Medical Acupuncture: The Department of Veterans Affairs

In this special issue of the Medical Acupuncture journal, we are pleased to have innovative acupuncture articles from the Department of Veterans Affairs (DVA). Acupuncture is becoming well-established in the DVA. For the benefit of our international readership, a little history is offered here: The DVA was established on July 21, 1930. Previously the independent Veterans' Bureau, the Bureau of Pensions, and the National Homes of Disabled Volunteer Soldiers were attempts to offer care for our veterans. Historically, the English colonies in North America provided pensions for disabled veterans, and the first law in the English colonies in North America was enacted in 1636 by Plymouth for veterans who became disabled in the colony's defense against some Native Americans.¹ Throughout the history of the United States an effort was made to care for veterans who served in the defense of our nation. Today, more than 9 million veterans are served per year, being treated at 1061 outpatient sites and at 170 Veterans Administration (VA) medical centers.² There are ∼21.8 million veterans in the United States and the DVA is the largest integrative healthcare system in our country.²

The VA provides the latest healthcare to veterans, not only keeping on a par with the state-of-the-art of medical practice, but even formulating avant-garde approaches to benefit the veteran patient population. Since its inception, the VA remains at the forefront of U.S. medicine, having contributed to many pioneering advances and earning international awards and recognition.³ In fact, 3 clinicians have received separate Nobel Prizes in Physiology or Medicine.⁴

Herewith a snapshot view of this special issue: The VA expands and embraces its use of acupuncture. Auricular acupuncture is very much at the forefront. Many veterans also seek this care at military hospitals. You will read about the acupuncture-research initiatives that clinicians are performing in such areas as: chronic pain; insomnia; pain reduction during colonoscopy; and auricular acupuncture use prior to Botulinum toxin A administration. Incorporation of acupuncture and other alternative medical modalities poses a challenge for changing the conventional implementation of care. Having licensed acupuncturists in the VA system is becoming a reality. I wonder: Will we eventually see the establishment of devoted acupuncture departments together with Western Medicine departments? Finally, is East meeting West or vice versa?

Acupuncture in a hospital system is a challenging effort not only for clinicians, but for administrative staffs and patients. Think of acupuncture as a source of beneficial technology. The technology should be chosen to accomplish a particular function for a patient's medical needs, such as resolution of acute or chronic pain, depression, dermatologic conditions, mood disorders, etc. One technology may not be all-inclusive; however, acupuncture offers tremendous flexibility for remedying pathologic challenges. Research has to be conducted to determine whether or not this technology meets the clinical objectives. Does it really work? Can we determine that it is easy to learn, safe, and reproducible? Data must be available that comprise convincing evidence. This determination may be a result of clinical trials and substantial literature reviews. Healthcare providers must be absolutely motivated, not only to learn new technology but to apply it in practice. Many practitioners start the training but never implement it into their clinics.

It is evident that the VA is moving to adopt acupuncture. This forward movement will be characterized by a greater understanding of acupuncture and the continued development of even other integrative-medicine modalities. History tells us that the VA is well-situated to accomplish this task. I could not imagine otherwise.