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Ask an expert - about acupuncture - finding an acupuncturist

10 questions

A:  It may sound a little like one of those silly advertising statements, but all of our members are the best practitioner in Cambridgeshire!  We are very confident that the degree level training which all our graduate entrants receive more than adequately equips them to deal with a problem like yours, and your best way of locating the nearest member to you is by using the postcode search facility on our home page.

Reflux is a fairly common presentation in clinic, which is why when we answered a query earlier this year we said:

There is surprisingly little research on the use of acupuncture for the treatment of acid reflux even though it is a very common presenting condition in our clinics. There are one or two studies like this

http://www.ncbi.nlm.nih.gov/pubmed/20697939

and 

http://www.ncbi.nlm.nih.gov/pubmed/17875198 

and occasional articles like this one

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4080874/

which suggest other possibilities for the appearance of heartburn symptoms, but not the solid body of evidence one might expect based on the usually quite effective treatment of this problem.

Obviously there are physical problems such as hiatus hernia where there has been a physical change in structure of the oesophageal tract which can cause heartburn. If this is the case, then it will seriously limit the possibilities for treatment in any system of medicine. If investigations show that this is not the case, however, then there may be some value in using acupuncture treatment.

From a Chinese medicine perspective the classic presentation of reflux or heartburn is described as Stomach Fire or Rebellious Stomach Qi where the energy of the Stomach does not follow its normal pattern of causing food to descend but lets it stay in the Stomach or reverse its flow to create the classic symptoms with which people suffer. Knowing the immediate precipitating cause, however, does not mean that one goes straight to this for treatment. The flow of energy in the body, called 'qi' in Chinese, is a complex interweaving of channels connecting Organs whose functions are also inter-related. The art and skill of the practitioner lies in determining what the primary underlying imbalances are, in the belief that treating here will cause the symptom to go and stay gone rather than be treated simply as a symptom.

This is one of the primary differences between Chinese and conventional medicine. From the Chinese medicine perspective the symptom is an alarm bell telling the practitioner that the system is out of balance. Thus twenty patients with the same symptom could have twenty different underlying causes and therefore twenty different treatments, in contrast to the standard western procedures which have two or three main strategies for a problem. In Chinese medicine the balance of the system is unique in every patient, and this means that each treatment plan is also unique.

It follows that this does limit what we can say about individual cases and why we invariably advise people to visit a local BAcC member for an informal assessment of what is going on and whether treatment would be of benefit. Most practitioners can get an idea in a very short time of what is going on and as a consequence give a good informed view of what might be possible. This would invariably take into account other changes in the way that everything functions which are perhaps not significant enough to concern anyone but from our perspective enrich the picture which we have. Reflux and heartburn are often accompanied by changes in digestion and bowel habit, and secondary information can refine the diagnosis a great deal. A practitioner can take all sorts of other factors into account, including mental and emotional ones, to offer you a much more precise assessment of what may be possible.

This remains the best advice we can possibly give to determine whether acupuncture really is the best option for you, and also to reassure you that this is such a commonly addressed issue that all of our members would tend to regard it as a 'stock' item.

Q:  We  are very attracted by the Channel Islands, and would like to move there. My husband has been practicing acupuncture in the USA for 30 years. In USA and in China, he learned TCM. He is an American citizen and I am German citizen. How would it be possible for him  to practise his profession  and help the people on the Channel Islands?

As far as we are aware,  the level of qualification which your husband has achieved in order to be able to practise in the USA should be more than adequate to meet the eligibility requirements for practice. We are familiar with the requirements in Jersey, having had extensive correspondence with the government of Jersey when the new Code of Practice

http://www.gov.je/SiteCollectionDocuments/Health%20and%20wellbeing/LD%20Piercing%20and%20tattoing%20law%20approved%20code%20of%20practice%2020140926%20JE.pdf

was introduced, and we are sure that the current US standard more than meets the criterion set down in page 22 of the document.

Guernsey and Alderney have a very similar statement in their byelaws

http://www.gov.gg/CHttpHandler.ashx?id=92734&p=0

We believe that Sark submits to, or complies with, the laws of Guernsey in most matters, but with a population of 600 we think it is highly unlikely that you will be choosing this as your primary practice site.

In all matters to do with registration for acupuncture practice we always advise people to initiate a dialogue with the authorities under whose jurisdiction they fall. In the end they will always have the final word on who and what is acceptable, and practitioners will always become visible sooner or later, so hoping to go unnoticed or uninspected is not a good option.

There are a number of aspects of the legislation in Jersey to which we took exception, mainly around requirements for second sinks in treatment rooms for washing equipment to be re-used. The laws apply to all skin piercing activities, and although none of the equipment we use is re-useable, our members were required to comply. This illustrates what we have always told our members, that whatever standards we set, the local authority rules, if higher, are the ones they have to follow. 

The only factor on which we cannot comment is the more general one about residency on the islands. Jersey, for example,. has fairly stringent rules for who can and cannot live and work on the island, and you would need to take advice from the relevant authorities on eligibility to work there.  The summary here

 http://www.cab.org.je/index.php?option=com_content&view=article&id=91:jersey-information-for-those-wishing-to-live-and-work-in-the-island-312&catid=20&Itemid=48

is quite useful and the formal portal

http://www.gov.je/LIFEEVENTS/CITIZENSHIPSETTLINGINJERSEY/SETTLEMENTINJERSEY/Pages/SettlementInJersey.aspx

gives further detail and paperwork.

We wish you every success in your endeavour.

Although we are honoured to have as members practitioners of the stature of David Mayor, one of the leading electro-acupuncturists in the UK, the range of possible users runs from people like David with 30 years or more experience in a specialist field to members who use small devices occasionally in clinic for use with musculo-skeletal problems. If we create a list it would be essential for us to set a standard which became a criterion for entry on the list, and we do not have the resources even to begin that task, let alone a realistic chance at this stage of agreeing criteria.

It is extremely important, when we make recommendations about specific techniques or members treating specific groups of patients, that we are able to say with confidence what a patient can expect. For example, we have two working groups currently developing standards in paediatric acupuncture and obstetric acupuncture so that someone visiting a member offering this as a specialist service can be assured that the member is able to bring specialist training to the table.

Unfortunately we do not think there is a likelihood in the short term of being able to offer the same kind of 'kitemarking' for electro-acupuncture. Most members within our local communities of practitioners, however, are usually aware of which of their colleagues uses EA more regularly. If this is a modality which you would prefer to have than needles alone, we are sure that you can be directed to someone who can meet your needs by contacting a BAcC member local to you and asking for their advice.

Q:  I had acupuncture before for my MS and depression but it was never regular like once a week. As I am very poorly at the moment I need to  find an affordable acupuncturist near me central London. I can even be  a volunteer in a teaching class. I can only afford £10 for a week at the moment.

A:  It is an unfortunate consequence of the fact that most acupuncture treatment is offered in private practice that its practitioners have to charge the market rate to make a living. This has sometimes led to the accusation that it remains a middle class option.
 
However, money was not the driving force which made the majority of BAcCv members train to become acupuncturists, and many are prepared to negotiate discounts if someone would really benefit from having treatment. The balance that many of us seek is to see enough patients at our normal fee rates to pay the bills to be able to offer treatment to those who cannot afford it at the normal rate. This is very much a personal choice and commitment by the individual practitioner; we do not interfere in this at all.
 
There are a number of members who are committed to a model of practice called the multi-bed clinic which has its origins in the United States. This is a clinic which houses several treatment couches in a large open space, and while it does not afford the privacy of usual practice it is how acupuncture is offered in much of China and the Far East. There is an organisation called ACMAC which is a forum for all providers of this form of treatment in the UK, and logging onto their site at acmac.net will offer you a drop down list of clinics in or near your area.
 
Finally there are a number of teaching institutions which sometimes have student clinics in which the fees are heavily reduced. Although the practitioners are in the process of qualifying they are under the supervision of some of the most experienced practitioners around, and this can be a very fruitful option. Contact details for all of the teaching institutions whose graduates are automatically eligible to join the BAcC can be found here http://baab.co.uk/study-acupuncture/accredited-courses.html.

Q:  I've done a search for acupuncturists closest to me.   I want to know which are 5 elements but there is no information at all about the practitioners. Do I need to go through the list and phone each one up?

A:  We have had many discussions over the years about how to communicate information like this to prospective patients, and we're sorry to say that we're no nearer to an answer. Our problem is that although we know where people trained there is no guarantee that this remains the style of practice which they mainly use. Many members take postgraduate training in other styles like TCM and Japanese Meridian Therapy, and it is highly likely that most members now use combinations of different styles as best suited to their individual patients.
 
I'm not sure that you need to ring very practitioner in the area. Asking one or two should very quickly elicit an answer about who locally uses this style, or if you type 'five element acupuncture milton keynes' into google search it generates two or three members in your area who focus on this style. 
 
 

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