient cannot then pursue the treatment due to cost. My clinic regularly sees patients with complex and chronic conditions who come to us after ending their treatment with "complete" providers because they have discovered that acupuncture helps them enormously, but there is no way on earth they can afford to pay $75 twice a week. We also hear very often from our patients and from acupuncturists who have switched from conventional acupuncture to community acupuncture that they are stunned at how much better the clinical outcomes are when acupuncture treatments are frequent, regular, and yes, cheap.
From Catasauqua, PA, 09/15/2008
It is all well and good to provide cheap acupuncture in a group setting, but it is just that. The more patients one sees, the less individualized the care. It is HMO acupuncture, and does not provide the full benefits of a complete acupuncture practice, which utilizes the full scope of acupuncture and Oriental Medicine training. That said, it is a great introduction to acupuncture and Oriental Medicine form many who would not have considered it previously because they did not have enough knowledge of what acupuncture and Oriental Medicine could do to assess its value. I can only hope that the acupuncture providers in these clinics refer out complex cases to complete providers instead of having the patients feel that acupuncture and Oriental Medicine don't work for them.
From Cedarburg, WI, 09/10/2008
My husband had been treated for years by various medical doctors for his sciatic pain. He received oral medication and injections. He got some tempoary relief as long as he kept taking medication but didn't want that as a continous lifestyle. During the first accupuncture treatment he
got immediate relief. The pain returned at a lower level and after a few more treatments he has total relief.
From Portland, OR, 09/08/2008
Dear Patricia,
I'm sorry I'm not very familiar with CT, but here is the contact information for a member of the Community Acupuncture Network. If he is not near you, maybe he will know someone who is:Bob Robles/Market Square Wellness Center/100 Market Square/Newington, CT/860-667-0949 (clinic) 860-833-9330 (mobile)
good luck and best wishes.
From Voluntown, CT, 09/06/2008
Hello to all. Thank you for you comments. I have to have surgery. Im looking into acupucture instead of steriod shots and pain medicine. I have talked to 2 people who have had acupuncture and said not only does it take care of the pain they felt so energized after session. I am a smoker and would love to quit also. I am new to this and I am looking for a acupucturist near me. My fear is what if they are not trained well enough and do not know fully what they are doing. Any thoughts on this would be greatly appreciated.
Thank you
Trich
From Brentwood, NH, 09/06/2008
Your story on acupuncture has inspired a useful discussion, and I truly appreciate the polite tone of all the comments. I hope MarketPlace continues to do stories on other alternative medicine practices, if only from the point of view of consumer protection from fraud, and presents critical evidence regarding whether clients get what they pay for.
Human nature has us persist in believing things just because others believe in them, even over thousands of years; you can think of your own myriad examples. And as Will Rogers said (about a politician, originally), "It's not what he's ignorant of that bothers me. Its what he's absolutely certain about, that just ain't so."
Previously I quoted a scientific article, clearly citing it as coming from 1991, because it was succinctly put, and nothing has really changed.
From Denver, CO, 09/05/2008
In my practice of Oriental Medicine I have seen many patients who had tried everything that allopathic medicine had to offer and were still suffering from their condition. Using acupuncture (sometimes combined with Chinese herbal prescriptions) I saw their symptoms diminish and their quality of life restored. It might be interesting to ask them if they think that acupuncture works. My doctoral degree in Research Psychology helped prepare me to understand the science behind Acupuncture.
Martha Lucas, Ph.D., L.Ac.
From Santa Monica, CA, 09/05/2008
I am the CEO of Emperor's College of Traditional Oriental Medicine in Santa Monica, CA, where we train master's and doctoral level students in acupuncture and Oriental medicine. The master's program students receive over 3,000 hours of training in western sciences, acupuncture, and herbal medicine, and qualify as primary care providers in CA upon licensure. We operate a community teaching clinic that provides 35,000 acupuncture treatments a year, treating conditions such as chronic pain, substance abuse, and mood disorders, among others. The World Health Organization recognizes the effectiveness of Oriental medicine in treating respiratory, gastrointestinal, gynecological, nervous system, and emotional and psychological disorders, among others. Also, there are several thousand studies looking at controlled clinical trials that show the effectiveness of acupuncture for a variety of conditions. Our doctoral students currently treat patients in the Acute Rehabilitation Unit of Good Samaritan Hospital, a major teaching and research hospital in downtown Los Angeles, and work alongside other health professionals. The future of health care lies in the integration of Eastern and Western medicine to provide comprehensive and compassionate care to those in need.
From La Verne, CA, 09/05/2008
There is a logical reason why scientifically proving the effects of acupuncture has been so difficult to do: acupuncture works by stimulating the body’s own self-healing resources and understanding exactly how those resources work is remarkably complex. As a rough analogy; imagine lightly touching someone under their nose with the tip of a feather and causing them to sneeze. When this happens, it’s because the feather triggered a natural, self-regulatory reaction of the body. It is not a placebo effect – it happens because a specific threshold has been crossed, setting off a domino effect that culminates in a sneeze. Acupuncture works the same way; it stimulates natural, self regulatory resources when the right trigger has been tripped.
Unfortunately, finding the right trigger can be very difficult to do, that is why there are hundreds of acupuncture points and endless point combinations. There is no one spot under the nose that will make everyone sneeze every time; a spot that makes one sneeze today may not do so tomorrow while a spot that makes one sneeze tomorrow may not today. When the feather touch triggers a sneeze, there are real physical reasons behind it but our ability to understand the mechanisms of those reasons are limited. In the same manner, our ability to understand the mechanisms of acupuncture is limited and so research into this practice gets mixed results.
The complexity of triggering self-healing reactions does not mean it is unreliable but it does mean that only those with the most comprehensive training can get the best results. It also means it may take several trials before the best spots are found and so I think it is great that there are well-trained acupuncturists out there making multiple treatments affordable.
From Boulder, CO, 09/05/2008
Acupuncture NOT scientific? Check the definition of science, which will include "The careful observation of nature" and "Ability to reproduce results". The results of acupuncture have been observed for millenia, and the results of each acupoint has been reproduced literally billions of times on millions of people. Today's Acupuncturists are well- educated healthcare providers who can work very closely with western medical doctors to give patients very effective and affordable health care.
From Philadelphia, PA, 09/05/2008
I also wish to sing apraise for acupuncture. Approximately 8 years ago I went to the Univerity of PA Hospital Alternative Medicine Department for smoke cessation. After approximately eight session of acupuncture I am pleased to say that I no longer smoke after over thirty years of smoking. I don't know how or why it worked but it did the job for me. Additionally it was offered in a traditional medicine setting, how cool is that?
From Detroit, MI, 09/03/2008
A nationally certified and state licensed acupuncturist completes an extensive 3-4 year post graduate masters degree program in oriental medicine. When to make a western medicine referral is an important part of our training. Acupuncture is not a replacement for western medicine. It is an adjunctive treatment that is very effective for many of the conditions western medicine struggles to treat. Acupuncture is well accepted and respected in the modern scientific and medical community. The majority of my patients are referred to acupuncture by their M.D.
I recently found a potentially serious symptom in a patient that had been missed at her recent physical because she had no pain from it. I immediately sent her to her primary care physician for an evaluation.
One of the previous posters would like people to believe that acupuncture keeps people from receiving western medical care. That is not true, our profession works with western medicine. I have physicians from various specialties in my referral network.
From Portland, OR, 09/03/2008
In a previous comment, Mr. Stock argues that acupuncture is unproven and unscientific by quoting the National Council Against Health Fraud. Unfortunately, Mr. Stock does not state that the position paper he quotes from was written eighteen years ago in 1990 (http://www.ncahf.org/pp/acu.html). Since then, the NIH came out with a consensus statement in 1997 that attests to the efficacy of acupuncture in some diseases. Clinical studies in the last 10 years have shown the use of acupuncture helps for a range of issues, from low back pain to migraines to insomnia. The scientific community no longer debates whether acupuncture works but rather what conditions acupuncture can treat and whatâ??s the best way to increase its efficacy. As for how it works, there are a number of different biomedical theories and supporting evidence for its mechanism of action. The only reason acupuncture has not shown more research results is that itâ??s difficult to get research funds when so much money gets sucked into the drug making businesses!
From Newark, CA, 09/03/2008
I operate a Community Acupuncture office. Many people are scared of needles because they think of those used for injections. Acupuncture needles are hair-thin. As a result, the sensation is nothing like what one would receive from an injection. Most clients fall asleep with the needles. Also, to echo what E. Blair Reilly of Chicago wrote, acupuncture works on animals, too, and animals (dogs, horses, etc.) have no expectation re what acupuncture will do for them. Animals don't know how it works, and yet it's still effective.
From chicago, IL, 09/03/2008
I run a community acupuncture studio in Chicago and was so delighted to read about our recognition…until I got to some of the comments. I forget that there are so many people that are ignorant about the effects of this beautiful medicine. It’s upsetting to see words like “quack” and “pseudoscience” in the same sentence as acupuncture! The proof that these people are looking for is in the results. Medicine doesn’t work just because the Western world says it does. Depending on what you read, acupuncture is between 3,000-5,000 years old—the fact that it still exists and has treated billions of people is significant for one thing. If you don’t believe a human is telling the truth about his/her experience then watch an animal get acupuncture—they have no preconceived notions about what’s about to happen. I’ve seen dogs crippled with arthritis carried into a session only to bounce out on their own. Anyone that calls acupuncture quackery has clearly never had the pleasure of being stuck with these miraculous little needles!
From Seattle, WA, 09/03/2008
I am the cofounder of a similar clinic in Seattle. We are also witnessing a large demand for this type of affordable health care and I too cannot tell you how acupuncture works, but the results speak for themselves.
For the record, the NCAHF which Mr. Stock quotes above, is not a U.S. government agency as the name might tend to indicate.
The National Institute of Health Consensus statement on acupuncture can be found here:
http://209.85.173.104/search?q=cache:vucIyD6Qt5EJ:consensus.nih.gov/1997/1997Acupuncture107PDF.pdf+NIH+acupuncture+consensus+statement&hl=en&ct=clnk&cd=2&gl=us&client=firefox-a
Respectfully,
Jordan Van Voast, L.Ac.
09/02/2008
Here are two proofs that Acupuncture doesn't work. # 1. It's been around for over a thousand years and there's still no proof that it works. # 2. If it really worked, insurance companies would be the biggest advocates. Have chronic pain? No expensive surgery, meds or physical therapy for you. A couple of inexpensive needle sessions will cure all of your ills.
From San Diego, CA, 09/02/2008
I noticed that the subject of whether acupuncture is truly medically effective was not addressed. In fact it was indicated that it was not even known how it worked. Perhaps you should do more stories on pseudoscience, quackery, and fraud medicine and the dangers they can pose both directly from injury and indirectly by convincing people to not see a credible doctor and properly treat their conditions
From Abington, PA, 09/02/2008
I am a client at Philadelphia Community Acupuncture, and I find the discussion about group visits somehwat misleading. Before my first visit, I received a private intake in a small room adjacent to the group treatment area. Subsequent sessions began with a brief rundown of current symptoms, in a private conversation before treatment. The treatment I recieved was completely individualized, even though it took place in very pleasant group space. As for how or why it works, relief of suffering without unpleasant side effects is proof enough for me.
From Rydal, PA, 09/02/2008
I am a client at Philadelphia Community Acupuncture, and I find the discussion about group visits somehwat misleading. Before my first visit, I received a private intake in a small room adjacent to the group treatment area. Subsequent sessions began with a brief rundown of current symptoms, in a private conversation before treatment. The treatment I recieved was completely individualized, even though it took place in very pleasant group space. As for how or why it works, relief of suffering without unpleasant side effects is proof enough for me.
From Rydal, PA, 09/02/2008
I am a client at Philadelphia Community Acupuncture, and I find the discussion about group visits somehwat misleading. Before my first visit, I received a private intake in a small room adjacent to the group treatment area. Subsequent sessions began with a brief rundown of current symptoms, in a private conversation before treatment. The treatment I recieved was completely individualized, even though it took place in very pleasant group space. As for how or why it works, relief of suffering without unpleasant side effects is proof enough for me.
From Rydal, PA, 09/02/2008
I am a client at Philadelphia Community Acupuncture, and I find the discussion about group visits somehwat misleading. Before my first visit, I received a private intake in a small room adjacent to the group treatment area. Subsequent sessions began with a brief rundown of current symptoms, in a private conversation before treatment. The treatment I receieved was completely individualized, even though it took place in very pleasant group space. As for how or why it works, relief of suffering without unpleasant side effects is proof enough for me.
From Brentwood, NH, 09/02/2008
Your piece on accupuncture was very wrong-headed! Although people say they get the various touted benefits, it's an unproven, unscientific modality. And I'm speechless that you go on to say it's group-treatment format makes healthcare more affordable! "Without health insurance, your condition is untreatable by medical science. But fortunately for you, I'm a quack!"
I quote the National Council Against Health Fraud:
Acupuncture is an unproven modality of treatment.
Its theory and practice are based on primitive and fanciful concepts of health and disease that bear no relationship to present scientific knowledge
Research during the past 20 years has not demonstrated that acupuncture is effective against any disease.
Perceived effects of acupuncture are probably due to a combination of expectation, suggestion, counter-irritation, conditioning, and other psychologic mechanisms.
The use of acupuncture should be restricted to appropriate research settings,
Insurance companies should not be required by law to cover acupuncture treatment,
Licensure of lay acupuncturists should be phased out.
Consumers who wish to try acupuncture should discuss their situation with a knowledgeable physician who has no commercial interest.
[Clinical Journal of Pain 7:162-166, 1991]
By the way, the revival of Chinese traditional medicine was fostered by Chairman Mao just for the propaganda value of being able to say that he increased the number of "medical" practitioners in China.
From Philadelphia, PA, 09/02/2008
I've been regularly visiting Philadelphia Community Acupuncture for a month now and find it a wonderful practice. After my first session I felt both relaxed and totally sharp (no pun intended), ready to attend to whatever my day had in store. Only thanks to the Working Class Model is acupuncture available to me. I think it is an excellent model.
Keep up the good work Ellen and Korben!!
From Landisville, PA, 09/02/2008
No way! I don't have anything to do with any therapy that has the word "puncture" in it. So people come in the door in a state of panic attack. Well, I'd leave in that state if they stuck needles into any part of my body.
Sounds like more snake oil to me! No thanks.
From Tucson, AZ, 09/02/2008
The Working Class model of community acupuncture is both far ahead of its time and steeped in a long tradition of accessible medicine for the people. It's great to see acupuncture being made far more accessible for everyone in this country who needs it.
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