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Q: Is there a need for people to practise on. So students get experience. If so how can I offer myself as a person to be practised on.

A:  Most of the teaching institutions run college clinics in which patients can get heavily subsidised treatment under the direct supervision of highly experienced acupuncture tutors, but this is not quite the same as being practised on. The nature of acupuncture treatment is that it is evolutionary and dynamic, so a patient would remain under the care of a single practitioner for several sessions while he or she assessed the impact of the treatment and how to refine it. This is essentially a normal course of treatment, and the days of sticking needles in onself, each other or in human volunteers to learn the techniques are largely gone. Many students practise on prosthetic limbs carefully designed to replicate the 'feel' of needling a real human arm or leg.
 
If the idea of being a patient in a student clinic is one which interests you, however, there is a list of accredited institutions whose graduates are automatically eligible for entry to the BAcC to be found on the website of the British Acupuncture Accreditation Board,     http://baab.co.uk/study-acupuncture/Accredited-courses.html.
 

A:  We must admit to being a little stumped by this question. We don't quite know what an 'acupuncture full body massage' is and we googled it without any real success.

The only thing that we can think of is that this is being used to describe a form of Chinese massage like tui na which uses a knowledge of the acupuncture points and channels to reinvigorate the energy, or 'qi', of the body. There are a number of variations on this theme, although we find it a little surprising that someone would describe this as 'acupuncture full body massage'. The other possibility is that someone offers both modalities, and this is some sort of shorthand for a session which might involve both.

We have to admit, though, that this did ring an alarm bell because there are, like it or not, a number of practitioners out there with very poor qualifications and training who offer all sorts of strange hybrids. We find this dispiriting, because anything which they do reflects on all of us, and this is why we have maintained our call for the statutory regulation of acupuncture for over twenty years.

However, we would not want to be unfair to someone who may be doing legitimate work. If they are, there is every probability that they belong to a reputable professional association with a published code of conduct and register, and equally a probability that they will be happy to explain exactly what they are doing and where they trained to learn how to do it. If neither is the case, or if you are not satisfied with the explanation, it is perhaps best to go elsewhere.

 

Q:  What are the legal implications and requirements for an acupuncturist when treating a patient who refuses to register with a GP?

A:  There are no legal requirements of which we are aware about treating patients who are not registered with a GP. Registration with a GP through the NHS is entirely a matter of choice for a patient, and if someone exercises their choice not to register it does not mean that we cannot treat them or are not legally allowed to treat them.
 
However, there are circumstances where it may be essential to refer a patient on to orthodox or conventional medical services. Indeed, this is taken seriously by many regulatory bodies, and the Advertising Standards Authority has a long and very exhaustive list of named conditions which it believes put a patient at risk if someone who is not suitably medically qualified promotes their treatment instead of referring to orthodox care or fails to ensure that someone is receiving orthodox care. 
 
This might present something of an ethical dilemma for a BAcC member. If the practitioner believes that the patient should consult an orthodox medical practitioner and the patient refuses, the question would be whether offering some treatment 'blind', so to speak, is better than refusing to treat and running the risk that the patient will have no treatment of any kind. In circumstances like this our members would almost certainly seek advice from our experts in the field of insurance, conventional medicine and law.
 
The BAcC has all of these expert facilities in place, and if there is any perceived risk to either patent or practitioner, we advise and encourage our members to contact us.
 
This will always remain a troublesome area, however. Even if someone is registered with a GP they may refuse consent for a practitioner to contact the GP or may listen to the practitioner's advice and ignore it. Breaching confidentiality by disclosing details to a third party, even in the patient's best interests, is also a minefield, and the legal advice we have been given is that only in exceptional circumstances can disclosures without consent be made, and only where there is a real risk to the general public.
 
Essentially we would deal with each case on its own merits, given that some medical needs are more pressing than other. It would be true to say, though, that such instances are quite rare, and we hear of very few people who opt out of registration with a GP.
 
 

Q:  Is Rother District Council (East Sussex) linked in anyway to the Acupuncture Association?  I ask as I have been told that most London Councils are affiliated and accept the rule of the society.

A:  We think what you are alluding to here is the difference between the registration of acupuncturists in the UK outside London and the licensing of acupuncturists in Greater London.
 
Outside London, local authorities grant a one-off registration to a practitioner under the Local Government Miscellaneous Provisions Act 1982. This registers the premises and the practitioner, and often if the premises have already been registered by someone working there, any new practitioners joining their set-up pay a lower fee. There are no affiliations or exemptions granted to any organisations or members of organisations, unless the practitioner is a doctor or dentist in which case they do not have to register.
 
In London, however, most local authorities have adopted the London Local Authorities Act 1991 which requires the annual licensing of 'special treatments' of which acupuncture is regarded to be one. There are, however, provisions within the Act to exempt practitioners registered with statutory bodies, such as physiotherapists or osteopaths, and also members of professional organisations which can demonstrate that they have all of the necessary codes of conduct, registers and disciplinary processes to protect the public interest. A list is maintained of these associations, and a recent version can be found on Westminster's website at:
 
      http://transact.westminster.gov.uk/publications/publications_detail.cfm?ID=4401
 
In all cases a practitioner belonging to one of these bodies is required to make themselves known to the local authority if they set up business in a borough, and the local environmental health officers have the power to inspect premises and require standards to be met on penalty of refusing to accept the exemption and requiring a licence subject to conditions.
 
 

Q: I recently watched a programme on television in which it was stated that acupuncture can be obtained free or at a greatly reduced cost if you volunteer to be a guinea pig for students to practice on. I have had acupuncture in the past for allergic rhinitis and found it to be very helpful but just could not afford to keep the treatments up. I enquired at my GP if I could have the treatment on the NHS but they only provide it for tennis elbow.

A:  The short answer is, we're afraid to say, 'no'. The list of training institutions which are in a formal relationship with the Accreditation Board can be found here:http://baab.co.uk/study-acupuncture/accredited-courses.html
 
and you will see that none is particularly close. In most cases the cost of travel would exceed the cost of treatment.
 
However, it would be fair to say that the great majority of our members are not driven by money, although clearly they have to pay bills and eat just like everybody else. Many members are willing to discount fees for patients who are genuinely hard up, and it may well be worthwhile asking the practitioners close to where you live whether they would be prepared to reduce fees.
 
However, this can get into some interesting discussions about what counts as hardship, and all of us have been 'burned' at least once in the early stages of our career by people pleading hardship when the patient's definition has extended to 'down to the last million and the Rolls has a puncture.' This particular expert let someone have treatment for £5 per session over several weeks on pleas of poverty, and was surprised, when asking whether the patient was booking in next week, to be told, 'oh no, dear, can't do that, we're off to Barbados for six weeks.' 
 
The vast majority of people who seek reductions are bona fide, however, and if you happen to live near BAcC members whose primary concern is helping people to get better, all shall be well. 
 

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