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To the Board of Physical Occupational Therapy:

My name is Ashley Mayrose, and I am a receptionist and office assistant at the Iowa Acupuncture Clinic as well as the Assistant Director for the Iowa Association of Oriental Medicine and Acupuncture (IAOMA).

I was an employee at the Iowa Acupuncture Clinic before I ever had acupuncture. It took me six months to get over my apprehension and have an acupuncture treatment. I knew acupuncture needles were tiny—I saw them when I was stocking and in the hazardous waste bins where we put them after use. I also knew that the acupuncturists at my clinic were incredibly good. They have been practicing for twenty years, and there are many patients who have been regularly scheduled or scheduled as needed throughout all of those 20 years. I heard and saw firsthand how effective and safe Elizabeth and William were, and greatly respected them for the great wealth of knowledge they possessed, both in the ancient Oriental notion of the body and in the Western understanding I recognized from Human Biology classes in college.

Even so, there are risks associated with acupuncture, some minor and some major. In my time working here (since August of 2012), I have never seen Elizabeth or William have any truly dangerous complications from their treatments. Headaches, minor bruising, and dizziness sometimes happen, but never anything more significant. I know that this is because of how well they know the body, the points, and, in particular, the way acupuncture needles interact with different body types, tissue types, and application styles. There are many factors they have to consider for every needle they insert: where to put it, what angle to use, what depth to use, whether or not they need to tap, twist, or piston the needle once it is in place. I learned just today that there are times when the needles literally bend because of how hard the tissue is, and that there are multiple ways of dealing with that situation if it occurs. All of these factors they have learned to assess and calculate through more than 2500 hours of schooling, schooling that specifically was aimed at making sure they were safe and effective handlers of acupuncture needles at the end.

The educational discrepancy between a physical therapist and an acupuncturist isn’t one that 24 hours of Continuing Education can fill; it isn’t even one 200 hours of extra education could fill. To perform acupuncture, you should be trained in acupuncture. Physical therapists who want to use acupuncture needles should go to school to add a diplomate of acupuncture to their credentials, not a certificate verifying they attended a weekend course and are now “qualified.” It ended up being February of 2013 before I had my first acupuncture treatment, six months after I started working at the clinic, and I was still nervous. I was nervous, even though I knew and trusted my acupuncturist; even though I had seen and heard such amazing stories from their patients; even though I knew the needles were tiny and would only be inserted a little ways. I was nervous, because having needles stuck in your body is invasive, and contrary to my instincts. I can stretch my muscles, pop my spine, and massage a sore calf at any time, without really thinking, because these are natural movements. Having needles stuck into my body is unnatural, and requires absolute trust.

I trust my acupuncturist because I have seen her work, listened to her patients, and researched what it means to be a Licensed Acupuncturist and hold a Diplomate of Acupuncture from the NCCAOM. If I weren’t her employee or if I hadn’t researched what those terms meant, I wouldn’t know exactly what those credentials mean, but I would still trust that she was honestly representing herself and her skills. It seems more than dishonest to me that there are health professionals claiming proficiency in acupuncture by calling it another name and taking short workshops on the topic. Dry needling is acupuncture, and to call it anything else and to have less than the proper level of knowledge is wrong. It insults the work Elizabeth and William have put into their education and their clinical practice, and it misleads the public by falsely promoting a skill physical therapists do not truly have.

We, the public, place trust in the licensing and regulating systems. We trust that if a medical professional says she or he is qualified to perform a certain task, she or he truly is. It is not our responsibility to make sure they are who they say they are—that is your responsibility, and we trust that you do it to the best of your abilities. Allowing dry needling to be performed by physical therapists violates the trust we place in you, and personally undermines the way I see many health professionals now. Are there other cases where licensing boards might have let something slip through their fingers, something that might potentially mean a practitioner I trust to be qualified actually isn’t?

I hope not. I hope I can continue to trust that professional licensing boards like you take your responsibility seriously, and that now that you have this issue before you, and all the facts for your consideration, you will take the proper course and find dry needling to be outside the scope of physical therapy.

Thank you for your time.

Sincerely,

Ashley Mayrose