Acupuncture gaining acceptance in Ohio
The opioid epidemic, which has hit Ohio particularly hard, has prompted the medical community at large to more widely accept acupuncture as an effective method to treat pain.
For one, Northeast Ohio's largest health systems — Cleveland Clinic and University Hospitals — report increased activity in their acupuncture practices. Both also recently extended acupuncture services as a covered benefit for their employees. MetroHealth plans to add acupuncture to its pain management program next year.
And perhaps signaling even greater acceptance of the ancient Chinese therapy, the state of Ohio in January added acupuncture as a covered service under Medicaid for low back pain and migraines, making the state a trailblazer of sorts in the Midwest, according to an Ohio Department of Medicaid spokesperson. The spokesperson said a proposal that expands the provider types that can offer the service is currently being reviewed.
Moreover, hospitals across the country are working to provide more nonpharmacological options to treat pain and side effects associated with other treatment in advance of revised Joint Commission pain management standards that take effect Jan. 1.
Commercial insurance, for the most part, hasn't added acupuncture services to its roster of benefits, but proponents are hopeful that will soon change as attitudes toward the therapy continue to shift.
Last month, for example, the National Association of Attorneys General even sent a letter signed by 37 state attorneys general — Mike DeWine of Ohio was not one of them — to the America's Health Insurance Plans advocacy group urging its members to prioritize non-opioid pain management options like acupuncture over opioid prescriptions for treatment of chronic pain. In the letter, the attorneys general argued that the amount of pain reported by Americans has remained steady since 1999, though prescriptions for painkillers have almost quadrupled over that timeframe.
At the Clinic, for instance, patients paying the full freight for acupuncture would be charged $120 for the first visit and $100 for follow-ups. Because of the lack of insurance coverage available, health systems like the Clinic and UH are increasingly hosting less costly group sessions — the Clinic charges $40 for such — where multiple patients receive treatment at the same time by a single practitioner.
"There is much more acceptance in 2017 then there was a decade ago — from patient end and the physician end," said Jamie Starkey, lead acupuncturist and manager of the Traditional Chinese Medicine Program at the Clinic's Wellness Institute. "When we started, it was grassroots and we were lecturing to whoever would listen."
Acupuncture, of course, is the practice of inserting slender needles into the skin at certain points in the body, usually near nerves, practitioners say. The needle points tend to send messages along the nerves to the brain, which releases endorphins — natural opiates — that can reduce or eliminate entirely the message of pain being received by the brain.
"A big misperception about acupuncture is that because it involves needles, they think it will hurt, but that's rarely the case," said Christine Kaiser, University Hospitals' lead licensed acupuncturist and Chinese herbalist at the system's Connor Integrative Health Network, who was inspired to study acupuncture because she saw her father benefit from the treatment as he suffered from rheumatoid arthritis.
She added, "They are the size of a human hair, and most people take a nap during treatment. ... Patients usually leave with a big smile."
Acupuncture's effectiveness is wide ranging, according to its practitioners. In addition to treating migraines and lower back pain, they say it can be effective in treating some of the side effects of chemotherapy, menopausal symptoms, issues related to anxiety and even seasonal allergies.
"One thing I wish people had a better understanding of — and this is a little more nuanced — what acupuncture is really best at is helping people who have multiple issues that they're dealing with together," said Jared West, a Cleveland-area acupuncturist in private practice who is also president of the Ohio Association of Acupuncture and Oriental Medicine.
He added, "It's a lot less expensive, we get people back to work sooner. Often, the people with multiple issues are the hardest to treat with conventional medicine."
At the major hospital systems, acupuncture is not viewed typically as an alternative treatment, but an integrated piece of a larger care plan. More and more, UH and the Clinic are integrating Eastern philosophies into their care plans, and both systems have dedicated centers to advance those concepts.
UH's Connor Integrative Health Network this fall will open an office at the health system's flagship medical center downtown — a move that Kaiser sees as evidence that the center's work is being accepted by physicians and system leadership. In addition to acupuncture, the center offers meditation, life coaching, yoga and massage therapy services.
"We're definitely being integrated throughout the health system," Kaiser said. "More providers are asking us to come to the table when developing care ideas for their patients."
West, meanwhile, is glad that acupuncture is being accepted by Ohio's Medicaid program to treat migraines and lower-back pain, but he would like to see it be accepted for other uses as well.
"I wish we could go further. Why not make it more accessible?" he said. "It doesn't make much sense to me."
"Acupuncture gaining acceptance in Ohio" originally appeared in Crain's Cleveland Business.
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