askaliotis Posted July 7, 2005 Share Posted July 7, 2005 Hi just wanted to get some opinions on the use of acupuncture in pain management. Is there a demand for this service? My experience is that there are few 3rd parties reimbursiing for acupuncture other than work injury. I will be graduating this August and would like to incorporate acupuncture in a pain management practice. I am interested in your opinions. Thanks Aris Link to comment Share on other sites More sharing options...
BlocDoc Posted July 7, 2005 Share Posted July 7, 2005 Hi just wanted to get some opinions on the use of acupuncture in pain management. Is there a demand for this service? My experience is that there are few 3rd parties reimbursiing for acupuncture other than work injury. I will be graduating this August and would like to incorporate acupuncture in a pain management practice. I am interested in your opinions. Thanks Aris Hi Aris- Boy, my knowledge curve on this is not good- Certainly I have familiarity with patients who I referred Accupuncture or have had it prior to seeing me- There is an observed benefit but not typically a long one in my experience- Of course my experience would not necessarily be reflective of any evidenced based work on the subject and that is very necessary for third party payors to cover it- I don't even know if Act 6 (auto) is covering it. There are at least 2 pain practices in my area that incorporate physicians who provide accupuncture- So, I know that it is being done- I do not know to what extent they are being paid- Link to comment Share on other sites More sharing options...
Guest guetzow Posted July 7, 2005 Share Posted July 7, 2005 We have a similar experince with using e-stim in our ortho/rehab practice. Only workers comp pays for it. If you can get enough comp patients and self pays to keep you afloat, go for it. Link to comment Share on other sites More sharing options...
askaliotis Posted July 8, 2005 Author Share Posted July 8, 2005 I agree with your observation that acupuncture like lumbar diskectomy for example which hasn't been proven better than pt (as well as many other conventional treatments) for mechanical back pain can be short lived yet there are many cases where patients obtain longterm pain relief. In MA where I practice there is personal/ auto injury insurance coverage for acupuncture services. I would still be interested to know if others in pain management have experience with acupuncture. Thanks again Link to comment Share on other sites More sharing options...
BlocDoc Posted July 8, 2005 Share Posted July 8, 2005 lumbar diskectomy for example which hasn't been proven better than pt (as well as many other conventional treatments) for mechanical back pain can be short lived yet there are many cases where patients obtain longterm pain relief. In MA where I practice there is personal/ auto injury insurance coverage for acupuncture services. I would still be interested to know if others in pain management have experience with acupuncture. Thanks again Sir, lumbar discectomy isn't indicated for mechanical back pain- Further only 20% of all medical treatment (medication & physical intervention) has been proven to work, to include physical therapy- The fact is, every treatment helps someone while no treatment helps everyone- Treatments are simply tools that, when appropriately indicated, judiciously selected and proficiently rendered, will remediate some or all of a patient's symptom constellation. I agree that the vast majority of treatment, regardless of the condition for which they are rendered, will palliate but rarely obviate. Therefore, medical decision making regarding the selection of treatment can transcend evidenced based medicine if the provider feels that there is sufficient evidence that such treatment may provide a degree of relief, that the patient is educated as to any untoward effects or complications and the patient thus consents to such treatment- While I am not a surgeon, the process is the same for surgical decompression, despite the percieved lack of efficacy that you describe. Best of luck in your endeavors and if you find yourself in a position to write up and publish any of your outcomes, it will undoubtably help to increase the public and third party payor's awareness of Accupuncture! Anyone else with help on askaliotis's query? Link to comment Share on other sites More sharing options...
Guest Josh L.Ac. Posted October 19, 2006 Share Posted October 19, 2006 Since the answer to askalioti's questions depends on where he/she is going to practice, the safe answer is another question: Why take 3rd party reimbursement for 50% of what you make with cash-only patients? Right now I am in week 9 of my accelerated BSN program [52 weeks baby!] and if I go the FNP route, I plan on taking insurance of FNP stuff and cash-only for acupuncture / CHM. It is hard to tell what the environment in KC will be like in four years, but if it is feasible, I would like to have a cash-only practice for the FNP stuff as well. KC you ask? Perfect place for acupuncture. I graduated from Bastyr university in Seattle WA and would have competed with 800+ acupuncturists. Many of my classmates are still struggling to pay bills 2 years post-graduation while my wife, also a Bastyr grad, will be at 40 pt/week in about 6 months of starting her practice in KC. Her practice is cash-only. Why rush to see 80-120 pts a week in order to pay the bills with the insurance model when you can see 40+/week and make almost 6 figures? Here's an even better question: why are there more acupuncturists going the PA route instead of the FNP route? Over at all-nurses, there are many more members but only a few acupuncturists. I do a search for acupuncture on this site and see many more. J/K. The reason why I chose FNP [unless I go the CRNA route] over PA is the same as the earlier part of my post - location. If there was a PA program in KC, I would have looked into it. [/thread derail] So why take insurance? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 19, 2006 Moderator Share Posted October 19, 2006 "So why take insurance?" a lot of pain med pts are work comp from min wage jobs. your avg mcdonalds employee who hurt his back on the job can't afford accupuncture, let alone vaccinations for his kids...... the ones who are not work comp include lots of pts on state disability, also not a great reimbursement rate..... if there are enough cash paying pts out there to fund a practice then go for it but you will probably exclude 95%+ of the pain clinic type pts by doing this.... Link to comment Share on other sites More sharing options...
askaliotis Posted October 19, 2006 Author Share Posted October 19, 2006 Josh L.Ac. You are absolutely correct when it comes to the viability of an acupuncture practice and location. I don't know much about KC, I have an acupuncture practice in Massachusetts and have never netted more than 40K after all expenses were paid. I have been working as a PA for 10 months in pulmonary/primary care. Base salary 70K, 40% production so far 5K all other covered by group ie cme, license, dea, malpractice etc ( I pay 5K for family plan H/I). Also have continued acupuncture on side and will moonlight in ER at $55/hr. I prefer the scope of PA practice vs acupuncture and of course the steady pay. BTW I have good friend who is a CCU RN and acupuncturist. He spent 75k in business loans plus student loans for the acupuncture practice and unfortunately had to give it up...b/c not enough income. He is back in nursing F/T. Good luck to you and your wife. I'm sure that your nursing degree willl provide a stable income while you and your wife pursue acupuncture. FYI Most of my acupuncture patients are work injury referred by MDs therefore the insurance reimbursement is excellent 100-200 per visit vs $60 for cash. Aris:D Since the answer to askalioti's questions depends on where he/she is going to practice, the safe answer is another question: Why take 3rd party reimbursement for 50% of what you make with cash-only patients? Right now I am in week 9 of my accelerated BSN program [52 weeks baby!] and if I go the FNP route, I plan on taking insurance of FNP stuff and cash-only for acupuncture / CHM. It is hard to tell what the environment in KC will be like in four years, but if it is feasible, I would like to have a cash-only practice for the FNP stuff as well. KC you ask? Perfect place for acupuncture. I graduated from Bastyr university in Seattle WA and would have competed with 800+ acupuncturists. Many of my classmates are still struggling to pay bills 2 years post-graduation while my wife, also a Bastyr grad, will be at 40 pt/week in about 6 months of starting her practice in KC. Her practice is cash-only. Why rush to see 80-120 pts a week in order to pay the bills with the insurance model when you can see 40+/week and make almost 6 figures? Here's an even better question: why are there more acupuncturists going the PA route instead of the FNP route? Over at all-nurses, there are many more members but only a few acupuncturists. I do a search for acupuncture on this site and see many more. J/K. The reason why I chose FNP [unless I go the CRNA route] over PA is the same as the earlier part of my post - location. If there was a PA program in KC, I would have looked into it. [/thread derail] So why take insurance? Link to comment Share on other sites More sharing options...
Guest Josh L.Ac. Posted October 20, 2006 Share Posted October 20, 2006 I understand that many people would be unable to recieve acupuncture if their insurance didn't pay for it. But if you are only able to make 40K a year with a master's degree that took 3-4 years to complete, then obviously something has to change. I've often wondered how on earth a medical acupuncturist [MD or DO] can afford to provide acupuncture with the amount of insurance reimbursement that they get...especially in light of how much they get paid for a regular office visit. Acupuncture treatments take time. The maximum number of patients I feel comfortable handling is 3 every 2 hours. While this number can increase with experience, I also know many that would prefer to see 1 patient an hour. With insurance paying $35-45 per patient, this model just doesn't fit. Hey Askaliotis, sorry to hear about your practice, although you did say something that peaked my interest: Did you really get that much of a payment from insurance if the pt was referred for pain? That's absolutely crazy! Did that include cupping, electro, TDP [read: the works treatment]? In the context of that level of insurance payment, then combining PA + acupuncture would definitely make your practice financial solvent. Link to comment Share on other sites More sharing options...
Guest Josh L.Ac. Posted November 18, 2006 Share Posted November 18, 2006 Any update? Link to comment Share on other sites More sharing options...
askaliotis Posted November 22, 2006 Author Share Posted November 22, 2006 This December will be my last month for the acupuncture office. It has been beneficial to me interms of patient care experience. Now its time to move on. I recently started per diem in a local ER in addition to my primary care outpatient position. Overall I have fewer headaches, more support and an improved bottom line. Wish I went to PA school before acupuncture school but what's done is done. Best of luck to you and your wife. Aris Link to comment Share on other sites More sharing options...
Guest Josh L.Ac. Posted November 24, 2006 Share Posted November 24, 2006 Congratulations on the next stage in your career. As an acupuncturist, I see the need for those in our field to have a strong biomedical background. Who knows, you can always end up doing integrative medicine at some point in the future when it becomes a little more profitable. Link to comment Share on other sites More sharing options...
acvdmlac Posted May 30, 2011 Share Posted May 30, 2011 I know this is a very old thread, but I am interested in any updates germane to my questions, which are: how much opportunity is out there in California for dually-licensed PA-Cs/L.Ac.s to practice integrative East/West medicine in my fields of interest which are, in order, 1) phys med & rehab; 2) peds & adolescent med; 3) family medicine; 4) pain medicine; and in what settings? Private practice? Multi-specialty clinic? HMO? Hospital? Teaching/Research/Academia? Viability of my providing both standard medical + acupuncture services in any of these settings? Or as a P.A., am I likely to wind up limited to just standard medicine, and giving up my skills and experience in acupuncture (except as a moonlighter)? My background, to help focus anyone who cares to reply to my post: I have been in private practice as a Licensed Acupuncturist in Santa Cruz CA for last 8 years, also part-time clinical instructor at local school of Traditional Chinese Medicine, now contemplating application to PA programs because 1) I would like to expand my training, education and scope-of-practice to have more tools and modalities, better serve wider variety of patients/conditions; 2) would like more workplace support, as being my own receptionist, office manager, insurance biller, and marketer is too much and detracts from focus on medicine and patient care; 3) would like greater financial security and regular hours. I have averaged $75k for the last 5 years, but the ups-and-downs and lack of benefits, PTO, and too-frequent 12-14 hour days are wearing; 4) I don't care for being a for-profit entrepreneur and having to sell my services, would like more options to work in public health or not-for-profit settings; 5) my main referral source, a busy pain medicine physician, just hired a dually-licensed PA-C/L.Ac. to do my work in-house (thus partially answering my own question) and serving as a wake-up call that I may need to expand my scope/training to stay competitive. If you'd like to answer, I will appreciate any specifics, suggested resources, data, experience, people to contact etc. Please spare me Eastern vs. Western medicine debates (which I was sad to see the above threads devolve into); let's just say I see that both have their strengths/weaknesses, risks/costs/benefits ratios and leave it at that. I've already worked in physician's offices, currently 60% of my patients are referred by M.D.s/D.O.s and another 15% by PTs, OTs, PAs, DPMs, ATCs, etc.. So obviously I am comfortable w/Western Medicine (owe my life to it, in fact), but also have seen it's down-sides and cast-off disaster patients. And my own experience w/acupuncture and Chinese herbal medicine is that they have some unique strengths, but as a stand-alone modality, some serious flaws and limitations, and the acupuncture profession in CA is an anarchic, dead-end mess with too many "leaders" suffering from oppositional defiance disorder. So part of my hope is that by expanding my training and scope, I can offer patients a variety of modalities as best suits their needs, preferences, and exit the political and ideological debates between professions, while practicing evidence-based, integrative medicine. Thank you in advance to any responders...I really appreciate anyone who takes the time to share their experience and perspective! Link to comment Share on other sites More sharing options...
maebashi Posted May 30, 2011 Share Posted May 30, 2011 I'm a former SC/South Bay acupuncturist gone PA. I just sent you a PM. Link to comment Share on other sites More sharing options...
Jesse pHelps Posted September 15, 2011 Share Posted September 15, 2011 I am a LAc about to start my MSPA program. I have much of the same questions as acvdmlac regarding others experiences and opportunities with dual licenses in CA. I plan on practicing primary care upon graduation and would like to hear any advice as to what to expect in the field. Link to comment Share on other sites More sharing options...
chunkstyle Posted May 13, 2012 Share Posted May 13, 2012 I'm an acupuncturist/PA and have been working in pain medicine for 18 months. It's a great fit because my supervising physician is an interventionist and we really try to use opioids sparingly or as a last resort. The mix of Eastern/Western medicines makes for a much stronger approach to treating chronic pain but the trade off is that I'm becoming highly specialized. Ideally, working part-time in primary care or the ED would keep my options open for the future but it's a good fit presently. The skill set a licensed acupuncturist brings to the pain medicine table is huge. To get someone off of methadone with a mix of lumbar epidurals, acupuncture, and Du Huo Ji Sheng Tang is truly integrative medicine. Link to comment Share on other sites More sharing options...
whatevs Posted May 13, 2012 Share Posted May 13, 2012 Thanks for sharing this. I'm an acupuncture physician as well and will start PA school in a few weeks. I was thinking orthopedics or pain management would be a good specialty, but I'm also looking forward to experiencing EM. Link to comment Share on other sites More sharing options...
Contrarian Posted May 13, 2012 Share Posted May 13, 2012 Thanks for sharing this. I'm an acupuncture physician as well and will start PA school in a few weeks.... I'm confused... If you are a physician... why would you be attending PA school... ??? Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 13, 2012 Administrator Share Posted May 13, 2012 I'm confused...If you are a physician... why would you be attending PA school... ??? Sounds potentially like someone with a doctorate in TCM or equivalent, just not one of the Western DO/MD degrees. Not all physicians have DO/MD's; NDs call themselves naturopathic physicians, for example. Link to comment Share on other sites More sharing options...
Contrarian Posted May 14, 2012 Share Posted May 14, 2012 ^^^ "McFly"... YOU are the "new guy"...!!! I'm well aware of what folks are calling themselves and correct titles... L.Ac.s don't typically refer to themselves as PHYSICIANS unless they are actually PHYSICIANS. A Doctorate in TCM doesn't necessarily make one a PHYSICIAN. Which is why I posed the statement as a question... the te person who wrote it to answer. GO STUDY...!!!! :wink: Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 14, 2012 Administrator Share Posted May 14, 2012 Aw, Contrarian, you know I only come here to post when my eyes cross from too much studying! :-) Link to comment Share on other sites More sharing options...
whatevs Posted May 15, 2012 Share Posted May 15, 2012 In Florida, the acupuncturist title is "Acupuncture Physician" (AP) and we are also allowed to call ourselves "Doctor of Oriental Medicine" (DOM). But my point was not to start a title discussion that's unrelated to PAs. I've had to spend a good amount of time explaining to my MD patients and my PA interviewers that it is not necessary to call me doctor, because I am not an MD/DO. Link to comment Share on other sites More sharing options...
Joelseff Posted May 15, 2012 Share Posted May 15, 2012 In Florida, the acupuncturist title is "Acupuncture Physician" (AP) and we are also allowed to call ourselves "Doctor of Oriental Medicine" (DOM). But my point was not to start a title discussion that's unrelated to PAs. I've had to spend a good amount of time explaining to my MD patients and my PA interviewers that it is not necessary to call me doctor, because I am not an MD/DO. Theyre just busting your Baoding Jianshen Qiu....lol Sent from my VEGAn-TAB using Tapatalk Link to comment Share on other sites More sharing options...
whatevs Posted May 15, 2012 Share Posted May 15, 2012 Theyre just busting your Baoding Jianshen Qiu....lol Thanks! That was funny! Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.