Avera Physician Practices the Ancient Art of Acupuncture
The ancient practice of acupuncture, the placement of needles along nerve pathways or ‘meridians’ to treat conditions ranging from pain to insomnia and diarrhea, is slowly making its way into Western medicine as patients look for drug-free ways to treat their problems. Family Practice Physician Dawn Flickema, MD, of Avera McGreevy Clinic has practiced medicine in Sioux Falls for 15 years and has used acupuncture to complement her practice for the past 2. She received her acupuncture training through a 300 hour CME course for practicing physicians through the University of California, San Francisco and says acceptance is growing.
DF: More and more, we are beginning to recognize that traditional Western medicine does not have all the answers. And a growing number of patients are looking for things other than drugs to treat their problems. They come in and ask their doctor about them, and it forces you to look at the legitimacy. It is easy to tell them that you don’t know anything about it, but that is not the answer they are looking for. They are looking for someone to counsel them on these things, someone whose opinion they trust. Also, I had some issues with a cervical disc myself and acupuncture helped me deal with it.
MED: How do you explain what acupuncture is?
DF: Acupuncture is a form of neuromodulation. Acupuncture points are a dense collection of peripheral nerves. When you place needles into these points, you are stimulating the peripheral nervous system, which sends a message to the central nervous system. A drug like Neurontin for pain also stimulates the central nervous system, but does it through chemical means.
MED: We know that acupuncture has been used in Eastern medicine for centuries, but is there any science behind it?
DF: There is, but many of the studies have been done outside the U.S. and do not meet our standards for methods and control groups. There are more studies now being done in the U.S. and the WHO in 1997 did a review of the literature on acupuncture from across the world. The science we do have suggests that about 75 percent of patients will see a response with acupuncture. In the two years that I have been offering it, I have found that my own results with patients are pretty close to that.
MED: What kinds of conditions can be treated with acupuncture? And how do you decide who is a good candidate?
DF: Acupunctures melds very well with family practice because of the variety of problems I treat. Acupuncture is often associated with treatment of chronic pain, but I also use it to relieve menopausal hot flashes, anxiety and depression, chronic abdominal pain, constipation and diarrhea, dysmenorrhea, fertility issues and seasonal allergies. Most of my patients have already had the appropriate medical workup for their complaint and have either tried a few treatments and not gotten relief, or were bothered by the side effects. Some of these are my own patients, some are patients of my partners in the clinic, and some are referred by outside physicians. Some patients have read about acupuncture and are self-referred. In these cases, we always make sure that they have had a full medical workup first and I do a consultation with every patient to determine if I think acupuncture could help them.
MED: How many treatments – and how many needles – are needed before a patient could expect to see results?
DF: New patitns need to come in at least once a week, because the effects of acupuncture are cumulative. I tell patients not to expect much change from the first three treatments, but by the sixth treatment, we usually know if we are going to see results and may decide at that point if we should stop or we should go ahead and do another six treatments. If a patient has had their condition for a long time, it is going to take longer to treat them. Patients with acute conditions usually see faster results.
Depending on what you’re treating, you may use as few as 4 acupuncture points or as many as 10. We’re treating them bilaterally, so you could have as few as 8 needles or as many as 20. At each appointment, needles are left in place for 20 minutes, or 30 minutes if you are doing ear acupuncture, which I also offer. Some people may need to come back for more treatments after a few months, and others with more acute problems may not need to come back at all.
MED: What has been the reaction of your physician colleagues to acupuncture?
DF: When I first started doing this, I expected that younger physicians would be the most open-minded and accepting of it, but I have found the opposite to be true. Many long-time doctors are very open about it. I think, the longer you practice, the more you realize that you don’t have all the answers. I have found the same thing with patients. Many seniors have chronic problems that they just haven’t been able to find relief for, or they may be on multiple medications and want to avoid another drug.
MED: Does the fact that you have an MD have any impact on your acupuncture practice?
DF: I think there is a comfort level for patient in having a physician offer them the treatment. And because of my medical knowledge I can always refer them back if they need another kind of treatment. My goal is to take the best form Eastern and Western medicine and combine them to offer the best possible treatment for each individual patient and condition.