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第四届美国中医药大会在贝尔维尤凯悦酒店召开 http://sea.uschinapress.com/2018/0807/1139133.shtml
2018-08-07 17:13 来源:西雅图在线 编辑:Jay

【侨报记者王馨谣8月6日西雅图报道】2018年8月4日至8月5日,第四届美国中医药大会暨太极集团国际中医药论坛在位于贝尔维尤的凯悦酒店(Hyatt Regency Bellevue)内隆重召开。

本次大会由美国中医校友联合会(TCMAAA)与全美中医药学会(ATCMA)主办,成都中医药大学北美校友会承办,美国南海公司(西雅图)协办。

成都中医药大学教授刘敏如、成都中医药大学教授廖品正、班康德博士(Dr. Dan Bensky)、太极集团秦少容总工程师、中国名中医张发荣教授、马寿椿教授、成都中医药大学书记刘毅教授、全美中医资格认证安全委员会主席布罗姆利博士(Dr. Afua Bromley)、贝尔维尤市议员李瑞麟、505集团来辉武教授等国内外中医学界专家莅临大会。

今年大会的主题是“中医药针灸的经典与临床”。大会以中医妇科及皮肤美容为主要讨论议题,也涉及到过敏性鼻炎,糖尿病,眼睛的疾病以及疼痛等常见疾病的治疗。同时,由多位妇科,皮肤科专家参与的妇科,皮肤科论坛,在现场回答大家临床上遇到的问题,并把他们自己临床几十年的经验和与会者们分享。

值得一提的是,本次大会还邀请到了两位国医大师刘敏如教授与廖品正教授。据介绍,两位大师均为80多岁的高龄,但依然不辞辛苦从中国来到美国,与在这里的中医药学者们交流经验。

在接受侨报记者采访时,中国第一位女国医大师刘敏如教授表示,这已是她第三次来到美国参加美国中医药大会。刘教授称,她来到美国的初衷是希望能够提高中医在国际上的地位。刘教授强调,在很多人认为中医是一种传统医学,但实际上中医正在与时俱进。临床上中医对一些疑难杂症的治疗甚有疗效。刘教授说,中医学发展,要在继承传统经典理论的基础上创造中医学的新观点、新学说、新理论。刘教授表示,这次的美国之行中她很欣喜的发现,在大西雅图地区的中医发展很好,相信在未来也会有长足的进步。

作为中国首位中医眼科博士导师廖品正在接受采访时表示,这是她第一次来到美国参加美国中医药大会。她既感叹于中医在美国发展,也希望在美的中医师们能够凝心聚力为中医在美国的发展继续做出贡献。她尤其希望能够通过这样的机会让更多的人重视中医治疗在眼科中的作用。

成都中医药大学书记刘毅教授也是第一次来到美国参加大会。刘毅向记者表示,近几年中医的发展受到越来越多人的关注,尤其在国际社会,中医被更多的人支持。而参加这次大会,中医校友们在海外的凝聚力让他很感动,他也坚信在海外中医师们的努力下,中医在海外的地位一定会有所提高。

全美中医药学会常务副会长兼美国中医校友联合会/全美中医药学会CEO魏辉告诉记者,根据今年1月最新的数据统计,目前全美共有中医师37866人,而这其中华人中医师只有8000人左右。这个数据反映出:在美国,华人中医师只占很小的一部分。魏会长称,通过全美中医药大会聚集在美的华人中医师,这样既可以交流互相的经验心得,也可以增进华人中医师们的凝聚力。而本次大会中有来自全球各地的中医师前来参加也足以证明中医的发展在进步。

此外,中国太极集团、505集团、CAI Corporation、NCCAOM、TCMZONE、西雅图移民之家Laura Counsell资深理财、巴斯蒂尔大学(Bastyr University)、Atlantic Financial Group,李彩芹、UPC Medical Supplies美国太平洋药业、Active herb Technology、Bio Essence herbal Essentials Inc.、E-Fong Herb Inc.中国华林公司酸碱平项目武汉德瑞团队、KPC producers Inc.、Blue light Inc.、四川好医生药业集团、发龙公司、奇正藏药、American Acupuncture council、TS Emporium、Marathon Ginseng Gardens这些赞助商和参展商也为本次大会的顺利召开提供了不可或缺的支持。

太极集团卿玉玲教授、中国名医张发荣、金鸣博士、谢克蓉教授、沈晓雄博士、刘宁教授、郑崇勇主任中医师、苏毅文教授、刘国晖教授、凯瑟琳·卢米埃尔博士(Dr. Kathleen Lumiere)、段俊国教授等多位中医师们带来了经验讲座。身为本次大会顾问的西雅图马寿椿博士和美国道教文化学院院长莫至城道长给大家带来了养生公益讲座。美国全国针灸中医认证委员会NCCAOM派出代表团向大会介绍了美国中医师针灸师的认证以及最近的一些政策变化,今年针灸师正式获得独立的职业代码,使这个行业正式成为美联邦认可的一个健康保健类职业。华盛顿州的针灸和东方医药协会(WEAMA), 两所中医针灸相关院校巴斯蒂尔大学(Bastyr University) 和 SIOM 的师生们都积极参与支持大会。

现场还有气功晨练、妇科大论坛交流等活动,活动参展商们也摆出的摊位。晚上精彩的节目表演更是将大会推向了高潮,在欢声笑语中,第四届美国中医药大会暨太极集团国际中医药论坛完美落幕。

 

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来源:新华社作者:杨士龙 吴小军责任编辑:柳晨

新华社纽约1月18日电(新华社记者杨士龙 吴小军)如果没有碰到“针灸医师”魏辉,美国纽约芭蕾舞学校新生妮可的芭蕾梦可能早就碎了。

妮可家住佛罗里达州西棕榈滩,去年年初参加佛州一次芭蕾舞比赛前韧带拉伤,当地医生建议去医院接受手术治疗,但那样会错过比赛。看到孩子的医疗保险可支付大部分针灸治疗费用,母亲雅西卡抱着试试看的心情,带女儿去了魏辉的针灸诊所。没想到只扎了两次针,辅以艾灸治疗,小姑娘就得以顺利参赛并获奖。后来,妮可又去魏辉那儿巩固治疗了6次。

去年9月,妮可到纽约上学前,特地与母亲一起去跟魏辉道谢并告别。雅西卡当天在自己脸谱账户上贴出了女儿与魏辉的合影,并配文说,魏辉是她们“最喜爱的针灸医师”,称赞她“用爱心和耐心让女儿免除了对针灸和拔罐的恐惧感”,成功解除了孩子的病痛。

从不熟悉到逐渐认可,甚至依赖,雅西卡母女对针灸乃至中医的认识过程,是美国社会日渐接受和认可中医的一个缩影。

“中医正在被越来越多的美国人认可。”1999年,魏辉从北京中医药大学毕业后移民美国,目前是全美中医药学会常务副会长。她在接受新华社记者电话采访时说:“三四年前,来我这里的病人,用保险支付针灸费的只有5%,现在这个数字超过了30%。”

她介绍说,1997年5月,美国国家卫生研究院(NIH)召开了针灸共识会议,决定承认中国针灸并正式应用于患者的临床治疗,这标志着美国在联邦层面正式认可了针灸。

美国50个州中,已有46个州及华盛顿特区通过了针灸立法,各州立法有所不同,但反映出地方政府对针灸这一健康产业的重视。资料显示,目前全美有执照的针灸师有4万左右,每年接受针灸等“整合治疗”的人口约3800万,已形成一个产值数十亿美元的重要产业。

“以前谈针灸和中医,这边人习惯称‘替代疗法’,现在称‘整合医疗’,明确了它是社会健保机制的一部分。”大纽约中医针灸学会副会长陈德成完全赞成魏辉的看法。身为南京中医药大学针灸专业博士的陈德成介绍说,针灸已通过立法的各州被大多数商业保险公司定点、定向、定额为医疗保险项目。

美国政府对“非正规传统医学”(相对于西医)研究工作的支持力度也在逐年加大。NIH成立的国家补充替代医学研究中心,每年经费高达1亿多美元,主要任务是研究各种补充替代医学和疗法,其中对针灸和中药的研究已有几十个项目,太极拳、气功和推拿等也在研究之列。

魏辉和陈德成均表示,中医针灸之所以逐渐从健保产业的边缘走向中心,是与中医“治未病”的理念以及独特显著疗效分不开。更现实的是,相对于西医,很多种病的中医治疗费用相对较低,风险小,候诊时间短。

“比如说,一些膝盖疼的病人,医院都建议手术替换,费用高不说,人工关节只管10多年,之后怎么办呢?”陈德成说。“我的不少病人都很感激地说,是我帮他们远离了手术台。”

然而,在“西医是正统”的美国,中医真正被全面认可还是远景。针灸、推拿、艾灸等与中医药被区别对待,即便是已被普遍接受的针灸业,也面临被瓜分蚕食和改头换面的危险。

陈德成说,一些西医根本未接受任何针灸培训,就宣称自己掌握了针灸技能,以抢夺针灸市场,当治疗效果不佳时,他们不认为自己技术不精,而是埋怨针灸无效,严重影响了针灸在公众中的良好形象。

此外,大多数针灸医生活跃在临床前线,针灸科研是一个弱项,而西医作为“标准的制定者和判断者”,常用循证医学的标准来衡量中医针灸。“中医针灸今后应加强科研,还要申请专利保护自己权益,”魏辉说。

陈德成指出,中医针灸界应该形成合力,推动立法和参与规则制定来最大限度地保护自身权益。例如,在美国中医校友联合会基础上建立起来的全美中医药学会为提升中医学术水平,保护行业利益,扩大中医针灸的影响发挥了重要作用。

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新华社华盛顿9月17日电 专访:“针灸是个好东西”——访全美中医药学会会长田海河

http://www.xinhuanet.com//health/2017-09/19/c_1121684776.htm

新华社记者林小春

第三届美国中医药大会16日至17日在华盛顿举行,来自美国、中国等国的300余名中医药专家参会。就中医在美国面临的机遇和挑战,会议主办方之一、全美中医药学会会长田海河接受新华社记者专访时说,“针灸是个好东西”,但科研仍有待进一步加强,同时中药发展也应及早提到日程上来。

田海河说,自美国前总统尼克松访华把中医带回美国,至今已45年。经过多年坎坷,中医在美国有了长足发展,现在已有46个州和华盛顿特区完成了针灸立法,目前各类有执照的针灸医生约有4.5万人。

“这个发展形势很好,但是学术水平良莠不齐,而且中医尚未进入医学主流体系,”田海河说,“就像美国人选择餐馆时还是以西餐为主,喜欢中餐的人虽有,但仍不占多数。要把中医带入美国主流社会,我们还有很多工作要做。”

田海河说,作为外来医学,中医在美国“还是会受到一定排挤”,虽然临床、科研等为针灸有效性提供了一些证据,但还不是非常充足,“需要我们更有效地开展工作,提供更有说服力的证据,让民众、媒体以及立法、保险等各方面能更进一步认可中医,接受针灸”。

他说,很多人都认识到针灸的价值,近期一些其他行业也想参与其中。“我们欢迎更多人来做针灸,惠及民众,但有些人只接受了很少的训练,就提供针灸服务,还有人把针灸改成‘干针’,试图绕过法律和执业范围限制去做针灸,非但没效果,还给病人带来安全隐患,所以我们要反对,并普及知识,帮助民众找到合格的针灸师”。

田海河介绍说,“干针”本来就源于针灸,有人把针灸“改头换面”,说跟中医无关,“这是一种剽窃行为”。

谈到中药在美国的发展,田海河认为,中药在美国未列入药物范畴,只能归类为食品补充剂,不能宣传治疗效果,这限制了中药的广泛应用和发展。

田海河说,这次大会是由全美中医药学会和美国中医校友联合会主办,目的就是团结更多的华裔和非华裔中医药相关人士,共同探讨如何抓住机会,应对挑战,提升整体学术水平,引领中医药在美国向正确方向发展。

在这次大会上,世界针灸学会联合会主席、中国针灸学会会长刘保延作了题为《针灸临床疗效研究的思考与实践》的主题报告。他指出,虽然针灸临床研究论文在1992年以后快速增长,但一直没有形成系统的临床评价方法,缺乏高质量研究数据,为此中医学界制定了针灸临床研究和技术操作等一系列规范并仍在继续完善,希望按照国际通行标准,“推动针灸堂堂正正进入主流医学体系”。

美国食品和药物管理局植物学评审组官员李静介绍了该机构有关植物新药的评审情况。她指出,截至去年年底,共有超过650种植物药物提出或通过“新药临床试验申请”,其中绝大多数处于二期临床试验阶段,有两种获准上市。如果把植物药物按全新成分的药物看待,这个通过率“还不错”。

会上,世界中医药学会联合会秘书长桑滨生介绍了中国《中医药法》及其对海外的影响,来自美国国家卫生研究院等多家机构的十多位专家学者作了学术报告。大会主要赞助企业同仁堂也介绍了其国际化之路,这家企业已在纽约、旧金山和洛杉矶开设分店,正致力于提升这一中国品牌在美国的知名度。

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2018年04月07日05:47  来源:人民网-人民日报海外版 http://webcache.googleusercontent.com/search?q=cache:http://world.people.com.cn/n1/2018/0407/c1002-29909910.html

莎伦又一次躺在熟悉的床位上,针灸师樊蓥轻、稳、准地在她肩部和颈部的重要穴位扎上了细细的针。莎伦的耳边响起了柔和温馨的轻音乐,她慢慢闭上眼,呼吸均匀,心情平和。

樊蓥是美国弗吉尼亚州与华盛顿特区持照针灸师,他的诊所——美京中医院位于弗吉尼亚州梅克林小镇。300平方米左右的诊所内共有15个床位。身为一名职业律师的莎伦·希普勒已经忘了这是她第多少次来到诊所接受治疗。

喜欢运动的莎伦今年60岁,她与针灸的缘分始于3年前。当时她的腿部得了肌腱炎,西医告诉她最快也要几个月才能恢复。在朋友的推荐下,她来到樊蓥的诊所。樊蓥仔细查看了腿伤后告诉她:“两周来做一次治疗,3次后就能康复。”

西医的数个月康复和针灸的3次就好,这差距大得让莎伦有些不敢相信。面对莎伦的怀疑,樊蓥只是笑笑说,咱们试试看吧。

出乎莎伦意料,一个疗程下来,肌腱炎竟奇迹般康复,她矫健而轻盈的身姿很快又重现跑道。

“太神奇了!”她在接受新华记者采访时禁不住多次感叹。此后,莎伦对中医从信赖到依赖,身体稍有不适,首先想到的就是看中医。目前,莎伦所参加的医疗保险覆盖针灸治疗,可报销80%。

律师工作压力大,导致莎伦睡眠不好。多次针灸后,她感觉睡眠明显改善;每次莎伦感觉有感冒前兆,或者美国将有流感,她就赶紧来找樊蓥。莎伦相信,针灸疗法帮她提高了免疫力。最近她肩部受伤,又是针灸让她免受了手术折磨。

如今,莎伦不仅是针灸的粉丝,更成了针灸的传播者。亲朋好友生病了,她会向大家推荐中医。85岁的老母亲经常背疼,她力劝母亲尝试针灸疗法。

莎伦对中西医治疗差别感触很深。“樊蓥和他的助手对我十分耐心、细致,我感到很放松,恢复得也快。如果是去看西医,幸运的话,医生会给我10分钟,然后就开药,或安排更多检查。看到我肩痛或脚痛,西医会给我打止痛针。我可不喜欢打针和手术。所以,我会来针灸诊所。我虽不知道针灸原理,但我知道它有效。我坚信今后会有越来越多的人看中医。”

众所周知,阿片类止痛药包括杜冷丁、吗啡等,镇痛作用强大,但有极强成瘾性,这迫使人们接受非药物疗法。在各种非药物疗法中,针灸以有效和廉价脱颖而出。中国数十年来持续进行的中医机理研究形成大量成果,此时成为有力佐证。美国国家科学、工程和医学学院2007年7月发布题为《疼痛管理与阿片类药物流行》的报告指出,近几十年来针灸止痛已成为普遍做法,包括针灸在内的一些非药物干预手段是止痛的有力工具。

不久前,作为全美中医药学会(ATCMA)副会长的樊蓥,参加了在美国国会举办的针灸推介会,向议员推荐和介绍针灸在止痛与治疗药物成瘾方面的作用。现场气氛热烈,40多人还尝试了耳针。

(据新华社电 记者郭一娜 林小春 胡友松)

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国医节的回顾与前瞻

(作者:陳明 三藩市 )http://singtaousa.com/031811/sq01.php

三月十七日,是中國第八十二屆國醫節。八十二年前的一九二九年,任上海醫院醫務長的醫生余雲岫,早年留學日本,受日本明治維新取締漢醫的影響,主張「廢醫存藥」,他向南京國民政府提出《廢止舊醫以掃除醫事律法之障礙案》。此案經南京國民政府衛生部召開的第一屆中央衛生委員會之議通過,準備正式施行。中醫面臨生死存亡的鬥爭。兵書有云:「置於死地而後生」。國民政府通過廢止中醫法案,把中醫醫務人員推向背水之戰,全國中醫界空前團結,群起反對。結果取得了勝利,並定每年三月十七日為「國醫節」。

中醫是中華民族幾千年來生產生活實踐和與疾病鬥爭逐步形成並不斷豐富發展起來的醫學科學,為中華民族的繁衍昌盛作出了重要貢獻,對世界文明進步也產生了積極的影響。一百多年前隨著華人移民到美國,也把中醫中藥帶到美國。據筆者所知,第一位來美國的中醫師就是黎普泰,他是廣東順德人,一八五四年四月,黎普泰在《金山日新錄》(The Golden Hills’ News)刊登中醫館廣告。以此算起,中醫中藥傳入美國三藩市已有一百六十年。

黎普泰的中醫館最初設在華埠華盛頓街,後遷至都板街夾企李街的錦生堂樓上。黎普泰以中藥治療奇難雜症,名揚遐邇。由於求醫甚眾,他一個人難以應付,便叫他的外甥譚富園來幫忙。  譚富園就讀於北京太醫院,是當時全國唯一的最高中醫學府。一八九零年譚來三藩市,襄助普泰醫館,聲名鵲起。三年後因黎普泰病逝,譚的父親譚子山在廣州行醫,命他回去幫忙,譚富園便回到廣州。

一八九四年,富園攜妻子及三子一女來加州,在南加州的列連埠(Redlands)創立富園醫局(Foo and Wing Herb Co.)。由於富園醫術精湛,妙手回春,聲譽日隆,引起西人醫師的妒忌,在報上攻擊中醫中藥不科學。譚富園把自己的醫案交給記者發表,證明中醫的奧妙,其功效一點也不遜於西醫,甚至有些西醫無法治療的奇難雜症,中醫能夠對症下藥,藥到病除。這場關於中醫是不是科學的筆戰,由於富園既有理論,又有治癒病例醫案佐證,終於取得了最後勝利,為弘揚中醫中藥作出了貢獻。

但是,歧視中醫中藥,並不因譚富園的貢獻而結束。一八九九年創辦金山華人仁濟醫院,只設西醫部,沒有中醫部,當時旅美華人有病多喜歡中醫診治,仁濟與華僑需求有矛盾,一年後停辦。

一九零零年,華人在三藩市創辦東華醫局,一九二五年改為東華醫院,始設立中醫門診。可是,中醫中藥立法的道路,在美國還是十分漫長的。在美國的五十個州中,只有佔人口五十萬的內華達州,於一九七三年四月二十日通過第448號法案,第一次為中醫中藥立法,在法律面前承認中醫中藥的合法地位。而作為中醫中藥的兩大重鎮的加州和紐約州,至今仍沒有取得合法地位。目前中醫中藥唯一生存空間,就是在美國把中藥當作「保健品」經營。「中藥」的經營不是某個人某個組團的專利,藥材舖有商業牌照,就可開舖立市,有合法地位。「坐堂醫」開出保健菜單(處方),自然是合法的。中醫師在美國名不正言不順,美國學界稱中醫中藥為「替代醫學」。美國醫學會的標誌是「蛇」,奧巴馬醫改法案只有「蛇」,而不見有中醫中藥的「龍」。美國只在商業上承認中藥作為保健商品的合法地位,而沒有作為醫療衛生的專業領域承認中醫中藥的合法地位,豈非咄咄怪事。

針灸是中醫的一個科目,而中醫才是主體,目前加州州政府只承認針灸合法,而不承認中醫中藥合法,確是本末倒置,令人費解。

在迎接第八十二屆國醫節的時候,筆者倡議全美國的中醫中藥醫務人員,不分甚麼政治觀點,不論甚麼宗教信仰,大家團結起來,為爭取中醫中藥的立法而鬥爭。在這裡,筆者提出四點建議:

第一,吸取內華達州中醫中藥立法的經驗,以針灸立法為突破口,繼承和發展前輩爭取中醫中藥立法精神。

第二,中醫中藥全體醫務人員團結起來,不要「岐黃相輕」,而要「岐黃相親」。不要「同行如敵國」,要「同行如一國」。兩岸關係不是「一中原則」嗎?我們中醫中藥醫務人員也要樹立「一中原則」,就是爭取中醫中藥立法的原則,一切言行都要以有利於中醫立法為原則。

第三,贊同加州執照針灸醫師公會會長沈華舒的意見「實行學院教育與師徒教育相結合」。中醫傳統教育,是先有師徒教育,後來才發展為學院教育。現在卻出現只重視中醫高等教育,而輕視名中醫的授徒教育。這兩者各有優點,學院重視系統教育,師徒則重視專長教育。前者注重理論修養,後者注重臨床經驗。把二者結合起來,取長補短,培養出一批既有高深的中醫基礎理論素養又有豐富臨床診療技術水平的醫務人員,才能投入美國主流社會,征服美國社會民眾,進而為中醫中藥立法創造充分條件。

第四,把中醫中藥提高到哲學思想和世界觀來認識。過去一些著名中醫稱為「儒醫」,就是他有具有儒家思想的根底。也有一些道觀的道士為名中醫,就是他們具有道家養生的根底。可見,沒有真正認識和領會儒家和道家的哲學思想和世界觀,也就不可能真正瞭解和領會中醫中藥的真諦。中醫中藥是姓「中」,即使你已入了美國籍,但只要你是中醫中藥的醫務人員,你就永遠改變不了姓「中」。中醫中藥是中華民族文化的瑰寶之一,只有維護民族的特色,才有利於中醫中藥的走向世界,而要做到這一點,其根源正是淵源於儒家和道家的思想。

近年來,加州華裔參政人士取得很大的成績,我們希望這些參政的華裔官員和議員,不要忘記支持你們走向政壇的華裔選民。你們最好的回報,就是利用你們力所能及的影響,爭取中醫中藥早日立法。

 

 

 

譚頴秀 – 註册針灸師 http://kaywin.ca/WellnessCentre/LingLanWellnessCentre.aspx

7725 Birchmount Road Unit 29/30, Markham, Ontario L3R 9X3
Phone: 647-282-3996            Email: LingLan333@hotmail.com

譚氏曾祖父譚富園公受其父親中醫譚子山之薰陶, 就讀於北京太醫院學習中醫,曾在清朝末年任太醫,後跟隨舅父中醫師黎普泰(第一位到美國之中醫師),到美國三藩市行醫,再與康有為弟子在南加州的列連埠(Redlands)創立富園醫局。由於富園公醫術精湛,妙手回春,引起西人醫師的妒忌,在報上攻擊中醫中藥不科學化。富園公把自己之醫案交給記者發表,證明中醫之奧妙,其功效一點也不遜於西醫,甚至有些西醫無法治療之奇難雜症,中醫也能夠對症下藥,藥到病除。這場關於中醫是不是科學化之筆戰,由於富園公既有理論,又有治癒病例醫案佐證,終於取得了最後之勝利,為弘揚中醫中藥作出了貢獻。其四子譚少富繼承衣砵在加州行醫,退休後回港飬老。那時譚氏年幼未能跟隨叔公學習中醫,但他留下不少清代名醫陳修園之書籍及治療札記,令譚氏獲益良多。

譚氏從小移民來加,初習太極,後醉心於氣功,不斷研習各派氣功如少林禪功、道家氣功及治療氣功(五雷神針和日本靈氣)等。因先祖均是中醫,耳濡目染,便到加拿大中醫藥學院(北京首都醫科大學分校)修讀中醫針灸,畢業後跟隨多倫多中醫針灸臨床學院創始人沈清瑞中醫師學習運用多種臨床針灸療法。譚氏所用之治療針法,不限於傳統針法。她辨証論治,根據不同患者之病患,施以不同療法,例如:薄氏腹針、董氏奇穴、王氏刺血及黃氏耳穴等。譚氏精於氣功,扎針時運用五雷神針指法將氣輸入患者體內,同時配合氣功、靈氣或水晶療法等,推動患者體內之內氣,喚醒患者體內沉睡的臟器起來工作。本着醫者父母心,用心與患者共同對抗病魔,達到理想療效。

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Our new article has been just published. https://authors.elsevier.com/a/1YjvU7STV7irBO

Citation: Fan AY, Ouyang H, Qian X, Wei H, Wang DD, He D, Tian H, Gong C, Matecki A,Alemi SF. Discussions on real-world acupuncture treatments for chronic low-back pain in older adults.J Integr Med.2019; 17(2): 71–76.

 

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Info from: https://www.daocloud.com/acupuncture/cost

As you can imagine, the cost of acupuncture varies from city to city and from one acupuncturist to the next. In this article, we’ll explore the kinds of costs you can expect when you seek treatment, the types of discounts you may be eligible for, how to find low-cost acupuncture using community clinics, and acupuncture costs in some of the major cities.

If you’re looking to use insurance, we’ll reveal which insurance companies will pay for acupuncture treatment, And if you’re looking for a specific treatment for weight loss, back pain, infertility, or migraines, we’ll also give you an idea of what you can expect to pay for those treatments.

Contents

  1. How Much Does Acupuncture Cost?
  2. Typical Costs
  3. Discounts
  4. Total cost
  5. How to find low cost acupuncture (please consider the quality before consider low cost)
  6.  Which insurance companies cover acupuncture?
  7.  Acupuncture Cost by City
  8.  Cost by treatment type
  9.  For infertility
  10.  For Weight Loss
  11.  For Back Pain
  12.  For Migraines
  13.  Additional costs to consider
  14.  Tips for shopping for acupuncture
  15.  Frequently Asked Questions
  16.  Does medicare cover acupuncture?
  17.  Does medicaid cover acupuncture?
  18.  Do Medicare supplemental insurance plans cover acupuncture?
  19.  Will my insurance cover acupuncture?

Typical Costs

Fees for your first session of acupuncture may include an initial consultation, medical exam, and acupuncture treatment. This will cost between $120 to $240. Additional visits may cost $75 to $160.

Discounts

Many acupuncturists offer a discount when you purchase multiple treatments. So for example, if you were to purchase one session at $150 or six sessions at $600, bringing the price down to $100 per session.

Other popular discounts are:

  • Student discounts
  • Senior discounts
  • Child discounts

Ask your acupuncturist if they offer any of these discounts to get a better price on your treatments. For example, in Atlanta, an acupuncture treatment will cost $120, but a student discount brings it to $85, and for a child, it’s only $65.

Total cost

According to consumer reports , people spent more than $200 out of pocket over the course of their full treatment for acupuncture and almost one in four spent $500 or more.

How to find low cost acupuncture

Non-profit community acupuncture clinics are gaining popularity. These clinics, like Phoenix Community Acupuncture , offer low cost acupuncture on a sliding scale, $17-$35. Look for a community acupuncture clinic in your area to find low cost acupuncture.

Which insurance companies cover acupuncture?

The following insurance companies may cover your acupuncture, depending on your plan. Be sure to check with your insurance provider to verify coverage before seeking treatment. Your acupuncturist may also be able to assist you.

  • Aetna
  • Blue Cross/Blue Shield
  • Cigna
  • Humana
  • Johns Hopkins EHP
  • Kennedy Krieger’s Core Source
  • Landmark
  • Optum
  • United Health Care

Acupuncture Cost by City

Methodology

These prices estimate the costs you may expect to pay for acupuncture without insurance. To determine these prices, we sampled acupuncturists listed in the Google business directory in each area.

Cost by City

City Acupuncture Session Cost
Atlanta $80
Austin $85
Baltimore $90
Boston $100
Charlotte $80
Chicago $95
Cincinnati $100
Cleveland $85
Columbus $75
Dallas $85
Denver $125
Houston $160
Indianapolis $95
Kansas City $75
Las Vegas $70
Los Angeles $120
Louisville $85
Memphis $75
Miami $120
Milwaukee $90
Minneapolis $120
Nashville $100
New Orleans $85
New York $300
Oklahoma City $75
Philadelphia $95
Phoenix $75
Portland $150
Raleigh $75
Richmond $90
Salt Lake City $75
San Diego $108
San Francisco $150
San Jose $85
Seattle $135
St Louis $60
Tampa $125
Washington DC $160

Cost by treatment type

For infertility

If you suffer from infertility, plan to pay a lot of money to increase your chances of getting pregnant. A typical acupuncture program for fertility might last three to six months, with treatments every week. Plan for a major portion of your expenses upfront with various diagnostic tests running from $160 to $325, which may include:

  • Male hormone panel
  • Female hormone panel
  • Estrogen ratio test
  • Adrenal salivary index
  • Salivary food sensitivity panel

Sample infertility costs

Initial Visit $150

Female hormone panel $325

Estrogen ratio test $200

Herbs ($150 monthly) $900

Weekly acupuncture for 6 months $1,680

___________________________________________________________________

Total Cost $3,255

For Weight Loss

If you need to lose some weight, acupuncture could help. Weekly acupuncture was shown to improve weight loss in this study. If you figure three months of acupuncture to accompany your exercise regime, you’d spend $840 or more depending on the per session cost.

For Back Pain

If you consider testimonial and anecdotal evidence, some people have used acupuncture to become free from pain in has few as 24 sessions. If you figure on a cost per session of $70 to $150, that amounts to $1,680 to $3,600.

However, some research suggests the effects of acupuncture on pain are temporary. In this case, you might need weekly acupuncture on an ongoing basis, resulting in a cost of $280 to $600 monthly for your back pain.

For Migraines

The same situation is true from migraines as back pain. Considering that you may need ongoing acupuncture treatment to relieve the pain associated with you migraines and keep them at bay, you may need to plan on spending anywhere from $280 to $1200 for weekly or bi-weekly acupuncture treatment.

Additional costs to consider

Here are some additional costs you may need to consider before purchasing an acupuncture treatment.

  • Herbs and supplements. Many acupuncture clinics will recommend patients take Chinese herbs or other supplements as part of their treatment program. These will always cost additional money above and beyond your acupuncture treatment, ranging from $30 to $150 monthly.
  • Tui Na. Your treatment may begin with an optional Tui Na session. This is similar to massage, but with a therapeutic emphasis, rather than relaxation. You may be charged extra for Tui Na.
  • Gratuity. With most bodywork, you may be expected to leave a tip for your practitioner; somewhere between 10-20%. Some clinics encourage gratuity while others discourage it.

Tips for shopping for acupuncture

  1. Ask your friends for a recommendation.
  2. Research online.
  3. Read online reviews.
  4. Understand the practitioners training and specializations.
  5. Call and ask for an introductory session. (Don’t forget to ask about what insurance they take)
  6. Go to your first appointment and evaluate the doctor and the office.
  7. Make a decision to return or keep looking for an acupuncturist you like.

Frequently Asked Questions

Does medicare cover acupuncture?

No. Medicare does not cover acupuncture.

Does medicaid cover acupuncture?

No. Medicaid does not cover acupuncture

Do Medicare supplemental insurance plans cover acupuncture?

Some Medicare supplemental insurance plans provide coverage for acupuncture treatment but most don’t offer coverage.

Will my insurance cover acupuncture?

While many insurance companies are beginning to cover acupuncture, most plans that do are higher cost plans. If you have had chronic pain for six months and the traditional forms of treatment, like drugs or physical therapy have been ineffective, there’s a higher chance your insurance will cover your acupuncture treatments.

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via Distribution of licensed acupuncturists and educational institutions in the United States at the start of 2018  

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We have a new published article: there are 50 days free access online, if you like to read the detail, you may click the link:

https://authors.elsevier.com/a/1XydF3RTyQQ3iH

Abstract

This study was conducted to identify the approximate number and density of actively licensed acupuncturists, as well as the number of schools in acupuncture and oriental medicine (AOM) by January 1, 2018 in the United States (U.S.). We contacted the appropriate department governing acupuncturists, such as the Board of Acupuncture or Board of Medicine, etc. in each state and U.S. territories, to collect the data. We also conducted online license information searches in order to collect the most accurate numbers of licensed acupuncturists, especially for those states in which a board could not be reached. We found that the number of actively licensed acupuncturists as of January 1, 2018 in the U.S. was 37,886. The ten states with the largest number of acupuncturists (28,452 or 75.09% of the U.S. total), in order by total, included California, New York, Florida, Colorado, Washington, Oregon, Texas, New Jersey, Maryland and Massachusetts. The number of practitioners was greater than 1000 for each of these states. Among them, the largest three were California (12,135; 32.03%), New York (4438; 11.71%) and Florida (2705; 7.13%). These three states accounted for more than half of the overall total. The number of total licensed acupuncturists has increased 257% since 1998. The overall acupuncturist density in the U.S. – measured as number of acupuncturists per 100,000 – was 11.63 (total number of licensed acupuncturists: 37,886, divided by the total population: 325,719,178 at the start of 2018). There were 20 states with an acupuncturist density of more than 10 per 100,000 population. Hawaii (52.82) was the highest, followed by Oregon (34.88), Vermont (30.79), California (30.69) and then New Mexico (30.27). There were 62 active, accredited AOM schools which altogether offered 100 programs: 32 master degrees in Acupuncture, 53 master degrees in Oriental medicine, 13 postgraduate doctorate degrees and 2 entry-level doctorate degrees. Among these active accredited schools, institutions in the West and East Coast states comprised 77.42% of the national total. California, Florida, and New York represented 41.94%. There were 48 jurisdictions (47 States and the District of Columbia) with acupuncture practice laws in place. States without acupuncture laws included Alabama, Oklahoma and South Dakota. The data suggests that acupuncture profession has steadily grown in the United States.

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NAF No_of_Licenses_chart 2005 National Acupuncture Foundation 07042018 record

Click to access No_of_Licenses_chart.pdf

 

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欧阳晖,樊蓥, 等. 美国阿片类药物危机与针灸发展的契机 2018

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Today, 10:45am, Dr. Arthur Fan was on a TV show, and interviewed by known TV host Ms. Marylee Joyce. The topic is acupuncture’s role in opioids epidemic.

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Distribution of licensed acupuncturists and educational institutions in the United States in early 2015   (https://www.sciencedirect.com/science/article/pii/S2095496417300122)

Abstract

In recent decades, acupuncture has been used more widely and extensively in the United States (U.S.). However, there have been no national surveys or analyses reported in academic journals on the number of practicing or licensed acupuncturists. This study was conducted to identify the approximate number of licensed acupuncturists active in 2015. The Board of Acupuncture or Board of Medicine in each state or U.S. territory was contacted to collect data. Online license information searching was also performed in order to get accurate numbers of licensed acupuncturists for those states in which a board was unable to be contacted. The study found that the number of licensed acupuncturists in 2015 in the U.S. was 34,481. Of this, more than 50% were licensed in three states alone: California (32.39%), New York (11.89%) and Florida (7.06%). The number of licensed acupuncturists increased 23.30% and 52.09%, compared to the year 2009 (n = 27,965) and 2004 (n = 22,671), respectively; increasing about 1,266 per year. There were 62 and 10 accredited acupuncture institutions providing master and doctoral degrees, respectively. The West Coast comprised 51.39% of degree granting programs, while the East Coast comprised 29.17%; together the coastal states housed more than 80% of all programs, with the remainder sprinkled across the southern (9.72%), northern (8.33%), and the middle/central states (1.39%). Forty-four states and the District of Columbia regulated acupuncture practice by law at the time of data collection. Acupuncture continues to be a quickly growing profession in the U.S.

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Arthur Yin Fan1,2 , Jun Xu1,3, and Yong-ming Li1,3

1. American Alliance for Professional Acupuncture Safety. Greenwich, Connecticut (06878), U.S.A.;
2. American Traditional Chinese Medicine Association. Vienna, Virginia (22182), U.S.A.;
3. American Acupuncture Association of Greater New York, New York, (10016), U.S.A

The original white paper was published in Chinese Journal of Integrative Medicine:   [AAPAS White Paper on Dry Needling(I-III) Fan AY, Xu J, Li YM]

1. Fan AY, Xu J, Li YM. Evidence and expert opinions: Dry needling versus acupuncture (I) : -The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016. Chin J Integr Med. 2017 Jan;23(1):3-9. doi: 10.1007/s11655-016-2630-y.
2. Fan AY, Xu J, Li YM. Evidence and expert opinions: Dry needling versus acupuncture (II) : -The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016. Chin J Integr Med. 2017 Feb;23(2):83-90. doi: 10.1007/s11655-017-2800-6
3. Fan AY, Xu J, Li YM. Evidence and expert opinions: Dry needling versus acupuncture (III) : -The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016. Chin J Integr Med 2017 Mar; (3):163-165. doi: 10.1007/s11655-017-2542-x.

The white paper includes in 7 topics:
1. What Is Dry Needling? [page3]
2. Who First Used Dry Needling in the West? [page5]
3. Has Dry Needling Been Used in China? [page7]
4. Does Dry Needling Use Acupuncture Points? [page9]
5. What Is New About Dry Needling Points (Trigger Points)? [page13]
6. Is Dry Needling a Manual Therapy? [page16]
7. Summary of Dry Needling [page17]
(1) Academic perspective [page17]
(2) The Problems Dry Needling caused [page18]
(3) Our Position [page20]

Summary[AAPAS White Paper on Dry Needling(I-III) Fan AY, Xu J, Li YM]
In the last twenty years, in the United States and other Western countries, dry needling (DN) became a hot and debatable topic, not only in academic but also in legal fields. This White Paper is to provide the authoritative information of DN versus acupuncture to academic scholars, healthcare professionals, administrators, lawmakers, and the general public through providing the authoritative evidence and experts’ opinions regarding critical issues of DN versus acupuncture, and then reach consensus.

We conclude that DN is the use of dry needles alone, either solid filiform acupuncture needles or hollowcore hypodermic needles, to insert into the body for the treatment of muscle pain and related myofascial pain syndrome. DN is sometimes also known as intramuscular stimulation, TrP acupuncture, TrP DN, myofascial TrP DN, or biomedical acupuncture. In Western countries, DN is an over-simplified acupuncture using biomedical language in treating myofascial pain, a contemporary development of a
portion of Ashi point (Ah-yes point, or tender point) acupuncture from traditional Chinese acupuncture. As developed by Travell & Simons, C. Chan Gunn and Peter Baldry, et al, it seeks to redefine Acupuncture by re-translating reframing its theoretical principles in a Western manner. It reflects the effort of de-acupoint, and de-theory of Chinese medicine by some healthcare professionals and researchers. DN with filiform needles have been widely used in Chinese acupuncture practice over the past 2,000 years, and with hypodermic needles as Dr. Travell described has been used in China in acupuncture practice for at least 72 years. In Eastern countries, such as China, since 1800s or earlier, DN is a common name of acupuncture among acupuncturists and the general public, which has been used 2000 years, and its indications, is not limited to treating and preventing musculoskeletal disorders or illness including so called the myofascial pain.
Medical doctors Travell, Gunn, Baldry and others who have promoted dry needling by simply rebranding:
(1) acupuncture as dry needling and (2) acupuncture points as trigger points (dry needling points). Dry needling simply using English biomedical terms (especially using “fascia” hypothesis) in replace of their equivalent Chinese medical terms. Trigger points belong to the category of Ashi acupuncture points in traditional Chinese acupuncture, and they are not a new discovery. By applying acupuncture points, dry needling is actually trigger point acupuncture, an invasive therapy (a surgical procedure) instead of
manual therapy. Travell admitted to the general public that dry needling is acupuncture, and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in acupuncture profession to locate trigger points as acupuncture points. Among acupuncture schools, dry needling practitioners emphasize acupuncture’s local responses while other acupuncturists pay attention to the responses of both local, distal, and whole body responses. For patients’ safety, dry needling practitioners
should meet standards required for licensed acupuncturists and physicians.
DN is not merely a technique but a medical therapy and a form of acupuncture practice. As a form of acupuncture, an invasive practice, it is not in the practice scope of physical therapists (PTs). DN has been “developed” simply by replacing terms and promoted by acupuncturists, medical doctors, and researchers, and it was not initiated by PTs. In order to promote DN theory and business, some commercial DN educators have recruited a large amount of non-acupuncturists, including in PTs, as students and
customers in recent years. The national organizations of PT profession, such as APTA and FSBPT, started to support the practice of DN by PTs around 2010. Currently, there are probably more PTs involving DN practice and teaching than any other specialties. In most states, licensed acupuncturists are required to attain an average of 3,000 educational hours via an accredited school or program before they apply for a license. The physician or medical acupuncturists are required to get a minimum of an
additional 300 educational hours in a board -approved acupuncture training institution and have 500 cases of clinical acupuncture treatments in order to get certified in medical acupuncture. However, a typical DN course run only 20-30 hours, and the participants may receive “DN certificate” without any examination. For patients’ safety and professional integrity, we strongly suggest that all DN practitioners and educators
should have met the basic standards required for licensed acupuncturists or physicians.
KEYWORDS dry needling, acupuncture, biomedical acupuncture, authoritative evidence, experts’ opinions, consensus

Click to access AAPAS%20White%20Paper%20on%20Dry%20Needling.pdf

AAPAS White Paper on Dry Needling(I-III) Fan AY, Xu J, Li YM

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Acupuncture: Safety [120]

The World Health Organization (WHO) reports that acupuncture can be considered inherently safe in the hands of well-trained practitioners; however without proper training, acupuncture can lead to serious, sometimes life-threatening complications (as in the case of organ puncture and hepatitis transmission). Large-scale clinical trials of over 2 million acupuncture treatments found only 8.6% adverse events in which less than 1% reported as serious.[3,10] All of the reported infections and 68% of the serious adverse events occurred in village clinics or rural hospitals in China where clinical skill disparities exist between rural and urban hospital acupuncturists because rural acupuncturists rarely receive formal education in acupuncture medical colleges.[10] In the United States, ACCAOM accredited curriculum includes indications and contraindications for acupuncture point selection (single and combination), anatomy and needle insertion depth, as well as evidence-based clean needle technique practice, as necessary to protect the public.

Increased cost of care from Opioid Epidemic.

In contrast to acupuncture’s safety record, deaths related to opioid misuse have reached epidemic levels, the financial impact of the epidemic is at crisis levels, and incurred expenses rise from general pharmacological-care side effects, medical errors, and failed surgical procedures. In fact, two Oklahoma citizens die daily from opioid overdose according to the Center for Disease Control: 725 deaths in 2015, 777 in 2014, and 790 in 2013 which 12 is an increase from 662 deaths in 2010, and 127 deaths in 1999.113 Oklahoma, has the highest prevalence of prescription painkiller abuse in the country and more overdose deaths involve hydrocodone than methamphetamines, heroin, and cocaine combined.113 The national epidemic is costing public and private insurers more than $72 billion annually.13 Additionally 30% of patients with chronic pain conditions also suffer from clinical depression, and nearly 50% of patients who suffer from both anxiety and depression disorders have a co-morbid pain diagnosis, which shows the compounding concerns of opioid use for pain.13 The impact of the epidemic is far reaching, including but not limited to families, incarcerated persons, children, and disabled. See Appendix C, D, F.

 

Emergency room misuse.

The percentage of emergency department (ED) visits associated with pharmaceutical misuse or abuse increased 114% between 2004 and 2011. Opioid overuse not only increases ED visits but leads to increased avoidable services and costs that may actually harm beneficiaries. In fact, Medicaid recipients have a higher rate of ED visits and hospitalization for poisoning by opioids and related narcotics than individuals with other forms of insurance or the uninsured.13

 

Acupuncture Regulation Impact

Accepted method of care. Acupuncture is a standardized, licensed and regulated health care profession1 that conducts technical, master’s, and doctoral level training in U.S. Department of Education recognized accredited institutions.2 A Licensed Acupuncturist (or comparable state designated title) provides safe, low cost, and comparatively effective health care services.3,4 Forty seven states and the District of Columbia have developed licensure laws and regulation for acupuncturists. Alabama, Oklahoma, and South Dakota are without acupuncturist regulations. See Appendix B.

 

Recognized as a distinct occupation.

In 2016, a recommendation to establish a new code for this distinct occupation in 2018, “29-1291 Acupuncturists,” was made by the Bureau of Labor and Statistics (BLS) Standard Occupational Classification Policy Committee (SOCPC).1 Projected growth of the profession through 2024 is greater than average (13%), with 17,700 new job positions predicted.8 Since 2009, “Acupuncturists” have been recognized by the Bureau of Labor and Statistics’ O-Net Online as an emerging profession and assigned a Standard Occupational Code (SOC) of 29-1199.01 under “Health Diagnosing and Treating Practitioners, All Others.”7,8

 

Congressional Support.

The National Institutes of Health (NIH) affirms the validity and promise of acupuncture by the 1997 NIH Consensus Conference, concluding that there is sufficient evidence to expand its use into conventional medicine, encouraging further studies of its physiology, and urging broader public access through insurance companies, federal and state health insurance programs, including Medicare and Medicaid, and other third party payers.67 For twenty years thereafter, rigorous scientific investigation of acupuncture continues through the NIH National Center for Complementary and Integrative Medicine.68

 

Acupuncture efficacy.

An expanding body of evidence confirms that acupuncture stimulates the body’s natural healing abilities, promoting physical and emotional well-being.15,18 Through evidence review in 2003, the World Health Organization determined that acupuncture is an effective treatment for 28 named conditions and 79 potential conditions.78 See Appendix A.

 

Utilization.[120]

Acupuncture utilization is rapidly increasing in the United States. Nearly 100 primary and specialty physician practice guidelines recommend acupuncture as a non-pharmacological approach to patient care. An integral component of the “collaborative
model of care”, thousands of licensed acupuncturists are independently practicing acupuncture in hundreds of clinics, hospitals, universities, military and veterans’ care facilities. An increasing number of insurance companies are reimbursing for acupuncture, Medicaid in some states covers acupuncture for specific conditions, and the military has long utilized acupuncture for conditions from PTSD to brain injury. 61 See Appendix C, D, E, F.

 

Acupuncture for pain and mental health.[120]

Effective as a non-pharmacological approach to pain management and compounded by a holistic approach to comorbidity care, tens of thousands of licensed acupuncturists effectively treat patients with acute and chronic pain across the nation while now thousands of hospitals and clinics employ acupuncturists to improve outcomes and reduce costs. Acupuncture has recently been found to be as effective as counseling, and both more effective than usual care, for reducing symptoms of depression, a common co-morbid condition found in patients managing chronic pain.50 See Appendix D, E, F.

 

The opioid epidemic & auricular (ear) acupuncture.

To improve behavioral health program retention, reduce withdrawal symptoms, enhance recovery outcomes, and decrease costs, a standardized auricular (ear) acupuncture protocol has gained favor throughout the nation for use as an adjunctive treatment by a variety of health care and criminal justice workers within a variety of comprehensive programs.28,32,33,36,39,92,94 The National Acupuncture Detoxification Association (NADA) has trained over 25,00029 professionals to use the NADA 5-point auricular acupuncture protocol to treat individuals of all ages recovering from substance use disorder, trauma, and other behavioral health issues.28 Over 628 licensed addiction treatment facilities utilize NADA30 and inclusion within comprehensive criminal justice programs has reduced inmate expense and re-incarceration rates for two decades.33,36,37,39,40,42,103 See Appendix D.

 

Emergency department savings.

Expanding acupuncture utilization in the ED provides a non-pharmacological option to citizens, reduces drug-seeking behavior, and can reduce costs. A clinically relevant “real-world” 2016 study published in the Journal of Emergency Medicine, finds acupuncture to be more effective than intravenous morphine in the ED, when individualized patient-centered plans are administered by licensed acupuncturists.55 Newly available preliminary statistical outcomes are available from Rhode Island’s state Medicaid Section 1115 Demonstration, a pilot designed to cut costs by reducing member emergency room visits; members with chronic pain receive acupuncture and other complementary services within a comprehensive pain management plan. Outcomes are demonstrating that on average per year, these members have: decreased ER visits by 61%, reduced opioid prescriptions by 86%, lowered prescription totals by 63%, and reduced annual costs per member by 27%. 90,92-94

 

Other cost benefits.

Overall savings resulting from acupuncture inclusion include decreased requirements for surgical procedures, shorter in-patient hospital stays, reduction in pharmacologic prescriptions, reduction of days lost at work, and reduction of necessary medical review appointments. See Appendix C, D, E, F.

 

Call for Inclusive Collaborative Action

Abusers of opioids have been found to have total health care costs eight times that of non-abusers, placing a significant economic and resource burden on providers and health systems. Dr. Shellie Keast, from the University of Oklahoma’s College of Pharmacy, which supports SoonerCare pharmacy operations, believes that the Medicaid agency is ideally positioned to leverage collaborative efforts with other state agencies in the development of documents and best practice guidelines for intrastate work.13 Appendix F. Oklahoma’s plan in 2012, Reducing Prescription Drug Abuse in Oklahoma, calls for lowering the states’ unintentional overdose deaths by 15% will aim for “action to ensure the proper and appropriate use of opioids to treat pain and improve patient’s quality of life while reducing the risk of abuse and diversion… through various partnerships…is imperative.”113 Governor Fallin emphasizes: “Immediate action must be taken in order to reverse this rapidly growing epidemic, which has become one of the most serious public health and safety threats to our state… a broad-based coordination between law enforcement, prevention and treatment providers, the Oklahoma Legislature, community organizations, tribes, and health care is required… It is unacceptable for any Oklahoman to lose their life to this preventable problem.”113

Appendix A: Physiological Effects of Acupuncture Attention through research has been focused upon the following modern theories to explore acupuncture’s effects upon the body:
· Stimulation of the hypothalamus and pituitary gland
· Change in secretion of neurotransmitters and neurohormones
· Conduction of electromagnetic signals
· Activation of the body’s natural opioid secretion system
Most recently, twenty first century state-of-the-art technological advances allow observation of physiological effects of acupuncture. For example-
· fMRI scans detect reduction in pain sensation within the brain after acupuncture.19
· Ultrasound Color Doppler Imaging detects increased blood flow of peripheral, mesenteric, and retrobulbar arteries.20
· PET-CT study concludes acupuncture induces different levels of cerebral glucose metabolism in pain-related brain regions.21
· Demonstrated autonomic nerve function control and modulation of neurotransmitters in related brain regions are observed.22
· Blood panels measure immune system regulatory function, increased humoral/cellular immunity, and NK cell activity.23
· Synchrontron radiation based Dark Field Image method finds accumulation of miro-vessels in acupoints.24
· fMRI scans detect bilateral activation of insula and adjacent operculum; correlation to increased saliva production.25
· Synchrontron x-ray fluorescence analysis detects concentrations of Ca, Fe, Cu and Zn in and around acupuncture points.26
· Acupuncture’s role in triggering the release of adenosine, a neuromodulator with anti-nociceptive properties, is confirmed.14
· Tonometery, electrocardiogram, phtoplethysmogram, ultrasonography, and cardiographyconfirm acupuncture effects upon peripheral pulse amplitudes, wave, blood flow velocity, and sympathetic nerve activity.27
A 2013 study of acupuncture effect upon central autonomic regulation concludes: “Acupuncture has clinical efficacy on various autonomic nerve-related disorders, such as cardiovascular diseases, epilepsy, anxiety and nervousness, circadian rhythm disorders, polycystic ovary syndrome (PCOS) and subfertility. An increasing number of studies have demonstrated that acupuncture can control autonomic nerve system (ANS) functions including blood pressure, pupil size, skin conductance, skin temperature, muscle sympathetic nerve activities, heart rate and/or pulse rate, and heart rate variability. Emerging evidence indicates that acupuncture treatment not only activates distinct brain regions in different kinds of diseases caused by imbalance between the sympathetic and parasympathetic activities, but also modulates adaptive neurotransmitter in related brain regions to alleviate autonomic response.”22

 

Appendix B: State Licensure and Regulation The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) has provided more than 21,000 certificates for acupuncturists applying for licensure in 46 states and the District of Columbia since 1982.6 NCCAOM Diplomates have passed a set of certification examinations which assure that the knowledge, skills, and abilities necessary for safe and effective entry-level practice of acupuncture have been demonstrated. The NCCAOM is the only national organization in the United States whose certification programs are accredited for the purpose of qualifying candidates for state licensure status. The Institute for Credentialing Excellence (ICE)’s National Commission on Certifying Agencies (NCCA) recognizes the NCCAOM national certification programs in Acupuncture, Chinese Herbology, and Oriental Medicine as having achieved national accreditation by meeting the NCCA’s 21 standards.6 When providing services in health system and hospital facilities within the 45 regulated states, licensed acupuncturists are credentialed as “Licensed Independent Practitioners” (L.I.P.) to be in compliance with The Joint Commission quality assurance standard for healthcare system accreditation.5 The Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) is recognized by the U.S. Department of Education as the accreditor for Acupuncture and Oriental Medicine (AOM) educational programs in the United States. ACAOM accredited institutions and programs are shaped by a rigorous peer review process. Over sixty institutions throughout the country have achieved the standards of educational excellence by meeting ACAOM’s accreditation requirements.2 The Oklahoma Board of Private Vocational Schools (OBPV) provides licensure and oversight of two acupuncture training schools.9 The existing grass-roots acupuncture education network may contribute to bridge-building collaborations necessary for acupuncturist workforce expansion within the fabric of Oklahoma’s existing infrastructures. Collaboration in the development of innovative tiered apprenticeship programs for life-long career advancement are in alignment with current workforce expansion plans. In addition, to accommodate evolving health care industry workforce requirements, stakeholders are exploring practice scope expansion solutions, such as competency based certifications. Oklahoma appears to be postured for incubating hybrid models that bridge life-long learners from beginner to entry-level and master clinician to doctoral research.

 

Appendix C: Acupuncture Utilization Examples Forty-seven states regulate the practice of acupuncture and over sixty colleges host accredited acupuncture programs. Hundreds of hospitals and health systems throughout the nation utilize licensed acupuncturist services. Some leading hospitals currently employing licensed acupuncturists include but are not limited to: Massachusetts General, Ohio’s UH MacDonald Women’s Hospital, Stanford Hospitals, Seattle Children’s Hospital, Los Angeles’ Cedar Sinai, Athen’s Regional Medical Center, Lutheran’s Medical Center, NYU Rusk, Beth Israel Medical Center, Columbia Presbyterian Medical Center, Long Island Jewish Medical Center, Mount Sinai Medical Center, Memorial Sloan-Kettering Cancer Center, Gouverneur Healthcare, University of Wisconsin Hospital and Clinics, Mercy Hospital Chicago, Children’s Memorial Hospital Chicago, Chanadaigua VA Medical Center, University Medical Center of AZ, Arizona Center for Integrative Medicine, Midwestern Regional Medical Center, Cancer Treatment Centers of America, University of Colorado Medical Center, University of New Mexico Hospitals, Cleveland Clinic for Integrative Medicine, Beth Israel Medical Center (Continuum Center for Health and Healing), and Duke University Medical Center, George Washington University Hospital, Greenwich Hospital Integrative Medicine Program. Research Hospitals that offer licensed acupuncturists services include but are not limited to: John Hopkins, Ronald Regan Hospital – UCLA, Cleveland Clinic, San Francisco Medical Center, University of California, Hospital of the University of Pennsylvania, Barnes Jewish St. Louis, and Henry Ford Hospital Detroit. An ever growing number of insurance plans throughout the nation include acupuncture as a member benefit102 and acupuncture meets, at minimum, five of the Essential Health Benefit (EHB) criteria and service categories of care: ambulatory patient services, maternity/infertility, mental health and substance use disorders services, rehabilitative services, preventative wellness, and chronic disease management. As a result of acupuncture being designated as an EHB, nearly 54 million Americans in six states (California,69 Alaska,70 Maryland,71 Massachusetts,97 New Mexico,72 Washington73) and four territories (American Samoa,74 Guam,75 North Mariana Island,76 Virgin Islands77) gained access to acupuncturists’ services in 2014. As of 2017, eight states provide acupuncture coverage through Medicaid (California,79 Maryland,86-88,99 Massachusetts,97 Minnesota,80 New Mexico,81 Ohio,82,83 Oregon84,85 and Rhode Island89,91); New Jersey’s Medicaid plan covers acupuncture anesthesia during surgery;108 and several states, such as Vermont,96 implement temporary innovative Medicaid pilot programs to examine outcomes and savings.90-93 Various programs within the United States Department of Defense medical community have long utilized acupuncturists’ services and provide introductory training for physicians.56 Acupuncturist services are recognized as important and “extremely effective” treatments for non-opioid pain management;57 post-traumatic stress disorder and resilience care;58 mild traumatic brain injury and related insomnia and headaches;59 traumatic brain injuries and psychological disorders,60 and for Gulf War Illness,62 in facilities across the country (e.g., Camp Pendleton, Ft. Hood, Ft. Bliss, Ft. Carson, Walter Reed Army Medical Center). Additionally, the military has provided these services to military families for stress management and post-traumatic stress disorder.61 The United States Department of Veterans Affairs has integrated acupuncture into a number of facilities while expanding outreach into the community; of 125 Veterans Affairs facilities, 58 offered acupuncture services to patients in 2011.34 The 2014 Veteran Choice Program provides acupuncture as a standalone procedure, or within a comprehensive plan, for treating veterans experiencing service-connected low back pain, PTSD, and more. The U.S. Health and Human Services’ Substance Abuse and Mental Health Services Administration identifies acupuncture as a complementary treatment for detoxification in comprehensive addiction treatment programs.31 A 2014 report for the National Association for Medicaid Directors recommends acupuncture as one part of a holistic approach to treating patients suffering from pain and co-morbidities such as substance use disorder (SUD) and behavioral health issues.13 The National Congress of American Indians issued resolution #SD-15-027 in 2015 requesting inclusion of licensed acupuncturist services within Indian Health Services and tribal health facilities. 16 To remove barriers to licensed acupuncturist services, equitable inclusion and expansion of coverage within all payer programs, including state and federally funded programs, is import to industry stakeholders for public health improvement.13,16,17,65,66

 

Appendix D: NADA and Substance Use Disorder – Utilization, Research & Cost-Saving Information Throughout the United States, comprehensive treatment settings utilizing the NADA protocol are multiple including but not limited to inpatient, outpatient, addiction treatment programs, mental health facilities, jails, prisons, criminal justice and parole, drug-court, prison psychiatric units, street outreach, homeless shelters, half-way houses, harm reduction, natural disaster emergency relief, HMOs, active-duty military programs, and veterans healthcare programs.28,29,33-37,39,64 Although studies now confirm high risk groups have poorer completion rates than non-risk groups, the high risk groups are proving more likely to complete treatment when participating in NADA treatment.32 NADA is used in the acute and chronic phases of substance use treatment and is increasingly integrated into dual diagnosis settings to help patients with substance use disorders with concurrent behavioral health conditions, psychiatric symptoms,32 and other comorbidities, including personality disorders.35 Report benefits from NADA include improvement in depression, anxiety, anger, sleep disturbances, impaired concentration, fatigue, and body aches/headaches as well as reduction in withdrawal symptoms and cravings.28,32,35-39 Referrals for comprehensive programs utilizing NADA typically include a variety of agencies, such as probation and parole, Drug-Court, Department of Social Services, Department of Motor Vehicles, Recovering Professionals Program, employee assistance program, and physician offices, to name a few.32,28,39 U.S. Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) identifies acupuncture as a complementary treatment for detoxification recognizing that it can be included as part of a comprehensive treatment program for addictions;31and, multiple studies support the adjunctive use of NADA for the treatment of nicotine, heroin, alcohol, and cocaine addiction.28,32,35-39 628 licensed addiction treatment programs30 included acupuncture as a therapeutic tool in 2012. Twenty-two states encourage utilization of the NADA protocol through regulation.28 A 2016 study of NADA within a substance abuse treatment program demonstrates long term savings to the state in NADA control group upon discharge: increased employment by 71% of those previously unemployed vs 35% in the control group, and long term abstinence from alcohol, drugs, and tobacco use.32 A study outcome produced expenditures in a non-NADA control group totaling $17,890.00 while NADA control group costs were $15,580.00, equating to a savings of $2,310.00 per patient,37 a savings of 1 million dollars to the state for every 433 participants. Prison and jail inmates are seven times more likely than individuals in the general population to have a SUD.13 Inmates medicated for violent behavior experienced improved behavior ratings and required fewer psycholeptic drugs than controls when receiving NADA three times weekly.36 A model comprehensive homeless and criminal justice incarceration diversion program in Oregon reports 11% recidivism, saving the state $25,000/year for every rehabilitated person.42 A Sacramento Drug Court Cost Study of a model program demonstrates cost-benefit through comprehensive programming with a 17% recidivism rate after two years for graduates compared to 67% in the non-participation control group, and a saving of $6,605 per graduate; ten year program lifetime savings is calculated as more than $20 million.64
Incorporating NADA treatment into Oklahoma’s existing drug-court diversion and rehabilitation programs may further reduce prison populations and drive down crime rates; for example, reducing Oklahoma drug court graduates’ re-incarceration rates by 50% could save the state 2 million dollars for every 100 additional rehabilitated persons. “The average annual cost of incarceration in the Oklahoma Department of Corrections is $19,000 per person, compared with the average annual per person cost for drug court participation of $5,000. Drug court graduate re-incarceration rates of 23.5% when compared with rates of those whom successfully complete standard probation, 38.2%, and released inmates, 54.3%, are further proof that Oklahoma Drug Courts work.”100 Oklahoma’s existing drug-court program has expanded to 73 of the 77 counties,100 increasing rural and underserved population
access throughout the state. However, Oklahoma incarcerates “a greater portion of its population than any state but one, and a greater portion of its women than anyone”118 and the building of three new prisons is being considered. Pregnant women and neonates are one of “three populations with unique risk in the context of the opioid epidemic.”65 NADA has proven to be safe during pregnancy.41 Although specific acupuncture points on the body are contraindicated during pregnancy, NADA has consistently proven safe and effective throughout term and post-partum. For more than 25 years, NADA was incorporated into the Maternal Substance Abuse Services Program, inspiring programming world-wide while continuing the legacy of the innovative award winning Lincoln Recovery Center39 pregnancy program, an award granted to the center in 1991 by the American Hospital Association.28 Between 2000 and 2009, the rate of newborns diagnosed with neonatal abstinence syndrome (NAS) and dependent on narcotics nearly tripled and the number of mothers using or dependent upon drugs more than quadrupled, while costs associated with treating these infants increased by 35%. Medicaid was the primary payer for over 75% of these births.13 New studies on NADA efficacy suggest savings in neonatal intensive care units from shorter hospital stays and decreased withdrawal symptoms resulting in reduced costly interventions.44,45 The CDC reports that over $170 billion dollars annually is spent on treating diseases caused by smoking; 16 million Americans are currently living with a disease caused by smoking. When used in combination with educational programming, auricular acupuncture protocols (including NADA) have demonstrated marked effect upon reducing nicotine withdrawal symptoms and long-term measurable outcomes are comparable to that of pharmacological approaches at greatly reduced cost.109

 

Appendix E: Acupuncture, Chronic Pain Efficacy, and Cost-Saving Information 30% of patients with chronic pain conditions also suffer from clinical depression, and nearly 50% of patients who suffer from both anxiety and depression disorders have a comorbid pain diagnosis.13 A study published by the NIH in 2017 documents that “evidence on acupuncture compared with usual care and counseling compared with usual care shows that both treatments are associated with a statistically significant reduction in symptoms of depression in the short to medium term, with no reported serious adverse events related to treatment. Acupuncture is cost-effective compared with counseling or usual care alone, although the ranking of counseling and acupuncture depends on the relative costs of delivering these interventions.” 107 A 2017 study finds that acupuncture rewires the primary somatosensory cortex in patients experiencing carpel tunnel syndrome.18 The research supports previous findings recommending the use of acupuncture as a viable first-line long-term cost-effective approach, prior to consideration of costly surgical procedures. Over one-third of patients avoided surgery (arthroplasty of the knee) when acupuncture was added to the standard treatment protocol – generating a savings of $9,000 per patient.49 When incorporated into pre-surgical care, acupuncture has been found to reduce the amount of post-operative morphine consumption; post-operative pain is a strong predictor of subsequent chronic pain.46 Acupuncture is routinely used to reduce pain in cancer patients, as well as alleviate chemotherapy induced nausea and vomiting.46,51-54 Cancer Treatment Centers of American (CTCA) employs acupuncturists in its five nationwide hospitals, providing acupuncture in an integrative setting.51 Dana Farber Cancer Institute at Harvard University has developed evidence-based acupuncture protocols to provide clinically relevant solutions for clinicians and cancer patients with pain, including: postoperative cancer pain, postoperative nausea and vomiting, postsurgical gastroparesis syndrome, opioid-induced constipation, opioid-induced pruritus, chemotherapy-induced neuropathy, aromatase inhibitor-associated joint pain, and neck dissection-related pain and dysfunction.52-54 The National Cancer Institutes comprehensive cancer database (PDQ) statement on acupuncture indicates usage in a wide range of conditions: hot fashes, xerostomia (dry mouth), neuropathy, and cancer related-fatigue & pain management. A 2008 military study documents how replacing pharmacotherapy with acupuncture care for symptoms of pain can generate a $4,000 savings per patient to the Department of Defense – additional savings of $10,000-$18,000 per patient occur when procedures such as spinal fusion and laminectomy are successfully avoided.47

 

Appendix F: Medicaid and Acupuncture The 2014 Medicaid report articulates: “In addition to the financial implications of prescription drug abuse and overdose, chronic and severe social implications reverberate through Medicaid and social service programs as well in the areas of homelessness, domestic violence, unemployment, foster care, and others that can burden states for years in service and care needs.”13 “Medicaid is the largest health care safety net program and is responsible for the health care of 73 million Americans, including those with the most complex health care needs. The program covers 50 percent of all U.S. births, promotes children’s achievement of developmental milestones and school readiness and, enables adults to maintain good health in support of work readiness and job retention, and furthers the values, dignity, safety and integration of individuals who require long-term services and supports. States and the federal government jointly finance and operate Medicaid, making an effective federal-state partnership critical to success of the program.”114 “Because rates of prescription drug misuse and overdose are elevated in individuals that have co-occurring mental illness and/or have a history of substance abuse, access to and effective coordination of care is essential… Inclusion of other clinical and support specialists on the treatment team could also be considered and may be amenable to payer support, including case management and promotion of non-pharmacologic therapies such as acupuncture, massage, and health/wellness classes. Together these ancillary providers may help in shifting the focus away from prescribing opioids as a primary or exclusive means of pain relief… By incorporating recommendations across the six strategies, states can reasonably expect to bring about a reduction in prescription drug abuse and overdose, resulting in an overall reduction in healthcare expenses and an improvement in the health outcomes of Medicaid beneficiaries.”13 A Medicaid report in March 2017 articulates that “Medicaid must also be given statutory certainty around its ability to support holistic initiatives addressing the social determinants of health, which may cross federal programmatic and funding silos. These types of initiatives represent the next horizon for health care transformation, and with federal support, states may lead the way.”114 The Oklahoma Health Care Authority is a state government agency responsible for administering the Oklahoma’s Medicaid program known as “SoonerCare.”112 In 2015, approximately 17% of Oklahoma enrollees were categorized as disabled, aged, or blind; 61% of enrollees were children and more than half of children in Oklahoma were enrolled; average monthly enrollment was 820,000; and total Medicaid spending was $5.1 billion (including funding of $3.1 billion from federal government).111 The agency’s mission is to “responsibly purchase state and federally-funded health care in the most efficient and comprehensive manner possible; to analyze and recommend strategies for optimizing the accessibility and quality of health care; and, to cultivate relationships to improve the health outcomes of Oklahomans.”112 As of 2017, eight states provide acupuncture coverage through Medicaid (California,79 Maryland,86-88,99 Massachusetts,97 Minnesota,80 New Mexico,81 Ohio,82-83 Oregon84-85 and Rhode Island89,91); New Jersey’s Medicaid plan covers acupuncture anesthesia during surgery;108 and several states, such as Vermont,96 implement temporary innovative Medicaid pilot programs to examine outcomes and savings.90-93 Oklahoma appears to be poised to lead, saving lives by qualifying for supplemental Medicaid funding through 1115 demonstration pilots.90 Expanding upon current successful programming, replicable demonstrations utilizing licensed acupuncturists, with clearly-defined baseline measures, goals, and evaluation criteria in targeted sub-populations groups, have clear potential to propel Oklahoma into the lead for innovative emerging community-based collaborative approaches addressing the unique challenges that must be overcome to successfully combat the nation-wide opioid epidemic.

 

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119. Governor Fallin- 2017 Legislative Session goals http://altustimes.com/category/news This brief has been prepared by Rhonda K Bathurst, L. Ac., Brandy Valentine-Davis, L. Ac., and Tim Williams, Cert. Ac. with evidence base provided by the American Association of Acupuncture and Oriental Medicine (AAAOM) and the National Acupuncture Detoxification Association (NADA). 9 August 2017.

120. Fan AY, Miller DW, Bolash B, Bauer M, McDonald J, Faggert S, He H, Li YM, Matecki A, Camardella L, Koppelman MH, Stone JA, Meade L, Pang J. Acupuncture’s Role in Solving the Opioid Epidemic: Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management—White Paper 2017. J Integr Med. 2017; 15(6): 411–425.

 

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