The State of 21st Century Acupuncture in the United States

Abstract

Clasina Leslie Smith,1,2,* Bill Reddy,3,* Charis M Wolf,4,5,* Rosa N Schnyer,6,7,* Korina St John,8,* Lisa Conboy,4,7,9– 14,* Jen Stone,15 Lixing Lao16– 18 1Chicago Healing Center, Chicago, IL, USA; 2School of Medicine, Southern Illinois University, Springfield, IL, USA; 3Vital Point Acupuncture, Annandale, VA, USA; 4Seattle Institute of East Asian Medicine, Seattle, WA, USA; 5Middle Way Acupuncture Institute, Seattle, WA, USA; 6School of Nursing, University of Texas, Austin, TX, USA; 7Oregon College of Oriental Medicine, Portland, OR, USA; 8Modern Medicine Woman, LLC, Palmer, AK, USA; 9Beth Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 10California Institute of Integral Studies, San Francisco, CA, USA; 11Pacific College of Oriental Medicine, San Diego, CA, USA; 12YoSan University, Los Angeles, CA, USA; 13Five Branches University, Santa Cruz, CA, USA; 14American Academy of Health and Wellness, Roseville, MN, USA; 15CTSI, Indiana University School of Medicine, Indianapolis, IN, USA; 16Virginia University of Integrative Medicine, Vienna, VA, USA; 17School of Medicine, University of Maryland, Baltimore, MD, USA; 18School of Chinese Medicine, University of Hong Kong, Pokfulam, Hong Kong*These authors contributed equally to this workCorrespondence: Clasina Leslie Smith, Chicago Healing Center, 1560 N Sandburg Ter, Unit 3215, Chicago, IL, 60610, USA, Tel [phone], Email [email protected]: The term “acupuncture” commonly refers to a non-pharmacologic therapy that is increasingly employed by diverse segments of the population for a wide variety of complaints including pain, insomnia, anxiety, depression, frozen shoulder, and other issues. The term is also used as a short-hand for the wider medical system from which the placement of needles into the skin for therapeutic benefit and related techniques evolved. Thus “acupuncture” refers both to the therapeutic technique and the therapeutic system of Acupuncture and Herbal Medicine (AHM). The other modalities included within AHM include a wide variety of physical and mechanical manipulations, herbal medicines, dietary recommendations, and lifestyle modifications. Clinically, acupuncture is increasingly offered in a variety of conventional medical settings such as hospitals, medical school clinics, veterans’ healthcare centers, oncology facilities, and rehabilitation centers, and its safety profile is excellent overall. Barriers to further incorporation of acupuncture into biomedical sites include insurance coverage of acupuncture, education of conventional medical practitioners and other stakeholders about the utility, efficacy, and evidence base of acupuncture. Acupuncturists in the United States are skilled practitioners who are highly educated in the complex therapeutic system from which acupuncture arose and in the technical aspects of its utility as a treatment modality. The training, certification, licensure, and regulation of acupuncturists is similar to that of conventional providers such has physician’s assistants, advanced practice nurses, and medical and osteopathic doctors. While clinical use and acceptance of acupuncture continues to grow, there is to date no definitive composite document explaining the utility of acupuncture in various healthcare settings, the current understanding of how acupuncture works, and the training, professional regulation, and certification of acupuncture practitioners. This article will address these topics and strive to create a reference for practitioners, administrators, legislators, insurance providers, patients and their families, and other stakeholders.Plain Language Summary: Acupuncture refers to the placement of thin, sterile needles into the skin to stimulate healing effects, and, in the United States, it also refers to the medical system from which the technique of acupuncture evolved. That system, Acupuncture and Herbal Medicine (AHM), uses acupuncture, dietary and lifestyle advice, herbal medicines, and other therapies to facilitate health and healing. Acupuncture is increasingly being used for a wide variety of medical problems including pain, difficulty sleeping, mental health concerns, and other issues in a wide variety of settings and is supported by a growing scientific basis for understanding why and how it works. Training and licensure of acupuncturists are similar to many conventional practitioners, and the process is accredited and overseen by various governmental and regulatory bodies. This paper aims to provide an overview of the use of acupuncture in the United States, the scientific basis for acupuncture, the training and licensure of acupuncturists, and the ways in which acupuncture is and might be incorporated into conventional medical settings.Keywords: acupuncture, herbal medicine, traditional Chinese medicine, integrative medicine, integrative health, medical policy

Keywords

• traditional chinese medicine
• traditional east asian medicine
• integrative medicine
• integrative health
• medical policy