Let Us Tell You about Our AERD! No, wait, come back...
Granted, you have to be a true safety nerd to get excited about an adverse events reporting database. Given that the acupuncture profession has never actually had one, though, we thought when we made one back in 2018, everybody else would be at least receptive, even if they didn’t share in our nerdy joy. And some acupuncturists were very supportive, which was nice. But we got a lot of resistance also, which we didn’t expect.
The main themes of this resistance could be summarized as:
Acupuncture is so safe compared to other medical interventions that we shouldn’t have to think about it - how is this even a thing?
Collecting data about acupuncture adverse events will make us look bad -- why are you MAKING this a thing?
The Clean Needle Technique Manual and certification is the only safety thing that acupuncturists need; and,
Patients are liars.
We knew that the acupuncture profession was not exactly blessed with a safety-positive attitude, but -- AERD haters? Seriously?
The Clean Needle Technique Manual is a great thing for acupuncture safety, especially if you’re a nerd; it’s beautifully organized, detailed and comprehensive. It includes “a review of the medical literature detailing the safety of various acupuncture and related AOM practices along with the uncommon risks or complications that may arise from these practices.” But it’s not the only safety thing acupuncturists need.
There’s an obvious delay between the time an adverse event happens and when it makes it into the medical literature. It would be good to have a means to learn about AEs sooner, a quicker feedback loop. As Jersey wrote, establishing feedback loops creates safer clinical environments, “with information flowing in a cycle between us. Along with the information circulating, so does the authority and the power.”
Perceived adverse events will never make it into the medical literature. And “perceived adverse events” should not equal “patients are liars”. A perceived adverse event can be as big a deal for the patient and the acupuncturist as an objectively verified adverse event. Perceived adverse events need to be addressed appropriately by acupuncturists, both in their role as clinicians and their role as small business owners (90% of acupuncturists are small business owners) and addressing them appropriately doesn’t mean shouting “acupuncture safety is not a thing!”
Safety work is gathering information, sharing information, communicating. Safety is process more than product. Our AERD is one layer of homemade, imperfect acupuncture safety. Please stay tuned for more posts about what we’re learning from it. (Special thanks to Suzanne Morrissey, Associate Professor of Anthropology and Gender Studies at Whitman College, for being our AERD advisor.)