Acupuncturist VS Physical Therapist
April 18th, 2017 The Denver Post published an article about the new lawsuit the Acupuncture Association of Colorado served APTA (American Physical Therapy Association) of Colorado for Dry Needling. Let's take a look at the ambiguity in the debate over training hours spent needling. In the Denver Post article, the main argument of this lawsuit mentions that Colorado Licensed Acupuncturists must have a minimum of “1,905 hours of classes in order to be licensed” and physical therapists only need “46 hours of training” to do dry needling. Let’s break this down. The training to be a licensed acupuncturist involves the entire realm of Chinese Medicine. Students learn Chinese history, theory of traditional Chinese medicine, herbal therapies, massage techniques, diagnostics, ethics, adjunct modalities including: cupping, moxibustion, and electrical stimulation. Students are even required to take a TaiQi and QiGong class. The curriculum goes over internal medical conditions as well as musculoskeletal. This in total, along with business and board prep classes, makes up that 1,905 hours. The programs for licensed acupuncturists vary from about 2,000 hours of training, 122 semester credit hours to 3,500 hours of training, 330 credit hours for a Masters degree with an optional, additional, Doctoral degree on top of that.
The Physical Therapy program is a now a Doctoral degree only. In Colorado their training varies between 110-116 semester credit hours. Both require clinical training during or after the program is complete. The 110-116 credit hour training of 2-4 years for physical therapists does not include any time discussing dry needling or demoing the therapy. Licensed acupuncturists on the other hand, spend between 165-225 conservatively on needling practicing alone. However, when breaking apart these practicum classes, not all these classes are spent needling alone. When looking at the school (Colorado School of TCM; CSTCM) with about 165 hours of needling training, about 40 hours of the total time was spent on non-needling modalities such as cupping, moxibustion and guasha (graston). The second acupuncture school in Colorado (Southwest College of Acupuncture; SWAC) designated 225 hours of needling but unlike CSTCM, they had two additional and optional classes of 45 hours each in training for trigger point needling and sports acupuncture. CSTCM only had a designated 8 hours in training their students to needle musculoskeletal conditions!
Furthermore, breaking down the traditional dry needling path most physical therapists take, they get a minimum of 22 hours per level of dry needling training, usually done through the company Kinetacore. Kinetacore has four main levels of training totaling in 116 hours of training needling supervised. There is an additional 16 hour course to learn needling the pelvic floor. Both licensed acupuncturists and physical therapists who dry needle get training in clean needle techniques.
When comparing how many hours licensed acupuncturists spend actively learning needle techniques to how many hours physical therapists spend learning needle techniques the difference is about 40%. If on average acupuncturists in Colorado receive 195 hours of supervised training in needle techniques and physical therapists receive 116, that means acupuncturists have 40% more training which conflicts with the statement from the Denver post claiming acupuncturist's receive 97.5% more training.
As you can see, these numbers are quite different. Although an acupuncturist's job is to insert needles, I have first hand seen how little training acupuncture students actually receive in the physical needling techniques portion. There are less than two, four-hour classes of training during acupuncture school that focuses on needling for musculoskeletal conditions (such as trigger points) or difficult points. Being in the acupuncture realm and seeing acupuncture students from around the country I have seen the deficiencies in needling proficiency. On the other hand, 116 hours of needling training is still very minuscule. Especially for trigger point needling which tends to be quite aggressive and potentially dangerous, 116 hours is just plain not enough training; but neither is 225 hours. Most importantly though, if acupuncturists are going to sue physical therapists over needling, it's blatantly obvious there is a severe void of any sufficient training in trigger point needling (dry needling) by the acupuncture schools. I feel if acupuncturists spend at least 116 hours of training each student, supervised, in a classroom, trigger point needling, then without a doubt acupuncturists should have every right to sue physical therapists for encroaching on their scope of practice. But 8-90 hours at the most of trigger point and musculoskeletal needle training is just simply not enough. It is an unfair comparison of the two therapies.
In my next blog in this series I will discuss the prevalence of dry needling in the acupuncture world and the differences between the two.
Dr. Christina Fick