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Archive for the ‘Acupuncture in USA’ Category

Great news! This month our article”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″ 1 (Arthur Yin Fan is the first author, and Dr.David Miller is the correspondence author, our colleague Sarah Faggert also a co-author-there are 14 authors across the United States) has been selected as one of ten articles for the November 2017 Elsevier Atlas Awards Nominations.

As is stated on the Elsevier Atlas Awards homepage: “Each month the Atlas Advisory Board are sent a selection of 10 articles to choose their winning Atlas article. The articles are shortlisted by Elsevier from across journal portfolios based on their potential social impact. We are delighted to present the entire monthly shortlist and congratulate the authors of the nominated articles.” While the voting is still in progress, we are still very excited to even be nominated. This marks the first time that an acupuncture article has been nominated for the Elsevier Atlas Award.You may click on the following link to take you the Elsevier Atlas Nominations page: https://www.elsevier.com/connect/atlas/nominations.

We will let you know should our article win!

Each month the Atlas Advisory Board are sent a selection of 10 articles to choose their winning Atlas article.
ELSEVIER.COM
Reference:
1. 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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Acupuncture is good for changing American Opioids Epidemic, at https://www.youtube.com/watch?v=ug3e0FzSRAI

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  针灸在美国被点赞 中药科研亟须提上日程

近日,第三届美国中医药大会在美国首都华盛顿举行,来自美中等国的300余名中医药专家参会。

中医在美国的发展现状如何?面临着什么样的机遇和挑战?带着这些问题,《经济参考报》记者采访了与会专家。

针灸发展形势良好执照医生约4.5万人

本次会议主办方是全美中医药学会与美国中医校友联合会,两个协会的会长均由曾就读于北京中医学院(现北京中医药大学)的田海河担任。

田海河对记者介绍说,自美国前总统尼克松访华把中医带回美国,至今已45年。目前,中医在美国有了长足发展,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。

“这是一个很好的发展形势,但是学术水平良莠不齐,中医尚未进入医学主流体系。”他说,“就像美国人选择餐馆时还是以喜欢吃西餐为主,喜欢中餐的人虽有,但仍占不是占多数。要想怎么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“还是经常会受到一定排挤和否定”,虽然临床、科研及发表的文章为针灸提供了一些有效果的证据,但证据还不是显得非常充足,“需要我们更有效地开展临床科研工作,提供更有说服力的证据,以此来说服民众、媒体、立法、保险公司等更进一步认可中医,接受针灸。”

他表示,针灸是个好东西,确有疗效,很多人都认识到它的价值,近期出现了一些其他行业想染指针灸,“我们的态度很明确,欢迎更多的人来做针灸,惠及民众。但一些其他行业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’,试图绕过法律和各行业的执业范围限制去做针灸,非但没效,更对病人造成安全隐患。所以,我们要抗争,并教育、帮助们民众找到一个合格的针灸师。”

“我们需要对民众的安全负责,对针灸的名誉负责,需要对我们中华民族文化保护。因为‘干针’本来就源自于针灸,他们把针灸改头换面,不认祖归宗了,反倒说跟中医无关,这是一种剽窃行为。”田海河说。

针灸临床研究正规范望入美主流医学体系

谈到美国中医药大会,田海河说,该会每年举办一次,今年是第三次,美国、中国以及其他一些国家的中医领军人物都来了,几乎所有以西人为主的全国性中医组织的主要负责人也来了,参会的还有美国食品和药物管理局及美国国家卫生研究院官员,美国针灸执照考试委员会、美国中医高校联合会及资格鉴定委员会等机构的主要负责人也都到场。

“这次大会的目的是要团结更多的华裔和非华裔针灸师,大家聚集到一起共同探讨如何抓住机会,面对挑战,并同时提升整体学术水平,引领美国中医药的正确发展方向。”他说。

会上,世界针灸学会联合会主席、中国针灸学会会长刘保延教授做了题为《针灸临床疗效研究的思考与实践》的主题报告。他指出,疗效是针灸发展的根本,虽然针灸临床研究论文在1992年以后快速增长,但过去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或正在制定针灸临床研究和技术操作等一系列规范,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”。

大会期间,全美中医药学会副会长、美国执照针灸师樊蓥做了题为《假针灸真是假的吗?》的学术报告,对一些结论认为针灸无效的论文的研究方法提出质疑。

樊蓥在接受记者采访时解释说,美国顶尖医学期刊《美国医学会杂志》近年来发表7篇针灸研究论文,最近的一次是今年6月发表两篇论文,其中刘保延负责的一项研究显示针灸治疗女性压力性尿失禁确实有效,而另6篇临床研究结果都是阴性(无效)结论,这可能与研究方法有关系。

樊蓥说,西医的临床研究要求随机、对照、双盲,对针灸而言,随机和对照没有问题,但双盲是有问题的,因为假针灸很难瞒过针灸师和病人,造成了所谓“真针灸不真、假针灸不假”的问题。

美国国家卫生研究院的夏月博士探讨了大数据对针灸科研的指导意义,希望美国和中国在中医科研方面加强对接。

中药尚处灰色地带科研亟须提上日程

田海河强调,中医不仅是针灸,还包括中药,但因为针灸首先进入美国,所以针灸在美国成了中医的代名词。目前,中药在美国未被列入药物范畴,只能归类为食品补充剂,不能宣传治疗效果,所以还处于灰色地带,这限制了中药在美国的广泛应用和发展,“要把中药发展提到日程上来,包括推动在州层面甚至联邦层面立法。当然,这需要一个漫长的过程。”

他举例说,包括麻黄在内,有几个中药因为安全性问题被美国食品和药物管理局禁用,“因此,有些人经常拿这些药说事,说中药不安全。我担心这类事件发生多了后,对在美国开展中药工作会有负面影响。所以,我们需要做一些科研,了解中药的毒副效应,保证民众的安全服用。如果只有针灸,而没有中药,不是一个完整的中医概念。”

会上,中国国家中医药管理局政策法规与监督司原司长、世界中医药学会联合会秘书长桑滨生解读了中国中医药立法及对海外的影响。桑滨生说,《中医药法》是中国中医药领域的一部综合性、基础性法律,不仅对中国中医药发展具有里程碑意义,而且对各国中医药和传统医学立法起到引领和借鉴作用。

美国药管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,但只有2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”。

另外,还有十多位中美知名针灸专家和科研教育领域的学者做了学术报告。大会主要赞助企业同仁堂也介绍了其国际化之路,表示已在纽约、旧金山和洛杉矶开设分店,要让更多美国人知道同仁堂这个品牌。记者 林小春

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http://news.xinhuanet.com/english/2017-09/28/c_136643669.htm

WASHINGTON, Sept. 27 (Xinhua) — Although traditional Chinese medicine as a whole is struggling in the United States, acupuncture itself is in a much better situation.

The ancient Chinese practice involving the insertion of fine needles into the skin was generally thought to be brought to America in the early 1970s, thanks to then-President Richard Nixon’s ice-breaking visit to China.

About 45 years later, over 46 U.S. states have legalized acupuncture, and the number of licensed acupuncturists in the country has grown to around 45,000.

BIGGER ROLE

Now, local acupuncturists expressed hope that the ancient art of healing could play a bigger role in solving the ongoing U.S. opioid epidemic, which claims 91 American lives every single day.

“Acupuncture is an effective, safe, and cost-effective treatment for numerous types of acute and chronic pain,” wrote a white paper released this week by several organizations that promote the practice in the United States.

“Acupuncture should be recommended as a first line treatment for pain before opiates are prescribed, and may reduce opioid use.”

The white paper came about a week after the U.S. National Association of Attorneys General (NAAG) sent a letter to America’s Health Insurance Plans (AHIP), asking its insurance company members to review their payment and coverage policies in order to promote alternatives to opioids, such as acupuncture.

Cathryn Donaldson, director of communications and public affairs for the AHIP, a trade association representing 1,300 health insurers, told Xinhua that they have responded to the NAAG letter, which was signed by 37 state and territorial attorneys general.

“Plans are exploring and improving access to non-pharmacologic pain treatments that have been proven effective in reducing pain,” Donaldson said in an email.

“Depending on the individual patient, therapies like acupuncture, mind-body interventions (yoga), psychological interventions (cognitive therapy), and exercise can be an effective first line of treatment for many before moving on to pharmaceuticals when necessary,” she said.

BIG DEAL

Although millions of Americans use acupuncture each year, the practice was considered primarily to be a complementary health approach.

As a result, many American acupuncturists were excited by the NAAG letter, which was virally spread and heatedly discussed in the social media. One of them, Fan Ying, whose clinic is based in the state of Virginia, called it “a big deal” for the industry.

“The spring of acupuncture might have come,” said Fan, one of the authors of the white paper.

“The U.S. opioid crisis will allow non-pharmacologic therapies, including acupuncture, chiropractic care and medical massage, to have a place in the U.S. healthcare system,” he said, but cautioned that “we can’t say there will be no spring chill in the future.”

Li Yongming, a licensed acupuncturist in the state of New Jersey, called the U.S. fight against opioid abuse and addiction “a new opium war.”

“Acupuncture is the most effective in all kinds of non-pharmacologic therapies for pain relief and management,” Li said.

“So the opioid crisis provides the best opportunity in decades for our industry to develop and even become more of a mainstream healthcare option. This may represent a new era of acupuncture.”

Tian Haihe, president of the non-profit American TCM (traditional Chinese medicine) Association, noted that the NAAG letter is only a proposal, but it may indeed mean a turning point and that the next question could be how to grasp it.

“We must demonstrate to patients that we can help relieve their pain, so they will have no reason or excuse to use painkillers and thus avoid being addicted,” Tian said.

“Even if the NAAG proposal is adopted, we should know that many private clinics that offer acupuncture treatments are still out of the insurance system, a problem we should worry about and think how to solve.”

“If acupuncture is covered by health insurance eventually, it’s way too good, but it should be a long process,” Tian said. “We can’t just wait. We need to provide scientific evidence to prove that acupuncture is safe and effective.”

GENERALLY CONSIDERED SAFE

So, how does American academia think about the practice of acupuncture?

“Acupuncture is generally considered safe when performed by an experienced, well-trained practitioner using sterile needles. Improperly performed acupuncture can cause serious side effects,” the U.S. National Center for Complementary and Integrative Health (NCCIH) wrote in an article posted on its website.

“Results from a number of studies suggest that acupuncture may help ease types of pain that are often chronic such as low-back pain, neck pain, and osteoarthritis/knee pain. It also may help reduce the frequency of tension headaches and prevent migraine headache,” the NCCIH said.

What’s more important, the U.S. Food and Drug Administration released a draft proposal in May recommending that doctors learn about acupuncture and other non-pharmacologic therapies for pain management.

Actually, a 2015 study conducted by Kaiser Permanente Center for Health Research, found that of more than 6,000 chronic pain patients who responded to a questionnaire, 32 percent reported acupuncture use, 47 percent reported chiropractic use and 21 percent reported using both.

The peer-reviewed work, published in the American Journal of Managed Care, included members of Kaiser Permanente health plan only.

“There is a growing body of scientific evidence which supports the use of acupuncture for pain management. Often the medications we use don’t work well, or have too many side effects. Thus both doctors and patients are eager for alternatives,” Charles Elder of the Kaiser Permanente Center for Health Research, the paper’s first author, told Xinhua.

“It would make sense that the role of acupuncture should continue to grow in the context of managing chronic pain within our health care system,” he said, citing as an example the state of Oregon where complementary medicine approaches including acupuncture are required to be covered for back pain patients of Medicaid — a joint state-federal health care program.

“My guess is that we will see more of this in the future,” Elder said.

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新华社华盛顿11月20日电通讯:针灸在美迎来发展好时机  新华社记者郭一娜 林小春 胡友松

http://us.xinhuanet.com/2017-11/21/c_129746359.htm

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,享受着45分钟的美好时光。

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几十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。当时她得了肌腱炎,西医告诉她最快也要几个月才能恢复。有朋友向她推荐了樊蓥,后者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。

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,她正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。”

“美国的医疗体系有很大问题,”莎伦说,“不少人在寻找替代疗法。我坚信今后会有越来越多人看中医。”

正如莎伦所说,当前,美国阿片类止痛药物滥用与成瘾危机日益严重,在这方面针灸大有可为。

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。官方数据显示,每天平均有91名美国人死于过量服用阿片类药物,年均超过3万人。10月底,美国总统特朗普向阿片滥用现象宣战,称“阿片类药物滥用是美国历史乃至全世界范围内最严重的药物危机”。

严峻现实迫使西医接受非药物疗法。而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。

不少旅美针灸师预感,针灸在美国可能迎来了发展的好时机。目前,经过业内人士长达40多年的努力,美国50个州中有46个州以及华盛顿特区已立法让针灸行医合法化。而在这个过程中,樊蓥的诊所,从15年前的无人问津到如今每周稳定在150位左右病人。个中改变,反映了针灸在美国从举步维艰到逐步受到认可的历程。

正是看到针灸治疗的良好效果和较大的市场空间,美国一些理疗师也开始学习针灸,但这也带来了一些干扰。美国的针灸与东方医学硕士需要学习2000小时以上,而美国部分理疗师将针灸改成“干针”,只需学习50个学时就可行医,且未接受中医针灸的完整训练,更缺乏中医针灸处理多科疾病的全能知识和技能储备。所谓干针是指理疗师用针头对激痛点进行针刺的方法。

“美国国内一些理疗师的做法是在混淆视听,给针灸在美发展带来挑战。”谈起这些“干扰”,樊蓥皱起眉头。

目前,莎伦所参加的医疗保险覆盖针灸治疗,可报销80%。10月,美国参众两院议员同意在老年人与残疾人联邦医保的一个补充项目中包括针灸。如果该法案最终通过,相信将进一步推动针灸在美国的发展。

11月,多个美国中医针灸团体在学术期刊上正式发布《针灸应对阿片类药物危机白皮书2017》,樊蓥也是作者之一。这份白皮书被送交美国卫生与公众服务部,并得到积极回复。

也是在初冬,作为全美中医药学会(ATCMA)副会长的樊蓥参加了首次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阿片类药物滥用与成瘾方面的作用。现场气氛热烈,40多人还尝试了耳针。“在国会和联邦政府层面,我们还将继续推动,为针灸在美迎来真正春天不懈努力。”樊蓥说。

+1

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http://news.xinhuanet.com/overseas/2017-09/27/c_1121734808.htm

如果说传统中医作为一个整体在美国还处境艰难,那么针灸的命运要好得多。经过业内人士长达40多年的努力,美国50个州中有46个州以及华盛顿特区已立法让针灸行医合法化。由于美国阿片类止痛药物滥用与成瘾危机日益严重,针灸在美国面临着大发展乃至被主流医学界所接受的良机。

一周前,美国35个州、华盛顿特区以及美属波多黎各的检察长联名发出公开信,呼吁美国健康保险计划联合会的1300个会员公司修改保险政策,将针灸等非药物止痛疗法纳入在内。此前,美国马里兰州、华盛顿州、阿拉斯加州等已将针灸纳入医疗保险体系。

美国针灸界26日发表一份21页的英文白皮书,列举一系列科研证据,表明针灸能作为一线疗法安全有效地治疗急性与慢性疼痛。

“针灸的春天也许来了,”在华盛顿特区从业的执照针灸师樊蓥对新华社记者说,“这次美国的阿片类药物危机,将让非药物疗法正式有了一席之地,包括针灸、整脊和医疗按摩,但也不能说没有春寒。”

自去年3月时任美国总统奥巴马提出止痛药物滥用问题,在新泽西州行医的执照针灸师李永明就意识到“这或许是一个针灸新时代的开始”。他第一个提出,美国正在开展“新鸦片战争”,这个说法在华人针灸师内部得到广泛认同。

“在各种非药物疗法中,针灸治疗疼痛效果最好,对替代阿片类止痛药最具特异性,所以这对针灸界无疑是个好消息和发展机遇,几十年不遇,为针灸进入主流医学提供了良机,”李永明说。

对于美国各州检察长的呼吁,他乐观地认为,美国保险公司照办的概率很大,一个原因是针灸成本不高,而“阿片类药物中毒急诊住院治疗平均每次9万多美元。够一个针灸师一年的工资。保险公司是要算成本的”。

全美中医药学会会长田海河强调,美国各州检察长的公开信只是一个提议,采纳与否不知道,但这确实可能意味着针灸在美国大发展的机遇即将来临,接下来的问题是怎么抓住机遇。

田海河说,目前美国有4.5万名针灸师,首先技术一定要过硬,能有本领去帮助病人止痛,使病人没有理由、没有借口去用止痛药,也就不会成瘾。“我们要有这个金刚钻,才能揽这个瓷器活。”

他还提醒,即使各州检察长的提议被接受,美国还有很多提供针灸治疗的私人诊所与个体医生并不在医疗保险体系内。保险体系内的一些医生也提供针灸服务,但称之为“干针”,认为这与中医无关。“干针”反而有可能抢先利用这个机遇,这是需要针灸师们解决的问题。

“如果针灸能被纳入医保范围内,这太好不过了。但这将是一个漫长的过程。结果不是等来的,需要我们提供科学证据,证明针灸止痛安全、有效,”田海河说。

对于各州检察长的提议,美国健康保险计划联合会通信与公共关系主管凯瑟琳·唐纳森告诉新华社记者,他们已在探索加强使用已被证明有效止痛的非药物疗法。

唐纳森说:“对于许多患者而言,诸如针灸、瑜伽和锻炼等疗法都是有效的一线疗法,但这视患者个体的不同情况而言,必要时再改而使用药物疗法。”

那么,美国学术界目前到底怎么看待针灸呢?

美国国家补充和综合健康中心官网在对针灸的介绍中指出,只要由有经验的、受过培训的针灸师施针,针消过毒,总体是安全的,但不当施针能引发严重副作用。一系列研究表明,针灸可能有助减轻腰痛、颈痛和骨关节炎疼痛,也有可能帮助减少紧张性头痛发生频率并预防偏头痛。

美国国家科学、工程和医学学院也于今年7月发布一份题为《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。

2015年,美国医疗保健机构凯泽·珀默嫩特公司曾在6000多名会员慢性疼痛患者中开展问卷调查,结果发现,32%的患者接受了针灸治疗,47%的患者接受了整脊治疗,21%的患者说同时使用这两种疗法。

研究第一作者、凯泽·珀默嫩特公司健康研究中心的查尔斯·埃尔德对新华社记者说,针灸是帮助治疗慢性肌肉骨骼疼痛的一种重要手段,有越来越多的科学证据支持使用针灸止痛。因为慢性疼痛很难治疗,所以针灸治疗就显得很重要。

“通常我们使用的药物效果不佳或者副作用太大,所以医生和患者都期待替代疗法,”埃尔德说,“针灸的作用应该在我们的医保体系里继续增强,这将很有意义。比如,俄勒冈州现在要求医疗保险覆盖包括针灸在内的补充医学方法治疗背痛患者。我预计我们将来会看到更多这样的要求。”

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https://www.eventbrite.com/e/hill-briefing-acupuncture-a-powerful-tool-in-solving-the-opioid-crisis-tickets-38772019153

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The United States is facing a national opioid epidemic and regulatory agencies, patient advocacy groups, chronic care organizations and our medical systems are looking for non-pharmacologic strategies to join in the battle to decrease our country’s opioid dependence. Acupuncture is a powerful, evidence-based, safe, cost-effective and available treatment ready to step into this role. Licensed acupuncturists can be utilized throughout the current systems delivering first-line treatments for pain and can be employed for treatments of those suffering through the debilitative world of opioid addiction.

Join us November 8th as we discuss how acupuncture can be safely, easily and cost-effectively incorporated into hospital and rehabilitation settings across the country to help dramatically decrease health care expenditures while offering patients non-pharmacologic options for treating and preventing opioid addiction and pain.

We will begin with a complimentary session of acupuncture led by a team of experienced licensed acupuncturists. All attendees are invited to participate. There will be a Q&A session following the presentations and lunch will be served.

Speakers:

Dr. David Miller, MD, LAc

Dr. Jun Xu, MD, LAc

Dr. Arthur Yin Fan, CMD, PhD, LAc

Dr. Tracy Soltesz, DAc, LAc

Dr. Kallie Guimond, DOM, LAc

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