Without proper training and licensure practicing any form of needling becomes a public safety issue. Would PTs be comfortable if personal trainers started helping patient to rehab from surgeries? questions is also important if they would begin billing insurance. Regardless of how other modalities (PTs) feel about it- using medical treatments without proper training and licensure and insurance undermines all health care practices and the system that is in place to provide safe, fair and ethical administration for the patient. Without clear boundaries of these systems the reliability and safety of these practices suffers. Using filiform needles under any other name but acupuncture (with the training and licensure that is included in that) is unethical and unsafe.