Why is AOM Stuck on Square One?

By Charles Ignacio Roman

An inquiry into the cultural state of the medicine in contemporary American society

I was speaking with a practitioner recently who complained about how many articles in the mainstream media carry similar introductory themes that don’t have much depth. “Does acupuncture work?” “Do needles hurt?” “Is acupuncture safe and effective?” She bemoaned having to focus so much energy on justifying acupuncture to the uninitiated, when acupuncture represents only one modality among all the various ways and means available to AOM practitioners. Can’t the public just get over it and get on with it? The constant focused defense of a single modality within a scope of practice seems to eclipse the broader story about how all the modalities work together to address health and healing. It strains patience for those of us who have long enjoyed acupuncture and Oriental medicine as a means to ensure good health overall. We use it, benefit, continue using it and understand that however it works, it sure does work. For practitioners like my friend, this need to constantly introduce is something of a nuisance.

So why do we all need to make the case of acupuncture at such an elementary level? Can’t we all get past this point-of-departure into a broader discussion about how acupuncture and Oriental medicine work and make that case to the public? The answer is yes and no. The preliminary discussion has to take place, even as the larger, more elaborate case may be compiled and asserted.

As a non-Asian, non-practitioner who uses AOM regularly, I am comfortable with the approach, respect the tradition, and easily relate to the language employed to describe the balance one needs to maintain to be healthy. But I also have traveled in Asia and have been exposed to Asian philosophy and culture as part of my education. For those of us already familiar with this, it’s easy to forget that not all Americans have read Lao Tzu or been exposed to Qi Gong.

Many Americans have neither been to China much less have traveled outside of the country. For these people a gap exists between what they know (informed by the epistemology lodged in a Western education) and the odd cultural import AOM represents. Acupuncture and Oriental medicine are foreign to them, literally and figuratively. How do we deal with foreign imports? We Americans like to assume that we are a tolerant people, open to new ideas. This is true—it is far easier to introduce change in this country than in many others where religious ideology is not distinct from government, to be sure. That said, xenophobia still exists—and drives some of the reluctance and mistrust involved.

We need to recognize one thing clearly: there is always going to be a cultural bridge to cross with the American public, since we cannot assume a cultural context in which discussion of acupuncture is second nature. Imagine if AOM did possess that cultural context! Consider Japan, for example, where TCM formulae have been standardized (kampo medicine), are subsidized by the government, enjoy universal insurance coverage and are prescribed alongside Western pharmaceuticals. Why has kampo medicine achieved such integrative success in Japan? One ready answer is that there is no cultural bridge to cross there. Concepts such as Daoism and qi are not cultural imports but have an “always already there” allure in Japanese society. As such, integrating classical Chinese formulae into Japan’s healthcare is easy. The public already “gets it” in a very intuitive way. This is not the case in the U.S., where AOM truly is an import.

The history of the AMA comes into play as well. This is an association responsible for the three most effective words imaginable to sustain market share in a competitive healthcare landscape: “Ask your doctor.” All healthcare inquiries lead to the allopathic doctor through that ingenious positioning of overarching authority. Curious about acupuncture? Ask your doctor. Are herbs from China safe? Ask your doctor. Unsure if acupuncture can help you with your back? Ask your doctor. It is hard to imagine a more effective funnel.

“Ask your practitioner” doesn’t have the same ring to it, but then, AOM presence in the U.S. is still nascent. Practitioners need to explain that needles usually don’t hurt, that needles are sterile, that acupuncture is safe and has little to no side-effects. Advocates will have to patiently assert the rigorousness through which herbs are tested, all the while defending the medicine from misconstrual and poorly informed perspectives. This is plodding work. But each of these efforts builds the cultural bridge toward AOM understanding. Who knows? Maybe Obama will turn to acupuncture to diminish his urge to smoke. An articulate voice like the president’s could build that cultural bridge we seek far easier and with the musculature of the executive branch behind such a message. Until a more prominent voice defends the efficacy and safety of the medicine, it seems likely that those who practice will have to breathe deeply and keep making the case themselves. The medicine itself will do the rest, one patient at a time.

Charles Ignacio Roman became fascinated with Chinese medicine during his extensive travel in Asia, where he witnessed TCM offer relief without Western pharmacological intervention. Roman studied writing at the University of California and contributes perspective pieces on the evolution of health-care practices and policy in the U.S. He may be reached at charlesignacioroman@gmail.com