Acupuncture Program Sets Smooth Sail in Unchartered Territory

By: Dr. Jeannette Painovich, DAOM, LAc, MA

September 1st marked the two year anniversary of the acupuncture fellowship program at Good Samaritan Hospital where doctoral students from Emperor’s College of Traditional Oriental Medicine (ECTOM) have been treating patients on the acute rehabilitation unit and at times, the emergency room. Given that this clinical externship was instituted in unchartered territory, there was mild trepidation intermixed with many high hopes that the initial objectives of the program would be met. The first goal of the program was to assimilate acupuncturists into the treatment teams in the both the acute rehabilitation unit and emergency room. Achieving the first objective would then afford the next purpose which was to provide the doctoral students with an opportunity to treat a unique patient population from which they could truly grow as clinicians. The third and fourth goals were to educate the patients and western medical staff on the benefits of Traditional Oriental Medicine (TOM) and through this program, increase the awareness of TOM to the general population as a whole. The last goal, which should inherently be present whenever we employ TOM, was to enhance treatment outcomes, increase patient satisfaction and overall quality of life.

Assimilating into the acute rehabilitation unit has been and continues to be a smooth process. The acupuncturists on the floor are seen as an important modality in the patient’s recovery and have been successfully integrated within the unit’s treatment team approach. There have even been times when the acupuncturists and physical therapists have simultaneously treated patients. When asked to comment on her current experience at Good Samaritan Hospital, Asha Randall, a doctoral candidate stated that, “First of all, I believe the interaction between the western medical personnel and DAOM candidates has been very encouraging and positive. They have welcomed us into their midst and are respectful of what we do. There is an ongoing dialogue between the hospital staff and 'us'...as we spread the word and they see the results...”

The emergency room, albeit a perfect setting for acupuncture intervention, had some inherent procedural problems given the nature of the environment. Legally, an acupuncture treatment cannot ensue until it is ordered by the ER physician. Unfortunately, the patients that could be readily been helped with acupuncture, such as those presenting with musculoskeletal, migraine or gastrointestinal complaints, would at times take hours to be seen because patients are attended to by the physician in order of there emergent nature. Because of the extended wait for treatment orders, it was felt that the students would be better served on the acute rehabilitation unit where the patients are in abundance and readily available. However, if the doctoral student population increases and issue of transition time could be remedied, treating in the ER will be reinstituted. The ER medical staff is seemingly anxious for our return after being readily impressed by the doctoral student’s ability to reduce a dislocated ankle pain free with the use of acupuncture as well as wake up a patient in ten minutes who had been in a drug induced stupor for the previous twelve hours!

Treating conditions rarely seen in the outpatient setting as well as treating the acute onset of ill health has definitely provided the doctoral students with unique clinical training. They consistently have treated conditions such as stroke sequelae, post-operative total hip and knee replacements and post-surgical back pain but unique conditions such as west nile virus, rabdomyolysis, guillien barre, amputation related pain, normal pressure hydrocephaly and paraplegia have also seen, just to name a few. Because patients on the acute rehabilitation unit are usually admitted for two to three weeks, the students have witnessed both the immediate and culmination of their treatment effects as well as the effect of the whole team approach to healthcare. Todd Gibson, a current DAOM acupuncture fellow, put it nicely when he stated, “It's nice to work on more serious cases such as those found in the hospital setting. I enjoy watching the patient’s progress. I feel like I'm regaining a lot of the passion I had 8 or 9 years ago”. Don Buck, a recent graduate from the charter ECTOM doctoral cohort stated that, “The unique patient population I treated while at Good Samaritan Hospital definitely enhanced my skills as a clinician as well as allowed me to recognize the how effective acupuncture is in the acute care setting.”

Educating both the patients and medical staff alike to the benefits of acupuncture and oriental medicine is strongly stressed in this program for two reasons. Having a presence in the western medical setting provides an exceptional opportunity to educate persons about TOM and as a profession we must take advantage of this captive audience. The other benefit of stressing education in this setting is that it forces the students to become proficient in understanding and translating western medical terminology into a TOM language lay people and the biomedical world can understand. Continuous communication in this fashion infuses a level of confidence into the students that they will be able to employ throughout their career.

When employing a program such as this, the long term goal was to increase the visibility of acupuncture and TOM to both the hospital staff and general population. After slow but steady progress, this began to happen. Due to the success of the program, the hospital administration has dedicated resources to help obtain funding to increase acupuncture coverage in the hospital so that a two year pilot study can be conducted. It is the hospitals hope that between an increase in program marketing as well as funding for the study proposal that word of this leading edge acupuncture program at Good Samaritan Hospital will be spread to the general population and medical world alike.

Increased patient satisfaction attributed to their acupuncture experience was one of the main reasons the hospital administration and staff took notice of this program. Given today’s increase in medical expenditures as well as a growing trend in patient dissatisfaction with the healthcare, our system is in need of interventions that can positively impact patient care. By in large, the patients treated with acupuncture reported positive experiences and truly felt that acupuncture enhanced their recovery. Don Buck also stated when reflecting on his Good Samaritan experience that, “one of the best parts of the program was seeing the patients eyes light up when they would get immediate pain relief or more function in a limb after a treatment”.

Dr. Jorge Minor, Medical Director of the acute rehabilitation unit summed up the programs success when he stated that “Patients are pleased with the addition of acupuncture as a treatment modality in the menu course of therapies for such conditions as stroke, trauma and pain management. More physicians are becoming aware of our services and quite interested in the studies we hope to conduct in the near future. Our long term goals for the program include trying to secure an NIH grant with which to conduct research on acupuncture in the inpatient setting”.

Ideally our entire profession will benefit, along with the students, educational institution and biomedical world, from the learning experience that the first two years of this program have provided. This doctoral fellowship has successfully demonstrated that a collective presence in the hospital setting can provide a powerful avenue for increasing visibility of the profession as well as positively impacting patient care. That being said, it is my hope that this program will provoke similar externships to be instituted around the country. As we work together to integrate into more hospitals or similar healthcare settings, the value of our medicine, not only in direct patient care but for the wellbeing of the healthcare system as a whole, will be exponentially realized.

Any inquiries about this article can be directed to Jeannette Painovich at Painovich@aol.com.

Dr. Jeannette Painovich, DAOM, LAc, MA,began her studies in Traditional Chinese Medicine in 1997 and completed her Masters Degree in 2000 and her Doctorate in Acupuncture and Oriental Medicine in 2006. She has been in private practice in Los Alamitos and Los Angeles, California for the past six years. In Los Alamitos, Jeannette has a family medicine based practice with an emphasis in women’s health where she also serves as the Director of Integrative Medicine for the Sklar Center for Women’s Wellness. In Los Angeles, her specialty is hospital-based medicine and is the founder and director of the Emperor’s College of Traditional Oriental Medicine’s inpatient doctoral fellowship program at Good Samaritan Hospital. Prior to beginning her career in TCM, Jeannette worked as a masters degreed exercise physiologist for 12 years at Good Samaritan Hospital and specialized in cardiovascular disease.