Just Say Know

Weighing in I have to say what a great experience it was to teach at CA training and to work with Andy and Diana, including some of Diana's staff and patients, and all of the other wonderful, enthusiastic, people who attended the weekend. Thank you to all of you and to CAN and all of you, and to WCA and all of you… To echo some of what Diana said, I too learned a lot from the experience. It’s funny how you can see something right in front of your face for a long time and not know how it fits into your life or maybe you have a feeling about some things you know a little about, but suddenly your are able to describe it. That is what has recently happened in my head in regards to the question of is it fair for other professions to practice acupuncture?

We visited this topic briefly during the conference, I posed a scenario where nurses in orthopedic wards performed basic acupuncture protocols for pain, to minimize the need for pain meds and to shorten hospital stays and to speed recovery. This scenario raised more than a few hairs on the back of necks, and the temperature of the room a little. This is a touchy subject with high stakes, and long term consequences. Folks in Connecticut right now are hoping to get their legislators to see that passing out acupuncture needles as if they were tongue depressors, is not fair to those practitioners who have spent the time, money and Spleen qi, to become fully trained in Oriental Medicine. I remember not too long ago testifying at the Rhode Island statehouse in order to stop chiropractors from gaining the right to do acupuncture here.

This is where the meat is for me. Saying no. Why are we saying no? In part it is about fairness, right. It isn’t fair that we spend a ton of our resources to pursue an ancient healing tradition that we passionately want to share with the world because we want to help others. It isn’t fair that just because other health professionals want a piece of our pie, and have the money and clout to influence the law, they can have a share. In some states, MDs can practice acupuncture without any training! That just ain’t fair. Nor does it sound very smart.

I can say no very easily to people doing all kinds of things without any training. Particularly if these things can potentially harm others. Several acupuncturists I know have shared their experiences of being treated with acupuncture by chiropractors who drained their qi. I have had patients who saw an MD (with several hundred hours of training) who did acupuncture, who said they preferred treatments from LAc.s
So if we want to say no unless others know the hows and the whats and the whys of acupuncture we have to look at why more of these people in other professions aren’t going to acupuncture school. Why are they just deciding that they can set their own training standards. Is it in part because it is not feasible for them to go to a full time acupuncture program while trying to maintain their own practices?

Most of us choose professions that we hope or think we can make a living at. Some folks in other professions want to do acupuncture because they are greedy and money grubbing plain and simple. But others really want to help their patients and they see our medicine as a way to support what they already do. Why do many acupuncturists use other non-OM therapies like homeopathy or essential oils or sound or light therapy? What is enough training in any therapy? and what is enough for Oriental Medicine?

ACAOM is calling for comments on the first first draft of proposed accreditation standards for First-Professional Doctoral Programs. ACAOM is supposed to be unbiased in its collection of commentary from the profession and current stake-holders (which to me would include patients.) If any one has figured out how to get into the commentary section please post the procedure in the comments. This link: www.acaom.org/DOCTORALsurvey.html doesn’t work and ACAOM doesn’t list an email address on their website. (I am a big fan of snail mail and letter writing admittedly, but I was surprised at the level of difficulty there seems to be for commenting on this proposed draft.) The first line of their announcement also reads that they are pleased to announce this first draft. Call me paranoid, but something seems a little unfair here too.

Two of ACAOM’s primary goals in their mission are:
"To develop, encourage, maintain, and improve sound educational standards and to promote the interest common to both colleges and schools, including to encourage research and teaching in the science, art, use and application of traditional oriental medicine as these activities enhance the purposes stated herein"
and
"To encourage the improvement of the conditions of education and practice of acupuncture and Oriental medicine within the United States.

ACAOM’s mission does not include creating accessibility to acupuncture, nor is their mission to help students of Oriental medicine, or even those interested in practicing some part of OM at a level of competency, to make a living. Their interest is to support the schools. They are an organization about accrediting. Since it’s inception in 1982 ACAOM has been successful in their mission as is evidenced by the number of accredited schools (about 50). The “use and application” of OM that is being “developed, encouraged, maintained and improved” seems to be limited to what can be taught in masters level programs, and possibly in the next 10 years, that which can be taught in doctoral level programs of 4000 hours.

If we really want acupuncture to be as widely available as possible, and to be practiced by qualified and trained practitioners, we would have to consider the possibility of a level of training that would perhaps create acupuncture technicians. Now, this may be what we actually are, but the intellectual elite want us to believe, and to back our beliefs with our tuition dollars, that a masters, and now a doctoral degree is what makes us really qualified to practice this medicine.

Let me propose here a different hair raising scenario. Let’s suppose that biomedicine begins to accept the idea that acupuncture really works (like, “even if it is a placebo—it’s still doing something…”) MDs want a piece of this alternative medicine pie that patients are willing to pay out of pocket for…, but can now get insurance to cover it. (MDs don’t have to wait for that boat to come in, but some are jumping ship). So MD’s establish their own standards of training, in schools, continuing ed classes etc. Now we as a profession are completely out of the loop. Does ACAOM get to say anything about what the curricula is for MD training in OM? Let’s say then that MDs find acupuncture so useful they want their staff nurses, PT, etc trained in their training programs, etc. This isn’t really that far out is it?

The point I am trying to make is that I think we are so distracted by saying no to other professions with whom we are engaged in a turf war, that we can’t see how it is our own people who are sharpening the very knives that are dividing us as a profession. I know all ‘punks aren’t in this for the same reasons. Not all of us want to help as many people as possible. Many of us cannot make a living doing what we love. Seeing graduates with successful practices would seem crucial to the survival of all of the certifying agencies and schools of our profession, and yet they seem to be supporting changes that will make it harder for someone to enter acupuncture school, and then be able to actually repay student loans after a 4000 hour program.

I am back to being less clear and more frustrated writing this and trying to figure out who is treading on who. To end let me quote from Diana’s recent post where she beautifully describes her…”frustration with a system that sets us up to struggle, and perhaps fail, not because people can’t benefit from our skills, or because no one “values” our medicine, but because we were never given a model for success: a model that creates access to these skills for the majority of people in our communities.” ---Maybe part of the proposed 4000 hours would be spent on learning sustainable business models.

My hope is that by bringing this up again and again, our discussions will continue to shed more light. Thanks for reading such a long post.

Cheers,
Cris