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Ask an expert - general
Q: I am trying to find a member who specialises in treating chronic fatigue and fibrmyalgia in the north london south hertfordshire area
A: We take the view that all of our members are competent to treat the vast majority of western named conditions with which patients present at their clinics, and therefore do not have specialists as such. There are one or two areas where we are developing guidelines for what we call 'expert practice' in which we recognise that for some groups of patients, especially children, pregnant women and people with mental health problems, there may be additional training which makes a practitioner better able to deal with the problems which they have. This does not mean that we would forbid our members from working with these groups without additional training, but we may decide that someone with this additional postgraduate training may be able to describe themselves as offering specialist practice.
Chinese medicine is very different from western medicine in one very central aspect - Chinese medicine treats the person, not the condition with which someone presents. It is founded on the belief that each person is a unique balance of energies, and that the skill and art of the practitioner lies in understanding the symptoms which someone has in the context of the patient's unique patters. This could mean thar twenty patients with headaches are treated in twenty different ways by a practitioner, a very different approach from western medicine. As such, we have practitioners who are skilled in treating people, not individual conditions which people may have.
In practice, we would advise that a prospective patient talks to a number of practitioners to determine for themselves who they would like to see. We have a search facility on our home page which means that you can quickly find all of the BAcC members close to your postcode, but it is important that you feel confidence in the practitioner, and all of us are more than happy to take a little time to explain who we are and what we do. Although we are all equipped to deal with problems like CFS and fibromyalgia, these can both be quite difficult conditions to treat, with results occasionally being very slow to gain and difficult to maintain, and having some experience of this can be an advantage in terms of managing expectations, from both sides!
There is as yet no statutory regulation of acupuncture in the UK, and as a consequence no Register with which every acupuncturist has to be registered in order to practise. In theory, this gives anyone a common law right to obtain needles and practise acupuncture.
However, in practice, there are a number of health and safety laws which mean that anyone involved in skin piercing activities, be this acupuncture, tattooing, ear piercing, or body piercing, has to be either registered or licensed with a local authority in order to set up in business. The only grounds for exemption are that a person already belongs to a statutory register like the GMC (for doctors) or the HCPC (for physios and other healthcare professionals). In all other cases there is a process to be followed which means not only that someone's working conditions are subject to some very strict scrutiny but also that their training standards are checked to ensure that they do not represent a risk to the general public. This latter check has been in recent times much more rigorously enforced by local authorities which have recognised that safe practice is not simply a matter of hygienic needling but also the competence which the professional has in their skill.
The best course of action is to contact the local authority in the UK where you intend to work and seek their advice.
If, however, you are outside the UK and seeking registration with a UK acupuncture body that would present a number of slightly more difficult problems. The BAcC long ago abandoned accepting applications for Overseas Membership from people outside the UK unless they had graduated from an accredited UK teaching institution or had previously been Full members in the UK. It proved far too difficult to check applications from overseas, and the BAcC was concerned that its status as a leading acupuncture body might be mis-used by spurious membership applicants.
A: The short, and somewhat trite, answer is that they make sure that they are properly trained to begin with. Training in the UK, at least for entry to registering bodies such as the BAcC, requires a three year degree equivalent course which ensures not only that the basic knowledge is wired in but also that the bestg possible clinical practice is inculcated in the students. Knowledge without wisdom and good practice is irrelevant, and the crucial element in training is not being able to generate lists of symptoms and syndromes but to be able to respond to the unique problems which each patient brings to the clinic. This requires a great deal of supervised practice, in our view, to give practitioners the confidence to be able to adjust and refine their work to the patient's best advantage, and also to deal with situations where things don't go as well as they hoped. Knowing what to do is important, but knowing what to do when something goes wrong is the sign of true skill and mastery.
Making sure that someone follows best practice is an individual responsibility, but regulatory bodies such as the BAcC have the responsibility for checking that practitioners registered with it maintain their skills and develop as practitioners. As well as offering our own advice and support, with a great deal of valuable material being available on our website and through our professional journals we also have a mandatory requirement for members to undertake what is called CPD, Continuing Professional Development, which is aimed at making practitioners develop their skills after they have qualifed and for as long as they practise.
That, of course, is the carrot. The stick is that we have some very well defined rules of behaviour, skill and conduct to which we expect our members to adhere, and we are always ready to take sanctions against someone who does not continue to meet or adhere to our standards. Expelling members is a rare event, but we do have occasion to ask members to up their game in terms of basics like good record keeping or respecting boundaries. The BAcC is a particularly well-behaved professional body, and disciplinary cases are rare. Above us, however, sits the Professional Standards Authority, a government agency with whom we are accredited, and its task is to ensure that professional associations such as ours continue to demonstrate that we are protecting the public by making sure our members are properly trained and accountable, and that members of the public have access to advice, support and pathways to complain if they are unhappy with any aspect of the treatment which they receive.
Q: Are there any acupuncturists specifically trained in non-surgical "face-lifts" who are members of BAcC and if so, are there any in Oxfordshire?
A: We find ourselves a little bit conflicted when we receive questions like this. There are a number of areas where are developing standards of expert practice. This in turn might lead to qualifications which would enable us to recommend specific groups of practitioners. However, at the moment the focus is on paediatrics and obstetrics, so although we are aware of a number of courses which offer postgraduate training in facial or cosmetic acupuncture, we have not yet agreed the standards against which they should be measured.
However, it is widely recognised by many of the trainers in this area that using facial acupuncture techniques without also attending to the underlying patterns of energy is not as effective. We always recommend, therefore, that if someone is conducting their own search for a practitioner they should ensure that the person is a fully trained professional acupuncturist, not someone who has learned a few specific techniques as an adjunct to beauty therapy. There are also some safety concerns about being treated by someone who is not a professional acupuncturist. There is no difference in health and safety terms between someone who uses ten needles a year and someone who uses ten thousand. The same scrupulous attention to hygienic practice is essential. We have some reservations about very short coirses which offer the technique and all of the safe practice essentials in a very time.
If you undertake a google search under 'facial acupuncture oxford' you will find a number of BAcC members whose standards you can trust and who have undertaken additional training in this area of work
Q: My farther has had his leg amputated 4 years ago and still has very painful phantom pains, can this be treated with acupuncture?
A: Phantom limb pain can be a very distressing phenomenon.
There have been a number of studies over the years which describe the use of acupuncture in individual cases, and if you google 'acupuncture phantom limb pain' you will find examples such as:
We are also aware of a paper published in the Journal of another acupuncture association which cites the following papers about phantom limb sensation.
Bradbrook D (2004) Acupuncture in Medicine Acupuncture Treatment Of Phantom Limb Pain And Phantom Limb Sensation in Amputees. 22; 2; 93-97
Hecker H. -U et al (2008) Color Atlas of Acupuncture 2nd Ed. Thieme, Stuttgart
Hill A (1999) Journal of Pain and Symptom Management Phantom Limb Pain: A review of the Literature on Attributes and Potential Mechanisms. 17; 2; 125-142
Johnson M.I. et al (1992) Pain Clinic Treatment of Resistant Phantom Limb Pain by Acupuncture: A Case Report. 5; 2; 105-112
Liaw M.-Y et al (1994) American Journal of Acupuncture Therapeutic Trial of Acupuncutre in Phantom Limb Pain of Amputees. 22; 3; 205-213
Monga T.N et al (1981) Archives of Physical Medicine in Rehabilitation Acupuncture in Phantom Limb Pain. 62; 5; 229-2321
The mechanism by which the treatment works is not at all clear from a Western medical point of view. From a Chinese medicine perspective it is perhaps easier to make sense of the appearance of the pain from the fact that the channels which run through the affected area spread out across the body, and even in 'conventional' Chinese medicine treatment it is not unknown to treat a problem in the lower left limb by using points in the upper right limb. The fact that the opposite limb is missing would not necessarily render the treatment useless.
The best advice we can give, especially when there is so little case evidence to point to, is to visit a BAcC member local to your father for advice on his specific circumstances. There may be a number of initial soundings which he or she could make to determine whether treatment may be of benefit.
The problem with conditions like this is that there are case studies which offer encouragement, but nobody publishes the results of case studies where things don't work, so for the small number which have been successful there may be ten times as many where treatment was tried and failed. It is best not to over-excited by the fact that some treatments work. Everything works for someone, but that doesn't mean that somehing works for everyone.