There are a variety of approaches to diagnosis and treatment in American acupuncture that incorporates medical traditions from China, Japan, Korea, Tibet, Vietnam, and France. " (2002) The American Medical Association additionally reports: "Acupuncture has been used by millions of American patients and performed by over 5,000 U.S. physicians, dentists, acupuncturists, and other practitioners for relief or prevention of pain and for a variety of health conditions. After reviewing the existing body of knowledge, the U.S. Food and Drug Administration reclassified acupuncture needles from the category of "experimental medical devices" in 1996 and now regulates them just as it does other devices, such as surgical scalpels and hypodermic syringes, under good manufacturing practices and single-use standards of sterility." (2002) Stated in conclusion by the American Medical Association relating to acupuncture is: "In addition to a positive clinical-therapeutic outcome, reported benefits to patients include avoidance of toxic side effects of pharmaceutical drugs, accelerated healing process, improved immunity, stress reduction, neuroendocrine balancing, and a greater sense of well being." (2002)

It is reported in the work of Dower (2003) that some individuals see acupuncturists "as their primary health care providers; others see them for selected health concerns or by referral from and in conjunction with care from another health care practitioner." Various conditions are listed by the World Health Organization as being treatable through acupuncture including respiratory and bronchopulmonary diseases and orthopedic, gastrointestinal and neurologic disorders." (Dower, 2003) Other conditions that California Acupuncturists utilize acupuncture treatment for include "adult post-operative and chemotherapy nausea and vomiting...rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma where acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program." (Dower, 2003)

Currently there are reported to be approximately 6,300 acupuncturists in the state of California who are licensed by the California Board of Acupuncture. Approximately 88% of these practice in urban settings and it is shown by licensure data that 86% of the state's acupuncturists are located in the largest 13 urban counties of California. Acupuncturists in the state of California are "trained in acupuncture and oriental medicine as well as western medicine...[and are required to complete] "...a minimum of 2348 hours of education and training, usually in a four academic-year program." (Dower, 2003)

It is reported that recent legislation in the state of California relating to schools that are approved to offer acupuncture that a minimum of 3,000 hours of study must be offered to students and followed a bill that was "hotly debated within the professional community and, while several programs already have close to or more than 3,000 curriculum hours, the new requirements may prove to be challenging to other schools. The effect of the increased hours on program costs and student recruitment is unclear." (Dower, 2003)

The work of Barnes (2008) entitled: "The Acupuncture Wars: The Professionalizing of American Acupuncture" states: "Since the 1970s, when Chinese acupuncture re-entered the awareness of the American public, it has encompassed multiple and sometimes conflicting orientations toward practice, practitioner identity, training, credentialing, and social status. Individuals who once saw themselves as countercultural guerrilla figures must now undergo increasingly complex examination and licensing procedures, along with an educational system that, in certain respects, bears a growing resemblance to biomedical training." Barnes additionally states in this work that "...this process has unfolded within the context of alternating interest, indifference, and rejection on the part of the dominant biomedical culture" and cites Wolpe (1985) Barnes addresses that transition that has occurred in what is termed to be a socialization process called professionalization and refers to the experiential marketplace challenges among members of this profession as the acupuncturist has secured a 'place' "in the medical landscape of the country." (2008) Barnes states that in the initiative of the study of professions, and specifically the acupuncturist profession makes a requirement of the "examination of the social dynamics..." (2008)

There are traditionally and historically two separates strains of acupuncture roots and beginnings and this is only in the country of China since other significant country derivations of acupuncture include those of Japan, Korea, and Vietnam. Acupuncture is considered to be an alternative and holistic form and method of treatment. Acupuncture history in the United States has been rife with challenges to its long-term use however, after a period of time which included the simplification of the technique and the minimization of its claims (Barnes, 2008) Acupuncture however, appearing...

(Barnes, 2008)
PURPOSE of the STUDY

The main purpose of this study is the analysis of the social interaction / structure between acupuncture doctors and their patients. Perhaps, that will help to explain the rising popularity of acupuncture and alternative medicine in Southern California. Alternative medicine and acupuncture, historically practiced in China, have become popular in America. The purpose of this study is to analyze the acupuncture treatment in a qualitative approach... To understand the underlying social interaction / structure between acupuncture doctors and their patients. Perhaps, that will explain, or make some contribution to the explanation of, the rising popularity of acupuncture in Southern California.

LITERATURE REVIEW

Findings from studies conducted in relation to the views of doctors on patients and alternative therapies reports that 68% of all doctors surveyed stated that approximately 15% of their patients utilize complementary medicine. Among these doctors, 58% always or often asked their patients about these therapies. Obviously, more patients are utilizing the alternative medical treatment and the work of Christine an Barry entitled: "The Role of Evidence in Alternative Medicine: Contrasting Biomedical and Anthropological Approaches" relates that the growth of alternative medicine and its insurgence into the realm of the biomedical system raises a number of questions about the nature of evidence." (Barry, 2005)

Because of the increase in the availability to alterative therapies in the Western world, resulting as well is a movement by the 'grassroots' element toward what is known as integrative treatment and this has occurred concurrently to the "rise in alternative and integrated medicine" combined with a "movement towards increasing reliance on science-based research to judge the effectiveness of treatments, otherwise known as evidence-based medicine (EBM)." (Barry, 2005) Paul J. Rosch and Helen M. Kearney presented a comprehensive overview in 1985 of the growing trend of holistic medicine in relation to the state of conventional medical technology. Their analysis focused on the field of American medicine, which seemed to be the most appropriate site for observing the development and use of medical technology in conjunction with the growing interest in natural, holistic approaches to health enhancement. Rosch and Kearney (1985) describe this interaction between technology and holistic health as a "modern dialect" that has generated important qualitative discussions concerning the nature of health care. Rosch and Kearney's examination of this issue also touches on what they call a "search for a new paradigm" where both the holistic movement and the movement for medical technology could come to a point of "workable equilibrium."

Rosch and Kearney (1985) begin their analysis with an overview of how people think about conventional medicine and alternative care, respectively. The authors assert that American physicians are witnessing rapid changes in the delivery of conventional medicine. Some of these rapid changes are ultimately resulting in the depersonalization of the patient by means of decreased time for patient care, computerization of medicine, etc. At the opposite end of the playing field we see the state of the holistic health movement, where the patient population is becoming increasingly well-informed about their own bodies and are enthusiastically latching on to the idea of health-care as opposed to sick-care. Throughout their comprehensive overview, Rosch and Kearney (1985) underline the fact that the doctor-patient relationship is going through wholesale changes and emerging as something closer to an equal partnership. Other studies have shown the difficulties of analyzing alternative healthcare in quantitative terms. Raphael J. Leo and Jesus Salvador a. Ligot Jr. produced a systematic review of randomized controlled trials (RCTs) that tried to test the effectiveness of acupuncture in the treatment of depression. Leo and Salvador Jr. examined nine RCTs, five of which were deemed to of low quality. The purpose of this review was to analyze and further understand the relationship between acupuncture's ability to treat physical pain and its ability to effect emotional states. Ligot Jr. And Leo's review concluded with mixed results, demonstrating the difficulty of analyzing alternative care in terms of standardized categories.

Guerrera (2008) writes in the work entitled: "Healing with Needles" as follows:

now more than ever, the rediscovery of the importance of relational healing factors and optimal healing environments is on the rise. Those subtle, often elusive aspects of healing, so challenging to measure and define, seem key to the preservation of medical practice and the well-being of those we serve.…