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If you're seeing an anesthesiologist for a series of 3 epidurals, you're probably not going to develop much of a relationship with him. ST: What kind of effort can be made to propagate the kind of treatment protocols you are using and that are used in acupuncture when you have an entire national healthcare system pushing against you? JF: The transcranial direct current stimulation that I use for treatment-resistant depression and chronic pain is still considered experimental, and in spite of a complete absence of side effects and 1300 published scientific articles, it's clinically available only in Atlanta, Boston, and New York. A grass-roots demand results from awareness, efficacy, and to some extent luck, but clinicians need to persevere in what they believe. Treatments change as a result of discovery and new paradigms. For example, 70 years ago depression was treated with psycho- therapy based on the social action model. It was superseded by the neurophysiological theory of depression, which results from low levels of neurotransmitters that can be corrected with pharmaceuticals. ST: Yes, and that has turned psychiatrists into psycho-pharmacologists. JF: Precisely. Reimbursement is now provided for medication management. Although psychotherapy is equally effective, the reim- bursement is limited or non-existent, primarily because it's more expensive and insurance providers don't want to pay for it. The new neural plasticity theory of depression is resulting in a new paradigm utilizing minute amounts of electromagnetic and electrical energy to alter brain function. These procedures are even more effective than psychotherapy and medications. And they produce no side effects. ST: So, to access this kind of treatment education of the public is a very real issue. JF: Knowledge is extremely important and educating patients is the key that provides them the ability to determine their treatment options. ST: Dr. Huang, what about patient/provider education from your point of view? How important is it? WH: Patient/provider education is very important. Again, take acupuncture as an example. People really support the use of acupuncture. However, we did a survey study that showed the providers have heard about acupuncture, but are still hesitant about referring because they don't know what kind of conditions they can refer to acupuncturists and whom they can refer to. Therefore, provider education is very important in that sense. It's the same for patients, education is important as well. Patients usually love the idea that acupuncture is non-invasive and would rather have acupuncture than taking pills or going through surgeries. I have a colon cancer patient with liver metastasis who went to an outside acupuncturist. The acupuncturist told him that he only needs acupuncture, but not chemotherapy. I know that acupuncture can help patients going through chemotherapy, but I do not believe acupuncture alone is able to treat metastatic cancer. Educating patients is an important task for providers so that they won't be misled by wrong information. ST: Right. Now, you mentioned to me that you took a six-month course in acupuncture techniques. I am seeing that some of the doctoral programs are quite variable in length and scope of curriculum. If there were a national exam WH: For licensed acupuncturists to really go mainstream, and to have a system monitoring the quality of the acupuncturists, I think it's one of the most important things, yes, of course, to get some kind of standardized or national credential. Also, you know, patient referrals are always important. I always tell people, Always ask people who you will see in the clinic you are going to. If you get positive feedback, then it's probably good. If you have people saying negative things, think twice. ST: Do you find that your colleagues have been very supportive of your effort? WH: Yes. Actually, that's kind of amusing because some of them even want acupuncture done to them. ST: It says in your biography that you work with chronic pain patients and sleep disorders. WH: Chronic pain patients comprise the largest population referred to me. These patients have almost end stage chronic pain. Usually they tried everything under the sun, and nothing worked. Then the physicians refer them to me. I did a couple of survey studies. The success rate in my clinic is above 75% in this group. ST: That's very, very successful. WH: Yes, huge. Acupuncture first of all, is very safe. Secondly, it doesn't involve chemicals or alter the body structure. Certainly, it is less costly than, for instance, surgery. Therefore, I really would like to see providers refer pain patients to acupuncture before they become end stage. For instance, before the providers load them up with all the medications, or load them with all the injections, just try acupuncture first. If acupuncture fails, then they can go to other routes of treatment. Wouldn't it be great to have a system set up this way? I believe this approach is used in Europe for example, and in some countries in Asia as well. Here in the US, it's almost like acupuncture is the last resort. In fact, surgery should be the last resort.
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