Since I posted my last article explaining the importance of supporting physical therapists in Maryland around the challenge to their state practice act, there has been a lot of discussion in social media regarding the dry needling issue. Detractors of dry needling seized this opportunity to launch yet another attack on the technique, with the same old arguments. My response on Twitter in particular has been to get across the message that whether or not you accept the evidence behind the use of dry needling, this is about an issue bigger than arguing the research behind one particular technique.
THIS IS ABOUT SUPPORTING COLLEAGUES IN OUR OWN PROFESSION AS THEY FIGHT AGAINST THE ABILITY OF OUTSIDE INTERESTS TO DICTATE OUR STATE PRACTICE ACT!
Did that come across loud and clear?
Make no mistake, the Maryland Acupuncture Society has sent out an alert nationwide to other state chapters encouraging acupuncturists to send letters to the Maryland Department of Health and Mental Hygiene. They are encouraging their members to write letters to influence the decision being made. Don’t believe me? You can see it right here:
The problem is that they are asking for letters of support based on faulty information and confusion of the issue, as seen from direct excerpts of their letter to the Maryland Board of Physical Therapy Examiners:
“As licensed acupuncturists are already extensively and competently trained and duly licensed to employ the use of this procedure in their daily treatment of patients, MAS holds that there is little to no public need established to justify allowing physical therapists to conduct this invasive procedure with such minimal requirements for competent education, training, and regulatory monitoring as these regulations would allow. For these reason, we strongly suggest that these regulations be withdrawn for consideration until such time as they can be amended to more than meet the minimum standards as recommended by the Attorney General.”
The AG, unfortunately, is lumping the use of dry needling by physical therapists together with physician training for medical acupuncture, which requires 230 hours of training. Since dry needling and medical acupuncture are two different things, and physical therapists already have such a strong education in the assessment and treatment of the musculoskeletal system, these recommendations are absurd.
Additionally, the MAS states that:
“Of greatest concern to Maryland Acupuncture Society is the unwillingness of the PT Board to police its own licensees during this process. Physical therapists continue to offer and advertise dry needling services throughout the state. There are three courses offered in Maryland by three different organizations – all of which instruct their attendees that they will be able to immediately perform this treatment. The courses are 12 hours, 24.5 hours and 135 hours respectively – all falling short of the minimum 200 hours of training required of a physician performing the same treatment.”
Again, the training for dry needling doesn’t “fall short” of the training for physicians who are performing medical acupuncture – they are two different treatments. Same tool, completely different treatment.
The above statement is also false because the course on dry needling that is 12 hours is a course taught by a chiropractor for other chiropractors. The requirement for chiropractors to perform this technique in Maryland is apparently 12 hours. This is NOT the course that is taken by physical therapists, and it is misleading to acupuncturists and to the public for the MAS to make this statement. It is completely false.
The deceit behind this initiative makes my blood boil. I hate lies. I hate it that the MAS is manipulating their members and the general public based on false statements. I also hate it that another profession believes they have the right to dictate what should be included in the physical therapy practice act of the state of Maryland.
I have no issue with acupuncture, and no interest in trying to dictate how acupuncturists perform acupuncture; after all, I don’t know enough about it to form a well thought out opinion. But, after spending 10 years in school to become a physical therapist (4 undergrad, 3 working full time to take prerequisites, and 3 full time grad school), and after 14 years of practice, and 104 hours of post graduate training to perform trigger point dry needling, I am really certain that I can safely perform this treatment technique as part of my overall patient treatment.
So, regardless of your personal opinion on the research behind dry needling, understand that the APTA has come out with a position paper in support of the use of dry needling. Understand that physical therapists in Maryland have been safely performing dry needling since 1987, with no adverse effects or safety concerns reported to the Department of Health and Mental Hygiene. And make no mistake that the MAS is seeking to dictate what we as physical therapists can do in the treatment of our patients.
If you think this doesn’t apply to you, just think about how you would feel if there was a challenge against your state practice act calling into question your ability to safely use exercise in your treatment plan. Or another form of manual therapy. Or taping. Or patient education. Or neuro re-education.
Food for thought.