OHSU’s Cost-Cutting Measures Hurt Patients: Why We Need Acupuncture and Other Low-Cost Therapies More Than Ever

Relief for Pain to Avoid or Reduce the use of Opioids

After the Oregon Health Authority launched its “Opioid Initiative” in 2015, OHSU responded by opening a Comprehensive Pain Center in 2016. Patients at the Center for Health and Healing were able to avoid or reduce their use of opioids by managing their pain and healing through a number of different somatic modalities.

OHSU recently announced that it would eliminate several cost-effective pain relief methods, including chiropractic care, massage and acupuncture. This decision is part of a broader strategic alignment, in which they say, “despite our best efforts to avoid program changes, today’s unprecedented financial environment means we can no longer support the full scope of services.” These changes raise a fundamental question: How can cutting pain management therapies that are affordable and effective save costs in the long term?

These low-cost and accessible modalities, including acupuncture, play an important role in treating pain, mental health, and addiction, providing relief to patients who often feel unsupported by traditional allopathic approaches. Eliminating these therapies is not just a loss for patients, but a step backward for healthcare in Oregon and beyond.

The Value of Acupuncture and Somatic Therapies

Acupuncture, chiropractic care, massage, and similar treatments have long been valued for their ability to manage pain, support mental health, and aid in addiction recovery (Cherkin, Sherman, Deyo, & Shekelle, 2011). Unlike many allopathic interventions, these therapies are not just healthcare appointments; they are experiences that patients look forward to.

Studies have shown that patients generally report higher satisfaction and better overall outcomes from somatic therapies compared to conventional medical visits, which many attend out of obligation rather than expectation of improvement (Sherman, Cherkin, Hawkes, Miglioretti, & Deyo, 2005). When people know they are going in for acupuncture or massage, they often anticipate the appointment for weeks. The day of and the days following these treatments are frequently positive experiences because these therapies lead to immediate improvements in well-being.

The effectiveness of acupuncture in managing pain is well-documented, making it a valuable alternative to opioid medications, which carry a high risk of addiction and side effects. Numerous studies have demonstrated that acupuncture not only provides significant relief for chronic pain conditions but also reduces the need for opioid prescriptions. For example, a large meta-analysis found that acupuncture is significantly more effective than sham treatment or usual care in providing pain relief, with lasting benefits up to a year after treatment (Vickers et al., 2018). Additionally, research shows that acupuncture can reduce postoperative pain and decrease opioid consumption, highlighting its potential as a safer, non-pharmacological option for pain management (Fan et al., 2017; Mao et al., 2021). These findings underscore the critical role acupuncture can play in addressing the opioid crisis by offering an effective alternative that reduces the risks associated with long-term opioid use.

Despite this, institutions like OHSU are moving away from these effective, patient-centered therapies. This raises a troubling question about the priorities in modern healthcare. Are we focusing on what truly helps patients, or are we allowing profit-driven motives to dictate the care we provide?

The Legacy of Andrija Štampar and WHO’s Vision

For me, it’s helpful to look at the work of Andrija Štampar, a key figure in public health and a founding member of the World Health Organization (WHO). Štampar believed that healthcare should be accessible, preventive, and deeply integrated within the communities it serves. His vision for healthcare emphasized the importance of physicians being educators and advocates within their communities, a model that resonates with the low-cost, high-impact healthcare measures—such as acupuncture and other somatic therapies—that we advocate for today (Rowlands, 2020; Štampar, 1990.).

In my work with the Acupuncture Relief Project in Nepal, we are striving to model this approach. By integrating somatic therapies with broader health screenings and preventive care, we are creating a healthcare model that truly serves people, keeping them healthy and reducing the need for more expensive, invasive treatments (Barrett et al., 2003; Schlabach, Woeltje, Guragain, & Groebner, 2021). If we can do this in Nepal, there’s no reason why it can’t be done here—except for the capitalistic priorities of health insurance companies that prioritize profit over people.

A Vision for a Better Healthcare System

Imagine a healthcare system where small clinics offering acupuncture, massage, and other somatic therapies also function as community health hubs. These centers could screen for non-communicable diseases (NCDs) and other risk factors during routine visits, catching potential health issues early and reducing the need for more costly interventions down the line.

We don’t need these centers to be as expensive as the Comprehensive Pain Center at OHSU, where they boasted, “we opened our beautiful new clinic on the 15th floor of the Center for Health & Healing in Portland's South Waterfront neighborhood. With a soothing environment and sweeping views of mountains and the Willamette River, our new clinic reflects our commitment to giving you the very best care.” We can actually be committed to providing the best care in much less expensive real estate, without the high-cost views.

We could have a single-payer system managed by the state rather than profit-driven CCOs. . This would provide a cost-effective healthcare solution that prioritizes patient well-being over technological excess. Isn’t this what the Affordable Care Act was supposed to achieve? A healthcare system that reduces costs by avoiding unnecessary high-tech interventions and focusing on the most effective, simplest treatments available (Witt, Reinhold, Brinkhaus, Roll, & Jena, 2008).

The Hypocrisy of Cost-Cutting Measures at OHSU

OHSU’s decision to cut these therapies while investing in more expensive, high-tech procedures reflects a broader trend in healthcare where cost-cutting measures and a focus on advanced technology often overshadow the importance of patient-centered care. While reducing healthcare costs is crucial, it should not come at the expense of quality care that truly benefits patients (Ryan, 2023).

The Affordable Care Act aimed to reduce reliance on unnecessary technology and shift the focus toward cost-effective, preventive care. However, OHSU’s decision to cut therapies like acupuncture, chiropractic, and massage seems to contradict this goal. By prioritizing expensive, high-tech procedures over these proven, cost-effective treatments, OHSU may be focusing more on maintaining its status as a high-tech leader rather than genuinely improving health outcomes for Oregonians (Ryan, 2023).

We must advocate for a healthcare system that prioritizes preventive care, patient satisfaction, and low-cost, effective treatments like acupuncture. To ensure that somatic therapists are fairly compensated for their evaluation and management time, we need to urge our legislators to reform parity laws. This will help maintain access to these valuable therapies that patients genuinely enjoy and benefit from.

While the conversation about moving toward a government-managed single-payer system is important, the immediate focus should be on supporting somatic therapies. These therapies not only attract patients due to the positive experiences they provide, but they also contribute to lowering opioid use, reducing the need for high-cost interventions, and offering opportunities for early health screenings. By promoting these low-cost, patient-centered care options, we can prevent unnecessary high-tech treatments and support overall public health.

References

Barrett, B., Marchand, L., Scheder, J., Appelbaum, D., Chapman, M., Jacobs, C., & Rabago, D. (2003). Bridging the gap between conventional and alternative medicine: Results of a qualitative study of patients and providers. Journal of Alternative and Complementary Medicine, 9(5), 717-729. https://doi.org/10.1089/107555303322524616

Cherkin, D. C., Sherman, K. J., Deyo, R. A., & Shekelle, P. G. (2011). A review of the evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain. Annals of Internal Medicine, 154(3), 171–179. https://doi.org/10.7326/0003-4819-154-3-201102010-00008

Fan, A. Y., Miller, D. W., Bolash, B., et al. (2017). Acupuncture's role in solving the opioid epidemic: Evidence, cost-effectiveness, and care availability for acupuncture as a primary, non-pharmacologic method for pain relief and management. Journal of Integrative Medicine, 15(6), 411-425. https://doi.org/10.1016/S2095-4964(17)60378-5

Mao, J. J., Kapur, R., Xie, S. X., et al. (2021). Comparative effectiveness of acupuncture for chronic pain and comorbid conditions. Pain Medicine, 22(1), 89-103. https://doi.org/10.1093/pm/pnaa296

Rowlands, M. (2020, March 30). Andrija Štampar: Croatia's pioneer of 20th century public health. Time Out Croatia. Retrieved from https://www.timeout.com

Ryan, A. M. (2023). The complex relationship between cost and quality in US health care. Journal of Ethics | American Medical Association. https://journalofethics.ama-assn.org/article/complex-relationship-between-cost-and-quality-us-health-care/2023

Schlabach, A., Woeltje, A., Guragain, B., & Groebner, R. (2021). Proposed healthy lifestyle center model utilizing integrated primary care for non-communicable diseases prevention and management in rural Nepal. Journal of Global Health Reports, 5, e2021036. https://doi.org/10.29392/001c.37936

Sherman, K. J., Cherkin, D. C., Hawkes, R. J., Miglioretti, D. L., & Deyo, R. A. (2005). Comparing yoga, exercise, and a self-care book for chronic low back pain: A randomized, controlled trial. Annals of Internal Medicine, 143(12), 849–856. https://doi.org/10.7326/0003-4819-143-12-200512200-00002

Štampar, A. (1990). The social and economic basis of health services. World Health Forum, 11(4), 376–380. Retrieved from https://iris.who.int/bitstream/handle/10665/45503/WHF_1990_11(4)_p376-380.pdf

Vickers, A. J., Cronin, A. M., Maschino, A. C., Lewith, G., MacPherson, H., Foster, N. E., ... & Acupuncture Trialists' Collaboration. (2012). Acupuncture for chronic pain: Individual patient data meta-analysis. Archives of Internal Medicine, 172(19), 1444-1453. https://doi.org/10.1001/archinternmed.2012.3654

Vickers, A. J., Vertosick, E. A., Lewith, G., et al. (2018). Acupuncture for chronic pain: Update of an individual patient data meta-analysis. Journal of Pain, 19(5), 455-474. https://doi.org/10.1016/j.jpain.2017.11.005

Witt, C. M., Reinhold, T., Brinkhaus, B., Roll, S., & Jena, S. (2008). Cost-effectiveness of acupuncture treatment in patients with headache. Cephalalgia, 28(4), 334-345. https://doi.org/10.1111/j.1468-2982.2008.01523.x