Let The Infections Continue

The results are in from the hearing to adopt a rule in Oregon that

would require Oregon licensees practicing acupuncture to follow clean needle technique and require the use of only disposable, single-use acupuncture needles.

It was decided not to adopt the rule.

Instead of making best practice a rule,

the OMB determined it would be most appropriate to partner with the OAAOM to establish clean needle technique as the standard of care in the acupuncture profession through educational outreach rather than rulemaking.

Education? As often as not education does not alter practice.

Widely used CME delivery methods such as conferences have little direct impact on improving professional practice

Nor do practitioners always follow guidelines.

A few weeks ago I saw a patient with S. aureus bacteremia that was probably due to acupuncture through eczema on the skin. I discussed the case over at Medscape. Although the patient clearly told me the acupuncturist put the needle in his forehead through obvious eczema, an acupuncturist noted in the comments

Regarding your comment about needling through eczema, it is unlikely. Acupuncturist will never needle through a skin lesion - no exception.

The literature on infections from acupuncture is clear with a quick Pubmed. The videos and photographs of acupuncture from a Google search gives an ID doctor the heebie jeebies. I would not be sanguine that practitioners whose understanding of disease and its treatment revolves around mythical meridians and qi will be punctilious about infection control and good technique.

I have been involved with quality control for 26 years and the best ways, unfortunately, to change practice for the better are to make the practice a rule, link payments to the practice or publicly report the practice.  

The approach by the OMM is likely to fail.  And supports my contention that pseudo-medical providers never change or abandon practice to increase patient safety.  So it appears that acupuncturists will continue to use poor technique. And I will continue to see the occasional infection denied by the acupuncturist. Same as it ever was.