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SHORT TAKES TREATMENT OPTION Acupuncture in the ER ALLINA HEALTH HANNAH LYNCH, PHOTO BY In some Minnesota emergency departments, patients may opt for an alternative to pain- relief drugs. ain is a common complaint among Chris Kapsner, patients admitted to the emergency MD, the medical Pdepartment at Abbott Northwestern director of Abbott’s Hospital in Minneapolis. If the case is emergency depart- acute, staff might administer pain-relief ment, sees several Adam Reinstein offers acupuncture to patients seeking pain relief in the emergency department at Abbott medication. But in less dire situations, the benefits to offering acupuncture. In ad- Northwestern Hospital. attending physician may refer the patient dition to potentially offering relief from to meet with Adam Reinstein, MAOM, pain, nausea and anxiety, the treatment likely to reimburse providers for the ser- LAc, the department’s full-time acupunc- has none of the side effects associated with vice. Both Abbott and St. Francis absorb turist. many pain-relieving drugs. What’s more, their ER acupuncture costs within their “After getting consent and putting in the given the recent spread of opioid addiction operational budgets, unable to bill insurers needles, I’ll spend anywhere from two to in America, many health care providers and unwilling to charge patients. 45 minutes with the patient, depending on are eager to reduce their use of potentially Indisputable conclusions regarding the day,” Reinstein says. “In addition to im- addictive medications. the benefits of acupuncture—for patients pacting pain, I’ve found that acupuncture “We’re always looking for methods of and for the bottom line—may not arrive often reduces nausea and anxiety.” dealing with pain other than narcotics,” anytime soon. But advocates like Reinstein A form of traditional Chinese medicine, Kapsner says. say introducing the practice has produced acupuncture has been used to treat pain Evidence supporting the use of acu- positive impacts. And they don’t mind if for thousands of years, and some U.S. puncture to treat pain in the emergency skeptics dismiss the results as little more health care providers have experimented department can be hard to find. A 2016 than a placebo effect. with the practice for more than a decade. study conducted by the Penny George Reinstein, for instance, values the time Abbott, for example, began providing acu- Institute for Health and Healing found he gets to spend with patients. (For safety puncture as an inpatient service in 2004. that, in observational trials, acupuncture reasons, he never leaves the room once Research on the effectiveness of acu- was “acceptable and effective” for pain and needles are inserted.) “Sometimes, people puncture is often disputed, however, and anxiety. This past June, the Medical Journal just need to talk. They might be alone. doctors both in and outside the ER have of Australia published a study conclud- They might be scared,” he says. “I think been slow to embrace the practice. Abbott, ing that “the effectiveness of acupuncture providing that level of care and comfort is which assigned Reinstein to his current alone was comparable with that of phar- what we’re supposed to do in hospitals.” position in 2013, is widely believed to be macotherapy,” but also noting that “neither – JOEL HOEKSTRA the first U.S. facility to offer acupuncture acupuncture nor standard pharmacother- services in its emergency department. This apy afforded patients presenting to EDs past May, St. Francis Regional Medical with back pain, ankle injury or migraine Center in Shakopee—which, like Abbott, clinically relevant reduction in pain within is affiliated with Allina Health—became an hour.” the second. Without more solid evidence of acu- puncture’s effectiveness in an emergency department setting, health insurers are un- 6 | MINNESOTA MEDICINE | SEPTEMBER/OCTOBER 2017.

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