Why Tunbridge Wells Hospital should get an Acupuncture Department

 

There are many, many, reasons why the Western health system needs to use more acupuncture. For starters acupuncture is cheap safe and effective; Western medicine by comparison tends to be expensive and relatively dangerous.

Take a headache: 

The patient comes to the hospital because they want to get rid of their headache. They may be concerned about a brain tumour, or perhaps a bleed, but generally they just want it gone.

'Foot overlooking tears' GB-41 is a fantastic point for tension headaches 

'Foot overlooking tears' GB-41 is a fantastic point for tension headaches 

Most Emergency departments now run like factories. On arrival they'll be triaged and then sent for blood tests before they see the doctor; they'll probably be given some pain killers at this time too. The blood tests are to ensure that NHS targets can be met, not for the benefit of the patient as many will be unnecessary. However, in the crazy centrally-planned business model of the NHS it's cheaper to bleed patients than miss targets.

Then, in due time, they'll be seen by a doctor. The doctor will take a history and perform an examination to decide on what further treatment and investigations are needed. 

This is the point where acupuncture could be given with relatively little effect on waiting times or delay in treatment. I know this because I've done it... well, I've used acupressure anyway (GB-41 ZuLinQi is a personal favourite)

Safe, cheap, effective... and I would argue in the cases it worked... curative.

Western medicine is increasingly driven by algorithms.

Western medicine is increasingly driven by algorithms.

This doesn't happen though... Why? 

In a word: dogma. There's no logical reason not too. NICE even recommend it for headaches. 

Instead of a simple curative safe treatment, the Western medicine algorithm takes a different altogether nastier turn.

To CT or not to CT: that is the question.

A good Emergency doctor knows there are only about eight serious causes of headache that need to be ruled out in the ED; the rest can wait.

They are:

  • Glaucoma (would have red eye);
  • Temporal arteritis (would have painful temples and be elderly); & then 
  • brain tumour, brain bleed, venous thrombosis; meningitis, carotid dissection, severe sinusitis/mastoiditis. 

All of these latter ones require a CT to rule out (most people do CT pre-spinal tap for meningitis).

Furthermore, if the patient came enough they would get themselves a CT just for perseverance. 

Lead glass is not there to augment 'placebo effect'

Lead glass is not there to augment 'placebo effect'

So what's the problem? Well, it has been estimated from survivors of Hiroshima and Nagasaki that these scans will add a 1 in 1000 increased risk of fatal cancer per scan. This has been backed up by this study, so a 1 in 1000 chance of cancer is looking increasingly accurate.

Bizarrely, doctors appear to have cognitive dissonance with this fact. I've had conversations within the lead-glass sealed scan rooms; I've pointed to the elaborate system of lights, warning, and personal radiation monitors; yet colleagues still find it not-credible that their CT scans could actually cause cancer. What is all that elaborate and expensive safety equipment for if not to protect the clinicians?

With an annual CT rate of 5 million in the UK alone that means the medical establishment is causing thousands of cancers a year. Thousands! 

Our headache patient is now facing a problem. A nervy intern, burnt consultant, over-cautious resident, or even inept junior may all go for the nuclear option; for no-one has ever been sued for nuking a patient and causing cancer. Causality... It's very difficult to prove that that CT scan twenty years ago caused your thyroid cancer.

The patient is in a vulnerable position and almost certainly, once the clinician goes down that arm of the algorithm, they're going to get that CT scan.

So the (NHS) bill for treatment is now approaching £1 000; the patient has just got an increased chance of cancer; the world is now a slightly more polluted place and the headache is not even gone!

Meanwhile; the simple, time-tested, clean and safe technique of placing needles into spaces in the body to heal goes unused.

Madness, non?

It would be easy to introduce acupuncture into this system; a single question at triage:

'Would you like to have some acupuncture for your headache?' followed by a checklist making sure no red-flags were present. Then send the patient down a simpler, nicer, cheaper pathway. 

That's why Tunbridge Wells Hospital (and all hospitals) should get an acupuncture department - its better medicine!