There is a new style of acupuncture being practiced all over the country. Practitioners in this field see more patients per hour and treat multiple individuals in the same room, allowing them to still cover their overhead but divided their cost per treatment accordingly. This makes them less expensive, but comes with limitations on time and access to the acupuncture points. For those who have never been to see a regular acupuncturist, these differences are not readily apparent. Unfortunately, those who practice community-style acupuncture erroneously advertise their services as traditional and more effective, without mentioning the limitations of their style. Below are four quotes found on the FAQ page of the Community Acupuncture Network's website, and a recourse of each.
1. “Acupuncture has been a community based medicine for most of its long history.” In Asia, acupuncture has traditionally been practiced in group rather than individual settings. ”
In the ancient tradition of Chinese medicine, acupuncture was practiced in different settings. There were some who practiced in clinics and some who were traveling healers (the famous “barefoot doctors”). But the most skilled practitioners worked for the royal families and did treatments on a strict one-on-one basis, which was considered to be the optimal ratio for the highest quality health care. Even today in China practitioners work in a variety of settings, just as it is here in America. Some have private practices, some work in hospitals, and some work in clinics. Those in private practice see patients on an individual basis. Those in hospitals work side-by-side with doctors and patients can choose to be treated with eastern or western medicine or even a combination of both, an option we do not even have here. The third group work in clinics where patients are treated all together in one large room. However, there are two very important differences as to how these clinics operate in China that is notably different from how community acupuncture is practiced here. First, in China there is not as much embarrassment about being naked so, if necessary, patients may completely disrobe in front of each other to allow access to certain acupuncture points or parts of the body that need to be treated. In American society this would be impossible so community acupuncture here is limited to treating only those parts of the body that can be reached while fully clothed. Second, in China clinics use regular examination tables for treatments while here it is usually done with patients sitting in armchairs. This means that in America, community acupuncture is also limited by the accessibility to access to all of the points on the back of the body. So in community acupuncture, as it is practiced here in America, over half of the total acupuncture points are inaccessible.
2. “For acupuncture to be most effective, patients need to receive it regularly and regularly.”
In Chinese medicine there is no frequency of treatment that is considered to be ideal for all people and all conditions. The frequency and regularity of treatments is determined in many ways, particularly by how long you have had your condition. For example, the longer you have had something, the less often you will need treatments. This is because chronic conditions are more ingrained with deep roots, and they generally tend to shift slowly and gradually over time. On the other hand, conditions like colds will definitely respond faster so frequent treatments would be ideal. Other factors that can influence frequency and regularity of treatment include your general state of health, your age, the severity of your symptoms, and your compliance with taking herbs and making diet and lifestyle changes. So, for some conditions daily treatments may be idea, while for others treatments every other week would be better. If the patient's goal is to utilize acupuncture for preventive medicine or to maintain wellness, they may come in even less often, say once per month to once per season.
3. “As acupuncture has moved towards the mainstream, it has been taken into a paradigm of one-on-one treatments and high prices, which has decreased not only patient access but treatment efficiency.”
There is no form of health care for which the efficiency of a treatment is dependent on the number of individuals in the room or the amount charged for the service. In Chinese medicine efficiencies depends much more on the skill of the practitioner to make an appropriate diagnosis and select the appropriate course of treatment. On the contrary, I would argue that the limits of community acupuncture have a greater potential to decrease treatment efficiency. First is the limitation of time, which makes it especially hard to make an accurate diagnosis. While most acupuncturists see about one patient per hour, community acupuncturists will see up to four. This does allow them to split their costs and do cheaper treatments but it restricts the time available for each patient. A high quality session with an acupuncturists can include questions about all bodily systems and functions, especially in the case of chronic and / or complicated cases, and this alone can take 30 to 45 minutes. In addition to this there may be a physical exam, dietary and lifestyle counseling, and discussion of a treatment plan. There should also be time allowed to answer patient questions and, especially in the case of pain, to do some of the hands-on therapies acupuncturists are trained to do like tui na (Chinese medical massage), cupping (glass orbs suctioned to the skin ), moxibustion (smoldering herbs used to warm acupuncture points), or acupressure (applying manual pressure to the acupuncture points). There is simply no way to complete all of this in just 15 minutes. The second limitation in community-style acupuncture is on access to the acupuncture points. Because all of the points on the back of the body and any point that requires disrobing are off-limits, the appropriate treatment may not even be possible. For example, the most common reason that patients come in is for pain and the most common area of pain is the lower back. In a community-style clinic not only would the practitioner be able to treat the lower back directly, they would also be unable to do tui na or any other hands-on treatments in that area.
4. “Community acupuncture clinics represent a return to tradition.”
Actually, this medicine is practiced in many different cultures in many different ways and there are literally hundreds of different traditions. In India there is a traditional form of acupuncture that is part of Ayurvedic medicine that is based upon the Suchi Veda, a 3,000 year old text that predates the written record of Chinese medicine. In this tradition the needles were dipped in herbal liquids. In Japan traditional acupuncturists use needles that are much thinner than those used by the Chinese and there is one particular style in which only one point is needed for treatment. The Japanese also developed shoni-shin, a type of pediatric treatment in which various metal objects are used to poke, prod, or scrape (but not pierce) the acupuncture channel system. They even have a 400-year old tradition of blind acupuncturists and currently about a third of all acupuncturists in that country are blind. In Korea there is a focus on needling the hands only. This is a kind of “microsystem” acupuncture in which the different areas on the hands are said to have a one-to-one correspondence with other specific areas of the body. Another microsystem form is auricular (ear) acupuncture, which is used extensively in America by members of the National Acupuncture Detoxification Association to help patients break drug addictions. There are also separate traditions in other countries like Vietnam and Tibet. Even in China there are multiple branches of this ancient medicine, with hundreds of guarded family tradition. In truth, there are many different traditions in this field and community acupuncture represent a new way in which this medicine is being practiced.