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MEDICAL ACUPUNCTURE A COMPLEMENT TO YOUR PRACTICE by Kirksak Jay Poonkasem, MD, LMT, Administrative Fellow, University of South Florida/Morton Plant Mease Family Medicine Residency, Integrative Medicine Fellow, University of Arizona College of Medicine – Center for Integrative Medicine “Mrs. J, could you please tell me what food you have the most affinity for, given no restrictions at all What about your favorite color What time of the year do you look forward to the most” These are not the standard types of questions that we ask patients in our primary care practices. I was not trained to ask such questions while I was in medical school, and most likely, you were not either. However, you will hear these questions being asked by practitioners trained in the Eastern philosophies of medicine. Several months ago, I embarked on a journey to explore other worlds and discover fresh ideas for treating my patients. To expand my mind and to look at medicine from a totally new perspective, I took part in a medical acupuncture course for physicians. Interestingly, I found physicians from all specialties of medicine participating in this course (family medicine, internal medicine, surgery, physical medicine and rehabilitation, sports medicine, anesthesiology, pain management, OB/GYN, etc.). Most physicians have heard about acupuncture but do not understand it. It can be difficult for us to understand the Eastern medical philosophies and accept them because they are so different from the philosophies our minds draw from when we see patients. To most of us, the concepts of “energy,” and yin and yang are foreign and, at best, theoretical. With a little background information, you can begin to realize the intricacies and the foundations of this type of medicine. A full discussion of the theory of acupuncture is beyond the scope of this article, but a simplified explanation will suffice. According to acupuncture theory, an energetic entity called Qi (pronounced “chee”) flows throughout the body. There are different types of Qi, and each type has its own properties and functions. Qi flows throughout the body through a multitude of energy channels called meridians. In a balanced and disease-free state, the energy flow is smooth and uninterrupted. When minor symptoms occur or diagnosable diseases are present, it is said that the energetic system of the body is out of balance and/or that the Qi flow is impeded or blocked. With careful placement of acupuncture needles at points along the meridians, we strive to unblock and rebalance the energetic system of the body. My current medical acupuncture course has continued to open my eyes to ways we can use this to help our patients every day, either in a hospital or office setting. Can you imagine decreasing the length of a patient’s stay with post-operative ileus using acupuncture Or making a patient more comfortable post-operatively by managing pain with only a few acupuncture needles Helping a patient to quit smoking non-pharmacologically, to tolerate chemotherapy better or to finally be rid of that bothersome tennis elbow These are just some of the possibilities. Practitioners are using acupuncture to treat these and many other conditions all over the country and the world! Many people inquire about the safety of acupuncture. The needles that I, and most physicians, use in practice are sterile, disposable needles that are meant for one-time use. The standard acupuncture needles that I use for the body are 0.25 mm in diameter and 40 mm in length. These needles are Dr. Poonkasem treating a patient with lateral epicondylitis different from the hypodermic needles we are accustomed to using. They are solid, non-cored and non-beveled. Acupuncture needles separate tissue as they are inserted rather than cutting the tissue. There is also no need to be concerned with introducing the skin plug down to the deeper tissue levels. Complications from acupuncture are very few. Some patients may experience “needle shock,” which is a vaso-vagal reaction to being needled. Most contraindications are relative. Patients should be evaluated on a case-by-case basis to determine if acupuncture is right for them. There is abundant literature available describing many randomized, controlled trials on acupuncture. Due to the nature of the modality, it is challenging to design acupuncture studies. Every patient is evaluated separately, and treatments are highly individualized. From my experience thus far, belief (or disbelief) in acupuncture is not necessary for it to work. Acupuncture has even been performed on animals with positive results. Family, friends and patients whom I have treated with acupuncture embrace it because they see results. As I near the completion of my medical acupuncture program, I can see that it has transformed how I evaluate and treat patients while never neglecting the standard of care. Acupuncture has been a great adjunct to my current practices. The American Academy of Medical Acupuncture is an outstanding resource for more information about medical acupuncture. If you are interested in incorporating this into your practice, a list of training programs is available on their Web site, at http://www.medicalacupuncture.org. You may also contact me for more information at kirksak.poonkasem@baycare.org. 8
The FAFP Partners with Atlantic Health Partners The Florida Academy of Family Physicians is pleased to announce a partnership with Atlantic Health Partners, a leading physician vaccine-purchasing program. With the increased burden you face providing a growing number of vaccines to your patients in a fiscally responsible manner, Atlantic may be able to help lower your costs and improve your purchasing terms. Advantages of Atlantic’s program include: • Favorable pricing for sanofi pasteur and Merck vaccines • Improved purchasing terms, as you do not need to make large, multi-product orders • No fee to participate and enrollment is voluntary • Online or phone orders placed directly with sanofi pasteur and Merck • Full spectrum of pediatric, adolescent, adult and travel vaccines • Reimbursement support provided by Atlantic We encourage you to contact Jeff Winokur at Atlantic Health Partners at (800) 741-2044 or jwinokur@atlantichealthpartners.com for more information and to determine how Atlantic can benefit your practice.
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