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Click here to download the transcript.
Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Choosing an acupuncture insurance policy type takes more than comparing premiums. Your policy should match how you practice, where you practice, the services you provide, the property you own, and what happens if someone reports a claim after a policy period ends.
For acupuncture professionals, two questions matter most: What coverage does your practice need, and does your professional liability policy use a claims-made or occurrence form? AAC also offers Preferred and Elite program options, plus endorsements for additional insureds, premises and general liability, and business personal property.
Transcript access: We could not independently locate a transcript or download link for the supplied video in the current indexed AAC materials. If the legacy page contains a transcript asset, preserve that existing asset and link during the WordPress migration.
Professional liability, often called malpractice insurance, addresses allegations that arise from professional services. The National Association of Insurance Commissioners describes medical professional liability insurance as protection for licensed health professionals against liability associated with wrongful practices, including bodily injury, medical expenses, property damage, and defense costs.
For an acupuncturist, start by checking whether the policy covers the services you actually provide. AAC says its acupuncture policy generally covers services within the practitioner’s state-defined scope of practice, subject to policy exclusions. The actual policy and endorsements therefore matter more than a marketing summary.
If your practice includes herbal medicine, cosmetic or facial acupuncture, or other modalities, confirm how the policy treats each service. Also confirm that the service falls within your state’s scope of practice.
The policy form determines when coverage can respond.
An occurrence policy generally responds when the covered incident occurs during the policy period, even if someone makes the claim later. A claims-made policy generally responds when someone makes the claim while the policy remains active, subject to the policy terms, including any retroactive date and reporting or extended-reporting provisions.
Consider a simple example. You provide care in 2026, but a patient makes a claim in 2028.
With occurrence coverage, the policy in force when the 2026 event occurred generally responds, assuming the policy covers the event. With claims-made coverage, the policy in force when the patient makes the claim generally responds, and the underlying event must fall within the policy’s applicable retroactive coverage.
This distinction matters when you change carriers, stop practicing, retire, or allow a claims-made policy to lapse. The National Association of Insurance Commissioners and the American Medical Association explain that extended reporting, often called “tail” coverage, can help address claims that arrive after a claims-made policy ends.
AAC’s current FAQ states that its claims-made option converts to occurrence coverage without charge after ten years. AAC also states that practitioners moving from another claims-made policy may qualify for retroactive coverage, subject to underwriting. Because policy terms can change, verify the current policy wording and transition provisions before you rely on those features.
Professional liability does not address every business risk.
Premises liability can address certain non-malpractice injuries or property-damage allegations that occur in the treatment area. For example, a patient could slip on a wet floor or trip over a hazard.
AAC explains that its general liability coverage can extend beyond the immediate treatment area. Depending on the policy terms, it can address risks such as injuries to invited guests, certain personal-injury claims, medical expenses, products liability, and fire or water legal liability.
If you lease space, share a clinic, or regularly welcome patients and other visitors, ask whether your premises or general liability coverage matches your contractual and operational responsibilities.
Business personal property coverage can address certain losses involving business equipment and furnishings that do not form permanent parts of the building. AAC currently describes coverage for items such as treatment tables and furniture, with a $10,000 limit and $500 deductible. Practitioners can request higher limits.
Ask one practical question: If a covered event damages or destroys the equipment you need to operate, what coverage responds?
Landlords, hospitals, clinics, or other organizations may ask you to add them as additional insureds. AAC explains that practitioners can request additional-insured coverage by endorsement and that the policy can treat limits differently depending on the circumstances.
Your professional corporation or other business entity presents a separate issue. Review the policy structure with AAC or your insurance professional so the named insureds and entities match your actual practice structure.
AAC currently describes Preferred as its standard program. Under the current program description, Elite provides a 30% discount when practitioners agree to use an arbitration form and informed-consent form with patients. The council also says its policy does not universally require arbitration and informed consent, although state requirements and clinical circumstances can vary.
Do not use a discount as a substitute for understanding the forms. Review each document, make sure it fits your practice, and confirm applicable state requirements.
Before you buy or renew acupuncture professional liability insurance, ask:
Your answer will depend on the actual policy, your practice structure, the services you provide, and applicable state requirements—not simply on the name of the coverage.
Choosing an acupuncture insurance policy type starts with understanding the risks you want to transfer. Professional liability addresses allegations involving professional services. Premises or general liability can address certain non-malpractice risks associated with the business and premises. Business personal property can address covered losses involving equipment and furnishings. Claims-made and occurrence answer a different question: When does the professional liability policy respond?
If you are reviewing your coverage, read the declarations, endorsements, exclusions, and applicable policy wording—not just the quote. Then ask the insurer to explain any provision that affects your services, practice entity, transition between carriers, or retirement plans.
The American Acupuncture Council provides acupuncture-focused professional liability information, coverage options, risk-management resources, and quote assistance. If you are comparing policies or reviewing an existing policy, AAC can help you identify available options and explain the program terms.
Educational disclaimer: This article provides educational information only. It does not provide legal, insurance, financial, or clinical advice. The actual policy, endorsements, exclusions, conditions, and applicable law govern insurance coverage. State requirements and available coverage can vary.
So again we’re gonna be talking about supporting insomnia or sleep issues with Chinese medicine, and this is part two.
Click here to download the transcript.
Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Hi, my name is Moshe Heller, and I’m from Moshen Center in New York, as well as the Moshen Herbs company for different herbal formulas. And today I am going to talk about… This is part two of treating, supporting insomnia with Chinese medicine. And I wanted to thank the American Acupuncture Council for letting me speak today about this important subject.
So I think we can go to the slides. So again we’re gonna be talking about supporting insomnia or sleep issues with Chinese medicine, and this is part two. In part one we talked a little bit about the pathology of in, of sleep but now we’re going to talk about patterns and formulas and how to treat them.
Again, I’m reminding you from the mechanism aspect of pattern differentiation we usually look at blood when we hear about trouble falling asleep. We think about yin when we’re talking about trouble staying asleep. And if we have a lot of restless dream disturbed sleep, we can look at the blood and Hun or blood and actually Shen or heart.
So all this is the different mechanisms that we need to look at so the first imbalance I want to discuss is this heart and kidney disharmony which is usually a representative of this yin vacuity that is not supporting the yang, and then the yang tends to rise up and disturb sleep. This is usually the pattern where it’s might be easier to fall asleep, but then wakes up frequently throughout the night.
If it’s really bad, it might be also difficult to fall asleep, but then again, the waking up at, during the night is the main thing. There could be also some night sweats and dry mouth and and palpitations and anxiety. I wrote here low-grade anxiety, but the anxiety can be quite severe. The tongue will have very little coating and be more red and the pulse will usually be more thin and tend to be a little rapid because of the deficiency heat that’s thinking– that’s happening here.
So the formula that we think about when we think about this situation is Tian Wang Bu Xin Dan. It’s a very for- famous formula for, that addresses this yin vacuity. One of the main herbs there is Shu Di Huang, Rehmannia, and is one of the basic herbs that we use for strengthening the the yin and supporting the blood.
And also there are herbs that help to relieve deficiency heat and calm the shen. So together, this is our best combination for this kidney yin vacuity with yang rising. And this in the, the correlating points then when I think of Tian Wang Bu Xin Dan is points like kidney three combined with heart seven.
Sometimes I think of heart six and kidney seven because that is the combination that allows the, the yang to go back to its source. And I usually combine that with spleen six, which supports the blood and the yin and also circulation. So those are the points that I think in this pattern. The next pattern is a heart, liver heart and liver blood vacuity where we’re seeing both difficulty falling asleep and also there could be dream disturbed sleep.
And and then there’s there could be some waking with disturbed sleep, but there … It’s not necessarily one of the important sign of the pa- pattern, and usually a little more paleness, pale tongue maybe maybe choppy pulse. There is some roughness because of the deficiency but we see definitely blood vacuity as the source.
And for this pattern, it’s more of a liver… it’s a, a livery person that we want to look for. And then the combination that we think of is Suan Zao Ren Tang. That’s the most important formula. It’s one of the main formulas we think of when we think of sleep issues or insomnia. And by the way, Suan Zao Ren could be used as a single herb to help fall into sleep.
So that’s something that we need to remember. And sometimes you can just give a handful of Suan Zao Ren and have the patient make some tea before going to sleep, and which is a great technique to help this ability to fall asleep, especially if the main issue is difficulty falling asleep.
So the acupuncture points that we might think of in this case is Spleen 6 and Heart 7 combination. We might need to also support the spleen to be able to create blood, so we can use points like Stomach 36 a- as supporting for that, and that would be our choice when we’re seeing this pattern The next pattern is a heart qi and blood deficiency with unsettled shen.
And the f- my favorite formula for this pattern is Hu Po Yang Xing Dan or amber nourished heart pill which is a very special formula. I really like that combination for insomnia, especially when it comes with pr- pal- palpitations and easily startling and this kind of unsettled shen with heart unable to support the s- the shen when it needs to go to…
when we need to go to sleep. The important thing is the Hu Po Yang Xing Dan is all about this ability to transition, but also it works on the heart’s ability to focus and concentrate. So I use this formula for children who have a lot of blood heart qi and blood vacuity together with sleep disturbances, but as well as difficulty fol- fo- focusing with ADD and ADHD.
So this is a, a, a very versatile formula and can be used in many ways and one of my favorite formulas, Hu Po Yang Xing Dan. The correlation may be a combination of Heart 7 and Pericardium 6, and together with Bladder 15, and sometimes we can even think of Bladder 20 to nourish the spleen and support that blood production.
And the next formula is more of an excess type of insomnia, right? When we have a lot of liver qi stagnation causing either depressive heat or actually depressive fire, or fire coming from this liver qi stagra- stag- stagnation. So there’s people with a lot of agitation, and they get very anxious, and they get very, they think of all the things that they haven’t done when they need to go to sleep, and they, instead of falling asleep, they start trying to solve all the things that they haven’t done. So there’s this very strong difficulty falling asleep, a lot of irritability and anger outbursts, very typical of liver constraint.
And the thing that we– the formula that we think in this case is Chai Hu Long Gu Mu Li Tang. It’s a sedative formula, right? It sup- it suppresses the liver, but also helps with moving the liver qi. And and it’s usually w- the thing that the type of insomnia that we’re looking here is more of an excess type.
The person or the patient is more of an excess patient. Then we need to think of points that move the liver, so we can use Liver 3, we can use Gallbladder 34, and we combine that with Heart 7 to calm the spirit, and we can get a good effect on that w- with these points. So these are just examples, and you– it gives an idea of how to address these issues So there’s another aspect that we need to think of in terms of insomnia and that’s when we have phlegm or phlegm-heat or phlegm-dampness, and that’s harassing the heart.
And so when we get that, we’ll have really restless sleep, very vivid or disturbing s-dreams. There’ll be also some chest oppression and sensation of phlegm in the throat. And maybe if there’s heat involved, if it’s phlegm damp… If it’s phlegm-heat there’ll be some bitter taste in the mouth. Or if there’s phlegm-dampness, it might be only a kind of feeling of nauseous and a sweet taste in the mouth.
And the pulses, of course, will be very slippery and rapid or just slippery and a greasy tongue coat is definitely could be involved. So the formula that I think in this case is Wen Dan Tang, and Wen Dan Tang is very important formula for many issues relating– emotional issues that that are resulting from dampness that’s hindering the free flow of the liver qi liver and gallbladder qi.
So I think of Wen Dan Tang when people get stuck in their thinking, stuck in their activity, and then also have this a lot of repeated dreams, like the dreams are play, are played on replay because the phlegm is causing that stuckness that’s associated with damp and phlegm that we know from Chinese medicine.
Wen Dan Tang is an amazing formula, and if there’s a lot of heat, you can think of Huang Lian Wen Dan Tang as another option. The acupuncture points that are associated with that would be maybe Pericardium 5 together with Stomach 40 and Heart 8. Or for those of you who are shy of making or of needling Heart 7, Heart 8, you can think of Heart 7 as another option for that.
That’s the, the phlegm harassing the heart, or sometimes it’s called gallbladder deficiency with phlegm accumulation. Okay. So I want to just point out two important herbs that I always think of when I I’m thinking about when I’m making the formulas for these patients who are suffering from insomnia.
One of them is Suan Zao Ren, and we mentioned that earlier how important this herb, especially in people who are having difficulty falling asleep. And there’s also a lot of information about Wu Wei Zi, and traditionally we are using Wu Wei Zi with- for as an astringent, as kind of holding the jing or astringent the jing, and it calms the shen and it helps to consolidate the exterior.
So it has to do something with the Wei Qi circulation and it’s just used a lot for insomnia. So when you are making formulas for your patients that are dealing with sleep issues, definitely think of these two herbs to add there to help with the different aspects of insomnia so again, when we are treating insomnia, always diagnose the, where it’s, where the disturbance is happening.
So you n- the– let that guide you in what’s happening. So if it’s more at the beginning of the sleep, the middle of the sleep sometimes early waking is another pattern that we need to look at. And then match your treatment to the specific pattern. And always know that there are some general things that you need to know, do.
And one of the other things that we always need to discuss is what we call sleep hygiene, which is keeping the environment that you’re… When you’re walking into a place where you’re going to sleep, how can you make it clean and not disturbing to your, the pattern of falling asleep and staying asleep?
This ends our second part. I want to again, thank the American Acupuncture Council for letting me speak today about sleep disturbances. And thank you very much. And again, if anybody wants to be in touch with me and to ask more questions, please feel free to contact either the motioncenter@gmail.com or motionherbs@gmail.com.
And you have the two relative and websites on the slide here. And thank you very much for your time.
American Acupuncture Council | Revived publication
Acupuncture is generally regarded as a relatively safe clinical intervention when performed by appropriately trained practitioners, but no invasive procedure is risk-free. For acupuncture practices, malpractice risk management is therefore broader than buying insurance. It starts with sound clinical screening and technique, continues with informed consent and accurate records, and includes knowing how professional liability coverage responds if a complaint or claim develops.
This article updates the American Acupuncture Council’s original presentation around three practical areas: documentation, informed consent, and insurance coverage.
Watch the AAC presentation on documentation, consent, and coverage.
A transcript download was not located on the current AAC page during this revival review. If a transcript exists in the AAC media library, preserve or restore that asset near the video before publication.
AAC’s patient-record guidance emphasizes documenting the reason for the visit, medications and allergies, examination findings, diagnosis, treatment plan, treatment provided, patient education, referrals, and follow-up. The broader principle is simple: the record should accurately reflect what you assessed, what you did, why you did it, and how the patient responded.
CMS likewise describes complete, accurate, timely documentation as important to patient care and compliance. Although CMS requirements do not automatically govern every acupuncturist, the documentation principle is useful: avoid vague, incomplete, or copy-forward notes that do not reflect the encounter.
For acupuncture, a practical treatment note may include:
Electronic records deserve particular attention. AAC specifically cautions against “cookie cutter” notes that look identical from visit to visit. Templates can improve consistency, but they should not replace encounter-specific documentation.
A signed consent form can be useful documentation, but informed consent is fundamentally a communication process. General medical-ethics guidance emphasizes discussing the nature and purpose of an intervention, material risks and expected benefits, alternatives when appropriate, and the patient’s opportunity to ask questions. The exact legal requirements for informed consent vary by jurisdiction and profession.
For acupuncturists, the conversation should be appropriate to the actual treatment and patient. The 2009 prospective safety study of 229,230 patients found that bleeding or hematoma, pain, and autonomic or “vegetative” symptoms were among the more common reported adverse effects; two patients experienced pneumothorax. The study also developed a consent form with modules addressing acupuncture, risks, conditions that increase risk, and consent.
More recent evidence reinforces the importance of recognizing that serious adverse events are uncommon, but not impossible. A 2021 systematic review and meta-analysis of prospective studies estimated serious adverse events at about 7.98 per million treatments, while noting substantial heterogeneity among studies.
That means consent should be clinically meaningful rather than generic. When a patient’s circumstances or the planned intervention changes the risk profile, document the relevant discussion. Depending on the case, that may include issues such as anticoagulant use, bleeding risk, pregnancy-related considerations, infection risk, needling near the thorax, or other factors relevant to the treatment plan and the practitioner’s scope.
Consent does not eliminate risk or guarantee a defense to a claim. It is one part of a broader process of safe care, communication, and documentation.
Risk management should begin before the needle is inserted. The World Health Organization’s benchmarks for the practice of acupuncture address procedures, facilities, and safety, providing a framework that can be used to evaluate practice systems.
For a practice, that translates into routine attention to:
The evidence base also supports a balanced message. A 2013 systematic review of case reports identified serious complications including infections, tissue or organ injury, and pneumothorax, while case reports cannot establish the incidence of complications in routine practice. A 2021 prospective-study meta-analysis found that most reported adverse events were minor, while serious events were rare.
The practical lesson is not that every adverse event indicates malpractice. It is that practitioners should have systems for prevention, recognition, response, communication, and documentation.
Insurance is a backstop, not a substitute for clinical risk management. Practitioners should review the actual policy, including covered services, limits, exclusions, reporting obligations, and provisions that apply to claims-made or occurrence coverage.
The National Association of Insurance Commissioners explains the basic distinction: an occurrence policy generally responds based on when the covered event occurred, while a claims-made policy generally responds when the claim is reported during the applicable policy period, subject to policy terms, retroactive dates, and any extended reporting period.
That timing issue matters when changing carriers, retiring, closing a practice, or otherwise ending a claims-made policy. Do not assume that a new policy automatically covers prior acts or that every policy treats tail or extended reporting coverage the same way.
AAC provides current information on its policy and coverage options, including acupuncture-focused professional liability coverage, additional insured options, premises liability, and other endorsements. Because insurance terms can change and coverage depends on the actual policy, practitioners should verify current terms directly with the carrier or qualified insurance professional.
Preventing acupuncture malpractice claims is not about assuming that every complication can be avoided. It is about building a practice in which clinical safety, patient communication, documentation, and insurance coverage reinforce one another.
Good records cannot guarantee that a complaint will never occur. A consent form cannot waive every legal or clinical obligation. Insurance cannot replace appropriate care. But together, these measures create a more disciplined risk-management system and a clearer record of how care was planned, delivered, and followed up.
If you are reviewing your acupuncture professional liability coverage, AAC provides information about its policy, coverage options, claims service, and risk-management resources. Practitioners can also request a current Quick Quote.
This article provides general educational and risk-management information. It is not medical, legal, insurance, financial, or regulatory advice and does not establish a standard of care. Requirements vary by jurisdiction, profession, and insurance policy. Practitioners should follow applicable law and professional standards and obtain qualified legal, clinical, or insurance advice when appropriate.
And one of the chapters in the book is all about self-care. So what are some of the things that you need before getting started?
Click here to download the transcript.
Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Hi. Welcome to today’s presentation on facial acupuncture self-care. My name is Michelle Gellis, and I would like to thank the American Acupuncture Council for this opportunity to present to you today. Can we go to the first slide?
So I put this present… i’m an acupuncture physician. I’ve been seeing patients for over 22 years now. And I put this presentation together because I teach cosmetic and neuromuscular facial classes internationally, and have been for over 20 years. And one of the questions that frequently gets asked to me is, do I treat myself?
And the answer is, yes, I do. So I thought I would share some of the information today with you. And one source of this information is from my book. I have a almost 500-page hardcover, full-color textbook resource manual on treating the face, and it covers everything from cosmetic acupuncture to Five Element acupuncture facial cupping, gua sha, microneedling, neuromuscular conditions, and a wide range of topics, everything related to treating the face.
And one of the chapters in the book is all about self-care. So what are some of the things that you need before getting started? One thing you will need is a magnifying mirror. I have one here that I got on Amazon. Fingerprints all over it. But this one lights up. Wait a minute. Let me center it. Can’t see what I’m doing, but it does…
Take my word for it. It lights up. There we go. And this is a great little travel one. I have a more substantial one at home that plugs in, but this is rechargeable, and it does the job. So before I get started, I can turn that on, and I can see what I’m doing Also, if you’re going to be doing acupuncture on yourself, you’ll need a sharps container and some tweezers if you’re going to be inserting any intradermal needles, which are those tiny little needles.
I think I have a picture of them in a future slide. But these are by Tweezerman. They have a wide grip and a slanted tip, which makes them really good for grabbing those little intradermal needles and inserting them. Arnica gel. I prefer the gel as opposed to the cream. And arnica gel is also really good for preventing bruising.
Also has a little alcohol in it, which helps to clean the face. And because of the different ingredients, some of the arnica gels can help with pain and sensitivity also The needles that I use when I do cosmetic acupuncture on myself are the .14 the shorter needles, the 0.5 millimeter and the .14, 1.0 millimeter needles.
And the longer ones I use for the more fleshy part of the face and the shorter ones I use for the more bony parts of the face. I do like the Seirin needles and using tubes for insertion so that I’m not coming at my face with just the point of a needle. So these are those intradermal needles I was talking about, and lots of needle manufacturers make intradermals.
I like these because of the way they were packaged. There was five needles on a little piece of foam, and then you could just pull them by the handle. And then I typically squeeze a wrinkle and push the, these tiny little intradermal needles in not perpendicular to the skin but parallel inside the wrinkle.
Q-tips are helpful to have in case you see any bleeding or potential bruising about to happen. And then it’s a good idea to have maybe a piece of paper. Look at yourself in the mirror. Decide what you want to work on. Do a little self-diagnosis. Maybe draw some lines on a picture. And that way you have something to think about when you’re doing your treatment plan.
And of course, make sure to check that you have no contraindications or precautions. I cover all of these in detail in my webinars and facial acupuncture has different contraindications and precautions than a typical acupuncture treatment would So you’re gonna make your plan. Where am I gonna put the intradermals, and which acupuncture points am I going to do for different conditions?
Am I going to do any threading of a longer needle into a ring– into a wrinkle? And am I going to do any points on my body? I typically don’t, but sometimes I’ll do maybe some points in my feet. Or if I’m going to lay down, I can do a couple of points in my hands, let’s say large intestine four.
And then while I’m lying down, those points can work Make certain to review your safety concerns as far as what to look for veins, arteries, nerves on your face. Re-familiarize yourself with facial anatomy before you start putting needles in your face, and then review your techniques. My classes have specific mandatory points and optional points that we use.
And so you wanna think about your own needs and which points are you going to use, and really use precision needling techniques when you’re working. So threading yourself is, You could see I’m looking at myself in the mirror here. Again, these are pictures from my book. But threading the nasolabial fold here with a shorter needle and putting an intradermal in.
You can see I’m squeezing the wrinkle, and I’m placing the intradermal into a little chin wrinkle. So you want to go through your protocol starting at the lower part of your face, working your way up. I tend to work on both sides of my face when I’m needling, not one side and then the other. But that way I can work from the bottom up and do all of my threading as a first thing.
Something else I do on myself after I take all the needles out, I do facial cupping and gua sha. And for cupping, I recommend using glass cups with bulbs that are easy to squeeze. These are from AccuLift. They come in a set. This is what the set looks like. Comes with two cups, two gua sha tools, a little velvet bag, and a case for them.
And using cupping oil. These are available at acculiftskincare.com, and the oil has Arnica and CBD in it, things that are very calming for the skin and help to prevent bruising. So I take all my needles out, and then I’m going to do my cupping. Always starting with a lymphatic drainage. Again, don’t try to just wing it or make stuff up or watch some YouTube video.
It’s important to get properly trained before you do facial cupping and especially working on yourself. You don’t wanna injure yourself when you’re doing cupping. For gua sha, again I do the cupping first, and then I do the gua sha after the needles come out. I use genuine jade gua sha tools and the same oil.
And I always start along the clavicle, massaging lymph nodes and then walking working across the jaw, so from the bottom of the face up. And this entire protocol is available, again, on my website, facialacupunctureclasses.com. You can see I have CEUs recorded webinars step by step exactly what you’re supposed to do.
For microneedling, that can come in several different forms. You can either use a derma roller on yourself, or you could use a microneedle pen. And these are all tools available from Accu Lift. These microneedle pens are professional grade and professional quality pens. Or you can use one of these devices.
This is a Hydra needle, so you fill it with serum, and you would stamp the serum directly into the skin. And these are all forms of microneedling So if you would like more information on self-care for acupuncturists, for health professionals, you can go to my social, which on Facebook I have a personal page, Michelle Gellis.
I also have a professional page on Facebook, Facial Acupuncture Classes, and a Facebook group called Facial Acupuncture. I’m also on Instagram and TikTok under my name, Michelle Gellis. And I have two websites, facialacupunctureclasses.com and my affiliate, which is aculiveskincare.com for tools and serums and oils and things like that.
You can also get my book there. Again, I wanna thank the American Acupuncture Council for this time to speak to you about self-care, and I hope to see you again soon.
Video: Watch the AAC presentation above. A transcript/download link was not identifiable on the current source page; see the Manual WordPress Tasks below before publication if an original transcript asset exists.
Prospective evidence supports the overall safety of acupuncture while showing that adverse events are not zero. A 2021 systematic review and meta-analysis found at least one adverse event in about 9.31% of patients undergoing an acupuncture series and 7.57% of treatments. The most frequent events were minor, with bleeding, pain, or flare at the needling site accounting for about half of reported events. The review estimated serious adverse events at 7.98 per million treatments, although the authors emphasized substantial heterogeneity in study methods and adverse-event definitions.
A 2024 review likewise concluded that serious acupuncture-related adverse events are rare and identified pneumothorax, nerve injury, heart injury, abdominal-organ injury, infection, and needle breakage among the important serious events reported in the literature. Common minor events included bruising, hematoma, bleeding, dizziness, fainting, tiredness, and residual needling pain.
Case-report literature should be interpreted differently from prospective incidence studies. Case reports can identify rare but important complications, but they cannot establish how frequently those events occur. For example, systematic reviews of case reports have documented pneumothorax and other organ or tissue injuries, reinforcing the importance of anatomy, appropriate needle depth and direction, sterile technique, and clinical vigilance.
A minor reaction does not automatically mean negligence or malpractice. The clinical event and the legal question are separate. A patient can experience an expected or recognized adverse reaction even when care was appropriate. Conversely, a seemingly small event can become more consequential when follow-up is missed, warning symptoms are minimized, the patient is not given appropriate instructions, or the record does not accurately describe what occurred.
From a risk-management perspective, the critical transition is often not the initial event but what happens next. Consider a patient who becomes lightheaded after treatment. The immediate response may be straightforward. The risk increases if the episode is not assessed, the patient is allowed to leave before it is appropriate, the event is not documented, or the patient later reports worsening symptoms and cannot understand what happened or whom to contact.
The same principle applies to bleeding, bruising, increased pain, suspected infection, retained or broken needles, or symptoms that could signal a more serious injury. The appropriate response depends on the clinical circumstances and the practitioner’s scope, training, and applicable law.
1. Document the treatment. Record the relevant history, examination findings, treatment performed, points or regions treated, patient response, and clinically significant adverse events. AAC emphasizes the importance of accurate patient records because documentation can become important if a complaint or claim later arises.
2. Explain foreseeable reactions. Patients should understand what they may experience after treatment and what symptoms warrant contacting the practice or seeking medical evaluation. Communication should be understandable and consistent with the actual treatment provided.
3. Use informed consent appropriately. AAC advises using a professionally prepared informed-consent process, discussing the form with the patient, answering questions, and noting in the record that the discussion occurred. Requirements vary by state, so practitioners should confirm the rules that apply to their practice.
4. Recognize when referral or escalation is appropriate. Acupuncture practice does not eliminate the need for medical assessment when symptoms fall outside the practitioner’s competence or suggest a potentially serious condition. WHO’s acupuncture benchmarks emphasize stepwise treatment procedures, appropriate infrastructure, and safety practices.
5. Have a plan for complaints and claims. If a patient reports an unexpected injury or threatens a claim, avoid speculation or admissions about legal responsibility. Preserve the clinical record, communicate professionally, and follow the procedures of your professional-liability carrier or legal advisers.
Good risk management should come before insurance. Sterile technique, anatomy knowledge, appropriate needle selection and depth, patient screening, informed consent, clear aftercare instructions, accurate documentation, and timely referral all reduce avoidable risk.
Insurance serves a different function. It helps provide financial and legal protection when a claim or other covered proceeding occurs. AAC describes its risk-management and claims service as part of its broader member support, with specialized experience in acupuncture-related professional liability. Coverage terms vary, so practitioners should review the actual policy rather than relying on general statements about insurance.
The safest approach is neither to assume that acupuncture is risk-free nor to treat every adverse event as evidence of malpractice. Instead, treat every unexpected reaction as a clinical communication and documentation opportunity. Assess the patient, respond within your competence and scope, give appropriate follow-up instructions, document what happened, and escalate care when indicated.
That approach protects the patient first. It also creates a clearer record of the care provided if questions arise later. For acupuncture practice owners, a written risk-management process and appropriate professional-liability coverage can provide an additional layer of protection.
Minor acupuncture complications are often transient, but they should never be dismissed. The evidence supports acupuncture as a treatment with relatively uncommon serious adverse events, while also documenting rare but potentially severe complications. For practitioners, the practical lesson is straightforward: use sound clinical technique, communicate foreseeable risks, document care carefully, recognize red flags, and know when referral is necessary. Insurance cannot replace those practices, but appropriate professional-liability coverage can help a practice respond when an unexpected event develops into a complaint or claim.
Learn more about AAC’s approach to acupuncture risk management, informed consent, and professional-liability protection. Practitioners can review AAC’s risk-management resources and obtain current coverage information directly from the American Acupuncture Council.
Educational disclaimer: This article is for educational and professional risk-management information only. It is not medical, legal, insurance, or regulatory advice and does not establish a standard of care. Practitioners should follow applicable law, professional standards, scope-of-practice rules, and the terms of their insurance policy, and obtain qualified advice when needed.