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Working Unregulated

Whist attending a Massage New Zealand talk last night I was inspired to hear about research & ideas from Rachel Ah Kit who attended the International Massage Therapy Research Conference in Seattle. The 2 main messages I got from this were:

  1. Massage is proven to work for pain relief: see,

  1. For us to actually share & use this knowledge with credibility, we have to keep using science, keep researching and keep improving education standards to be on equal footing with those in Primary healthcare. All so everyone can have access to what we in natural health already know.

Acupuncture is on a similar path. As education has improved so has the research. There are plenty of studies that have proven the efficacy of Acupuncture & TCM. But still there is doubt, and I think I know why. Acupuncture is still an unregulated industry in New Zealand.

As part of my training I was taught some massage and although I worked at a massage college for many years picking up more skills I am not a Massage Therapist. To me it is about professional respect for knowledge, time spent, safety & scope of practice; doing what you are trained to do.

It seems obvious, but unfortunately it is not the world we live in. A big part of working in unregulated industries is that anyone can do anything. Currently in Complementary, Allied Medicine (CAM) circles (which includes Physio's & Chiropractors) anyone can call themselves a Acupuncturist, Massage Therapist, NeuroMuscular therapist, etc. Most do have qualifications but the big problem is that many do not keep to the boundaries of what they were trained to do.

On the face of it it may not seem a big deal. It's a competitive world, most intelligent people can learn & turn their hand to many things and do it well - where's the harm?

Number one is safety. Many trades have struggled with the lack of regulation and have been plagued with "Cowboys" spoiling it for others and ruining credibility for the whole.

Most trades now work to compulsory regulation requirements in an effort to ensure consumers, employees, and investments are safe. Surely your health deserves the same, especially when it comes to placing needles?

Expectation when talking to clients is that this is already in place. Many are shocked that it is not. It is extremely worrying that this is not clear for the public. Without regulation to create consistent training levels and safe practice criteria we end up with many inconsistencies, and ultimately doubt for the profession creeps in.

According to the the Health Practitioners Competence Assurance Act 2003. Acupuncture (and Massage) is deemed "low risk" and we are left self regulate. Many such as myself choose voluntary regulation. We have the help of the Health & Disability act 2003 and Consumer Guarantee Act. Both of which basically state, we should play nice, stay within training & don't rip people off. However I don't believe this goes far enough when it comes to defining training requirements & and safety protocols for practitioners.

To me respect & integrity is also a consideration. Maybe this my idealist side coming out, to me all individuals strive to have a place in the world, one of the things we can do for ourselves is invest in education.

Even after many years in practice, it bugs me that a physio, massage therapist or MD can do a month long or even a weekend course in acupuncture or dry needling then add it to their practice. Despite my similar level qualifications in this area I can't do a weekend course in orthopedics then start at the out patients clinic on monday. Surely four years of needling practice & supervision is different, and what of TCM? Can we simply just strip this out of the equation? (Can of Worms, and a topic for another day).

New Zealand is one of the last westernised countries to have unregulated Acupuncture. Since compulsory regulation elsewhere Acupuncture qualifications have become standardised, a new level of professional has been attracted, and as a result research proving efficacy continues to improve. Acupuncturists are now appearing in hospital settings around the world and continue to add credibility and respect for holistic health practices.

Physiotherapy has been through this process over the last 20 years, When I started as an physio assistant at Sports Med in 1991 physiotherapy was unregulated and many held a 3 year diploma. Since then it has gone to a four year bachelors and changed to compulsory regulation. Nursing has also made this transition. Both have certainly benefited and cemented their place in the health system because of it.

However until compulsory regulation for Acupuncture is law in New Zealand we will continue to fight for credibility to hold our place among our CAM & primary health colleagues. All the while continuing the cycle of attracting practitioners who have variance in qualifications and standards of practice, ultimately contributing to an ongoing public perception of doubt for natural health practices, despite evidence that it works.

In the meantime I strongly suggest for Acupuncture, Massage, or what ever treatment you seek, always look for a voluntary registered practitioner such as myself to ensure you are getting the expertise you are paying for.

Nicci Blain

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