Monthly Archives: August 2013

If I Had 3 Million Dollars

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I would buy you all a boat.

Just kidding.

I would —

  • Compile and make available a list of the specific requirements necessary to obtain an acupuncture license in each state, making sure to highlight current and oncoming obstacles. (For example, as of October 1, 2014, Florida will require passage of the NCCAOM Oriental Medicine Module for licensure. Although the Florida rules will continue to show that those enrolled in school prior to August 1, 2007 need complete only a two-year course of study which does not need to include herbs, the new examination requirement means that no one with only the two-year education will be able to obtain a Florida license.)
  • Compile data on the professional success of acupuncture graduates of every US school. The data would be available to all.
  • Explore why those who aren’t practicing have left the profession and whether there are different rates of success among graduates of different schools. If there is a difference in graduate success, are there factors common to the more successful schools?
  • Gather data on the safety record of acupuncturists in various states. Does it matter if the state requires NCCAOM exams or credentials? In acupuncture? In herbs? If the states require graduation from ACAOM schools?
  • Use the data to identify the lowest common denominator. Identify the least restrictive education/credentialing necessary to ensure public safety and prepare practitioners for success.
  • Show how uniform and non-burdensome state standards are a critical step in providing acupuncture to the 313.9 million people in the US. Build consensus for reasonable minimum standards, and work for their adoption in all states.
  • Establish a team of public policy professionals with expertise in regulation and legislation to help develop a set of attainable and effective strategic initiatives.

Where would I get my 3 million dollars? Not by yet another “now is the time, we must submit legislation that mandates access to the federal healthcare system” fundraising effort. We’ve heard this before. We should know by now that submitting legislation is guaranteed to suck up resources, it is passing laws that can make a difference – if we’re prepared for the consequences of success.

Please, respond to the AAAOM’s call for comments by August 31st. With, at best, 30,000 acupuncturists available to 313.9 million people, is submitting legislation which has a snowball’s chance in hell of passage really the best use of 3 million dollars?

And, if you really want to do something that will improve access, ten minutes and two stamps will do it – here’s how.

Making a Difference, in ten steps.

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  1. Write a letter to the Delaware Acupuncture Advisory Council, and mail it by this Friday, August 23rd. Here is a new, improved template!  Do this now! (Please cc Gayle MacAfee at the board and send a copy to de@theacupunctureobserver.com. Thanks!)
  2. Share this post on facebook.
  3. Tune in. Subscribing to this blog is a good start but I can’t keep track of everything. Check in at websites for the AAAOM, NCCAOM, ACAOM, your state association, POCA, etc.  A few current issues (which I’ll be posting more about soon) — AAAOM is calling for public comment by August 31st on draft legislation, NCCAOM wants public comment on proposed changes by September 30th, ASVA (Acupuncture Society of Virginia) is having a town hall October 19th to discuss possible changes to scope, and the IHPC wants us to stay involved regarding implementation of section 2706 of the Affordable Care Act. Any one of these issues could impact your ability to practice.
  4. Question Authority. Is X really the biggest problem facing the profession? Is the public better off in a state that requires the OM certification rather than the AC certification? Is an independent board better for acupuncturists? Will an FPD degree lead to greater respect? Does scope mean what you think?
  5. Know the system. For example, boards can only regulate their own licensees. And the executive branch doesn’t determine what Medicare covers, regardless of how many signatures are on a petition.
  6. Avoid us/them thinking. In Our Worst Enemy I wrote about the practitioners in focused on increasing standards as a “them.” That was a mistake.
  7. Remember, we are all in this together. What happens in another state or a change that seems to impact only new students or new licensees might end up affecting you in unforeseen ways.
  8. Assume good intentions. Assuming bad intentions (the PT’s want to do dry needling to make money, for example) doesn’t lead to productive dialogue.
  9. Be consistent. Do we support the right of people to choose their healthcare provider? Are herbs safe? Is acupuncture safe? When we change our answers to these questions based on the circumstances we create a negative impression.
  10. Learn from history. Has participation in  health insurance been good or bad for healthcare? For providers? Has a standardized system of Chinese Medicine led to greater effectiveness?

In the short run it is easier to ignore the big issues, to figure you’ll be okay, or to decide you can’t really make a difference. Staying involved takes time and energy you’d rather use to see clients or spend time with your family or learn that new technique. Do it anyway. Tune in, question, participate. The future you save may be your own.

You Can Make a Difference

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Many LAcs do their best to ignore the “politics” of acupuncture. The experience of participating in professional dialogue can be disheartening and discouraging. It isn’t easy to participate even when we want to — things are happening at the state level, with schools and ACAOM (the coming FPD), or with credentialing (proposed changes at NCCAOM), for example. All too often the debate gets heated and divisive. It is hard to get the whole story and figure out the possible consequences of a change or know what action might be effective. When the licensure legislation was developing in DE few outside of the state were involved. Some of my colleagues in DE had concerns, but they eventually gave up what felt like a fight for a better bill.

Five years after the DE legislation went into effect, there are approximately 35 LAcs serving a population of over 900,000 people and many of those practitioners were either grandfathered in or granted a waiver. Two years went by without a single non-waivered approval. Clearly, the legislation is not giving the people of DE access to qualified LAcs. As I wrote about in my last post, I know of two excellent practitioners who have recently been denied licensure even though their credentials surpass those of many practitioners in the state.

In the long run, the Delaware legislation should be changed. Rules that exclude the majority of NCCAOM credentialed Acupuncturists make no sense, especially when acupuncture can be done by other professionals with far less training. In the short run, the Acupuncture Advisory Council should acknowledge the record of safety of NCCAOM AC practitioners and consistently grant waivers to those with that credential.  In the very short term, the Council should grant waivers to Virginia LAc Sharon Crowell and Maryland LAc Sue Berman.  To facilitate those short term goals I ask that all of you write to the Acupuncture Advisory Council expressing your support of such a waiver.  Please mail your letters by August 22nd!  Feel free to post a copy of your letter in the comments section to inspire others. Email a copy to de@theacupunctureobserver.com. That will help if further action is necessary.

You can see the letter I sent (and borrow from it if appropriate) —  DE Observer Letter.  I’ve also generated a DE LAc sample letter that you can personalize. You could add some of these Possible concerns or your own concerns (please share any additional concerns in the blog comments). The letter can be modified for clients or others who are interested. If you’d like an excuse to visit Dover, DE, the next Advisory Council meeting is September 12th. It should be lovely at that time of year – but don’t count on being able to find an LAc in town :).