Kind of Like a Pit Bull
Before I was the chief administrator of an acupuncture school, I was aware of the oddness of the acupuncture profession’s approach to safety but it didn’t bother me in the way that it bothers me now. I thought there was something that didn’t quite add up, but it wasn’t exactly my problem. Now it is EXACTLY my problem (hence this blog).
But let’s talk about dogs! (That sounds like a non sequitur but give me a minute, I promise it’s not. Though I admit I always want to talk about dogs.)
In a similar way that the acupuncture profession specifically tries to weaponize safety against physical therapists, in a general way it treats safety like a watchdog guarding the perimeter of the profession against possible intruders. Even the Clean Needle Technique Manual says meaningfully, “Licensed acupuncturists in the U.S. are well-trained. As noted in the introduction to this manual, there are a number of healthcare practitioners, however, who utilize acupuncture with minimal and inadequate training.” A common argument among acupuncturists worried about encroachment from other practitioners is that nobody can safely practice acupuncture without at least three years of post graduate training at an accredited acupuncture school.
Before I spent years of my life painstakingly defining educational objectives and outcomes for virtually every hour of a 2000+ hour entry-level acupuncture program, I didn’t fully grasp how much magical thinking was involved in that argument. Especially in acupuncture programs that emphasize biomedical science, there are many hours devoted to topics that don’t include acupuncture safety. No, you do not need a class in physics to safely practice acupuncture, nor for that matter, physiology and pathology. These classes might be valuable for other reasons, but they don’t help with acupuncture safety. (I took physics and pathology and all the other science classes my alma mater required; I thought they were interesting but I promise you, they have helped me not one bit with any of these.) POCA Tech's program devotes a lot of hours to the history of acupuncture and Chinese medicine because we think it’s important -- but does being familiar with the I Ching and the Huang Di Nei Jing ensure that you will be a safer practitioner than someone who has never opened those texts at all? Of course not; preparation for safe practice and total hours of training are not identical. If they were, it would be a lot simpler to write all those syllabi.
The more you look into the argument of "Master’s-level diploma equals safety", the less sense it makes. Training is certainly an important component of safety, but it’s one component among many; you wouldn't want to imply that once someone is trained, they'll never make a mistake. Hmm...acupuncturists insisting that acupuncture safety is not a legitimate topic EXCEPT for the part about how you need 2000+ hours of training not to screw it up? Sketchy, acupuncture profession, very sketchy.
Blurring the distinction between actual safety training and total hours of acupuncture education doesn’t help create or maintain appropriate safety training. On the contrary, I think it makes us inattentive to what students actually need to become safe, confident, competent acupuncturists. Having been responsible for an acupuncture school for seven years now, I’m convinced that we need to stop thinking of safety as if it were a watchdog defending our turf against threats from outside the perimeter, and start thinking of it more like an emotional support dog taking care of what’s inside the perimeter.
Because it’s not like someone who graduates from a Master’s or even Doctoral level acupuncture program never needs to think about safety after they get their diploma. Once you cross the barrier from “outside the acupuncture profession” to “inside the acupuncture profession”, safety considerations ought to be your faithful companion who’s never far from your side. And not a companion who’s snapping and snarling and raising your stress levels, either, but a gentle presence keeping you company in ways that help you stay calm and focused. 90% of acupuncturists are self-employed, and small business is hard. Experiencing an adverse event can be stressful at best and devastating at worse. Our attitude of “acupuncture safety isn’t a thing until it’s a really bad thing” does nothing to promote the compassion and resilience that acupuncturists need to navigate safety issues.
What if safety wasn’t about showing our teeth and growling at strangers, but cultivating a non-judgmental, stabilizing presence? What if safety was about keeping ourselves emotionally regulated? What if safety was what got us to maintain consistent routines and good habits? What if safety mostly helped us pay attention to ourselves? One of the things I learned from having a fantastic emotional support dog who happened to be a pit bull was that most pit bulls make terrible watchdogs because they just love people so much. I think safety might be like that too: a lover, not a fighter.
To quote the CNT manual again, “AOM educational institutions now have...an accreditation mandate to cover bloodborne pathogens, safe practice, emergency procedures, risk management, and safety protocols in their curricula.” In other words, safety appears as a theme across a host of different classes, but not all of the classes in an acupuncture program. Sometime last year I realized it was very difficult to teach the safety topics that we need to without an overarching, safety-positive framework -- a way to tie it all together and help students pay attention to safety without being scared. One of the purposes of this blog is to generate the material for a fourth workbook in our series about the praxis of community acupuncture.
And also (this is a stretch goal for sure) to cultivate a better professional culture for our students to graduate into, one with a more positive -- maybe even cuddly -- approach to safety.