Interview with Dr. Bryan Frank
March 1, 2000
8:00 p.m. to 9:00 p.m. (EST)
Chatters (29 including Moderator & Dr. Frank): russ, Richard, Jkates, wldmd, Hika, gyntrix, Unnamed person, Greg Melby, GauriW, Jby, Suel, dinggge, Mario, Rod, Dr.Bryan Frank, backache, Cyinders, claude, Mark, Moderator, zucrew, Terry, Priya, Bat, Robert, bat, suel, vivi, hika
Moderator Dr. Bryan Frank is an anesthesiology/pain medicine specialist in the Dallas, Texas, metropolitan area. He received his certification in medical acupuncture in 1994, and teaches regularly for the UCLA Medical School's Medical Acupuncture for Physicians Program. Thanks for joining us tonight, Dr. Frank. Our first question is from "backache.''
My back hurts from sitting at a desk all day. Would acupuncture help. My insurance won't cover it, so how much money will it cost to make the pain go away?
Dr. Bryan Frank Back pain is one of the most common ailments we treat with acupuncture. It would certainly be appropriate to consider acupuncture. Costs will vary from region to region, and type of practitioner- perhaps $50-120 per visit is a round figure, chronic problems I would want to treat with an initial trial of 6-8 visits.
Do those needles hurt?
Dr. Bryan Frank Claude, many people feel little or no sensation with needle insertion, others feel some pain. The needles should not hurt, if at all, once they are in place.
Dr. Frank, what is medical acupuncture and how is it different from ordinary acupuncture?
Dr. Bryan Frank Robert, great question. Medical acupuncture is that acupuncture practiced by a person who is also a licensed medical physician, from a variety of medical specialties. They can understand you from both conventional medicine and acupuncture points of reference.
What else can you treat with acupuncture besides back pain?
Dr. Bryan Frank Claude, we commonly treat headaches, migraines, tennis elbow, trauma and injuries, arthritis- most an pain. Also we treat many medical illnesses, such as sinus and hay fever, gut distress, urinary and gynecology problems, and more.
How can you fix a GYN problem with a needle?
Dr. Bryan Frank Backache, the acupuncture needle has many known physiologic effects on the body- muscle relaxation, endorphin and other hormone and chemical release, altered nerve conduction, etc. Many gyn patients have great relief with acupuncture.
The World Health Organization estimates more persons have been treated throughout history by acupuncture than by all other medical modalities combined. Also you can address asthma, carpal tunnel, and other problems.
Dr. Frank: I want to know where you have got your acupuncture knowledge?
Is your training similar to TCM (Traditional Chinese Medicine)?
Dr. Bryan Frank Vivi- I began studying over 20 years ago with a Japanese acupuncture master, and formalized my training through the UCLA School of Medicine's Medical Acupuncture for Physicians Program.
Dr. Bryan Frank Vivi- most physicians in the US train in multiple traditions of acupuncture, of which TCM is only one- in fact it is one of the recent ones. other traditions include classic energetics, 5 Elements, modern neuropsychological models, microsystems, and more.
Dr. Frank, I've not participated in a chat room before so if I ask questions beyond the scope of the current session -let me know. But, how difficult is it to treat postherpetic neuralgia in most patients?
Terry, I think that's over my head.
I'm sorry-postherpetic neuralgia=herpes zoster=shingles
Dr. Bryan Frank Terry, post herpetic neuralgia may respond well- and as with conventional medicine approach, it is critical to try to treat early! (ASAP)
I agree. I was referring to a failed conventional approach with symptoms for more than 12 weeks.
Dr. Bryan Frank Terry- I have known of cases of various bowel disease that responded to acupuncture. These are certainly serious and need medical management along the way, either by the physician acupuncturist, or by the physician in coordination with a non-physician acupuncturist.
Dr. Frank, can you please explain the concept of meridians?
Dr. Bryan Frank Vivi- the meridian theory says that Qi (chi) circulates through the body in channels. these appear to be the intrafascial planes between muscle groups. Science is learning a great deal about the importance of the fascia and other "subtle" tissues in transmitting information and messages throughout the body-
Thank you. Do you feel that energy work (i.e. Reiki, Polarity, Therapeutic Touch) also work because they manipulate the balance of chi?
Dr. Bryan Frank Vivi- I think there is a lot of overlap between acupuncture effects and those seen by various manual therapies- Qi, muscle relaxation, improved microcirculatory perfusion, endorphins, etc
Do you have good success treating peripheral neuropathy with acupuncture?
Dr. Bryan Frank GauriW- I have had some success treating peripheral neuropathy-important factors include chronicity, etiology(cause) of the problem, and other medical problems, etc
Do you have to treat them forever?
Dr. Bryan Frank GauriW- as with any other treatment modality, some patients see complete resolution of their pain or illness while others see moderate or little effect. Some conditions do respond and benefit from periodic treatments to maintain the benefits. Each patient and condition must be considered separately.
How do I know if med. acupuncture might help me?
Dr. Bryan Frank Robert- if you have a problem we have discussed, it likely would be that an initial evaluation to see if your physician or acupuncturist has experience with your problem and then can give you an idea-
Yes, Dr. Frank, on average how many treatments are needed?
Dr. Bryan Frank Robert- with acute, recent problems, often only 1-3 treatments are needed. With almost any chronic condition, I want to see the patient 6-8 times as an initial trial.
Are there any side effects to acupuncture?
Dr. Bryan Frank Side effects are rare, at least serious ones- these could include punctured lung or other organ, infection, etc. They are very rare, by a qualified medical acupuncturist. Minor things like bruising occur occasionally but are not serious. Other risks could include the lack of detection of a serious medical illness an unqualified person
I have heard of acupuncture training at the University of Alberta and through the Acupuncture Foundation of Canada compare to the UCLA course?
Dr. Bryan Frank The Canadian courses are well taught- likely not as comprehensive in teaching the multiple traditions taught at UCLA- They do teach excellent anatomical based acupuncture and have expanded on that recently
When do you think Medicare cover medical acupuncture treatment?
Dr. Bryan Frank jby- I do not know when or if M-care will cover acupuncture- the concern is that if they do, the coverage will be so poor it may in fact make it unavailable to the M-care population because providers will not be able to see them without literally losing money through the care, insurance filing, etc.
Can you recommend a book which clearly explains acupuncture?
Dr. Bryan Frank Mario, there are many books now available and it is likely best to scan a few at your favorite book and coffee shop first to see which seems the best suited for you. For physicians, the most comprehensive and medically oriented text is Helm's book, Acupuncture Energetics, A Clinical Approach for Physicians
Dr. Frank how would I find a medical acupuncturist in my area?
Dr. Bryan Frank Robert- the American Academy of Medical Acupuncture has a referral line at 1-800-521-2262, for physician acuputurists. For non-physicians, check through the National Commission for the Certification of Acupuncture and Oriental Medicine
Do you use magnets in conjunction with acupuncture?
Dr. Bryan Frank GauriW- yes, I sometimes use magnets- many patients do very well, some do not- but I have never had a patient do worse.
As a Therapeutic Touch practitioner, it interests me that many of the problems and symptoms you talk about are also the ones most receptive to energy work: headaches, stress, backaches, high blood pressure, inflammation to name a few. I've had acupuncture treatments (for disk problems) that were highly successful, and feel that acupuncture has more lasting effects than other methods of chi balancing.
Dr. Bryan Frank Vivi- acupuncture is a more invasive (even though fairly gentle) therapy than many other touch or manual therapies. Deep seated problems may really need more- I often see great things happen when patients have acupuncture and, say, massage, in combination.
acupuncture, depression and electroconvulsive shock therapy...comments?
Dr. Bryan Frank Terry- I and many have had very gratifying results for depression. I have had a patient taking years of ECT be able to do much better with greater intervals between ECT- she was a very complex case, but very happy with the improvement with acupuncture.
acupuncture for High Blood Pressure?
Dr. Bryan Frank JKates- good question. Some do well, others less so. This emphasizes the importance of integrating the medicine and the acupuncture- the "best of both worlds", so medication is still used if needed, hopefully less meds and less amounts.
for a patient with a chronic problem such as IBS, how often would they need to see an acupuncturist?
Dr. Bryan Frank JKates- for chronic problems, I ask for an initial trial to see if we can help of 6-8 or 10 visits, usually 1/week or 2/week.
great answer...I suspected so...Thank you!
Can you give your number again so I can find a doc in my area?
Dr. Bryan Frank Claude- the AAMA referral line is at 1-800-521-2261(AAMA).
In our current situation with billing insurance, is there an icd-9 number? Also can acupuncture be billed private insurance and or Medicaid?
Dr. Bryan Frank Mario- acupuncture has a CPT (ICD-9 is for diagnosis codes). There is one for acupuncture with or without electrical stimulation. Many insurances are now covering the treatments, but it is variable. The federal systems, M-care and M-caid do not.
Do you think people are finding relief from medical acupuncture that they weren't able to find before?
Dr. Bryan Frank Claude- I personally began in acupuncture as a failure of medical/surgical therapy that saw profound relief in acupuncture. We see this commonly in medical acupuncture- often patients come to see us as a last resort, but increasingly they are coming as a first choice!
Are there plans again for acupuncture proficiency exams and review courses again this fall if I cannot make it to Orlando this April?
Dr. Bryan Frank wldmd- the AAMA will offer the proficiency exam and review courses also in the fall (Dates as yet uncertain).
Thanks. Everyone on line now needs to know what a good teacher you are!
Dr. Bryan Frank wldmd- hey, Orlando looks like we will have over 500 docs be there, if you can!
Hi, sorry I'm late.....I'm a psychotherapist and I'm wondering if acupuncture is helpful for patients who are depressed.
Dr. Bryan Frank JKates- some of my most rewarding work with acupuncture is in the treatment of depression, anxiety, stress, etc.
Do you have a web site?
Claude and gang, you can click on the AAMA logo at the top of the chat room to get to the website.
Dr. Bryan Frank Robert- thanx for the heads up info- check out the AAMA at www.medicalacupuncture.org.
How effective is acupuncture for smoking cessation?
Dr. Bryan Frank Richard- many reports have shown acupuncture to be quite effective with cigarettes, and also with heroin, cocaine, etc. Serious drug rehab of course needs to be in the context of a true rehab program. Smoking cessation successes are one of the most common things that people tell me about form their experience or that of a friend or relative.
What is your opinion on the weight control?
Dr. Bryan Frank Hika- some report that they respond for weight control- but I truly believe that is most appropriate and likely if acupuncture is part of a complete bariatric(obesity) medicine approach, including nutrition/diet, exercise, endocrinology, etc--sorry no magic fixes!
I'm a physician who was taught by Dr.Frank and I just wanted to observe and say hello
When dealing with conventional doctors who do not practice acupuncture, or accept any but the most Western of medical practices, how can a patient integrate the differences to take advantage of both?
Dr. Bryan Frank Vivi- unfortunately there are many conventional docs who think acupuncture, or even say nutrition nonsense. "You can lead a horse to water, but you cannot make it drink." If you re not getting cooperation from a doc who will not even be open minded, call the AAMA referral line at 1-800-521-2262 and see if there is someone in your area-
Do you recommend acupuncture as a post-surgical treatment, to speed up the healing process?
Dr. Bryan Frank Viv- as an anesthesiologist, I am very interested in preoperative management with acupuncture- to speed healing, decrease pain, nausea, etc.
Do you know how many physicians practice acupuncture in the US?
Dr. Bryan Frank Mario- the AAMA has over 1700 members, all physicians. We estimate perhaps 3500 or so practice at some level.
Is acupuncture known to help one gender more than the other? Or is it the same for both men and women?
Dr. Bryan Frank Claude- I have enjoyed treating both genders and do no find either more or less responsive based on gender- it has more to do with chronicity, how deeply seated the problem is, and other medical conditions that exist.
Dr. Frank - do you find acupuncture is helpful for Fibromyalgia?
Dr. Bryan Frank Greg- that is a difficult and very complex illness. Yes, I and many physicians have had many patients do much better with their fibromyalgia- I would not expect a cure, but often significant improvement- they will often need periodic Maintenance therapy as well.
Moderator We're out of time. Thanks to everyone for great questions, and to Dr. Frank for his informative answers. Remember everyone, feel free to stay online in this room and continue to chat for as long as you like. Have a great evening!
Dr. Bryan Frank Ciao- thanks to you all. (1-800-521-2262)