Acupuncture touted for low-cost care



KAI RYSSDAL: Whoever wins in November's going to have to do some pretty serious thinking about health care. Surveys consistently show it right near the top of the list of things voters say they're worried about -- the availability of care, as well as the cost. On that latter point, one possible solution might be coming from an unlikely source. An alternative form of treatment that involves lying completely still while they stick needles in you.

Joel Rose reports from Philadelphia.

JOEL ROSE: Philadelphia Community Acupuncture occupies a big, open room on the top floor of a former firehouse. About half a dozen patients doze in reclining chairs with little needles sticking out of their arms and legs.

KORBEN PERRY: Can I see your tongue? And you're sleeping better?

ILIANA PAGAN: I'm going to bed early for me. . . .

Iliana Pagan whispers with acupuncturist Korben Perry. He takes her pulse, inspects her tongue, and then slides tiny needles a few millimeters into her skin, where they'll stay for most of the next hour.

Rose: How does this work again?

Ellen Vincent: Acupuncture? No one really knows. The most important thing is that we see results.

Ellen Vincent started the clinic with Korben Perry just over a year ago. Now it's treating 150 patients a week for a variety of conditions.

Vincent: A lot of back pain. A lot of anxiety, especially panic attacks. I have many people walking in the door in a state of panic and we give them needles, and they walk out the door, saying "Thank you, so much. I feel so much better.

At a typical acupuncture clinic, Vincent and Perry would see one or two patients an hour and charge $80 or more a visit. But Philadelphia Community Acupuncture is organized around the so-called group visit model where up to a dozen patients are seen at the same time. Because of the volume, they're able to keep their fees low. Their sliding scale starts at just $15 dollars a treatment, which means more patients can afford to get treated more often.

Lisa Rohleder: When we say our goal is to take back acupuncture for the working class, we are not kidding.

Lisa Rohleder pioneered the community acupuncture business model at her clinic Working Class Acupuncture in Portland, Oregon.

Rohleder: A large number of our patients have no health insurance at all. And no access to health care. We think that's wrong.

She says this model is closer to the way acupuncture is practiced in China, where it was first developed thousands of years ago. And she thinks group visits for routine health care like this could be applied to more conventional medicine. Kjersten Gmeiner thinks so, too. She's a family doctor in Seattle who's been offering group visits for years for patients with diabetes and hypertension.

Kjersten Gmeiner: It's something that decreases cost -- that's the grail in current medical care -- with increased patient and provider satisfaction.

So far, there isn't a whole lot of research backing up Gmeiner's claims, though one promising study in Denver did show that group visits for seniors lowered their overall health care costs by more than $40 per month. But not everyone is convinced that group visits are the Holy Grail. Deborah Peel heads the organization Patient Privacy Rights.

Deborah Peel: A significant number of people are not comfortable telling anyone but their doctor some of the things that are the most disturbing or troubling or frightening about their symptoms or their bodies. For actually getting the best treatment, one-on-one is far more effective than group treatment.

Even group visit advocates admit they won't work for everyone or every situation. But the idea does seem to be catching on with patients like Jessica Winegar at Philadelphia Community Acupuncture.

Jessica Winegar: You feel like you're all sort of in this together. And, I don't know, I mean, it sounds flaky to say but there is some sort of, like, collective energy that's produced that I think is actually . . . outweighs any of the negative aspects of not having a one-on-one -- an extended one-on-one -- with a provider.

For Winegar, the most important thing is that her back finally stopped hurting.

In Philadelphia, I'm Joel Rose for Marketplace.

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My friend went to a couple of acupuncture sessions and now she feels much better, even if a lot of people don`t think this kind of therapy helps I can firmly say that it helped her with her headache problems. She also tried sports therapy on http://www.usatc.com/ and the results are amazing, her cholesterol level has lowered since she started the program.

i am a physical therapist and an acupucturist and i have to say that there's a lot os physical problems that can't be resolve with acupuncture, and the opposite too. The important thing its to find a good professional to work on your body.
i think the Philadelphia Community Acupuncture its a great way of working and very good for the area.

I have been seeing Ellen Vincent at PCA and she has been treating my various post-partum complications. Because of the treatments, I have been able to walk and workout without the pain it used to cause me. I no longer have intense cravings either! Acupuncture works. In this open setting you still have personalized care and my initial intake(the most private part) was in a separate room. She isnt shouting my symptoms from the rooftops by any means. Most of the people are asleep anyway! In that open space, you see people of all genders,ethnicities, neighborhoods, etc...It brings us all together under one roof, how rare is that? We are all getting the same care at a price that each of us can afford. Unfortunately, in our healthcare system, that too is rare.

Acupuncture has been the major reason for the change in my mental health. Before acupuncture, I couldn't tell you the last time I had felt happy, truly happy. These days, it's one happy day after another. I would highly recommend acupuncture to anyone like me, who suffers from anxiety and depression. And pairing it with a little bit of p*t really puts life way more into perspective.

It's disappointing to read comments by those who would relegate Oriental Medicine to the same category as treatments by unlicensed persons. Licensed Acupuncturists, or Doctors of Oriental Medicine, depending on what State you live in, are trained in a four academic year Masters degree program. Most programs are between 3000 and 4000 hours, and they are provided extensive biomedical (microbiology, pathophysiology, etc.) training to communicate with western medical providers. At least 1000 hours of clinical training are included in professional internship, and in the best schools, Chinese herbal studies are a core subject. The term Acupuncturist is misleading. In Traditional Chinese Medicine, or TCM, acupuncture is merely a facet of the totality of treatment. Herbs, which are safe if prescribed by a qualified practitioner, are an integral part of treatment, which assist in making the effects of acupuncture long-lasting.
TCM in China is considered a peer to Western medicine. No one in that country sees one side without the other. This system of medicine has a 5000 year history, and although there is only a 50 year or so history of clinical studies, most of which support the effectiveness of oriental medicine, we have at least 2000 years of case studies of individual improvements in health and cures. Compared to less than 150 years of documented success in Western medicine, it at least deserves consideration as a complimentary practice in the future model of integrated medicine. No one model has all of the answers. Over 100 thousand citizens of this nation die each year from properly prescribed Western pharmaceuticals. MDs and DOs aren't perfect, nor are they better trained for their field than we are for ours. Both are first-professional degrees in their respective fields. We don't perform surgery, either. We both have our limitations. In the areas of chronic pain, recovery from stroke, and neurological disorders, oriental medicine offers great promise, as detailed by hundreds of individual cases. Before criticizing a field with which you may not be fully informed, do your research outside of the "quackwatch" hacks that thrive on providing as "evidence" the opinions of practitioners who see us a competitors.

As an acupuncturist having a conventional practice but intrigued by the Community Acupuncture model, I want to clarify an impression implied in some postings. Those acupuncturists adopting the community acupuncture model have full training and licensing. They are no less qualified than acupuncturists seeing less patients per hour time merely because there has to be a private room for each patient to stay in while the needles are in place. Generally, once acupuncture needles are inserted, they stay in place for some period of time while the acupuncturist leaves the room. I tell my patients that it's like putting a battery in a charger until it's ready to use. One of my acupuncture teachers sees 5 patients per hour in private rooms. But she only sustains that caseload because she has apprentices (who are graduated and licensed acupuncturists) performing parts of the treatments after she evaluates the patient. That was how she was trained in Japan. I do everything myself with two treatment rooms and have to set fees to make a living based on that caseload.

In response to the previous comment, I am glad this issue has come up because it is an area in which community acupuncture sharply differs in philosophy from conventional acupuncture. Rather than equating seeing many patients a day with "HMO acupuncture", we are attempting to emulate the long tradition of Asian master acupuncturists who were and are able to effectively treat dozens of patients a day by relying on the core diagnostic skills of acupuncture such as pulse reading. We do not believe that "complete" treatment for a patient is the same thing as lengthy interactions with an acupuncturist; rather, "complete" treatment represents a complete COURSE of treatment (five, ten, or twenty treatments in a row, once or twice a week). The needles do the real work. In China, someone with a complex or chronic condition would be treated with acupuncture every day for weeks or months. This rarely occurs in America because of the high cost of acupuncture, and as a result, the conventional "complete" model of acupuncture often produces inadequate results, simply because patients cannot afford to fulfill a course of treatment. The analogy in Western medicine would be going to see a doctor who performs a lengthy diagnosis and prescribes antibiotics -- but only a single pill when a ten-day course would be needed to resolve the problem. There is no benefit to the patient if the acupuncturist utilizes "the full scope of acupuncture and Oriental medicine training" when the patient cannot then pursue the treatment due to cost. My clinic regularly sees patients with complex and chronic conditions who come to us after ending their treatment with "complete" providers because they have discovered that acupuncture helps them enormously, but there is no way on earth they can afford to pay $75 twice a week. We also hear very often from our patients and from acupuncturists who have switched from conventional acupuncture to community acupuncture that they are stunned at how much better the clinical outcomes are when acupuncture treatments are frequent, regular, and yes, cheap.

It is all well and good to provide cheap acupuncture in a group setting, but it is just that. The more patients one sees, the less individualized the care. It is HMO acupuncture, and does not provide the full benefits of a complete acupuncture practice, which utilizes the full scope of acupuncture and Oriental Medicine training. That said, it is a great introduction to acupuncture and Oriental Medicine form many who would not have considered it previously because they did not have enough knowledge of what acupuncture and Oriental Medicine could do to assess its value. I can only hope that the acupuncture providers in these clinics refer out complex cases to complete providers instead of having the patients feel that acupuncture and Oriental Medicine don't work for them.

My husband had been treated for years by various medical doctors for his sciatic pain. He received oral medication and injections. He got some tempoary relief as long as he kept taking medication but didn't want that as a continous lifestyle. During the first accupuncture treatment he
got immediate relief. The pain returned at a lower level and after a few more treatments he has total relief.

Dear Patricia,
I'm sorry I'm not very familiar with CT, but here is the contact information for a member of the Community Acupuncture Network. If he is not near you, maybe he will know someone who is:Bob Robles/Market Square Wellness Center/100 Market Square/Newington, CT/860-667-0949 (clinic) 860-833-9330 (mobile)
good luck and best wishes.


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