Open Letter

Spanish Health Minister

Excma. Sra. Dña. María Luisa Carcedo Roces
Ministra de Sanidad, Consumo y Bienestar Social
Ministerio de Sanidad, Consumo y Bienestar Social
Paseo del Prado, 18
28014 Madrid

Dear Mrs Maria Luisa Carcedo Roces,

My name is Andrea Thorpe and I have been licensed in Chinese medicine for the past 25 years. I am Spanish born and obtained my professional titles and accreditations by completing two 4 year degree courses in Chinese Medicine in both England and the United States. I am currently completing a Doctoral degree at the Pacific College of Oriental Medicine; this program is an accredited doctoral program in the US. I write to you in regard to your plans to expel what you term pseudo-therapies from the Spanish National health system in which you have included Acupuncture. Before I go into details of why I consider this a major mistake, I would like to present to you the current practice of integration of therapies that is taking place in the United States. I would like to illustrate how hospitals, universities and medical organizations across the country are incorporating acupuncture programs into their services, and how the extensive collaboration between allopathic and Chinese medical practitioners has been a resounding success. 

As you well know, we cannot measure all health related issues through double blind placebo controlled trials. This study model was designed to test the safety of drugs before making them available for prescription and public consumption. This model cannot explain how a medical system as complex as Chinese medicine functions, in the same way that it cannot explain how psychotherapy works. However, despite the limitations present when providing the evidence that Acupuncture and Chinese Medicine works, the last study published in PubMed in May 2018, leaves little doubt about the efficacy of this medicine when treating pain related health issues. This study goes beyond being anecdotal evidence as the size of the study involved more than 20.000 people who received acupuncture with vary favorable results for the treatment of chronic pain (Vickers, et al. May 2018). The truth is that at this point, the only obstacle to the global acceptance of the efficacy of Acupuncture in the allopathic community is that scientists cannot explain how Acupuncture works through randomized double blind placebo controlled trials which are considered the gold standard of medical research. 

If there is one thing I have learnt in the 25 years I have spent studying Chinese medicine, it is that all medical modalities, therapies or philosophies, must be observed through their own unique paradigm and theoretical underpinnings. The frustration that the scientists feel at not being able to demonstrate “how” the insertion of needles in specific body points creates a physiological change, does not take away from the fact that it works with great efficacy and safety. Which brings me to my next point.

I understand that you are proposing this plan to expel acupuncture from Spain’s country’s health system as a measure to protect the safety of your citizens. I would like to emphatically point out that the number of cases of harm produced by acupuncture treatments is very small, and of the few cases that were reported in the US, they involved professionals who had not been properly trained. A rigorous and accredited professional training program is of extreme importance and as I explained earlier, one cannot legally practice in the US until one has completed a 4 year masters degree course and has passed a rigorous licensing exam. If you are truly concerned about the safety of your citizens then create accredited acupuncture programs that fully train medical professionals. In England there are acupuncture schools that are integrated in traditional allopathic medical schools. For example at Westminster University in London, students of Chinese medicine complete all basic pre-medical subjects together with the rest of the student body. To remove the study of acupuncture and Chinese Medicine out of the educational system and further remove it from the health care system, will lead to the creation of programs and certifications that have not been formally accredited by a recognized medical body. This will inevitably result in the presence of professionals practicing acupuncture who have not been formally and adequately trained, and that does pose a risk to your citizens. It is imperative that the education, licensing and the accreditation of medical professionals takes place in regulated and established institutions.

More than 56% of the citizens of Spain believe in the efficacy of acupuncture and its not because they have read scientific studies to that effect. In the United States the public demand for acupuncture services is such that in the past decade there has been a dramatic increase in the number of medical integration programs across the health care system of the country. For example Memorial Sloan Kettering, one of the most prestigious oncology hospitals in the US, has created an acupuncture department to support patients with the side effects of chemotherapy. Children’s Hospital Los Angeles has an acupuncture program that not only offers treatments to its young patients, but a teaching and observation program to interns. Kaiser Permanente, one of the largest health care providers in the country, offers acupuncture services both in their hospitals and clinics as well as having a referral service to licensed acupuncturists in the community. 

The success and the benefits that these medical integration programs are having, is being studied by the Academic Consortium for Integrative Medicine and Health (ACIMH), an organization composed of 72 institutions including various universities, hospitals and professional associations. Their mission is to create programs of medical integration when they find evidence that these treatment programs are effective. In their last proposal the ACIMH emphasized the importance of the introduction of non-pharmacological therapies in the treatment of chronic pain and have included acupuncture as a key therapy. Another example is the opiod crisis that is currently sweeping the US. This crisis has become a mayor catalyst for the search for resources and non-pharmacological medical techniques for the treatment of chronic pain. With regards to the massive over-dependence on opioids and the disastrous consequences this is having in communities across the country, the Veterans Administration (VA) together with the National Acupuncture Detoxification Association (NADA), has established an extensive collaboration to use acupuncture as part of comprehensive and cost effective opiod detoxification programs. 

These are only a few examples of the collaboration that is currently taking place in hospitals, universities and medical organizations in the US. These treatment programs have been implemented not only because of public demand, but because of their success in providing effective therapeutic treatment and outcomes. Removing acupuncture from Spain’s health care system would be a monumental mistake. While UNESCO has catalogued Chinese Medicine as a world heritage medical practice, it has also been scientifically proven to be extremely effective in the treatment of both chronic and acute conditions and specifically in the treatment of chronic pain.

As the famous Spanish expression says: “ hablando se entiende la gente” “through conversation we understand one another”. I sincerely hope this letter serves as a reason for pause in your plan to remove acupuncture from your health care system and can start a conversation on this issue. We as fully accredited and trained acupuncture professionals should have a seat at the table and participate in this conversation. I truly hope that through this conversation, you may come to see the incredible value that Chinese Medicine and Acupuncture has and how promoting its education and implementation in the health care system will be of tremendous benefit to the citizens of Spain.

I hope this letter is well received,

Andrea Thorpe L.Ac, Dip Ac (UK), FABORM

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