The Practice of Acupuncture: Who Are the Providers and What Do They Do?

Karen J. Sherman; Daniel C. Cherkin; David M. Eisenberg; Janet Erro; Andrea Hrbek; Richard A. Deyo

doi:10.1370/afm.248

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Table 1.

Demographic and Training Characteristics of Acupuncturists Licensed in Massachusetts (1999) and Washington (1998)

	Licensed Acupuncturists
Characteristics	Massachusetts N = 101	Washington N = 116	PValue
NADA = National Acupuncture Detoxification Association.
* For training in same state.
Demographic characteristics
Female, %	58.4	56.0	.72
Race, %
White, %	81.4	77.3	.59
Asian, %	16.5	20.9
Other, %	2.1	1.8
Median age, years	47	43	<.001
Basic training
US only, %	67.3	74.1	.37
US same state, %	59.4	56.0	.61*
US and foreign, %	18.8	12.1
Foreign only, %	12.9	13.8
Licensed in another health profession, %	15.8	32.8	.004
Median years in acupuncture practice	11	4	<.001
Postgraduate training
At least one type, %	96.0	67.2	<.001
Addictions (NADA certification), %	32.7	19.8	.03
Chinese herbs, %	71.3	35.3	<.001
Japanese acupuncture, %	48.5	19.0	<.001
Oriental massage, %	40.6	12.9	<.001
Nogier, %	16.8	6.0	.011
Other (eg, pediatrics, qi gong), %	49.5	17.9	<.001

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Table 2.

Top 10 Broad and Specific Diagnostic Categorization of Reasons for Visits to Acupuncturists Licensed in Massachusetts (1999) and Washington (1998)

Massachusetts (N = 1,298 Visits)			Washington (N = 1,263 Visits)
Categories*	Primary Reason %		Categories*	Primary Reason %
* Broad categories of primary reason for visit codes correspond to ICD-9 chapters.
† Wellness was not part of the National Ambulatory Medical Care Survey reason for visit classification.
NOS = not otherwise specified.
Broad			Broad
1. Musculoskeletal conditions	33.0		1. Musculoskeletal conditions	46.9
2. General conditions	12.1		2. Nervous system conditions	11.5
3. Psychological and mental health symptoms	10.4		3. General conditions	9.1
4. Nervous system conditions	9.9		4. Psychological and mental health symptoms	7.6
5. Respiratory system conditions	7.1		5. Digestive conditions	4.5
6. Genitourinary system conditions	5.7		6. Respiratory system conditions	4.3
7. Digestive conditions	4.9		7. Genitourinary system conditions	2.9
8. Wellness^†	3.9		8. Cardiovascular system conditions	2.4
9. Cardiovascular system conditions	2.7		9. Infectious disease conditions	2.0
10. Neoplasms	1.6		10. Skin conditions	1.7
Specific	Primary Reason %	Any Reason %	Specific	Primary Reason %	Any Reason %
1. Back symptoms	11.3	17.8	1. Back symptoms	17.0	25.3
2. Anxiety or depression	7.5	16.7	2. Neck symptoms	7.3	13.7
3. Fatigue	4.8	11.8	3. Headache	6.6	11.0
4. Headache	4.0	6.2	4. Shoulder symptoms	5.6	12.7
5. Wellness^†	3.9	5.3	5. Anxiety or depression	4.5	12.6
6. Neck symptoms	3.4	8.2	6. Fatigue	2.8	9.7
7. Allergies to food, milk, NOS	2.6	4.4	7. Knee symptoms	2.1	4.1
8. Shoulder symptoms	2.6	7.9	8. Abdominal pain, cramps, distention	2.0	3.4
9. Other nervous system symptoms	2.2	3.1	9. Infectious disease	2.0	3.7
10. Problems of pregnancy or fertility	2.0	2.5	10. Allergies to food, milk, NOS	1.9	3.8

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Table 3.

Styles of Practice of Acupuncturists Licensed in Massachusetts (1999) and Washington (1998)

Style of Practice*	Massachusetts (N = 1,298 Visits) %	Washington (N = 1,263 Visits) %
* Styles of practice are defined in the Appendix.
French energetic	1.1	5.1
Japanese eclectic	17.7	7.6
Japanese meridian	0.2	5.5
Traditional Chinese medicine	79.4	85.5
Trigger point/Western style	6.2	5.6
Worsley 5 element	12.2	5.0
Other styles	5.3	2.4
Two or more styles used	20.6	14.4

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Table 4.

Diagnostic Techniques Performed by Acupuncturists Licensed in Massachusetts (1999) and Washington (1998)

Diagnostic Technique*	Massachusetts (N = 1,298 Visits) %	Washington (N = 1,263 Visits) %
*Diagnostic techniques are defined in the Appendix.
At least 1 diagnostic technique	99.7	99.8
Abdominal diagnosis	25.5	17.5
Asking diagnosis	89.8	93.1
Auditory diagnosis	22.7	19.3
Muscle strength	7.8	5.6
Olfactory diagnosis	17.1	16.4
Point palpation/channel diagnosis	47.6	58.3
Pulse diagnosis	90.5	81.4
Tongue diagnosis	70.5	75.0
Visual diagnosis	71.8	77.8
Other	0.9	6.6

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Table 5.

Types of Needling Performed by Acupuncturists Licensed in Massachusetts (1999) and Washington (1998)

Type of Needling*	Massachusetts (N = 1,298 visits) %	Washington (N = 1,263 visits) %
* Types of needling are defined in the Appendix.
None	2.1	1.8
Intradermal	8.0	5.8
Ion pumping cords	8.4	4.6
Microsystem: ear	21.4	24.7
Microsystem: hand	2.3	4.2
Microsystem: scalp	2.6	1.3
Plum blossom	0.3	0.3
Regular body	95.1	93.3
Shallow	4.9	14.0
Other	6.1	2.9
Multiple types	33.0	33.4

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Table 6.

Use of Adjunctive Treatments by Acupuncturists Licensed in Massachusetts (1999) and Washington (1998)

Treatment*	Massachusetts (N = 1,298 Visits) %	Washington (N = 1,263 Visits) %
* Most adjunctive treatments are defined in the Appendix.
At least 1 adjunctive treatment	79.4	76.9
At least 2 adjunctive treatments	31.8	48.7
Heat	49.4	44.2
Infrared lamp	23.8	23.8
Moxibustion	27.3	21.4
Other heat	0.7	3.5
Multiple heat sources	0.2	3.4
Acupoint bloodletting	1.9	5.8
Cupping	5.5	12.8
Gua sha	1.9	1.7
Laser acupuncture	1.3	2.2
Magnets	16.7	2.6
Oriental herbs	30.6	30.3
Oriental massage	18.6	37.5
Other (eg, liniment, plasters)	3.2	14.9

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Supplemental Appendix

Supplemental Appendix. Acupuncture practice styles, diagnostic techniques, types of needling, and adjunctive treatments.

Files in this Data Supplement:

Supplemental data: Appendix - PDF file, 3 pages, 102 KB
The Article in Brief

Despite the growing popularity of acupuncture in the United States, little is known about acupuncturists� training or practice. A study of acupuncturists was conducted in 2 states, Massachusetts and Washington. The most common reasons for visiting an acupuncturist were musculoskeletal pain and headaches, although acupuncturists treated a wide range of other conditions. About one half of acupuncture patients were also being treated by a doctor; however, there was little communication between the acupuncturist and doctor. The authors recommend that doctors ask patients about the acupuncture treatment they are receiving.