Perceived Barriers of Implementing Battlefield Acupuncture in Outpatient Family Medicine Clinics: A Qualitative Study

Background: Battlefield Acupuncture (BFA) is a quick, in-office procedure effective in treating pain. Supplies cost between $6.40 and $8.50 per procedure, with up to $116 reimbursement per session. Despite availability in training and implementation in military medicine, BFA is not frequently performed in civilian medical care. We investigated what perceived barriers exist to implementing BFA in civilian practices. Methods: We performed a qualitative study by interviewing nine faculty physicians of the University of Nebraska Medical Center Family Medicine Residency program in Omaha, Nebraska. After obtaining demographic data, we utilized a 12-question standardized interview protocol, with clarifying follow-up questions when needed. Interviews were recorded and transcribed. Transcripts were reviewed by investigators independently looking for common themes. Independent results were then evaluated as a group. Results: The most common barrier reported was patients’ ability to pay, as BFA is not usually covered by insurance. Other common barriers included the credentialing/privileging process within a large health care system, and lack of patient awareness and physician education on the technique. Time to become trained and the time required to perform the procedure in clinic were less commonly identified as barriers. Conclusion: Pain is universally experienced by patients. BFA has been demonstrated to be safe and cost-effective in reducing acute and chronic pain. Implementing BFA may increase patient satisfaction and quality of life. Solutions to reduce out-of-pocket cost to patients, as well as clarifying the credentialing and privileging processes at individual clinics, are needed to enable physicians to perform this technique.