Friday, July 03, 2009
Here's an article Dr. Brendan Armm was mentioned in and photographed for while treating a patient on the Acute Rehabilitation Unit at Good Samaritan Hospital in downtown Los Angeles, for a publication called The American Acupuncturist -- AAOM’s Official Publication for Practitioners of Oriental medicine - News Editions, www.aaom.org, Winter 2006, Vol 38. The article is written by Dr. Armm’s then supervisor in the hospital, Dr. Jeannette Painovich, DAOM, LAc, MA, and it is titled “Acupuncture Program Sets Smooth Sail in Unchartered Territory”.
“As you can see, acupuncture finds a greater place in hospitals in the United States. I recall how well the eastern and western medicines integrated in Hospitals in Beijing, Shanghai and Nanjing, China in 2005. Hope you enjoy this important article”. - Dr. Brendan Armm
The American Acupuncturist
AAOM’s Official Publication for Practitioners of Oriental medicine - News Edition
Winter 2006, Vol 38
Acupuncture Program Sets Smooth Sail in Unchartered Territory
By Jeannette Painovich, DAOM, LAc, MA
September 1, 2006 marked the two–year anniversary of the acupuncture fellowship program at Good Samaritan Hospital, Los Angeles, CA. Through this program doctoral students from Emperor’s College of Traditional Oriental Medicine (ECTOM) have been treating patients on the acute rehabilitation unit and, at times, in the emergency department. This clinical externship was instituted in unchartered territory; there was mild trepidation intermixed with many high hopes that the initial objectives of the program would be met.
The first goal of the program was to assimilate acupuncturists into the treatment teams in the both the acute rehabilitation unit and emergency department. Achieving the first objective would then afford the next purpose, which was to provide the doctoral students an opportunity to treat a unique patient population from which they could truly grow as clinicians. The third and fourth goals were to educate the patients and Western medical staff on the benefits of Traditional Oriental Medicine (TOM) and, through this program, increase the awareness of TOM to the general population as a whole. The last goal, which should inherently be present whenever we employ TOM, was to enhance treatment outcomes and increase patient satisfaction as well as their overall quality of life.
Assimilating into the acute rehabilitation unit has been and continues to be a smooth process. The acupuncturists on the floor are seen as an important modality in the patients’ recoveries and have been successfully integrated within the unit’s treatment team approach. There have even been times when the acupuncturists and physical therapists have simultaneously treated patients. When asked to comment on her current experience at Good Samaritan Hospital, Asha Randall, a doctoral candidate stated that, “First of all, I believe the interaction between the Western medical personnel and DAOM candidates has been very encouraging and positive. They have welcomed us into their midst and are respectful of what we do. There is an ongoing dialogue between the hospital staff and ‘us’...as we spread the word and they see the results.”
The emergency department, while theoretically a perfect setting for acupuncture intervention, had some inherent procedural problems. Legally, an acupuncture treatment cannot commence until it is ordered by the ER physician. Unfortunately, patients who could readily have been helped with acupuncture—such as those presenting with musculoskeletal, migraine, or gastrointestinal complaints—would at times not be seen for hours because patients are attended to by the physician in order of their emergent nature. Due to this extended wait for treatment, it was felt that the students would be better served by treatment on the acute rehabilitation unit where the patients are in abundance and readily available. However, if the doctoral student population increases and issues of transition time can be remedied, treating in the ER will be reinstituted. The ER medical staff is seemingly anxious for our return after being readily impressed by the doctoral students’ abilities to reduce the pain of a dislocated ankle with acupuncture, as well as wake up in ten minutes a patient who had been in a drug induced stupor for the previous twelve hours.
Treating conditions rarely seen in the outpatient setting, as well as treating the acute onset of ill health, has provided the doctoral students with unique clinical training. They consistently have treated conditions such as stroke sequelae, post-operative total hip and knee replacements, and post-surgical back pain, as well as more unique conditions, such as West Nile virus, rhabdomyolysis, Guillien-Barre syndrome, amputation–related pain, normal pressure hydrocephaly, and paraplegia. Because patients on the acute rehabilitation unit are usually admitted for two to three weeks, the students have witnessed both the immediate and culmination effects of their treatment as well as the effect of the whole team approach to healthcare. As Todd Gibson, a current DAOM acupuncture fellow, stated, “It’s nice to work on more serious cases such as those found in the hospital setting. I enjoy watching the patient’s progress. I feel like I’m regaining a lot of the passion I had eight or nine years ago.” Don Buck, a recent graduate from the charter ECTOM doctoral cohort stated that, “The unique patient population I treated while at Good Samaritan Hospital definitely enhanced my skills as a clinician as well as allowed me to recognize the how effective acupuncture is in the acute care setting.”
Educating both the patients and medical staff alike to the benefits of acupuncture and Oriental medicine is strongly stressed in this program for two reasons. Having a presence in the Western medical setting provides an exceptional opportunity to educate the public about TOM, and as a profession we must take advantage of this captive audience. The other benefit of stressing education in this setting is that it forces the students to become proficient in understanding and translating Western medical terminology into a TOM language that laypeople and the biomedical world can understand. Continuous communication in this fashion infuses the students with a level of confidence that they will be able to employ throughout their career.
When instituting a program such as this, the long–term goal was to increase the visibility of acupuncture and TOM to both the hospital staff and the general population.
After slow but steady progress, this began to happen. Due to the success of the program, the hospital administration has dedicated resources to help obtain funding to increase acupuncture coverage in the hospital so that a two–year pilot study can be conducted. It is the hospital’s hope that between an increase in program marketing and the prestige of a funded research study, word of this leading–edge acupuncture program at Good Samaritan Hospital will be spread to the general population and the medical world alike.
Increased patient satisfaction attributed to their acupuncture experience was one of the main reasons the hospital administration and staff took notice of this program. Given today’s increase in medical expenditures, as well as a growing trend in patient dissatisfaction with the current state of healthcare services, our system is in need of interventions that can positively impact patient care. By in large, the patients treated with acupuncture reported positive experiences and truly felt that acupuncture enhanced their recovery. Don Buck also stated when reflecting on his Good Samaritan experience that, “one of the best parts of the program was seeing the patient’s eyes light up when they would get immediate pain relief or more function in a limb after a treatment.”
Jorge Minor MD, medical director of the acute rehabilitation unit, summed up the program’s success: “Patients are pleased with the addition of acupuncture as a treatment modality in the menu course of therapies for such conditions as stroke, trauma and pain management. More physicians are becoming aware of our services and are quite interested in the studies we hope to conduct in the near future. Our long term goals for the program include trying to secure an NIH [National Institutes of Health] grant with which to conduct research on acupuncture in the inpatient setting.”
Ideally our entire profession, along with the students, educational institution, and biomedical world, will benefit from the learning experience that the first two years of this program have provided. This doctoral fellowship has successfully demonstrated that a collective presence in the hospital setting can provide a powerful avenue for increasing visibility of the profession as well as positively impacting patient care. It is my hope that this program will provoke similar externships to be instituted around the country. As we work together to integrate into more hospitals or similar healthcare settings, the value of our medicine will be exponentially realized, benefiting not only direct patient care but also the well-being of the healthcare system as a whole.
Any inquiries about this article can be directed to Dr. Jeannette Painovich at Painovich@aol.com. I am happy to announce that due to the success of the fellowship program, Good Samaritan Hospital has just been awarded a $220,000 grant to study the benefits of using acupuncture in the hospital setting. This two year study, which will be done in conjunction with Emperor’s College of Traditional Chinese Medicine, will examine how the use acupuncture can impact health outcomes and patient satisfaction as well as healthcare resource use and cost savings. This study will also begin the process of determining the feasibility and best use of acupuncture as an adjunctive therapy in the hospital setting. You can find more articles detailing this exciting new research in following issues of the American Acupuncturist.
Dr. Brendan Armm practices in Santa Monica, Calif., and teaches Oriental medicine and meditation at Emperor’s College of Traditional Oriental Medicine. He can be reached at www.lotusew.com or firstname.lastname@example.org.