There is a debate raging between two providers in the healthcare field: physical therapists and acupuncturists. The acupuncture community claims that physical therapists who use dry needling are encroaching on their field. Their position is that dry needling is a westernized phrase for acupuncture and that PTs are not qualified due to lack of training.
Acupuncture comes from traditional Chinese medicine and has been practiced for two thousand years. Dry Needling uses the same "trigger points" to address pain and other symptoms, inserting needles into muscles to alleviate pain.
In North Carolina, the Acupuncture Licensing Board determined that PTs and clinics in that state who were using dry needling were illegally practicing acupuncture and demanded that they discontinue. In direct contrast, the North Carolina Board of Physical Therapy Examiners asserted the right of PTs to use dry needling as an appropriate modality in their practices.
The acupuncture practitioners maintain that using needles is an invasive technique. They argue that anything that actually breaks the skin is not within the scope of what physical therapy should be allowed to do, which they believe to be manual only.
Certainly acupuncture and dry needling are similar, but are they the same? It depends on who you ask. Acupuncturists who are trained in the practice are required to have over 3,000 hours, attend an accredited school and have hundreds of clinical treatments under their belts before they are licensed and certified. For physical therapists, on the other hand, there are a variety of programs of varying lengths that will give them a certificate in Dry Needling, usually with between 30 and 50 hours.
But when critics claim that PTs only have thirty hours of training, they are not counting the years of college and post-graduate education that were invested by a physical therapist on the path to licensure in the first place. Physical therapists are highly qualified with a staggering breadth of knowledge about the human body, how it moves and functions, and how to treat it when it isn't moving optimally.
A physical therapist who uses dry needling would tell you that it is just one of many interventions that are available to treat their patients, while an acupuncturist is limited to needles alone. Dry needling is an instrument in the PT's toolbox; and along with manipulation and other therapies, provides the patient with the best outcomes.
With the ongoing debate among healthcare providers, the issue won't be resolved quickly. It is likely that dry needling will be incorporated into the curricula in physical therapy degrees.
Sean Flanagan, a prominent physical therapist in the Arizona healthcare community says dry needling is a useful addition to manual physical therapy, "It allows us to get into places where our hands can't go. It carries very low risk and can be highly effective with the right patient population." That very point lies at the heart of the objections from acupuncturists.
They say that dry needling is identical to acupuncture in that it is technically a surgical procedure and beyond the expertise of a physical therapist. Calling it dry needling is only a ruse to avoid the same qualifications, state board examinations and other legal requirements that acupuncturists must meet.
So is this a turf war over market share or an argument born out of genuine concern for the patient? The answer is yes. Both sides have compelling arguments, but who is the winner? Ultimately, the consumer, the patient.
Please visit the Healthcare section of our blog to find out more about this and other relevant topics.
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