Acupuncture at the Phoenix VA: An Interview with Dr. Nacchal Nachiappan

Acus Acting Executive Director Brad Erickson, PhD, interviews Acus graduate Nacchal Nachiappan, MD, about her experience using acupuncture to treat veterans.

Where do you practice medicine, what kinds of patients do you care for, and what are their particular challenges?

I’m at the Phoenix VA. My specialty is general internal medicine and I see a lot of patients with chronic pain and mental health issues. The patients are more vocal in expressing their feelings and can be more aggressive in their demands than the general population. I try to explain things and show that I’m offering something different. I demonstrate that I’m not ignoring them, and that I’m giving them different options as I provide comprehensive care. I do this so that they feel they’re being heard and in order to build a relationship of trust with them that will carry forward into the future.

How did you come to integrate acupuncture into your clinical practice?

Taking the course with Dr. Helms opened up a variety of therapies and modalities, including electrostimulation for patients who didn’t want me to use needles. The patients really like it. You usually don’t get to cure people before your eyes but these practices can produce results on the spot. Only a few minutes of treatment can have a huge impact.

How does the option of acupuncture change your treatment approach?

I don’t have to wait to give a referral or wait to see how patients respond to treatment. Some patients experiencing pain are already taking as much narcotics as we can give them. Acupuncture is a great option that helps these patients. Many of them respond immediately while others respond over time.

What do you see as the obstacles and opportunities for the expanded use of acupuncture in the VA?

Currently, we have to get a consent form signed before we can administer acupuncture but that requirement will end soon. We’ll have one less barrier to using acupuncture. In common care we have many things to accomplish. My nurses and secretaries help advertise acupuncture to patients, so there is more demand. We’ve established a weekly acupuncture clinic so that I can see more patients.

In the military they do the battlefield acupuncture protocol on 30 to 40 patients together with just one doctor and a couple of assistants. They all get the same protocol and it’s very efficient. I thought I could try that but many patients want to discuss other problems, and record keeping is a challenge that tends to slow things down. However it’s still better than separate appointments.

Have you seen any patients achieve dramatically improved health incomes that you can attribute to acupuncture? Can you tell me about any patients in particular?

Yes, I had one patient experiencing level 8 pain on a 1-10 scale and with just two acupuncture points he felt much better. He came in on a wheelchair and walked out with a walker. Other patients come in every six to eight weeks for a treatment and they say it helps them sleep better and the treatment lasts a long time. I had another patient taking a huge amount of methadone, 180 5mg pills per month. After a series of acupuncture treatments he’s down to 40 pills a month and the goal is to get him off it completely.