Irony Defined

Treatment by acupuncture
Acupuncture is just one traditional and ancient therapy that is no longer available to most people, because it is usually not covered by insurance.

After I was diagnosed with coronary artery occlusion and had a stent placed, it was really important to me to be proactive and engaged about my health. I had developed high blood pressure for the first time in my life – in fact, it went UP after my stent was placed. And I searched for the best evidence based practices that could lower my blood pressure and insulate me from ever having to lay on that damn table again.

It might surprise you to know that cardiac catheterization and stent placement have never been shown to reduce the rate of death from coronary artery disease. I never would have had a stent placed if I had made the decision myself but because my husband was very strongly in favor of it, and because I very much wanted to alleviate his pain and fear, I did it. But afterward, the search was on.

My first thoughts were to change to a completely plant based diet as espoused by Caldwell, Esselstyn, McDonald and Fuhrman as capable of arresting and reversing heart disease. The problem is that that there is a lot of conflicting and confounding evidence available, so I am still sifting through it all.

One thing about which there is strong evidence is acupuncture, at least as far as reducing blood pressure. Actually, the World Health Organization (WHO) has published research showing that there are more than 100 conditions for which acupuncture is an effective treatment, including low back pain, dental pain, headaches, morning sickness and others. If you think about how suddenly aware of the dangers of the kajillions of narcotic pain relievers that are prescribed for just a few of these, one would think acupuncture would be used a lot more as at least a possible treatment modality.

One problem. Acupuncture is almost never covered by insurance in the United States, unless it is performed by a medical doctor, who has to take specialized training to perform it. Most acupuncturists in the United States are not medical doctors. They are licensed by the state – in Iowa, they are actually licensed by the state Board of Medical Examiners, after completion of an accredited program of study and written exam. Typically, acupuncture treatment for a given condition takes 7-8 treatments – it works by working with your own body, which is not bothered by calendars and schedules.

The irony is that when Western allopathic medicine gained ascendancy and traditional methods of healing were considered backward, archaic hocus pocus, poor people could not afford the new medical marvels and were cared for by the traditional providers. Now that the traditional methods in many cases have been shown by studies to have some efficacy, a patient cannot afford to choose them if they can’t afford the out of pocket payment.

I think about that – I always think about stuff like that. I think about the patients I have with chronic pain that affects every minute of every day for them, and how I wish I could offer them the chance to try acupuncture, or medical qigong, or hypnosis. I think about the refugee patients who are definitely more comfortable with some modalities like that, and a thousand times more likely to follow through with a treatment plan they understand and agree with, but who cannot access those plans because of the way our insurance works. I don’t know what the answers are.

But I do know I can encourage patients to learn about meditation, and offer to teach people. I can share my experiences with acupuncture and Tai Chi. And I can keep talking.

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