Geese, ganders and scope....... (rant)

[Guest guest]

" What's good for the goose, is good for the gander " ....????

We can't expand our scope to include modalities that acupuncturists use but they

can expand theirs?

I just came back from the OAAOM meeting at NCNM. I went because they were going

to address the dry needling issue and I am really trying to understand both

sides of the argument.

One thing is clear, Oregon acupuncturists believe that we want to perform

" acupuncture " by disguising it as dry needling. In addition, they really have no

idea what we do regarding anything other than spinal manipulation. They have no

idea or don't really respect our status as doctors.

Another thing I realized (I suspected this all along); many of us don't really

know what they know with regards to biomedical interventions. In our defense, I

don't think the acupuncture profession is clear on this either.

Then.... it happened, the handout they gave everyone states that ordering and

interpreting lab results are part of their scope but the medical board is

requiring an investigation to the education to do this as an acupuncturist.

Wait.... they spend quite a bit of time trashing our profession for trying to

increase our scope to include a modality to treat myofascial trigger points and

they are actively and aggressively going after lab work to come up with western

medical diagnoses???

There is irony here but also a threat to our piece of the pie as primary

caregivers. Do we really need another natural and complementary profession to

muddy the waters with their version of a PCP? Many DCs argue that acupuncturists

are trying to invade our turf under the disguise of " Tui-Na " . While this may be

the case here and there; it's apparent that OR acupuncturists are trying to

expand their scope to diagnose and treat western medical illnesses.... and

they're fighting us to include another modality to treat myofascial trigger

points; entities that we already detect, diagnose and treat. Does anyone else

see this as absurd and threatening?

One of their main counterpoints to us using DN is that we are doing it for

purely monetary reasons; we are a greedy bunch. I have also heard from more than

one ND that we try and be as specific as possible with our adjustments so we can

see the patient more often to adjust a little each visit.... I am offended on

both fronts.

Tell a recent patient of mine who has had severe myofascial pain related to TMJD

and lateral pterygoid TP's, that acupuncturists are better trained at finding

and treating myofascial trigger points with needles.

Despite spending thousands of dollars of her own money (she's 26 and right now

has no job) on TMJD specialists, cranial work, naturopathy and chiropractic care

from multiple providers, she valued my referral to an acupuncturist in Portland

who claimed to do trigger point needling. I relayed to him that her lateral

pterygoid may be the offending muscle, he stuck a needle right through her TMJ

in addition to a few other peripheral points which didn't help at all; and he

used a 30mm needle, which can't possibly reach the muscle.

She has a classic lateral pterygoid referral pattern and I have treated as much

of it intraorally, that I can access with good but not complete results. She

needs to have DN to the muscle (the same way I was taught by Jan Dommerholt).

She is actually considering traveling to another state to get the treatment by a

PT who has gone through his courses too.

I am very surprised that she continues to trust me with her care, I am able to

knock back her pain significantly (more than any other treatment), but is comes

back. She begged me Wednesday to perform DN on her but I can't risk it. I am

actually considering flying her out to Casper, Wy for the next course with Jan

just so we can treat her.

Since our board has decided that we are not allowed to perform DN; I have seen

so many people who need it; many of which I have sent to various acupuncturists

in Portland who claim to do myofascial TP DN with varied success and

satisfaction.

Are we attempting to rebrand acupuncture as DN? Well, I don't know of any DN

course that teaches us to become acupuncturists.

Is it purely for monetary gain? Them's fighting words!

Here's a question (rhetorical or not): Are we so focused on being included in

medicare and Obamacare that we are going to allow another profession to stifle

our ability to evolve and use modalities (DN or not) to treat things we are

already adept at (experts, if you will) finding, treating and rehabbing? All the

while, this profession is attempting to broaden their diagnostic scope to be

relevant and more competitive in the health care market?

Can you actually see yourself recommending that a patient go see their

acupuncturist to get lab work? Tui-na? Trigger point therapy? Soft-tissue work?

Anything but acupuncture? If not, we need to huddle-up and realize that the DN

issue is a bigger issue; it's an issue of scope, the creativity to use various

modalities and create a unique package of care for our patients. One that,

arguably, no one else possesses the skills to offer.

In the handout for the meeting, it states that, despite a hearing with the court

of appeals in 6-8 months on the DN issue, OAAOM is claiming that they have had

their first legal success nationally on said issue and that we (DCs) are all but

defeated.

Rant over.....

-Tim Irving DC, MS, LMT