Explaining acupuncture in family medicine: patients’ and physicians’ use of metaphor

Background: Metaphorical language has long been used by patients and providers to explain health experiences. Still, some studies indicate that metaphors can be counterproductive and inhibit patients’ willingness to try new treatments, especially those that are unfamiliar, complex, or stigmatized. This is particularly complex in integrative settings where conventional medicine providers (family medicine physicians) offer patients complementary and alternative therapies, like acupuncture. To fully determine the potential translational value of metaphor, scholars argue that we must ‘prepare, test, and practice’ metaphors that represent both patients’ and providers’ preferences. Method: We conducted a thematic analysis, informed by metaphor theory, of 32 interview transcripts from physicians (N = 15) and patients (N = 17) in which they described patient-provider communication experiences for a study on acupuncture integration. We separated thematic analyses by group, keeping in mind that providers and patients may gravitate toward different metaphorical language. Results: Patients and providers used metaphor to explain (1) why they accept acupuncture as a treatment (by validating acupuncture as a viable treatment option); (2) why the body needs acupuncture (by illustrating an unhealthy state of the body); and (3) how acupuncture affects the body (by highlighting the healthier state of the body as a result of acupuncture). Conclusions: This study provides both physician- and patient-generated metaphorical explanations of acupuncture treatment, thereby illustrating how conventional medicine physicians and patients make sense of a traditionally Eastern medical practice by using concepts familiar to them. The results could be used to develop interventions or translational tools.