A fellow veterinarian recently drew my attention to a glaring example of the disconnect between the logic of science and the logic of politics, and how Big CAM is, sadly, better at playing politics than scientists seem to be. A proposal has been filed with the Washington state Department of Health to revise the scope of practice for acupuncturists. Apparently, the acupuncture lobby in Washington(1) wants to expand its role in primary health care beyond sticking needles in people. What they are requesting is:
“the addition of seven modalities that will enhance public health. These
modalities are: breathing, relaxation, and exercise techniques; qi gong, health education; in-office testing of temperature, blood pressure, oscultation[sic], weight, body fat percentage, urine, saliva, stool, and blood to assist the practitioner in determining the need for referral to a primary care physician and to assist in treatment; massage and tui na; heat and cold therapies; and recommendations and dispensing of herbs, vitamins, minerals, and dietary and nutritional supplements.”
They would like this new conglomeration of diagnostic and therapeutic techniques to be labeled “Asian Medicine” by the state, since “Acupuncturist” implies they limit themselves to acupuncture, which they clearly do not. Now, it would seem from the perspective of science that the logic of licensing acupuncturists is itself not ironclad. A method of therapy that has never demonstrated itself to be more than an unusually good placebo gains more from the implicit endorsement of government licensure than the public health would seem to gain from regulating the practice. Still, one could argue that regulations such as requiring disposable sterile needles and so forth might be appropriate to minimize the admittedly small harm that acupuncture can do since people are going to have the treatment whether it is licensed or not.
But giving official imprimatur to a hodgepodge of techniques united only by their basis in ephemeral, and unverifiable, energies and forces seems questionable. And allowing practitioners of such methods, who frequently denounce the core principles of scientific medicine, including the germ theory of disease, to handle body fluids and make themselves the first line of primary health care seems obviously misguided. But the logic of politics is not the logic of science. Public demand for the services involved, and the marketing successes of the applicants, will likely count for more than any hard evidence that the practices involved are ineffective and based on erroneous theories.
Still, the political playing field is one we in science-based medicine had better get used to if we truly want to serve public health. So any of you in Washington, take a lok at the proposal and make your voices heard.
1. American Association of Acupuncture and Oriental Medicine (AAAOM)
PO Box 162340
Sacramento, CA 95816
Washington Acupuncture and Oriental Medicine Association (WAOMA): 223 members
Advocates for the Advancement of Asian Medicine (AAAM): Unknown number of members
South Sound Acupuncture Association: 29 members
Southwest Washington Acupuncture Group: 26 members