This episode of the What the Health podcast features an in-depth conversation with Dr. Nell Smircina, a licensed acupuncturist and advocate for the ancient medical practice of acupuncture. The discussion highlights acupuncture’s growing popularity in the U.S., touching on its reported benefits for conditions like pain management, allergies and stress, as well as the safety, effectiveness and misconceptions surrounding the practice. 

Dr. Nell shares her journey from aspiring surgeon to acupuncturist, emphasizing acupuncture’s role within the larger system of traditional medicine and its potential as an integrative remedy in modern healthcare. The episode also covers the importance of choosing a licensed practitioner and how acupuncture is adapting to contemporary needs, such as through telehealth. Resources for further exploration of acupuncture, its benefits and finding qualified practitioners are shared and included below in the show notes.

00:32 Introduction to Acupuncture: Popularity and Questions

01:46 Exploring Acupuncture with Dr. Nell Smircina

02:32 Dr. Nell's Journey into Acupuncture and Herbal Medicine

04:19 Demystifying Acupuncture: Misconceptions and Realities

10:07 The Evolution and Efficacy of Acupuncture

14:47 Acupuncture's Role in Recovery and Pain Management

17:20 Understanding How Acupuncture Works

20:54 Integrating Acupuncture with Traditional Medicine

25:50 Navigating Licensing and Finding a Qualified Acupuncturist

30:24 Closing Thoughts and Resources on Acupuncture

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Connect with the American Society of Acupuncturists

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The medical establishment. is even more open than ever when it comes to incorporating the practice into its arsenal of proactive and reactive remedies and procedures but for all its current acceptance and growth. There are still a lot of questions for many when it comes to this ancient process. Is it safe, painful, and effective?

How does it work? And exactly what is it supposed to do? And is it right for everyone? Fortunately, there is a growing wealth of information on acupuncture, including research designed to identify just how effective it is when it comes to its reputed benefits involving pain management, allergy relief, headaches, carpal tunnel syndrome, and respiratory conditions.

There's also more regulatory control than ever of the industry, especially at a state level. Admittedly, there is a lot to wade through, especially for the uninitiated, before someone can determine if acupuncture is right for them. Our upcoming guest, an acknowledged proponent, is here to help, and in her own words, move the needle when it comes to this practice.

What we always consider to be the best part of the What the Health's podcast is our interview with our guest. And as we mentioned, we're going to explore acupuncture today. What it is, what it can do, maybe some of the misconceptions, well definitely some of the misconceptions around it and how to approach it and we're going to do it with Dr. Nell Smircina and we went over the pronunciation earlier, did I get that right Dr. Nell?

[00:02:18] John: right.

right.

[00:02:20] John: Okay. And we probably couldn't find a better person to talk about acupuncture with we're going to start with Dr. Nell and having her explain a little bit of her background, just because it's a way to introduce people to what acupuncture is and how people get involved. So, Dr. Nell, please tell us a little bit about yourself and how you got involved in this aspect and also, I believe, herbal medicine alternative medicine.

And so I started looking into other career options did a little bit in physical therapy and in working at a physical therapy office, I met an acupuncturist. And many of my patients at the time were seeing this acupuncturist. I knew absolutely nothing about it. But I was really frustrated with the limitations I felt around my scope of practice.

And I wanted to talk to patients about things outside of the exercises they could be doing. And acupuncture not only allowed me pain relief from chronic injuries that I was experiencing, but really a new career path. And so with the herbal medicine component, acupuncture really is one modality in a much larger system of medicine, traditional medicine. And so herbal medicine is part of that. A lot of practitioners will do that specifically or exclusively, but it's really meant to effortlessly flow together to best support a patient. And so, got to have a really exciting new career path and still experienced my area of focus, which was post surgical care. And acupuncture and traditional medicine really answered a lot of questions that I had when it came to results people were getting from a more conventional medical model.

And I'm not saying that lightly. It's just the impression. And we're going to get into what acupuncture can do for you and what it maybe can't do for me and how it's evolved. But what are some of the misconceptions people still have? Still have about acupuncture, because part of your role is not only as a practitioner, I believe, is supporting the growth of acupuncture and acupuncturists.

The body's really intelligent and knows how to heal and you need a gentle nudge in that direction. And I think all aspects of healthcare and medicine. So when it comes to acupuncture, I like to refer to it as an adaptogenic medicine. So it helps the body adapt to different stressors that it experiences physical or mental. As well, and we know that mental stressors also cause a physiological impact on the body. So, it really just helps nudge people in the right direction. But a misconception around that is that, Oh, well, if there's no medicine on these needles, or, Oh, if it's needles it must be painful. So, acupuncture does not have to be painful to be effective.

Most of the needles are as thin as a human hair. And so you're not puncturing the skin like you would with an injection. It's a very different sensation. People often just feel a little bit of tingling or pressure or sometimes nothing at all. And generally even the most fearful patients end up relaxing on the treatment table in that first initial session because of the way that it does help the body adapt.

And I think another misconception is just the education around acupuncture. I'm often asked, Oh, do you have to go to school for that? Or, Oh, you have doctor in front of your name? Like, you must be some type of medical doctor. Acupuncture and traditional medicine in that integrative realm, it's really more of a specialty.

And if you look at acupuncture worldwide, it has a very medical focus.

Acupuncture is newer in the U. S. than in other countries. So people will be educated in traditional healthcare and then kind of add on that acupuncture in other countries. And we have very robust education for acupuncture and traditional medicine specifically in the U. S.

So I did a four year master's program on top of my undergrad, and then I did a two year doctorate on top of that. So there is a lot of education that goes into this medicine because you're expected to in California where I was educated, function as a primary care provider, know when to refer, when to enlist other professionals and really help people in all aspects of their health.

Is that what holds people back or lead to these sort of misconceptions?

So obviously there's efficacy there, but I do think there's a shift. And also, some international biases as well. In America we like to think that things that are American or that we're familiar with are best. And so there's, going back thousands of years in Asia and other continents utilizing this medicine.

It's not something we're super familiar with from a long-term standpoint in the us. I do think as these other providers are utilizing needles and people are talking more about acupuncture That certainly helps. We've seen the utilization of complementary care Increase almost double in the last few years.

We're still only at six percent but that is millions of people Who are interested? And I also think that if you are looking at trends in healthcare, there is such a blurring that's occurring in the traditional healthcare and health and wellness where you really have consumer driven healthcare happening right now. And so I think that is going to also drive utilization because people are being more proactive. with what does health look like? We're having different discussions about access when it comes to telehealth or med spas or okay, this service is covered by my insurance, but this one is not. So I think we're going to see more utilization in the future as that health and wellness market continues to merge with healthcare in general.

but

so,

we'll just say thousands.

[00:10:27] Dr. Nell Smircina: Yeah I think, it's a combination. So we definitely have seen a shift in how the medicine is delivered. I mean, from, thousands of years ago, needles were not surgical stainless steel. They weren't single use. They weren't as small as a human hair. They were made from bone or from stone. And That was just a matter of the resources that were available at that time. And there had been no industrial revolution. There were a lot of things that changed also regulations change. So, when, we talk about HIPAA, that's not something that's been around forever.

When we talk about, sterilization techniques that has not been around forever. So it's continued to improve and get more and more safe. And then also we're able to measure efficacy better. There's a difference. standard that people want to see knowing that are tools that are available. So we can look at a functional MRI and see that acupuncture is working and causing an effect in the brain and the body. We can look at lab results and say, Oh, Hey, I treated a patient with these herbs. for three months and this is how their liver enzymes improved or whatever the metric is that you are looking at for that time. So there's just more validation that's happening and also safer practices.

Can we identify causality with acupuncture at this point?

It's Hard when you do studies in general, particularly, like you can't do double blind

acupuncture. Like they're going to know if they're going to be needled or not. They've

[00:12:26] Dr. Nell Smircina: There are some limitations with that. But you know, when you send people home and you're not directly measuring at that point, it's really hard

This, You know, even in a treatment

[00:12:36] Dr. Nell Smircina: when I ask people to look at pain scale or I take their vitals before and after, you can say like, okay, like how much of this was the needles

How much of this was because you were in a dark room away from your

kids for 30 minutes

and had some you time.

So I think that's a challenge with any type of intervention. But, there has certainly been more research done to identify, different neurochemicals physiological shifts in the body, and eliminate some of those other potentials.

And, On top of that, you can also look at very tangible things, like something like scar tissue, where you're like, okay, this person is literally not doing Anything else

Acupuncture and we've seen this percentage reduction and these other types of changes.

So,

[00:13:49] John: mm hmm,

And certainly on the individual, like if there's debate around the amount of years, there's. Definitely debate among like who started

[00:14:11] Dr. Nell Smircina: a lot of things that are big deals

[00:14:54] Dr. Nell Smircina: Yeah. I think you're absolutely right. That the pain, most people are familiar with, even if they haven't tried acupuncture before they're like, Oh yeah, my friend had back pain and he tried all this other stuff for 20 years and finally he went to acupuncture and it worked. And then fertility, yes, would probably be second to that. I think there's multiple reasons for that as well. I actually don't think a ton of people are familiar with it being for allergies.

Um, obviously in the profession we are, that's really nice to hear that you had that experience. I had a similar one when I was pregnant. I relocated and suddenly had allergies and I was like, what is going on? And you're limited with any medications you could take. And man, Three treatments and then I was feeling completely better. So, I think those yes, those are big ones I you know, we don't talk a ton about how heavily utilized acupuncture is from a sports performance perspective I think practitioners talk about it

People still think that's not mainstream That is a big part of a lot of these like pro athletes

Um their recovery regimen.

For people operating at that level recovery is a full time job. So they're not just like leaving their football game and getting an ice pack or you know taking a nap And recovering in that way They are on a very specific protocol of many different modalities in order to address root cause concerns that they have and facilitate their recovery. That recovery piece is really has been my biggest interest with acupuncture. That stemmed from, being in physical therapy and seeing these post surgical patients and they were recovering at different levels. And so I think Everyone in modern society needs some level of recovery because we just are not operating like we did many years ago. And there are so many things, whether it's, toxins or working 80 hours a week or, not having family support. So many different things, different stimuli all the electronics we have. So everyone's body needs that recovery. And it's just a level of what level of recovery you need.

So I would say that's a really big area that people are not thinking about when it comes to

[00:17:14] Dr. Nell Smircina: A whole range.

I'm not going to an acupuncturist every week. And I got it that you're putting different needles in. It really doesn't hurt, though sometimes I do get weird sensations.

But it's explained that it's a release of energy. Can you explain a little bit why acupuncture supposedly works? Or what it's supposed to be doing to the body?

[00:17:45] John: That's good because I, yeah, okay. Okay. Okay.

things, because You can stimulate the nervous system to do different things, to release certain chemicals in the body. So when we are placing acupuncture points, We're not just stimulating things on a local level.

Yes, like you insert a needle, there's going to be increased circulation in that area. The immune system is going to wake up and say, Oh, I need to pay attention here. Something has happened. So it's going to start sending signals in that way. But at that point, you're really priming your nervous system to pay attention to something.

And you can release different neurotransmitters, chemicals into the body, depending on who you are. where you're placing things, if you're introducing additional modalities like electrical acupuncture moxibustion, which is simply a warming herb that gets placed in certain areas which is really a wonderful treatment as well, and one of the many modalities that's part of that larger traditional medicine.

I'm not saying this lightly, but it's like, I really don't understand what it's doing. But it's really designed to trigger something, your body to respond,

And, and I think it's important to note that the body Already knows how to respond, but it's because of all of the different issues that we're

facing day to day Or the injuries or whatever the case may be that blocks some of that from being an easy thing. So, just really giving it a gentle nudge in that direction.

And that is why it's important. more mild why, we recommend more than one treatment, especially for chronic conditions. And I think that's the part that sometimes is lost on people or as practitioners, we're not doing a good enough job educating our patients and the public on, this is it has a cumulative effect.

It's dose dependent. People will be like what you want me to come in three times this week, and I said well How many times did you take your pain medication? Well twice a day for the last ten years. Well, you're doing two doses a day

So I think we need to be more mindful about how we're communicating that because within conventional medicine That's not how treatments are done.

It's done very much a, let me do something that's going to shut down a body reaction or shut down a pathway in order to eliminate a symptom rather than retraining the body those symptoms.

What level do you see that integration and how has it evolved and what type of resistance is still out there? And I guess it's going to depend doctor to doctor or practitioner to practitioner, but where are we at in that sort of acceptance?

And I think, well, that. Is so strange to me Because this was the experience I had in california. I will say when it comes to integrative care California with health care is like eight to ten years ahead of the rest of the

[00:21:54] Dr. Nell Smircina: Yeah.

eight to ten years and then you know coastal areas.

So, you're new york's your dc's like I know a lot of DC practitioners who have thriving practices and then it kind of fills in the middle. Even if you look at like when everybody was doing the vitamin IV infusions, like that was like on every corner in California and they were trying to figure out how do we get this done in New Jersey? So there is a trend where that happens. So because I've seen that play out and that's how I built my my practice, I know that's possible everywhere and that there is that increased interest and again, like you have medical doctors who are getting trained in how to do acupuncture. And that is not slowing down. You have like the AAMA, their own association for medical acupuncture. So I think we'll see increased acceptance. Especially as that education is more out there and we're able to do more research.

[00:22:58] Dr. Nell Smircina: I would say it's more indifference because what happens is a lot of times an md will get asked by a patient like well What about acupuncture? And they'll typically say well, I don't know anybody or I don't know. It seems to work, but I don't know how and much less of the well that doesn't work and I can say from my experience I had surgeons who would have no problem with me doing acupuncture on a patient the day after surgery who were okaying that and said, Hey, it's safe.

It's helping them with pain relief. They're getting off their pain meds faster. They're healing better. They're sleeping better. And really seeing the value in that. But again, like health care is a business. So if you're a practitioner You need to be networking with other providers. You need to be explaining the value proposition I wish I could tell providers and patients it was enough to just say like hey this really works for your patients Send them my way.

What's in it for me? And so being able to articulate that And address those pain points is also really important and it's important from a patient advocacy perspective as well for patients to be able to say like, Hey, no, I do know someone, I do have an acupuncturist, they can talk to you. Or, hey, like my sister went to somebody and that's kind of the burden that we put on patients from, healthcare in general, but that's also how things get done. People are sticking with telehealth because patients want it. So.

[00:24:32] Dr. Nell Smircina: Yeah, so I'll give you an example with that again, like, Pre COVID, over 90 percent of our patients were being referred from surgeons. We're in California, healthcare shuts down, so I can still operate, but my referral sources are drying up because

nobody's having orthopedic

[00:24:49] Dr. Nell Smircina: emergency.

Nobody's having cosmetic surgeries. And so, We were doing in home care. But with telehealth, we were doing actually a lot. And it depends on your scope of practice per state. We could do labs in California.

So reviewing

Blood work, I guided patients through acupressure

I was able to ship them ear seeds, which are an acupressure device that are stuck on different points in the ear, which dramatically impacts the nervous system. Herbal medicine definitely saw

an uptick. So while, Supply companies were suffering a little bit herbal companies were doing really well because you're able to ship that. And I think it pushed practitioners to really not rely on only one modality in our entire scope And that one modality is acupuncture, but you have a lot of other tools at your disposal including, nutrition guidance. So I think That will be really exciting because I also think that is going to show people that this is an entire system of medicine and not just a modality.

Is it done by states? Are there states where there isn't licensing? Give us some background on that

The length of education varies by state a little bit.

So California, for example, it's a four year master's program. You have some programs that are more at that three year mark because they don't include herbal medicine and they're more focused on acupuncture and other modalities. And then states do issue the licenses, but you need to sit for a board exam. Generally what that looks like is there is a national certifying body, NCCAOM, and you take their four exams if you want to be able to do all of the things. Some states do not require the fourth exam, which is that herbal medicine, if you're not going to be practicing that, but you essentially take their exams and that's a prerequisite for licensure in the state. And you pay the state's licensure fee and anything else like fingerprinting background checks, all that good stuff. Sometimes they'll have an additional safety course or things like that. California is a little nuanced. They have their own board exam. And there's a lot of requirements around that.

The education is a little higher hours wise. So they want people to have had a certain level of education in California in order to sit for that. And California houses, about a third of the acupuncturists in the country. So if you want to be in California, it makes sense to do the education there as well.

But generally, yes, it's safe. For national board exams and then states like licensure.

[00:27:41] Dr. Nell Smircina: exception of three states Who do not have a practice act and that is really challenging and they all just have a handful of people Alabama is one of them And that's something that certainly can be looked up NCCOM, the organization that I referenced, has a great provider directory.

They also have a really interesting map of the U. S. where you can see what the different requirements are by state if they require NCCOM certification. So that way you're able to get a guide as to, like how credentialed is this provider that I'm seeing.

But yes, the grand majority of states require licensure.

Yeah.

I mean, certainly right now I'm speaking to you from Jersey City. I'm three miles from Chinatown in New York, you can find acupuncturists throughout Asia Town. Now it's not Chinatown. Who I'm sure maybe know what they're doing, but they're not licensed. So I'm sort of like, any medical practice, what risks does a patient face or warning signs that they need to be aware of to make sure they're getting Qualified support.

Look at the practitioner's name and license verification on Google, and

Department of Consumer Affairs. I'm also licensed in Virginia, that's the Board of Medicine.

So it's very easy to find if someone's license is active and, or if there's any action against that license or if they just don't have a license at all. Like I said, NCCOM is a great resource. resource just because they have a lot of robust data that is updated and you can see around the education and where someone's at and find an appropriate provider.

If you're not familiar with where to find one, you could find one on their website. Most states require acupuncturists to have their license visible and posted. So, even when you go and get your eyebrows waxed or your hair done, they have their certification that's supposed to be displayed So, medical providers, need to do the same.

So those are a few different ways.

We encourage everyone to continue digging on their own. A couple of great places to start are Dr. Nell's site, which is drnell. com, and that's Nell with two L's. Another great source is the American Society of Acupuncturists at ASACU. org, that's ASACU. org. They help facilitate this interview, so thank you Dr.

Nell, and thank you ASA.

Before we move on, we wanted to again encourage our listeners to take advantage of the hundreds of exclusive discounts WellWell offers on a range of health and wellness products and services. These cover everything from fitness and athletic equipment to dietary supplements, personal care products, organic foods and beverages, and more.

Signing up is easy and free. Just visit us at WellWellUSA. com, go to Milton's Discounts in the top menu bar, and the sign up form will appear. Signing up takes seconds. But the benefits can last for years. So acupuncture shows plenty of promise to help in all sorts of areas. There's also a growing collection of information available to help individuals decide if the practice can specifically deal with their particular issues, but as with any traditional acupuncture.

For alternative practice, knowledge and a healthy dollop of caution is recommended before proceeding. First off, don't hesitate to read up on what acupuncture can and can't do. There are endless sources from John Hopkins and the Mayo Clinic to acupuncture advocacy groups. that all offer their own spin on the practice's benefits and limitations.

Also, it's critical to make sure you're connecting to an accredited and licensed practitioner. Any reputable acupuncturist should make their credentials readily accessible. State licenses can also be checked online. Finally, practitioners vary in terms of style and approach. It's important to feel comfortable with whomever you choose.

Not sure if a particular acupuncturist is right for you? Ask for a brief phone consultation to feel them out. Any practitioner worth their salt won't hesitate to connect. That's it for this episode of What the Health. I'd like to thank Dr. Nell Shmersina for her time and insights. And if you're looking for more information, visit her site at drnell.

com. The American Society of Acupuncturists is another great source. This organization can be reached at A S A C U dot org. That's A S A C U dot org. Okay, thanks again for listening, and we hope you'll join us again for another episode of What the Health.