N.J. groups at odds over therapeutic use of needles

The claws are out in New Jersey as two types of health providers battle over who can use needles.

At issue is a technique physical therapists use called "dry needling." Acupuncturists see it as an invasion of their turf.

Now the trade group that represents physical therapists in the state is accusing acupuncturists of "bullying" a physical therapist who demonstrated the technique for a television crew. The group says the woman received a threatening call from an out-of-state acupuncture practitioner. Plus, the organization that represents acupuncturists posted a message on Facebook that named the woman's practice and urged members to pressure CBS not to broadcast the segment, which was produced for WCBS-TV in New York.

"We need everyone you know to call CBS and leave a complaint message," the post by the New Jersey Association of Acupuncture and Oriental Medicine said.

Daniel Klim, executive director of the American Physical Therapy Association of New Jersey, said the post was also e-mailed widely last week.

"I'm really . . . disappointed in the fact that one health-care professional was bullying or harassing someone else who's just doing their job," Klim said.

The physical therapist whose practice was targeted, Carol Cote of North Jersey Physical Therapy Associates in Hackettstown and Morristown, did not return calls.

Candace Sarges, president of the acupuncture association, said she wrote the Facebook post after seeing an e-mail from Cote promoting the television spot. "I never encouraged anyone to harass or bully anyone," she said.

Sarges said physical therapists are trained to do "manual manipulation" and do not receive enough extra training to safely pierce the skin with needles. Done improperly, she said, dry needling could spread infection or puncture the lungs.

During the procedure, a thin needle is used to penetrate the skin and stimulate muscle trigger points. Asked how it differs from acupuncture, Klim said physical therapists used needles only to manage pain.

The dispute is occurring against a history of tension over the pain-control technique.

"This issue has . . . really blown up within the last six years," said Justin Elliott, director of state government affairs for the American Physical Therapy Association. "Regrettably, it has become one of our biggest scope-of-practice battles."

Dry needling is a small but growing area of practice for physical therapists, he said.

Klim said the New Jersey Board of Physical Therapy Examiners had ruled dry needling falls within the scope of practice of physical therapists, but the state Acupuncture Examining Board called dry needling "the unlicensed practice of acupuncture."

The New Jersey Division of Consumer Affairs, which includes the warring boards, is reviewing the matter, spokesman Jeff Lamm said.

Meanwhile, physical therapists are backing a bill in the state Legislature that would officially make it legal for them to do dry needling.

Brian Mason, a Freehold physical therapist who is president of a New Jersey physical therapy group, said he learned how to do dry needling 20 years ago and still uses it to treat his own tennis elbow.

He said about 300 of the state's 8,000 physical therapists use the technique.

Mason said needles were one of many tools physical therapists use to reduce pain. Think of how many professionals can use a hammer. "A carpenter uses a hammer," he said. "An orthopedic surgeon uses a hammer."

In a competitive treatment environment, the procedure has been a flash point. According to Elliott, 25 states allow physical therapists to perform dry needling. Physical therapists are not allowed to do it in New York, but they can in Delaware. Pennsylvania is in a gray zone where the rules are unclear, he said.

In the Facebook post, which Sarges said she wrote, the acupuncture association offered a template for how to complain about the TV interview. It urges callers to tell CBS it would be "confusing the public and compromising public safety. Further, airing the program will lead to countless complaints filed with the FCC. I strongly request that CBS cancel this program."

Rachel Ferguson, a spokeswoman for WCBS-TV in New York, said there had been a handful of calls about the segment. Station officials had not yet seen it, she said, but the broadcast standards department would "make sure it's appropriate for our audiences."

Rick Blaski, owner of the Medical Media Group in Broomfield, Colo., which produced the segment, said he had received dozens of calls from unhappy acupuncturists even though his phone number was not posted. He said one told him, "If you air this, we will jam your phone with thousands of calls."

The two- to three-minute segment, he said, was to air Jan. 25 as part of American Health Front on WCBS. That half-hour show is paid programming made to look like a news show that runs a few times a year in local markets. It runs occasionally in Philadelphia on CBS3.

Medical practitioners pay $6,700 to be on the show and are promised exclusivity in their subject area.

Blaski said he had been told CBS's lawyers were looking into the issue. "Legal is going to decide whether we can air it or not," he said. Even if the lawyers say it's OK, deadlines may force him to bump the dry-needling segment to a later show.

Clearly annoyed, Blaski likened the deluge of calls to "terrorism."