Traditional Chinese medicine, including acupuncture, is a regulated healthcare profession in the United States. A common question is whether a medical doctor must perform the procedure. The definitive answer is that a medical degree is not required to practice acupuncture, but a license from a state regulatory board is mandatory. The professional extensively trained and licensed to perform this care is known as a Licensed Acupuncturist (L.Ac.). Their comprehensive education sets them apart from other healthcare providers who use needles in a more limited capacity.
Defining the Licensed Acupuncturist (L.Ac.)
The designation Licensed Acupuncturist, or L.Ac., refers to a dedicated professional whose scope of practice centers on the full spectrum of traditional acupuncture and Oriental medicine. This practitioner is recognized as an independent healthcare provider in most states, capable of conducting a comprehensive diagnosis based on the principles of Traditional Chinese Medicine (TCM). The L.Ac. utilizes needling techniques along the body’s meridian system to restore balance and promote the flow of energy, known as qi.
The training of an L.Ac. includes a wide array of adjunctive therapies that constitute the full practice of TCM. These methods may include Asian bodywork, moxibustion, cupping, and dietary or nutritional counseling. The L.Ac. is also typically trained in Chinese herbal medicine and, in many states, licensed to prescribe and dispense herbal formulas. This comprehensive background allows the L.Ac. to treat a broad range of conditions, from musculoskeletal pain to internal disorders like insomnia.
The Educational Pathway to Becoming an L.Ac.
Prospective acupuncturists must first complete a minimum of 60 to 90 semester hours of undergraduate coursework before enrolling in a professional program. The professional education is conducted at the graduate level, typically resulting in a Master’s or an entry-level Doctoral degree in Acupuncture or Oriental Medicine.
A standard Master’s program in Oriental Medicine requires a minimum of approximately 2,625 educational hours over four academic years. These hours are split between didactic instruction in TCM theory, point location, and diagnosis, and extensive training in Western biomedical sciences. The curriculum is complemented by rigorous supervised clinical training, involving hundreds of hands-on patient contact hours. This ensures competency in all aspects of patient care and sterile needling techniques.
State-by-State Licensing and Certification Requirements
The authority to license and regulate acupuncturists is maintained by individual state governments, which means the specific requirements for practice can vary across the country. The majority of states, however, rely on a national credentialing body to ensure a baseline standard of competency for licensure. This standard is primarily set by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).
The NCCAOM administers a series of comprehensive examinations that cover the foundations of Oriental medicine, acupuncture with point location, and biomedicine. A passing score on these examinations, or a current NCCAOM certification, is accepted by 45 states plus the District of Columbia as a prerequisite for state licensure. States use the NCCAOM certification as documentation of competency before issuing the official L.Ac. license.
For instance, a few states, most notably California, administer their own state-specific licensing examination instead of requiring the NCCAOM exams. Furthermore, while the NCCAOM offers separate certifications for Chinese Herbology, some states mandate that practitioners pass this specific examination if they intend to include herbal medicine within their legal scope of practice.
Physicians and Other Healthcare Professionals Using Acupuncture
While the L.Ac. represents the most intensive training pathway, physicians and certain other healthcare professionals are also permitted to use needling techniques within their existing licenses. Medical doctors (MDs) and doctors of osteopathy (DOs) in most states can practice acupuncture, but their training is typically a fraction of the hours required for an L.Ac. For example, a physician’s training program may consist of approximately 200 to 300 hours of instruction, often focused on applying acupuncture for pain management or specific medical conditions.
This limited-scope training for physicians concentrates on anatomical point selection and is not based on the comprehensive diagnostic framework of TCM. Their use of acupuncture is viewed as an adjunctive procedure within their conventional medical practice. Similarly, other licensed professionals like physical therapists (PTs) or chiropractors (DCs) may undergo specialized, short-course training. This training is usually restricted to musculoskeletal issues and trigger points.
Distinguishing Acupuncture, Dry Needling, and Related Practices
A point of confusion for many people is the distinction between traditional acupuncture and the related practice of dry needling. The key difference between them lies in the underlying medical philosophy and the placement of the needles. Traditional acupuncture is rooted in the principles of Traditional Chinese Medicine, where needles are inserted into specific points along the body’s meridian pathways to influence the flow of qi and treat the root cause of a condition.
Dry needling, conversely, is a treatment that emerged from modern Western medicine and anatomical studies. It is primarily a technique for treating myofascial pain and movement impairments by targeting specific, hyper-irritable spots in skeletal muscle known as trigger points. The intent of dry needling is to elicit a local twitch response and release tension in the muscle, based on neurophysiological principles. While both practices use needles, the diagnostic framework, insertion location, and therapeutic goal are distinct.