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The Job

Acupuncture is the best-known component of the larger system of Oriental medicine, which encompasses a variety of healing modalities, including acupuncture, Chinese herbology, bodywork, dietary therapy, and exercise. A practitioner may practice them all or specialize in only one or two.

Acupuncturists treat symptoms and disorders by inserting very thin needles into precise acupuncture points on the skin. They believe that the body's qi flows along specific channels in the body. Each channel is related to a particular physiological system and internal organ. Disease, pain, and other physical and emotional conditions result when the body's qi is unbalanced or when the flow of qi along the channels is blocked or disrupted. Acupuncturists stimulate the acupuncture points to balance the circulation of this vital energy. The purpose of acupuncture and other traditional Oriental medicine is to restore and maintain whole-body balance.

Acupuncture has been used for centuries to maintain health and relieve many common ailments, including asthma, high blood pressure, headache, and back pain. A recent use of acupuncture is for the treatment of substance abuse withdrawal. Some areas of medicine that use acupuncture include internal medicine, oncology, obstetrics and gynecology, pediatrics, urology, geriatrics, sports medicine, immunology, infectious diseases, and psychiatric disorders. In the United States, acupuncture is most frequently used to relieve pain.

Like many other healthcare professionals, acupuncturists take an initial health history when they receive a new patient. They need to know about the patient's past and present problems. They listen carefully and sensitively and incorporate the patient's history into their treatment plan.

Next, acupuncturists give a physical examination. During the examination, they try to determine if a patient's qi is unbalanced. If it is, they look for the location of the imbalance. They test the quality of the pulses in both of the patient's wrists. They examine the shape and color of the tongue, skin color, body language, and tone of voice. They also check the feel of diagnostic areas of the body, such as the back and the abdomen. Acupuncturists may test for weaknesses in the muscles or along the meridians.

Once acupuncturists identify the source of the qi imbalance, they choose the type of needle to be used. Traditionally, there are nine types of acupuncture needles, ranging from just over an inch to as long as seven inches. Each type of needle is used to treat certain conditions. Most acupuncturists in the United States and other Western countries use only three types of needles ranging from one to three inches long. After selecting the type of needle, acupuncturists determine where the needles will be inserted into the patient's body. There are thousands of possible insertion points on the body. Four to 12 needles are typically used in a treatment.

Acupuncture needles are flexible. They are about the diameter of a human hair—much thinner than injection-type needles. They are inserted to a depth of up to an inch. Insertion of the needles is generally painless, although sensitive individuals may feel fleeting discomfort. During treatment, acupuncturists may stimulate the needles to increase the effect. Stimulation is done by twirling the needles or applying heat or a low electrical current.

The first visit usually lasts an hour or more because the history and physical require extra time. Follow-up visits are usually shorter—perhaps 15 to 45 minutes, although treatments sometimes last an hour or longer. Occasionally, only one treatment is required. Other times, the patient may have to return for several sessions.

If acupuncturists incorporate other modalities of alternative medicine into their practices, they may supplement acupuncture with other treatments. They include herbal therapy, massage, exercise, or nutritional counseling.

In addition to treating patients, acupuncturists have several other duties. Most are self-employed, so they have to do their paperwork. They write reports on their patients' treatments and progress. They bill insurance companies to make sure they get paid. They also have to market their services to build their clientele. They need to maintain contact with other professionals in the medical community because other professionals may be good sources of referrals. Acupuncturists must also keep up with developments and changes in their profession through continuing education.