acupuncturists as primary care providers

[yummygummy]

What do you guys think about acupuncturists as primary care providers? They are considered PCP in California, which is where I am from. An Oriental Medicine school representative also told me that this means insurance pays them the same as MDs/DOs.

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[FutureCTDoc]

The individual reimbursements are determined by the insurance companies, they generally do not reimburse non MD/DO providers on the same scale i.e. DPN, PA or DC.

 

[CyclistOK]

What do you guys think about acupuncturists as primary care providers? They are considered PCP in California, which is where I am from. An Oriental Medicine school representative also told me that this means insurance pays them the same as MDs/DOs.

Depends on your definition of primary care. But I would be reluctant to lump them into any sort of traditional medical terminology. As far as whether or not I would go to one, or if I consider them primary care physicians... Nope.

 

[engineeredout]

Primary Care Physican must be a PHYSICIAN. Not an accupuncturist, not a chiropractor.

 

[Exalya]

I think that it's better than nothing. I am also from California (humboldt county, if you know what that means) and I knew a lot of people who just didn't trust anyone with an M.D. or a D.O. They put much more faith in acupuncturists, N.D.'s and chiropractors. I don't think it's a wise choice personally, but for some people it's the only kind of medically-oriented individual they trust. At least they get some kind of care, even if it's not traditional or always effective.

 

[TexasTriathlete]

What about the psychic hotline as your primary care provider?

 

[group_theory]

What do you guys think about acupuncturists as primary care providers? They are considered PCP in California, which is where I am from. An Oriental Medicine school representative also told me that this means insurance pays them the same as MDs/DOs.

Primary care huh? So they will be able to manage diabetes, benign essential HTN, dyslipidemia, asthma, along with provide appropriate immunizations? They will monitor and adjust someone's coumadin regiment?

They will see the rashes, the sore throat, the headache (is it a a benign headache or something to be concern about?)

They will see the hospital follow-ups for COPD exacerbation, seizure disorders, cellulitis that was unresponse to oral antibiotics, CAD with history of MI/stents/CABG, strokes, afib that is rate control, hypothyroidism, CHF, venous stasis, etc

Will they be the primary care providers for ex-24 week micropremie who have since graduated from the NICU but on chronic inhaled steroids, high calorie infant formulas, and need coordinations of their appointments with specialist (do accupuncturists even know why a NICU baby needs to see an opthalmologist?)

Will they be their patient's primary care doctor, or would they be the one referring every simple medical problems to specialists (since the waitlist to see a specialist is non-existent).

If you want to be the patient's primary care doctor, then BE THE PRIMARY CARE doctor (all the conditions above are in the realm of primary care ... since patients are sicker than ever before, and with DRG payments from medicare and insurance companies, expect the primary care physicians to handle and coordinate more of the complex patients). If you can't handle the above, then it's all talk without any substance to back it up

 

[mboaz]

What do you guys think about acupuncturists as primary care providers? They are considered PCP in California, which is where I am from. An Oriental Medicine school representative also told me that this means insurance pays them the same as MDs/DOs.

I believe that acupuncturists in CA are legally authorized to order blood work and x-rays. They cannot prescribe medications. I'm a licensed acupuncturist, though not in CA so I'm not clear on all of the laws in that state. The idea of acupuncturists as PCPs is a total joke as group_theory suggested. Their training is simply inadequate for them to be able to address the wide array of medical conditions that a PCP sees in practice and, hello, they can't prescribe drugs. According to http://www.acupuncture.ca.gov/ , they are "primary health care professionals," but their scope of practice is limited so there's really no way that they can effectively live up to such a title.

Regarding insurance compensation the above statement is very vague. PCPs bill for the services they provide. I don't know what they bill for a 'well visit' is, and I know it varies, but I'd wager it's more than an acupuncturist can bill for. At the office I worked at compensation for a visit ranged from a pathetic $12 to around $45. This is a moving target though, and I recall hearing news of CAM compensation being cut from CA government health care plans following the state's budget crisis.

I've studied acupuncture for more than a few years. There are zero large, randomized clinical trials that are sufficiently blinded that show acupuncture as more effective than placebo for any condition. Zero. Period. I know that there are people who frequent these boards who would suggest that this doesn't matter since not every conventional medical intervention is supported by evidence. This is a naive and intellectually and ethically bankrupt outlook. The same argument could be made in support of prescribing bloodletting and leeches.

 

[DO2Be2013]

Primary Care Physican must be a PHYSICIAN. Not an accupuncturist, not a chiropractor.

True. But PCP doesn't necessarily mean primary care physician anymore. There is some ambiguity there, as most insurance companies mean "primary care provider" when they say PCP. And that could be a physician but is frequently a nurse practitioner too. There are groups (the ND's are another) who are clamoring to be recognized as PCPs (second P for provider) in many states. This is for insurance reimbursement purposes.

 

[DO2Be2013]

Regarding insurance compensation the above statement is very vague. PCPs bill for the services they provide. I don't know what they bill for a 'well visit' is, and I know it varies, but I'd wager it's more than an acupuncturist can bill for. At the office I worked at compensation for a visit ranged from a pathetic $12 to around $45. This is a moving target though, and I recall hearing news of CAM compensation being cut from CA government health care plans following the state's budget crisis.

The idea with insurance reimbursement is, if they are recognized as PCPs, then patients can see them at will and they can bill for services without the restrictions imposed upon other specialists and allied health providers like physical therapists (referrals, prior-authorizations, etc.). If your acupuncturist or chiropractor or ND is recognized as a primary care provider and not a specialty care provider, you can bypass seeing a "real" PCP for a referral or order first. It creates an open access which logically would result in more business and more money.

 

[bkro]

Primary care huh? So they will be able to manage diabetes, benign essential HTN, dyslipidemia, asthma, along with provide appropriate immunizations? They will monitor and adjust someone's coumadin regiment?

They will see the rashes, the sore throat, the headache (is it a a benign headache or something to be concern about?)

They will see the hospital follow-ups for COPD exacerbation, seizure disorders, cellulitis that was unresponse to oral antibiotics, CAD with history of MI/stents/CABG, strokes, afib that is rate control, hypothyroidism, CHF, venous stasis, etc

Will they be the primary care providers for ex-24 week micropremie who have since graduated from the NICU but on chronic inhaled steroids, high calorie infant formulas, and need coordinations of their appointments with specialist (do accupuncturists even know why a NICU baby needs to see an opthalmologist?)

Will they be their patient's primary care doctor, or would they be the one referring every simple medical problems to specialists (since the waitlist to see a specialist is non-existent).

If you want to be the patient's primary care doctor, then BE THE PRIMARY CARE doctor (all the conditions above are in the realm of primary care ... since patients are sicker than ever before, and with DRG payments from medicare and insurance companies, expect the primary care physicians to handle and coordinate more of the complex patients). If you can't handle the above, then it's all talk without any substance to back it up

I hate to break it to you, but no GPs can handle all of that. Very few GPs can provide the standard of care of a specialist. It's kind of obvious so I don't know why people here are so high and mighty about the expertise of a GP. COPD, seizure disorders, etc. its called referral to pulmonologist, neuro, cardiologist, etc. Get real, Primary care is a gate keeper and right now the algorithms in the EHS tell you what to do. Being a GP is not what it used to be.

 

[bkro]

Acupuncturists can certainly be primary care. They just have to be willing to work as a team with other providers. It's not very hard to figure out when to refer. If its an emergency, you refer right away (as any GP does). If it's not an emergency, you try what's in your toolkit and if that doesn't work, refer to a specialist. Acupuncturists have a significant amount of alternative treatment methods that are very useful. If someone prefers a non-pharmaceutical route as a first line for non-emergency situations then why should that not be a choice ot try acupuncture or chiropractic or whatever regulated medical profession they like? Acupuncture is well established as having definitive effects and it is in many hospitals now. In fact, a recent study from Am J Emerg Med. showed that acupuncture worked better and faster than IV morphine in the ED. The "Success rate was significantly different between the 2 groups (92% in the acupuncture group vs 78% in the morphine group P<.001). Resolution time was 16±8 minutes in the acupuncture group vs 28±14 minutes in the morphine group (P<.005)." This is more about a turf war than about the competence or potential competence of a medical professional. In California, acupuncture school is 4 years. If you want a doctorate then its another 2. Med school at UCLA is 4 years. Chiropractic school is 4 years, Osteopathic school is 4 years. These are not PA's.
http://www.ncbi.nlm.nih.gov/pubmed/27475042

 

[AnatomyGrey12]

Why on earth did you do this? DO/Ph.D my butt...

 

[Marrowist]

Why on earth did you do this? DO/Ph.D my butt...

I too am puzzled...

 

[deleted407021]

Why on earth did you do this? DO/Ph.D my butt...

Member since...yesterday. And posts like that? Naw, calling troll.

 

[Marrowist]

I like the strike out effect... adds a hint of confusion.