South Korean acupuncturists are now pushing to perform X-ray exams, traditionally reserved for physicians, after using ultrasound and electroencephalograms (EEGs).
These tests, which remain costly, are considered essential for entering the rapidly growing market for elderly healthcare, valued at around 50 trillion won (approximately $34.9 billion). Doctors, however, are strongly opposing the move, citing concerns over misdiagnosis, and the dispute over the use of imaging exams between the two groups is expected to intensify.
On Feb. 25, The Association of Korean Medicine, an organization composed of acupuncturists, held a press conference in Seoul’s Jung-gu district, announcing that acupuncturists would begin using X-rays. Although the South Korean government’s regulations on diagnostic radiation officers include doctors and radiologists, acupuncturists are not mentioned.
According to government regulations, acupuncturists are effectively prohibited from using X-rays. However, The Association of Korean Medicine pushed ahead, claiming the courts have approved acupuncturists’ use of X-rays. Last month, the Suwon District Court ruled that an acupuncturist who was indicted for using an X-ray bone density meter was not guilty.
In response, the Korean Medical Association, an organization made up of doctors, issued a statement later the same day, stating that the Suwon District Court’s ruling only determined that the use of the X-ray bone density meter by an acupuncturist did not warrant criminal charges. “To claim the ruling as approval for acupuncturists using X-rays is a misinterpretation,” the official from the Korean Medical Association added.
The most contentious issue between the two sides is whether patients could be harmed by potential misdiagnoses or improper use of the imaging technology.
A representative of The Association of Korean Medicine argued that using X-rays would allow acupuncturists to determine whether a patient has a sprain or a fracture, enabling more accurate treatment through acupuncture or moxibustion. “Currently, patients have to visit hospitals for imaging tests to confirm fractures, leading to unnecessary additional costs and inconvenience,” the representative said.
Kim Suk-hee, The Association of Korean Medicine’s public relations director, noted that acupuncturists receive professional X-ray training as part of their education at Oriental medicine schools, and related questions are included in the national licensure exam.
The medical community, however, firmly disagrees. A representative from the Korean Society of Radiology stated that interpreting medical images requires extensive training, often undergoing years of residency and specialization. “If acupuncturists, who lack such professional training, conduct X-ray scans, it could lead to over-testing and unnecessary radiation exposure for patients,” the official said.
S. Korean doctors are particularly concerned about the increased risk of misdiagnosis for patients.
A professor of radiology at a university hospital in Seoul explained that interpreting medical images is a highly specialized field. “Even radiologists who have spent years interpreting chest X-rays can occasionally miss a small lung nodule that could indicate the early stages of lung cancer,” the professor said. “If a misdiagnosis causes a delay in treatment, the patient will suffer the consequences,” he added.
Previously, S. Korean courts ruled that acupuncturists’ use of ultrasound and EEGs was not illegal. A district court judge in the Seoul metropolitan area said that “as long as the acupuncturist uses imaging devices as supplementary tools, they should not face criminal charges.” The Association of Korean Medicine plans to push for acupuncturists’ use of CT scans, signaling that the dispute over imaging devices is likely to escalate.
Some view this conflict as a struggle for control over the expanding healthcare field between the two parties. According to the National Health Insurance Service, South Korea’s medical costs for people aged 65 and older totaled approximately $3.4 million in 2023, and gaining access to imaging equipment is crucial for tapping into this growing market.
For instance, X-rays are essential for examining bones, while ultrasounds help assess tendons and ligaments, followed by treatments such as manual therapy or pain injections. Similarly, EEGs play a vital role in diagnosing conditions like dementia or Parkinson’s disease.
