Abstract
In response to your editorial “Medical Acupuncture Increasing the Bandwidth of Specialty Care,” 1 in the October 2021 issue of the journal, we would like to share our story and opinion.
Medical acupuncture is a postgraduate program of study in Indonesia's education system. Graduate medical doctors can enroll in this program to become acupuncture specialists. 2 It is a challenge for medical doctors to not only learn the science of acupuncture, but also to collaborate with other medical specialists to improve the effectiveness of patient therapy.
In our daily practice, we are accustomed to having consultations with other specialists regarding severe pain, ventilator weaning in the intensive care unit, patients with neurologic deficits, chemotherapy-induced nausea and vomiting, in vitro fertilization, mental health problems, skin health problems, gastrointestinal diseases, and constipation.
Our department collaborates closely with our geriatrics department to address the needs of elderly people hospitalized for a variety of reasons. We are frequently astounded to discover that the general quality of life (QoL) of the patients we treat has improved despite their initial complaints.
One case was a 61-year-old woman who presented with significant dyspnea and was diagnosed with hospital-acquired pneumonia, functional class III heart failure, diabetes, and stage 5 chronic renal disease. This woman came to us initially with constipation. Constipation is resistant to normal treatments and must be treated immediately because, if left untreated, it might impair a patient's heart and lung function. Not only was the patient's constipation alleviated after only five sessions of acupuncture therapy, but also her shortness of breath was reduced, enabling her to be discharged from the hospital and receive outpatient treatment. The patient noticed an improvement in her general QoL following her acupuncture therapy.
It remains a problem in our educational system to convey to other professionals how acupuncture works not only on a single issue, but also on restoring the body's equilibrium. We expect that there will be a significant increase in the number of publications on high-quality clinical trials in the future, which will make it easier for us to explain, convince, and work with other medical specialists.
Numerous initiatives have been taken to promote medical acupuncture among other professionals. Our residents often conduct research on the efficacy of combining acupuncture with conventional biomedical treatments. Then, using previously published articles and evidence-based studies, we attempt to cooperate with a variety of other specialists and become active in the development of therapeutic pathways in our hospital. Additionally, our department frequently organizes symposiums and webinars in collaboration with experts from other areas of medicine to explore specific problems.
Recently, due to the impact of the COVID-19 pandemic, we have been encouraged to conduct several studies on the effectiveness of acupuncture to improve immunity and mental health in patients who have COVID-19; some of these studies have been published.3,4 Our department was also invited by the Indonesian Ministry of Health to develop an acupressure module for health workers, so that they can educate their patients on how to cope with physical and mental health issues in the midst of the pandemic. 5
The Ministry of Health of Republic of Indonesia, has been developing self-care acupressure since 2000, by arranging an acupressure Appropriate Technology training for mild complaints for health personnel as a guide to instruct the community. Since March 2020, the world has been battling the COVID-19 pandemic, making acupressure self-care an alternative therapeutic opportunity for addressing a variety of complaints through training for health personnel to overcome various conditions; this modality has had proven success in improving the health status of patients.
Numerous studies have demonstrated that acupressure at PC-6 may be beneficial for nausea and vomiting reduction. The National Institute for Health and Care Excellence (NICE) supports acupressure at PC-6, in its guidelines for addressing hyperemesis gravidarum (HG), which is consistent with the recommendations of several obstetric societies in various countries. Additionally, because PC-6 is located on the forearm, self-care acupressure at this point can be considered a therapeutic alternative for reducing during the COVID-19 pandemic. 6
Since 2015, medical acupuncture services in our country have been excluded from the national insurance system due to new regulations. This could obstruct our efforts to promote acupuncture to other specialists. However, we never give up hope, and we continue our efforts in the hope that medical acupuncture services may be reintroduced into the national insurance system in the future, benefiting a greater number of patients.