I have been using dry needling in practice and research for over 15 years as a physical therapist. I'm licensed in the USA and overseas and appalled at how patient safety is used as a decoy when this really comes down to a turf war.  So much energy wasted fighting against each other instead of fighting for our patients. Surely this dilutes access to care for patients and strangles quality of care by unnecessarily restricting health care professionals the ability to operate at their level of competence and training.

In 2014 I was invited to China to present on dry needling. Amazingly my hosts and audience including basic scientists, physicians and practitioners of TCOM could differentiate dry needling and acupuncture!  I can see a trigger point with ultrasound imaging and quantify its stiffness using shear wave elastrography in addition to assessing and quantifying blood flow changes associated with a trigger point. I cannot see a meridian nor quantify it. You cannot compare the two modalities – one is based on Traditional Chinese Medicine (TCM) philosophies regarding the existence of the meridian system, channels and their energetics . Dry needling from a physical therapy perspective is based on the work of Simons and Travel which dates back to the 1960’s (Travel’s work to the 1940’s) in addition to more recent research much of which has been produced by physical therapists. Each modality has a place in healthcare for the benefit of patients.

As regards competence and training, the doctoral degree (DPT) is the entry level education for physical therapists. The curriculum includes gross anatomy with cadaver dissection, clinical and functional anatomy, orthopedics, muscle physiology, pathophysiology, neurophysiology, neuroscience, pharmacology and diagnostics, patient care skills, clinical problems in addition to several research courses and clinical education rotations in a variety of setting.  Course work also includes study regarding the pathophysiology associated with and the treatment of myofascial trigger points, the neurophysiology of pain, and dry needling.  

An interesting article published in the Chinese Times Vol 2 Issue 4 - August 2007 by David Kailin, Ph.D., M.P.H., L.Ac noted that the “Clean Needle Technique Manual for Acupuncturists (CNT) did not correctly or fully convey the requirements of the Needlestick Safety and Prevention Act, nor did it provide current guidance on the use of alcohol-based hand rubs, as approved by OSHA in 2003…. additional deficiencies with respect to expressing key provisions of OSHA's Bloodborne Pathogens Standard and Respiratory Protection Standard” were also noted. All DPT programs require training in universal health care precautions in addition to OSHA bloodborne pathogen training which includes the needle stick safety act (Pub. L. 106-430).   I believe the rigorous doctoral level coursework more than confers the requisite knowledge to safely perform dry needling.

Furthermore, a recent report by the Federation of State Boards of Physical Therapy determined most of what PTs need to know to perform dry needling safely is acquired in their entry level education with the remainder being acquired in a dry needling or a residency course. Therefore, I believe 54 hours to practice the motor skill of needling is more than sufficient to ensure patient safety given the depth and breadth of physical therapy education.  Indeed many DPT programs have already introduced dry needling into the curriculum including the institution I work for. I introduced it into a program in Georgia in 2008 and other programs followed suit. 

 I do not believe any one tool or technique belongs to one profession. Putting our energy into providing health care in a collaborative environment rather than fighting turf wars would ensure more cost effective and patient centered care. Too often I hear the statement “patient safety” bantered about as the impetus for restricting each others scope of practice. My response is many PTs outside the USA have direct access and perform dry needing, many from the inception of their profession. Indeed my counterparts in the US armed forces have had direct access for more than 30 years, can prescribe certain medications in addition to ordering imaging studies. I’ve yet to be appraised of any patient safety issues. This is the Yin and Yang of healthcare in the USA.