A drop in the ocean

Mark Bovey

BAcC Fellow: Oxfordshire

I learnt acupuncture in a time and place where only one weekend per month of lessons was required, where you could miss all of the conventional medicine teaching but still pass the exam because we were told the questions beforehand, where we had to hand in an extraordinary number of pulses for homework, where teachers smoked in the toilets and watched the horse racing with us in the classroom. And then out into the big, wide world.

Living in Oxfordshire I felt (not exactly brimming with confidence) that the acupuncture market locally was already saturated (this was 1983), so I took up the opportunity to do a day a week in Loughborough, looked after by the wonderful Janie Prince and equally wonderful Isobel Cosgrove. A regional group was just starting in the East Midlands but was well established in Oxford, and in both of those we organised and attended meetings and social events as a matter of course.

For the first 15 years as a practitioner I had nothing to do with acupuncture research, and it didn’t cross my mind that there was anything to do, or even to know. My concerns were about whether I was at all any good as an acupuncturist, and whether I would be able to make a living from it when they finally rumbled me as a pig breeding consultant. Just in time I heard of the vacant Acupuncture Research Resource Centre position at Exeter University and thought that surely health research wasn’t that different from animal breeding research.

Early in the job I was passed a critical piece by one Edzard Ernst, the man who’d left the Complementary Health Centre for the medical school, taking the chair and the endowment cash with him. I spent two days painstakingly assembling arguments to rebut Ernst, only for it to be abandoned as a lost cause. It takes time to develop such skills and the confidence to put yourself into the firing line.

Twenty-two years later, and Ernst is still around, while some good people have gone. The acupuncture research world is a different place, with evidence thick on the ground. The arch-sceptics might seem now like King Canute, in the face of this tide of evidence, but positions are entrenched and the arguments go round and round. We can look optimistically at NICE’s endorsement for chronic pain but Covid has shown us still to have a rather fragile existence: though I believe it is stronger than when I first qualified.

Then, we expected to be rather insignificant players on the national healthcare stage, while now we think we deserve better. There is no automatic right to acceptance and recognition by the authorities, and it can come at the price of loss of independence, as emphasised 20 years ago by epidemiologist and good friend to CAM, Dr David St George, who said we had to stand up to the medics or they would swallow us whole (‘creeping medical imperialism’).

While acupuncturist researchers strive to convince hearts and minds for the long term, what do their efforts do to move forward our practices? I suspect very few acupuncturists would say that what they do has been changed or improved by research. So this is my vision for the future: that we reach a strong enough place for research to be able to be used to inform practice, rather than to prop us up as being bona fide healthcare professionals. There’s no reason why it shouldn’t come to pass: acupuncture is a very old medicine and aeons of time stretch out before us.