Doctors get the point

Employers looking for low-cost additions to medical plans are embracing the treatment.

Anahad O'Connor
the New York Times

January 31, 2006

Acupuncture, long shunned by mainstream medicine but for centuries
considered the crown jewel of alternative therapy, is slowly gaining ground in doctors' offices throughout the country. Although some experts still question its effectiveness, studies in recent years -- including one at Duke last fall -- have thrown scientific weight behind its benefits, supporting its usefulness in alleviating conditions from morning sickness to carpal-tunnel syndrome.

In the past few years, the number of hospitals offering acupuncture and other alternative therapies has doubled. "A lot of physicians who used to be extremely reluctant to refer patients for the treatment are now doing it regularly," says Dr. Nader E. Soliman, president of the American Academy of Medical Acupuncture.

A visit to an acupuncturist can cost $50 to $100. More and more employers looking for low-cost additions to medical plans are embracing the treatment. Nearly 50 percent of workers with benefits received coverage for it in 2004, compared with just over 30 percent two years ago, according to a survey last fall by the Kaiser Family Foundation and Health Research and Educational Trust.

Government financed research on acupuncture dates from the 1970s. It originated in China more than 2,000 years ago.

"Of the many different alternative therapies, this was really the first
one to be studied seriously by the National Institutes of Health," says Dr. Richard Nahin, of the National Center for Complementary and Alternative Medicine.

In some cases, acupuncture has been shown to ease certain conditions -- such as drug addiction -- when combined with other treatments, but not necessarily when used alone. For other ailments, however, acupuncture has been found to work better than standard medications -- and without side effects. It has been widely used for years to ease chronic pain, and studies have repeatedly endorsed its usefulness.

Last fall, researchers at Duke showed that it was far more effective for postoperative sickness in a group of subjects than Zofran, a widely used anti-nausea drug. Roughly a quarter of all those who undergo major surgery in the United States experience retching and illness afterward, usually brought on by anesthesia. Anti-nausea medications offer relief, but because they sometimes cause severe headaches and cramps a number of patients are reluctant to take them, says Dr. Tong J. Gan, an author of the recent study, published in the journal Anesthesia & Analgesia.

Gan's study looked at a group of 75 women who were either given Zofran before major breast surgery or hooked up to an electro acupuncture machine that delivered low doses of current during the operation. This high-tech acupuncture technique prevented illness in all but 27 percent of those who received it, while about half of the women given the anti-nausea drug complained of sickness the next day. The rate of sickness in a control group that received neither treatment was about 60 percent.

"We are seeing more and more evidence suggesting that alternative
therapies are beneficial, and patients are gradually demanding it," Gan says.

To some extent, the increased acceptance of acupuncture reflects a
growing understanding of its biological mechanism, Gan says, which until now has largely been a mystery. Research suggests that stimulating acupuncture points somehow prompts the flow of endorphins and other hormones that soothe pain. Other studies find that it affects parts of the central nervous system that mediate blood pressure and body temperature.

But whatever acupuncture's underlying effects turn out to be, experts say its gradual merger with conventional medicine will have broad implications, eventually opening the door to closer examination of other popular therapies.