Why should I see an acupuncturist?
There are four main reasons patients consider acupuncture treatment:
• Most commonly, patients have a condition that does not respond to conventional care. They seek a treatment option that can effectively provide a solution to their healthcare issue.
• Conventional treatment often requires drugs with undesirable side effects or an unwanted surgery to treat the condition; therefore an alternative medical option is sought.
• Patients are taking many western drugs that are expensive, have side effects or interfere with one another. Often Chinese medicine can treat these conditions so that the drugs can be withdrawn.
• Patients seek a natural, holistic medical approach to healthcare.
NY Times on Why Patients Choose Alternative Medicine
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Can acupuncture help me even if I feel healthy?
Yes, absolutely. Many patients come in for regular maintenance treatments to stay in ‘tip-top' condition so they can fully enjoy life. Acupuncture is a powerful preventative measure to keep patients healthy throughout the year. Acupuncturists see subtle signs of disease processes at work before symptoms begin to interfere with daily life. Chinese medicine effectively addresses these issues, preventing future problems from occurring. Because acupuncture treatments are so deeply relaxing, many patients find regular, maintenance treatments beneficial for stress relief. <BACK TO TOP>
How does acupuncture work?
Traditional Chinese Medicine is based on an energetic model rather than the biochemical model of Western medicine. The ancient Chinese recognized the vital energy inherent in all living things. This energy is called Qi (pronounced chee). Over thousands of years of practice, the ancient physicians discovered a system of cyclic energy flowing in the human body along specific pathways called channels or meridians. Each channel is associated with a particular physiological system and internal organ. When the Qi in the pathways becomes obstructed, deficient or excessive, disease occurs. The corresponding organs and muscles do not get their necessary flow of energy and nutrients to properly perform their physiological functions.
The channels communicate with the surface of the body at specific locations called acupuncture points. Needles inserted in these points influence the Qi that flows to internal organs. Acupuncture can also affect specific areas of pain associated with injury or trauma. A needle inserted near the area of overstrained muscle or tendon will adjust the flow of Qi and nutrients to that area, thereby reducing pain and accelerating the healing process.
The acupuncture points have various functions, like stopping pain, stimulating immune function, or resolving phlegm (for coughs or runny noses). There are even points with empirical functions, like treating rashes or constipation. Other points are chosen with regard to location; for example, using points on the shoulder, knee or back to treat pain. [Acupuncture: Traditional Chinese Medical explanation]
Using a system of pulse and tongue diagnosis, coupled with findings obtained by inquiring about related symptoms and physical exam, the acupuncturist determines the pathology affecting Qi (energy) flow to internal organs, muscles, skin and joints. The acupuncturist will then develop a treatment protocol to resolve the patient's condition.
From western biomedical research, we understand that acupuncture influences a number of physiological functions such as release of endorphins (natural pain killing chemicals) by the brain, restoration of proper circulation in diseased areas, and stimulation of hormonal glands and immune system function. Research into the effects of acupuncture is still young. Scientists discover more information every year that helps us understand more fully how acupuncture works. [Western science explains acupuncture] <BACK TO TOP>
How many treatments will I need?
In Chinese Medicine, we speak in terms of courses of treatments. One course is considered ten to twelve acupuncture treatments or weeks of herbal therapy. Clinical response to acupuncture treatment is individual, but there are some generalities acupuncturists expect. Some people will notice improvement after a single treatment. Others take longer to respond as acupuncture requires a cumulative effect. Most patients begin noticing changes within one to three treatments. After five to seven visits both the patient and the practitioner should feel confident that the treatment is effective. Acute conditions may be fairly well resolved at this point. Chronic conditions take longer. Excepting continual, longstanding problems (such as allergies ), most conditions are resolved within a course to fifteen treatments. <BACK TO TOP>
How frequently are visits spaced?
Generally patients are seen on a weekly basis. For some acute conditions, such as severe pain or extremely itchy, uncomfortable rashes, it may be necessary to come twice a week for the first two to three weeks, until symptoms are contained. As the condition improves, visits are spaced farther apart: every two, and later three weeks or monthly. On average, patients come weekly for about eight visits, and then begin decreasing the frequency of visits as symptoms become more intermittent and later disappear.
Once the condition has resolved, many patients choose to continue treatment for maintenance and preventative care. These maintenance visits can be monthly or quarterly, or semi-annually, depending on the patient's goals. [‘What are maintenance tune-ups?] <BACK TO TOP>
Do I need to keep coming after my symptoms are gone?
Generally speaking, once symptoms no longer occur, a clinical cure is achieved. Depending on the nature and history of the disorder, future treatments are usually not necessary to prevent recurrence. Exceptions are for chronic conditions that tend to recur, such as back pain and allergic problems. <BACK TO TOP>
What are maintenance tune-ups?
Some patients like to come on a monthly or quarterly basis for preventative care. These types of treatments are nicknamed ‘tune-ups'. Just as we get regular maintenance on our cars, our bodies need regular maintenance to keep them healthy, too. Acupuncturists see subtle signs of disease processes and can address these issues in a few number of treatments, thus avoiding the development of more serious health problems that require a longer series to treat. These preventative care visits are especially important for patients with long-standing, chronic conditions that tend to recur, such as back pain or allergic problems . Because acupuncture treatments are so deeply relaxing, many patients find regular maintenance treatments beneficial for stress relief. <BACK TO TOP>
What if I can't come for regular acupuncture treatments?
Herbal therapy is an effective option for those who cannot come regularly for acupuncture visits. Some patients opt for Chinese herbal formulas instead of acupuncture treatment. Combining the modalities of herbs and acupuncture creates a synergist treatment pair, each increasing the power of the other. Herbal therapy can fill in for the interval between acupuncture treatments, allowing some patients to decrease the frequency of acupuncture treatment.
TCM (Traditional Chinese Medical) herbalists use herbs instead of drug therapy to address problems internally. In fact, many conditions, such as gynecological problems, dermatology and immune system disorders require herbs for effective treatment. Pain conditions require regular acupuncture treatments for resolution of symptoms.
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Does acupuncture hurt?
The vast majority of patients do not consider acupuncture a painful procedure. Some patients feel a slight ‘Qi' sensation when the needle is inserted: most feel nothing at all. These ‘Qi sensations' range from warmth or tingling, to a brief ache or heaviness in the area being needled. Qi sensations are generally only felt on one or two of the acupuncture points. They indicate favorable results from the acupuncture treatment, as Qi has been strongly contacted. By and large patients describe these sensations as fleeting and the treatment experience as deeply relaxing. In fact, many patients find acupuncture so relaxing that they fall asleep during treatment and go into a dreamy state induced by the endorphins released during treatments.
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Are the needles safe?
Yes. Acupuncturists use sterile, disposable needles. They are used once and then disposed of in biohazard containers. These containers are sent to a medical waste management company for proper disposal according to federal laws and regulations.
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Are there any side effects to acupuncture?
In 2001, the British Medical Journal (vol. 323, no.7311) published the results of two large-scale studies showing that the benefits of acupuncture far outweigh negative side effects of treatment. The few post-treatment complaints were minor and short-lived, ranging from bruising to needle pain and lasting less than a week, with no serious adverse events noted. In an accompanying editorial, the journal concluded that complications from acupuncture are “remarkably rare and transient” [ranging from 0.1 to 0.7 percent] especially when compared with the rate of adverse drug reactions or prescribing errors in primary care medicine, estimated at 0.5 to 6 percent. <BACK TO TOP>
One of the reasons that acupuncture has been so well embraced in the West may have to do with its low rate of side effects. "For a medical procedure, you almost cannot get anything that is more benign," says James Dowden, Executive Administrator of the American Academy of Medical Acupuncture. "About the worst thing that can happen is you won't get better."
In it's landmark, 1997 Consensus Statement on Acupuncture, the NIH (National Institutes of Health) reported, “One of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same conditions.” (Acupuncture. NIH Consens Statement 1997 Nov 3-5; 15 (5): 9.)
Is acupuncture covered by insurance?
A growing number of insurance companies will reimburse for acupuncture treatments. Consult your insurance provider to determine the terms of coverage of your policy. If your policy includes acupuncture benefits, Asheville Center for Chinese Medicine will provide you with an insurance coded receipt that you may submit to your insurance company for reimbursement.
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I want to begin for treatment, what do I do next?
Call 828.258.2777 to schedule an initial consultation with Kath Bartlett, MS, LAc. The initial consultation consists of a comprehensive health evaluation, a TCM (Traditional Chinese Medical) diagnosis of your condition and a prognosis for treatment. A treatment plan can then be developed that will best meet your needs. [Initial Consultation]
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What should I wear for the acupuncture treatments?
Wear loose fitted, comfortable clothing. You might want to bring a tank top and shorts to allow the acupuncturist easy access to the body. Most of the points needled are on the torso and limbs, below the elbows and knees. Exceptions are for pain, where local points will be used in the affected area, such as the shoulder. <BACK TO TOP>
Should I keep my appointment if I'm sick?
Yes. Acupuncture and Chinese herbs are highly effective for treating acute conditions, such as colds and flus, stomach viruses and headaches. Patients report immediate improvement in symptoms after acupuncture treatment or commencing herbal therapy. An oft-repeated phrase by happy patients is, "As soon as I started taking the herbs I felt better!"
Many patients call immediately to schedule a treatment when they first notice cold or flu symptoms. These include healthcare practitioners who don't want to get their patients sick, business professionals who are too busy for a sick day or two, and patients who are chronically ill and want to 'get this one over with, quickly'.
So if you're sick, call your acupuncturist and make and appointment. If you have an appointment scheduled, keep it. If you're concerned about being contagious to your practitioner, request an herbal consultation instead of a treatment. <BACK TO TOP>
Are there different styles of acupuncture?
Chinese medicine is over 5,000 years old. During that time, many individual styles (off shoots or branches) have developed from the traditional, TCM style of diagnosis and treatment. These include Japanese style, Five Elements, Korean hand technique, French auricular (ear acupuncture), Daoist and Tibetan styles of acupuncture. The TCM style (Traditional Chinese Medicine) is the ‘granddaddy' of them all: the source from which the other branches sprang forth. Kath Bartlett, MS, LAc, practices in the TCM style. <BACK TO TOP>
Is an acupuncturist a doctor?
In the broad sense of the word, yes, an acupuncturist is a doctor. Acupuncturists diagnose and treat disease, as does a western medical doctor or chiropractor. However, the term ‘doctor' also includes those who have been formally educated at the doctorate level.
Acupuncture is medical field new to the US and thus is in its' early phases of growth and development. The first two 4,000 hour doctorial programs in oriental medicine only recently began in 2004. It will be some years before the doctorate degree becomes the standard for entry into the Oriental medical field. Currently, graduates of acupuncture colleges must complete a master's level program. Programs such as Pacific College of Oriental Medicine's 3,350 hour Master's of Science in Traditional Oriental Medicine (Kath Bartlett, MS, LAc's alma mater) are among the most rigorous training available to acupuncturists.
Because acupuncturists hold master's degrees rather than doctorate degrees, in a 2001 column the NY Times Ethicist, Randy Cohen unequivocally stated that it is unethical for an acupuncturist not possessing a medical doctorial degree to refer to him/herself as a doctor. Cohen reasons that using the Dr. title intentionally misleads the public who will naturally assume that the ‘doctor' holds a medical, doctorate degree.
As in most states, North Carolina acupuncture licensing law grants the title of Licensed Acupuncturist to acupuncture practitioners. The law only allows licensees to use the Dr. title if s/he holds a doctorate degree in the field of medicine (one cannot parlay a PHD degree earned in another field of study, or a doctor title granted by acupuncture licensure in another state to one's acupuncture practice in North Carolina ). <BACK TO TOP>
What kind of education and training do acupuncturists receive?
This important question has a varied answer. Chinese medicine first came to the US during the 1970's, when James Resdon, a NY Times reporter received acupuncture anesthesia during an emergency appendectomy while in China. (He was part of President Nixon's entourage reporting on negotiations to open China for trade with the US .) He ran a story about the amazing experience he had with TCM (Traditional Chinese Medicine). [How acupuncture became popular in the US: James Resdon story] Shortly thereafter, acupuncturists began noticeably practicing in this country, and acupuncture colleges began to appear.
The early acupuncture college programs in the US were typically two years in length. At that time, not many books on TCM had been translated or written in English, so the early students received much of their material orally from more experienced practitioners. Since that time, acupuncture colleges have proliferated in the US, the programs have increased in length, and a great amount of scholarly literature and clinical manuals have been published in English about Chinese medicine. There are now approximately 60 accredited and candidate acupuncture colleges in the US, and the master's degree level is required for state licensure.
Accredited master's level programs must be at least three years in length and at least 2,200 hours for Oriental Medicine (includes acupuncture and Chinese herbology), or 1,700 hours for acupuncture only programs. State laws vary regarding minimum length of study and content of programs they require for licensing acupuncturists. California is known for its especially rigorous requirements. Beginning in 2005, CA required graduates to have a minimum of 3,000 hours at an accredited acupuncture college. By this point in time most California acupuncture colleges had already increased their course curriculums to 2,700 and up to 3,350 hours at the more challenging programs.
Kath Bartlett, MS, LAc attended Pacific College of Oriental Medicine (PCOM) in San Diego, California. PCOM's Master of Science degree program in Traditional Oriental Medicine (MSTOM) is considered in the vanguard among American acupuncture colleges. MSTOM graduates of PCOM receive over 3,200 hours of classroom instruction and clinical internship. The curriculum, which includes more than 700 hours of western bio-medical sciences, over 1,300 hours in oriental medical theory, herbology and treatment techniques, and more than 1,000 hours of clinical training and internships, requires four years of accelerated, year-round studies to complete.
Bartlett added a fifth year of study (totaling 3,500 hours) in order to include additional coursework in Chinese language, herbal and oriental medical theory. In private classes with a widely respected Chinese physician: Dr. Min Fan, formally of Beijing University , Bartlett studied the four classic texts of Chinese medicine required for graduation from acupuncture colleges in China but rarely taught in the US. (To compare training, MD's and chiropractors complete 4,000 - 4,500 hours of study in their respective doctorial programs.)
Bartlett concentrates her post-graduate studies of Chinese medicine within the disciplines of clinical herbology, dermatology and the classic texts of Chinese medicine, including a multi-seminar series, Advanced Practitioner Training, from the Institute of Chinese Herbology (Oakland, California). She has studied with several famous TCM physicians, notably Dr. Jeffery Yuen. (Curriculum Vitae) <BACK TO TOP>
What are the licensing and certification requirements for acupuncturists?
The answer to this question varies, depending upon the state in which the acupuncturist is licensed. Most states, including North Carolina, require acupuncturists to pass the NCCAOM (National Certification Commission for Acupuncture and Oriental Medicine) acupuncture certification exam. The NCCAOM certifications are the gold standard of certification in the Oriental medical field. NCCAOM offers several different certifications: Acupuncture, Chinese herbology, Oriental bodywork therapy (Tui Na massage) and the comprehensive certification: Oriental Medicine.
In order to sit for the NCCAOM exam, one must have graduated from an accredited acupuncture college, and be certified in Clean Needle Technique by the CCAOM (Council of Colleges of Acupuncture and Oriental Medicine). As part of the certification process, NCCAOM verifies transcripts and graduation status from accredited acupuncture colleges, and Clean Needle Technique certification. NCCAOM exams test for adequate depth of knowledge and clinical expertise a diplomat must have in order to practice in the various disciplines of Oriental medicine. Oriental Medicine certification candidates must have completed required coursework in acupuncture, Chinese herbology as well as western, biomedical sciences, Tui Na massage, nutrition and Chinese dietary therapy, Tai Qi and Qi Gong (Chinese style meditative exercises used for therapeutic purposes). Kath Bartlett, MS, LAc is board certified by NCCAOM in Oriental Medicine. [Curriculum Vitae] <BACK TO TOP>
How do I know if my Chinese herbalist is qualified?
Though most states (such as North Carolina) include Chinese herbology in their licensed acupuncturists' scope of practice, licensure only requires that candidates have graduated from a 1,700 acupuncture program which does not include instruction in Chinese herbology. Only on rare occasions do states require practitioners be board certified in Chinese Herbology by NCCAOM. Prospective patients interested in Chinese herbal therapy should inquire whether the proposed herbalist has graduated from an Oriental Medicine program (includes instruction in Chinese herbology) and is a NCCAOM diplomat in Chinese Herbology (board certification ensuring adequate education and training in Chinese herbology).
Another telling question to ask a prospective herbalist is whether s/he uses a raw or granulated herbal pharmacy. An experienced Chinese herbalist will most likely utilize raw herbs, though a few might use only granules (powdered herbs). The herbalist has the most flexibility in writing and dosing herbal prescriptions when using raw and granulated herbs. These methods allow the herbalist to specifically tailor the prescription to the patient's presenting symptoms. An inexperienced herbalist does not have the necessary knowledge of Chinese herbal medicine to write his/her own prescriptions, and therefore will prescribe manufactured formulas, called ‘patent herbs' instead.
Kath Bartlett, MSTOM, LAc is highly educated and experienced in the practice of Chinese herbology. Bartlett attended Pacific College of Oriental Medicine (PCOM), well known for the rigor and competency of its herbal studies program. PCOM's MSTOM program includes 400 hours of classroom instruction in Chinese herbology, as part of the 3,200 hour MSTOM degree program. While at PCOM, Bartlett attended three years of additional private classes in Chinese herbology with Dr. Min Fan, formally of Bei Jing University . Bartlett concentrates her post-graduate education and training in the discipline of Chinese herbology, including a multi-seminar series, Advanced Practitioner Training, from the Institute of Chinese Herbology (Oakland, CA). Bartlett holds a Diplomate from NCCAOM in Oriental Medicine. This comprehensive board certification includes NCCAOM's Chinese herbology and Acupuncture certifications. [What are the licensing and certification requirements]
Asheville Center for Chinese Medicine has both raw and granulated herbal pharmacies of over 200 herbs in each. Bartlett strongly encourages her patients to include individualized, Chinese herbal formulas as part of their comprehensive treatment plan. She uses patent herbs only in rare occasions to suit the individual needs of a particular patient. <BACK TO TOP>
What is a Medical Acupuncturist?
This is an important question of great concern in the Oriental medical profession. Medical acupuncturists are MD's who have taken a 100-300 hour course in acupuncture (often at UCLA) allowing them to practice on patients. (Chiropractors are also legally allowed to practice acupuncture after completing a 300-hour course.) They do not have the extensive education and training in Oriental medicine NCCAOM certified practitioners receive.
NCCAOM certified practitioners must have graduated from an accredited acupuncture college with a minimum of two years and 1,700 hours for Acupuncture certification, or 2,200 hour for Chinese Herbology or Oriental Medicine certifications. (Oriental Medicine is a comprehensive certification demonstrating knowledge and training in acupuncture, Chinese herbology, western biomedical sciences, Chinese dietary therapy, Tui Na massage, Tai Qi and Qi Gong. [What are the licensing and certification requirements for acupuncturists?] However, most acupuncture college programs are considerably longer, taking three to four years of fulltime study to complete. California acupuncture colleges adhere to especially stringent laws, requiring 3,000 hours of education and clinical training, of which 2,000+ hours must be in the discipline of oriental medical theory. [Licensed Acupuncturists vs. Certified (Medical and Chiropractic) Acupuncture]
Of even greater concern is the 300-hour course for MD's and chiropractors was designed to give medical researchers the appropriate background necessary to develop and interpret studies on acupuncture. The Medical Acupuncture certification was not designed to meet the educational requirements and training neccessary to treat patients. If your doctor provides Medical Acupuncture services, inquire whether s/he is certified by NCCAOM, the most rigorous and extensive level of certification in the Oriental medical field . <BACK TO TOP>