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Ask an expert - general
Q: I am a Health and Social Care student researching into acupuncture. I am looking for information on regulation of acupuncturist and requirements they must have to be a registered practitioner. I haven't been able to find any information on your website if any practitioner must have any CRB checks, professional indemnity insurance or annual renewal of registration. Is there any in place for practitioners governed by the BAcC
A: All of our practitioners are covered by a bloc professional idemnity policy through Royal Sun Alliance which is a full 'claims occurring' policy with a £5million limit of cover. The only practitioners whom we do not insure are those working full time in the NHS, for whom NHS cover applies.
We do not routinely seek CRB checks for practitioners. The vast majority of the membership intake is from accredited teaching institutions, some of whom seek CRB checks when students enrol. The BAcC took advice from the Health Professions Council some years ago when acupuncture was about to be statutorily regulated on whether we should introduce mandatory CRB checks. We were advised that self-declaration was adequate, although we did investigate which of several agencies would be most appropriate for mass checking. The BAcC's Code of Professional Conduct requires that members do not work unsupervised in a number of situations where CRB checks would be essential. However, we do regard ourselves as exempt from the provisons of the Rehabilitation of Offenders Act 1974 insofar as we require members to disclose all convictions, including spent ones, because of the potential for working with vulnerable adults and undertaking home visits.
There is an annual renewal of registration process which requires members to make a number of declarations about their continuing fitness to practise, and any relevant issues to do with criminal or civil actions, or insurance claims. This process is under review and will be upgraded for the 2014 renewal process.
Q: I have persistent pain in my chest just under my left nipple. I have had heart scan, X Ray, endoscopy all to find everything is ok. Would acupuncture be worth a try?
A: When someone has had a battery of conventional medical tests to assess a pain they have, the first thing we say to them is that this should be reassuring - it has ruled out most, if not all, of the serious possibilities. We tend to 'inherit' a great many patients in your situation, and working in a different paradigm of medicine can sometimes offer new treatment possibilities.
Chinese medicine is based on an entirely different understanding of the way in which the body mind and spirit work as an interconnected system of energy called 'qi', a term which is virtually untranslatable. An understanding of the flow, rhythms and balance of this energy is integral to understanding the concept of disease in Chinese medicine, and the practitioner will be looking at excesses, deficiencies or blockages to try to establish what is causing the pain. This might lead to local treatment to clear a blockage, or could involve systemic treatment if the problem is the tip of a larger iceberg. Usually there is an element of both involved, with underlying patterns allowing local patterns to develop. A practitioner would probably ask you the same kinds of question you have already been asked - nature, frequency, onset, duration, etc etc - in order to refine their diagnosis.
The best advice we can give you is to visit a BAcC member local to you and seek a brief face to face assessment. This will enable someone to give you a much better idea of how treatable the problem is. Our experience is that these kinds of pains clear quickly with acupuncture treatment or not at all, and you should, if you decide to have treatment, set measurable outcomes and a set review point to avoid a sequence of treatment extending a long time without discernible improvement.
Q: I have had four sessions so far but my practitioner also prescrobes herbal medicine Jin ui Shen Qui Wan and another capsule which has no name on the packaging - when questioned about what they are for she simply said they are herbal and wont do me any harm. Is it normal to have to take tablets alongside acupuncture?
A: Chinese medicine includes acupuncture, herbal medicine, tui na (a form of massage), moxibustion (burning a warming herb) and cupping, as well as dietary advice and exercise (tai chi and qi gong). It is quite possible, therefore, to have chinese herbal medicine alongside acupuncture, and the BAcC has about 300 members who are also members of the Register of Chinese Herbal Medicine and use herbs regularly, as well as a further 250 trained to use ready made herbal formulae.
Where a herbal product comes in a ready made form it is required by law to list the contents. If the formula is made up by the practitioner, then there is no need to list the contents, and in most cases the patient would be none the wiser if they did - we certainly wouldn't! However, if we had a list, it would mean that we could check if we wanted to, and that is the important thing. In the days of the internet it is possible to find out just about anything, and the patient has a right to know what they are being given.
We are sure that there are good reasons why the practitioner has not told you what they are giving you, probably to do with the rather obscure names of the contents, but a responsible practitioner will certainly accede to your request for a list of the contents. If that is not forthcoming, then you would be entitled to take that up with the professional association the practitioner belonged to, especially if it comes in packaged form and does not list what it contains. Capsules can be made by the practitioners, so this does not count as packaging, but industrially produced boxes would seem to indicate ready-made herbs whose contents should be listed.
Q: My 9 year old daughter has transverse myelitis. I am looking for an acupuncturist who understands her condition and is qualified to treat a child. Can you advise me?
A: We do not have agreed special qualifications for treating children. However, for a number of conditions children are not simply small adults, and there have developed over the years a number of courses in the UK which train practitioners in the treatment of children. This extends to how best to handle small children and babies, and how to modify the standard treatments to ensure that they are not too powerful for a child. Because we have not yet reached agreement on the standards which would enable someone to advertise themselves as expert practitioners in this field, the best advice we can give is to use google to search 'acupuncture and the treatment of children'. This will generate a number of websites belonging to course providers who list postgraduate diploma holders who may well work in your area.
As far as understanding the condition itself is concerned, although most BAcC members have a thorough grounding in Western medicine, this may not extend to all of the technical details of specific conditions. What we imagine will happen, however, is that a practitioner would as a part of their normal duty of care for a patient find out more about the specifics if they treated someone with a problem such as this. Of course, Chinese medicine is based on an entirely different theoretical structure from conventional medicine, working with a concept of energy,or 'qi', and its flow and balance. That said, symptoms are the same whatever the system of medicine which describes them, and a practitioner's skill lies in understanding how the symptoms present from an eastern rather than western perspective. This can sometimes generate treatment options which are not available within conventional medicine.
However, there are conditions, and this is one of them, where the structural changes in the body are such that it would be over-optimistic to expect change. There are a small number of case studies, such as
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which describe encouraging successes, but these are too sporadic to be used as a basis for claiming efficacy, and with far too many potentially contributory factors involved in the changes.
If you can locate a BAcC member local to you who has undertaken postgraduate training in the treatment of children we are confident that they will be able to offer you a realistic and honest assessment of what they may be able to do for your daughter.
Q: I am considering accupuncture treatment for smoking cessation. i had this before some years ago combined with Chinese herbal medicine herbs and it worked wonderfully well, now i can't afford the herbs, just the accupuncture. i have been offered 5 appointments of 45 minutes each over 2 weeks for £150 total for accupuncture treatment. Do you think I will manage to give up smoking again with this treatment without the herbs? i just relapsed the last 3 months due to severe family upsets. After being a non smoker for 12 years, i would value your opinion. i have been diagnosed with schzophrenia in the past since 1992 and just recently have a new diagnosis of personality disorder instead.
A: This is a difficult question to answer. It is impossible to say whether it was the acupuncture, the herbs or the combination of the two which made such a successful impact on your cigarette smoking before, so the only way to find out, we suppose, is to see if the acupuncture alone can do it. There's no doubt that the fact that you managed to stay off cigarettes for twelve years would seem to indicate that you are more likely to be able to give up again, especially if the circumstances which brought about your relapse have resolved a little.
However, there are never any guarantees with treatment for giving up smoking.
We wish you the best of luck!