Medical Acupuncture vs. Licensed Acupuncture: What's the Difference? by Brian B. Carter, MS, LAc Brian is the founder of the Pulse of Oriental Medicine. He teaches at the Pacific College of Oriental Medicine and maintains a private practice in San Diego, California, and is the author of Powerful Body, Peaceful Mind: How to Heal Yourself with Foods, Herbs, and Acupressure.

Who are we? Licensed Acupuncturists.

What's the difference?

Medical Acupuncture is the name given to MD's, DO's, and DC's (chiropractors) who practice acupuncture.

Licensed Acupuncturists study mostly chinese medicine along with the basics of western medicine.

How much training does each type of acupuncturist get?

Training varies for medical acupuncturists because they are not held to minimum educational hours or a minimum competency level. Some are dedicated and learn much more than their peers. Most (80-90%) do not.

The following chart portrays the average acupuncturists of each type.

According to the American Academy of Medical Acupuncturists, "a minimum of 300 hours of systematic acupuncture training" is required for a physician to be certified as a medical acupuncturist. This is optional, however. In many states, physicians can practice acupuncture without any certification at all.

Lynda Harvey, L.Ac., a professor and clinical supervisor at the Pacific College of Oriental Medicine (PCOM) comments, "Some of us feel that the equivalent would be if Licensed Acupuncturists could take a weekend class in pharmacology and then go out and prescribe pharmaceutical drugs to our patients." Indeed, physicians would be in an uproar if such a thing was ever considered.

These misinformed articles in Cosmo and on iVillage imply that Medical Acupuncturists can practice acupuncture better than we can. Look at the top two rows in the chart above, and you'll see how likely that is.

Medical Acupuncture Spokesperson Denounces Misinformation

Jim Dowden, Executive Administrator of the American Academy of Medical Acupuncture (AAMA) says, "The bulk of our physicians use acupuncture as an add-on modality; it comprises only 10-20% of their practice." When asked about the iVillage inaccuracies, he said, "Most health writers are accustomed to doctors referring patients to other practitioners. I wasn't aware of that information. It certainly doesn't come from anything we've said."

When you look at the numbers, it's clear that Licensed Acupuncturists are getting a much more rigorous and diverse acupuncture education. Plus, acupuncture usually comprises at least two-thirds of their practice. They get significantly more clinical experience than most physician-acupuncturists.

So, the fact is that some of the press still hasn't caught on to the realities of acupuncture. Which is funny, because they are so quick to criticize western medicine... you'd think they'd jump on the idea that L.Ac.'s are a great alternative.

The Safety of Seeing a Licensed Acupuncturist

As for not being able to pick up ominous (red flag) symptoms and signs, I can't speak for the other schools, but at PCOM since our biomedical education is short, we spent the time talking about those very issues. We learned what kind of pain signals pancreatitis, the warning signs of cancer, TIA's, strokes, heart attacks, deep venous thromboses, etc. We are properly educated to pick up danger signals, and we know when to refer out.

The Danger of the Patient who Hates MD's

The only time it is critical for the acupuncturist to pick up red flags is when they are the patient's only healthcare provider. Most of the time, our patients have a regular MD/DO and/or DC. But there is the rare patient who is so against western medicine that they refuse to get tests or see an MD. In this case, we do our best to convince them to change their mind.

MD's never miss critical diagnoses?

I think a fair counter-question would be: Given that in the currently normative HMO managed care situation, what is the chance that an MD/DO (who has 5-7 minutes maximum with their patient) will pick up those critical symptoms and signs themselves? You can't tell me they don't miss some of them.

Medical Error is Unavoidable

The study of medical error and how to prevent it is a major effort in which many physicians, researchers, and academic have joined. Studies have shown dramatic error rates of 10% or more. Many believe that medical error is unavoidable, no matter how much we try to prevent it. I'm sure that doesn't make you feel too safe.

Acupuncture is Incomparably Safer than Drugs or Surgery

The statistics for how many people die in hospitals and from pharmaceutical drugs per year in the U.S. alone are stunning. 98,000 people per year is often quoted. Even if we give them the benefit of the doubt, we must admit the number is in the tens of thousands.

Compare that to three retrospective studies of acupuncture treatments of a total of 121,520 treatments... all the patients lived, and only 198 experience minor problems like dizziness, a drop of blood coming out, or finding a needle that wasn't removed after the treatment.

It can't treat everything, but it's the safest first line treatment for most non-life-threatening conditions.

MD's who practice acupuncture not taken seriously by other MD's

I don't envy them- they're stuck in the middle. Some Medical Acupuncturists try to claim that they specialize in acupuncture. But hundreds of thousands of their colleagues don't take them seriously. Why? Because real medical specialties have serious educational and clinical training requirements.

Sorry, but you can't take a weekend course and expect to be a specialist in anything!

Who is More Competent to Practice Acupuncture?

The better questions are:

• Would you prefer to be needled by the better trained, or the less trained acupuncturist?
• Would you prefer to be treated by someone with a lot of experience, or a little?
• Would you like to be treated by someone educated in the original medicine of acupuncture, or someone who's just read a few point protocol studies?

Are Licensed Acupuncturists Always Better At Acupuncture?

I can't say that's true. It's probably a better rule of thumb to assume that there are good and bad doctors, and there are good and bad acupuncturists. The difference is that licensed acupuncturists are held to a minimum level of education and competency in acupuncture. Medical acupuncturists are not. So, it would be better to say that the worst medical acupuncturist is light-years worse than the worst licensed acupuncturist.

What About Really Good Medical Acupuncturists?

But there might be medical acupuncturists who spend so much time studying and practicing traditional acupuncture that they become better than many licensed acupuncturists. On the upper end of the scale, it's more about intelligence, education, and experience.

So in Conclusion...

• Go see a licensed acupuncturist.
• If you find the rare MD, DO, or DC who has decided to devote his whole practice to acupuncture, and/or they are also an L.Ac., you may have found a good one.
• Otherwise, stick with the well-educated and more experienced sort of acupuncturists - licensed acupuncturists.
• And let your MD to stay on top of the red flags.

Find a licensed acupuncturist here: "Resources for Finding Acupuncturists and Herbalists"