Quality assurance for acupuncture therapy requires a good basic and on-going training in both conventional western medicine as well as in the theory and practice of acupuncture, the ability to synthesize the patient's objective findings and subjective feelings, and honesty with the patient and towards oneself. Thus, based on the continuous critical evaluation of the objective and subjective parameters, the question of acupunture as the optimal form of therapy for this specific case is honestly answered and one has the courage to admit failures. With regard to the theory, surveys of the acupuncture literature show that a considerable improvement in quality and honesty is necessary. There is a lack of standardised experimental methods (e.g. 28 different placebos in 28 different studies!). Especially German acupuncture journals have a disturbed relation to failures. To hide or deny failures is of no benefit neither to acupuncture, science to the relationship between the physician and the patient since the practitioner must be able to rely on the information in the literature. Furthermore, one should be open minded to alternative methods even if this means to refer a patient to a colleague.