Vote Yes to allow Certified Athletic Trainers add dry needling.

To be quick, this discussion is not about efficacy (already well established) or safety as long as practitioners stay within their training level (there needs to be multiple levels of training and permissions).  This conversation has devolved into a “turf war” centered around fear of who gets what piece of the health care dollar. 

1. Current scope and education of athletic training is adding basic skills to athletic training practice such as simple uninterrupted sutures and emergency IV placement for hydration and heat illness.  These are invasive skills, and the Team Physician should be signing off on these skills and subsequent standing orders placed in a policy/procedure manual.  No one argues about Athletic Trainers being trained and supervised for these skills because no one is worried that dollars are not being spent at local Emergency Departments or Health Clinics.  To be satirical, if all the sutures would someday be done in a training room, would that mean no one would ever need to use an Emergency Room anymore?  Of course not.  Allowing Athletic Trainers to dry needle is about the fear that Athletic Trainers would somehow take all the dry needling “money” from other providers.

2. Athletic Training is and should not be worried about revenue stream.  Side point, when our skill set comes to its end, a referral to the best provider or manual therapist should be quickly done for the best aid for the athlete/patient.  We should be focused on maximizing performance by using our personal skill set, building a Provider Team around our athletes/patients, and learning from that Team of providers to help future patients.   Athletic Training is a collaborative effort.  A principal part of our vocation is to get athletes/patients to the right provider at that right time.  Allowing Athletic Trainers some base level dry needling skill only helps this group effort.

3. Not to point fingers but:

4. 1. Acupuncturists believe only they should “dry needle”.  Not athletic trainers, not physical therapist, not chiropractors, not any other therapist other than acupuncturists.   Only they have the correct theory “how to needle.”  I believe this is an incorrect philosophical belief. That said, they have the most experience and I would refer an athlete to them for my most difficult cases.  Not for their “theory” but honestly for their acquired skill.

5. 2. Physical Therapists (only some) can still struggle with the belief that athletic trainers are just not educated, or skilled enough do things like dry needling.  But I don’t believe this is the real reason Physical Therapists would push against Athletic Trainers dry needling.  Money is the reason.  Not to get stuck here, but Physical Therapy referrals are an important part of building an Athletic Performance Model.   There should be and there will be continued referrals to Physical Therapists for rehabilitation, manual therapy, and dry needling work. 

For these reasons and many others, please consider clearly defining dry needling as a valid tool in the Athletic Training Scope of Practice in the State of Virginia.  Thank you.