Physical therapists have extensive foundational education on anatomy, biomechanics, circulatory, visceral function, and neuromuscular training at our entry level into the profession to then add perhaps 80-100 hours of specialty training (post graduate, continuing education) in needling to perform it safely and effectively. Our staff has been using this modality in Wisconsin since 2009 when it became a consideration and ruling as totally within our scope of practice. Out of respect to acupuncture, what we do is not acupuncture (which is a valid methodology in its own right, supported by evidence also, as is dry needling). An acupuncturist could do what we are doing but most that I know practice under a completely different foundation and paradigm. Every single one of our patients that has dry needling for myofascial trigger points, that has also had acupuncture, can attest that it is very different. We are not trained in acupuncture and do not perform it in our clinic. The needle is an extension of our well-trained and experienced palpation skills as certified manual physical therapists to identify taut bands and often tender trigger points. These are areas of myofascial tissue that we can also apply manual pressure in an effort to soften and desensitize, but it is more rapid (and therefore cost effective to patients) to glide the needle to the trigger point, effect a single or multiple twitch response and cause a relaxation of the point, decrease the tenderness, and improve range of motion. With our staff doing it without any adverse events for 8 years, and lots of positive patient outcomes, it cannot be stated that we are somehow unqualified. The paranoia and turf protection of the acupuncturists is unfounded and does not play out in actual practice in the way they catastophize in actual practice. They would actually benefit more by embracing this methodology that is very different than what they do with their traditional acupuncture training and expand their own effectiveness with patients.