The Kansas Senate is working toward a compromise this session on a bill that would require licenses for acupuncturists.
Senators are trying to find a path to passage that mollifies licensed physical therapists and chiropractors who use a procedure called “dry needling” to treat pain and muscle stiffness and acupuncturists who specialize in Eastern-style medicine.
Groups that represent osteopathic medicine providers and the Kansas Association of Oriental Medicine support Senate Bill 363 as a way to bring more uniform standards and credibility to the Kansas acupuncture industry.
They noted that Kansas is one of only five states that does not require a license to practice acupuncture.
Their call for more regulations of their own industry echoes that of massage therapy providers who made the same arguments last year on a bill that has not passed.
But SB 363 would require an acupuncture license for “dry needling” as well as traditional Eastern-style acupuncture. That drew opposition from physical therapists, some of whom already have been doing dry needling because they believed the practice fell under the part of their license that allows for “manual therapy.”
Dry needling and acupuncture use similar needles, but acupuncture is based on traditional Chinese ideas about the flow of energy in the body and dry needling is based on Western ideas about nerves and trigger points within muscles.
The ailments treated by acupuncture and dry needling may vary, too. While acupuncture can be used to treat everything from depression to weight loss to pain, dry needling is only used to treat pain and restore muscle movement, said Susie Harms, president of the Kansas Physical Therapy Association.
Physical therapists don’t oppose the acupuncture license itself, Harms said.
“I think that would be a very good thing for people in Kansas because it assures a certain level of competency and training by the acupuncturists,” she said. “But when they decided to define acupuncture and include terms used by physical therapists, that interferes with our scope of practice.”
Ironing out the concerns
Senators tried to iron out the physical therapists’ concerns with amendments when the acupuncture licensing bill went to the Senate floor last month but found they needed more time.
So the bill went back to the Senate Public Health and Welfare Committee, which had a hearing Wednesday on a second bill meant to resolve the dry needling question for physical therapists so the acupuncture licensing measure can move forward.
Senate Bill 490 would add dry needling to the scope of practice of physical therapy licenses, so physical therapists who want to perform that service for patients wouldn’t need to get a separate license.
But the hearing on that bill brought opposition from chiropractors, who said they receive more education on the procedure under their license than physical therapists do under theirs.
Travis Oller, legislative chair of the Kansas Chiropractic Association, said some physical therapists may not have the appropriate training to perform dry needling.
In a phone interview after the hearing, Oller said patient safety is his group’s main concern when talking about a procedure that involves sharp objects potentially being inserted near arteries.
“There are some fairly significant risks associated with dry needling,” Oller said.
But during the hearing Harms said most training on dry needling is done by physical therapists, and that a physical therapist’s education covers more than 80 percent of the dry needling curriculum.
“Physical therapists are educated and have the knowledge, and also do a lot of the research in dry needling,” she said.
Still, all the parties seemed confident they could iron things out after a little more discussion.
Representatives of the Kansas Association of Oriental Medicine, Kansas Physical Therapy Association and Kansas Chiropractic Association told committee members that they have come up with an agreement to resolve most of their differences over dry needling, which they will unveil in an amendment next week.
Diane Bellquist, a lawyer representing the Kansas Association of Oriental Medicine, described a Tuesday meeting of the three groups as “very productive.”
Rachelle Colombo, director of government affairs for the Kansas Medical Society, said the society would like to see a definition of dry needling but is pleased to see an outcome that likely will be acceptable to three groups.
“We come before you a lot, and it feels like turf battles,” she said. “This is an example of everyone working together.”
One patient who benefited from dry needling at the hands of a physical therapist told senators she wants to see a solution that allows it to continue.
Linda Beezley, a nurse practitioner from Lenexa, said integrating the technique with other physical therapy treatments helped her fully recover from an injury when traditional physical therapy alone wasn’t enough.
“I felt like I was meeting a place where I was no longer progressing (with traditional physical therapy),” she said. “(Dry needling) works. I’m back to running marathons.”
“We come before you a lot, and it feels like turf battles. This is an example of everyone working together.”- Rachelle Colombo, director of government affairs for the Kansas Medical Society
The original licensure bill would require acupuncturists to use a set of sterile, prepackaged needles on one patient and for one session, and would require acupuncturists to treat patient information with the same confidentiality expected of physicians.
It also would create an advisory committee that would help the Board of Healing Arts develop standards for continuing education, professional conduct and changes in the field. The board could suspend or revoke an acupuncture license for violation, or assess fines of up to $2,000 for a first violation, $5,000 for a second violation and $10,000 for a third violation.
Acupuncturists would have to renew the license each year and maintain liability insurance. Current acupuncturists who wish to be grandfathered in would have to show they had at least 1,350 hours of training and performed 1,500 visits in three of the previous five years.
Senate leaders have routed SB 363 through a committee that is exempt from a legislative deadline that passed last month. They’ve done the same for SB490.
— KHI News Service writers Megan Hart and Andy Marso contributed to this story.