APPLYING BA TO PRIMARY CARE
The most practical application of BA may be on the "battlefield" of the daily clinic. Many military acupuncture providers have achieved good outcomes for acute and chronic conditions, such as headaches and musculoskeletal ailments, sometimes by using just a single auricular acupoint.
At home in the United States, the pain treated in emergency departments (EDs) may relate best to pain seen in a combat zone. Use of BA in the ED may be a viable option for pain relief and could potentially reduce the use of narcotics and their associated side effects. Acupuncture may allow patients to remain awake and alert and to leave the ED pain-free, without having to wait for narcotic side effects to wear off, thus freeing up valuable bed space in already crowded EDs. Those of us who work in family medicine also see a wide range of pain-related issues in which medical acupuncture could be a tremendous benefit.
While complete resolution of discomfort is the goal, the reality is often significant pain reduction, hopefully enough for troops to complete the mission or return to duty or for civilians to go about their daily routine. Patients must be educated that acupuncture is not a replacement, but rather a supplement, complementing traditional Western treatments. In the noncombat environment, acupuncture is an additional therapy to consider after going through a standard history, physical examination, and diagnostic testing.
TRAINING TO BE AN ACUPUNCTURIST
Certification by the American Board of Medical Acupuncture (ABMA) is currently open only to physicians and requires 300 hours of formal training in all types of acupuncture. The ABMA's parent organization, the AAMA, requires its physician members to have a minimum of 220 hours of formal training and 2 years of clinical experience. The practice of acupuncture by nonphysicians is regulated in at least 33 states; several other states have statutes pending.6 As always, PAs should inquire about the specific training and oversight requirements for licensure and credentialing in their own state before implementing any therapy. In the military, the training of physicians in medical acupuncture and the goal of training and credentialing PAs in only the BA method represents the first potential large-scale incorporation of medical acupuncture use across the military health care system. JAAPA
Trevor Ambron is stationed at Moody Air Force Base, Georgia, and has served in both Iraq and Afghanistan. The author has indicated no relationships to disclose relating to the content of this article.
Acknowledgment: The author would like to express his sincere gratitude to Colonel (sel) Heather R. Pickett, DO, FAAFP, United States Air Force, for her assistance with this article.
The views expressed in this article are those of the author and do not reflect the official policy or position of the United States Air Force, Department of Defense, or the United States Government.
Sarah Zarbock, PA-C, department editor
REFERENCES
1. National Center for Complementary and Alternative Medicine. Acupuncture: An introduction. http://nccam.nih.gov/health/acupuncture/introduction.htm. Last modified October 13, 2009. Accessed May 4, 2010.
2. Spira A. Acupuncture: a useful tool for health care in an operational medicine environment. Mil Med. 2008;173(7):629-634.
3. Niemtzow RC. Battlefield acupuncture. Medical Acupuncture. 2007;19(4):225-229.
4. National Center for Complementary and Alternative Medicine. Acupuncture for pain. http://nccam.nih.gov/health/acupuncture/acupuncture-for-pain.htm. Last modified October 13, 2009. Accessed May 4, 2010.
5. Niemtzow RC, Gambel J, Helms J, et al. Integrating ear and scalp acupuncture techniques into the care of blast-injured United States military service members with limb loss. J Altern Complement Med. 2006;12(7):597-599.
6. Helms JM. An overview of medical acupuncture. American Academy of Medical Acupuncture Web site. http://www.medicalacupuncture.org/acu_info/articles/helmsarticle.html. Accessed May 4, 2010.