The modern American acupuncturist delicately balances between Oriental
and Western ideology. They
balance their goal of restoring patient’s qi dynamic with the reality
that the average patient, Western medical doctor, and insurance adjuster
do not understand Oriental Medicine concepts.
The push-pull of Eastern-Western medicine relationship is seen
throughout the day of an acupuncturist and aptly illustrated in their
Subjective - This is where patients describe their complaints. They will often recite their Western medical diagnosis
and may even present medical reports. The acupuncturist teases out
useful information and asks questions that seem irrelevant. A
patient’s pain associated with a “lumbar disc herniation3"
says little about the patient’s qi dynamic but “chronic, achy low
back pain that is worse during the morning, night sweats, and
frequent urination is much more revealing.
Objective - This includes the patient’s general countenance and
includes posture, facial appearance, voice, scent, tongue, and
pulse. The moment the patient walks through the door the objective
assessment begins. These observations are interpreted from the
Oriental Medical perspective. Objective findings may also
include Western “range of motion”- measuring the movement of the
body part that hurts- temperature and blood pressure as well.
Assessment/Diagnosis - The emerging collage of subjective
(symptoms) and objective (signs) are organized into a “pattern” or
syndrome. Different diagnostic systems/schools of thought have
different patterns; each reflecting their perspective.
A TCM practitioner may diagnose the above low-back pain
“herniation” as Qi and Blood Stagnation of the Du and Urinary
Bladder meridians with Kidney Yin Deficiency patterns. This suggests
that the low back pain (Qi and Blood Stagnation) is a symptom of
more systemic disharmony (Kidney Yin Deficiency).
Medical reports and medications may influence treatment and
diagnosis. Medical reports provide more detail about the physical
dysfunction and may help determine if treatment is long or
Medications add complexity to understanding the qi dynamic.
Medications can mask relevant signs and symptoms and/or create side
effects; another influence on the qi dynamic.
Plan - After a pattern has been identified, treatment goals are
developed and treatment plans are chosen. The plan for the above
case is to “Promote the flow of Qi and Blood of the Du meridian and
Tonify the Kidney.” “Restoring the integrity of the lumbar
disc” is not a treatment plan because that is the job the
chiropractor, physical therapist, medical doctor, physiatrist,
Treatment - The beauty of acupuncture is that there are a wide
variety of methods to choosing points. The acupuncturist is not
limited to the local area and just a few points can treat several
problems simultaneously. In fact, acupuncturists are not limited to
In order to bill an insurance company or interact with Western
providers (and often other acupuncturists to simplify speaking) the
acupuncturist uses Western terms once again. However, the
acupuncturist may use slightly different wording in writing. They
may say “lumbar myofascitis”- “low back pain of the muscles” and not
Western Medicine’s “herniation.” After all, the acupuncturist treats
qi-imbalances and the consequences of those imbalances not
The mind of an acupuncturist is complex. They listen to the
Western complaint, convert it to TCM terminology, treat the patient,
and then translate their findings back into Western terms in order
to interact Western-minded people. In summary, there’s a whole lot
more going on an acupuncturist’s mind than “sticking a pin where it
Lawrence Howard, LAc, MSAc is a New York State licensed
acupuncturist since 1998 and a Rei Ki practitioner as well. He
practices a unique style he calls “Energetic Acupuncture” a style
that integrates energetic healing techniques into the acupuncture