ACAOM update -- we gotta make some noise.
Posted December 11th, 2007 by Lisa Rohleder
I have some research to share re: the first professional doctorate and the workings of the ACAOM.
Those of you who are following the CAN internal forums (for those of you who are thinking what are those? Isn't this the CAN forum? No, this is the public blog. To see the forums you have to go through the "join CAN" process -- see the header at the top of the page. And yes, we are working on redesigning the website to make this less confusing) -- you know that I had what I thought was a nifty idea -- contact the ACAOM commissioners directly to convey the strength of our feeling about this first professional doctorate thing.
Those of you who know me know that I have a lot of nifty ideas that don't actually work...but that sometimes turn out in interesting ways anyway. This is one of those.
The ACAOM has a clear policy about not contacting the commissioners directly for advocacy purposes. This makes sense to me -- the ACAOM commissioners are all volunteers. They don't get paid to spend what could turn into enormous amounts of time talking to anybody who has an opinion about what the ACAOM is doing. What the ACAOM wants is for people to contact its office directly and talk to its staff:
301-313-0855
The idea of the first professional doctorate gained traction because there is a very vocal contingent who lobbied for it. This contingent is -- surprise, surprise -- from California. The ACAOM will listen to whoever is talking. (That's a quote, but I'm not going to say from whom. Just know that I'm not making that up.) So back in 2002, the ACAOM did a survey regarding the idea of a first professional doctorate. 55% of the practitioners who responded were against it; 45% were for it. Because there was a "substantial minority" who was in favor of it, the ACAOM went ahead with preparing the standards. Because they kept hearing from that vocal minority that the "profession" wanted it, and the ACAOM will listen to whoever is talking:
301-313-0855
If this first professional doctorate moves forward, it will still be up to the individual states to approve it as an entry level requirement. Certain states are already strongly opposed to this, Colorado and Maryland in particular. What will probably happen is that it will be approved in some places and not in others. The last update I heard about why acupuncturists don't qualify for federal student loan forgiveness is because there is no licensing reciprocity between states -- every state has widely divergent rules, and the feds can't deal with that. More divergence among entry level standards of practice is not going to be a good thing for new practitioners with lots of debt.
Back to the ACAOM. Apparently, over the years, the discussion has come up about the relationship between the cost of education for practitioners and the cost of care for patients. This is not a totally foreign concept amongst the commissioners. But the ACAOM maintains that they will do what the profession asks them to do. And so far at least some of the profession has asked loud enough and long enough that they are moving ahead with this first doctorate insanity.
This is our cue, folks. All we have to do to advocate for our patients is to speak up. The ACAOM knows that the survey they sent out does not necessarily represent US practitioners -- it only represents the ones who responded.
So please, please, speak up. If you have signed petitions from patients, mail or fax them so that they arrive by Friday. And call the ACAOM office if you can. Have your patients call.
301-313-0855
It's all about making noise.
Re: ACAOM update -- we gotta make some noise.
I just tried to send an email to one of the email addresses listed above. It bounced back. (info.md@acaom.org was the one that bounced back)
Really though, I don't see why we can't just call and leave messages that say, I don't prefer to leave my feedback online. I prefer to speak to someone in person. I haven't been able to talk with anyone in person yet, so I haven't tried this. But I am guessing that a little persistence will go a long way. What was it Margaret Mead said?
Sandy
Re: ACAOM update -- we gotta make some noise.
from ACAOM Spring 2004 Newsletter (at their website)
ACAOM DOCTORAL TASK FORCE
This document serves as an update and supersedes the information on page three of this newsletter
regarding the Doctoral Task Force.
Preface: As announced previously, the Accreditation Commission for Acupuncture and Oriental
Medicine (ACAOM) has embarked on a process to determine the level of support within the
profession for a transition to doctoral education as the professional entry-level standard for
licensure and practice in the field. In the spirit of supporting an ongoing deliberative process,
ACAOM recently convened a Doctoral Task Force comprised of representatives of all the
profession’s key stakeholders including educators, practitioners, and regulators. The Task Force
had its first meeting in Las Vegas, NV in March 2004.
Terry Courtney, M.P.H., L.Ac.
Chair, ACAOM
Intro: The following vision statement and guiding principles were formally adopted by the
Doctoral Task Force and have been subsequently endorsed by the Commission. The statement
and principles will help to shape the course of future discussions as the Task Force works to
analyze the implications for the AOM profession of a potential transition from Master’s to
doctoral education as the first professional degree for the profession. As an integral part of the
Task Force’s recommendations relative to implementing the vision statement, the Task Force is
recommending that ACAOM seek a change of scope in its recognition by the US Department of
Education from accrediting Master’s Degree and Master’s level diploma programs in AOM to
accrediting the AOM curriculum and allowing programs to seek state authorization to grant
either Master’s or Doctoral degrees based on that program of study. This request is currently
under review by the Commission.
Task Force Statement
We are considering the likelihood that our profession will migrate through a transitional process
towards implementing a First Professional Doctoral degree. To understand this progression it is
important to understand the distinction between First Professional Doctorates and other Doctoral
degrees. These distinctions include:
A Professional Doctorate is different from an Academic Doctorate.
First Professional Doctorates are:
a. Entry level by definition.
b. Not laddered degrees. They are not advanced degrees dependent upon prior
degree acquisition. Rather they are the first and only degree required for practice
of a profession.
c. Not intended to represent significant contributions to the science and body of
knowledge (as is, for example, an academic Ph.D.) but rather intended to
represent acquisition of the necessary skills for the practice of a profession.
3
Acupuncture and Oriental Medicine Accreditation
We undertake to help facilitate this process should it occur according to the following six
principles.
1. Above all else, we will endeavor to do no harm.
2. We will endeavor to bring all communities of interest and voices in the AOM
community into this process and through it together without eliminating or excluding
anyone.
3. We will respect all voices in the field and all traditions in the field.
4. We will provide clear communication about our discussions and the processes we
propose to the entire community throughout our discussions.
5. We recognize that our current curriculum leading to the professional degree in AOM
and the competencies that they represent support a valid First Professional Degree at
both the current masters and the proposed doctoral degree level.
6. We recognize that content of curricula will continue to evolve, as it always has, based
upon the need to support new professional roles which emerge for practitioners of
AOM.
Task Force Participants: American Association of Oriental Medicine (AAOM), Acupuncture and
Oriental Medicine Alliance (Acupuncture Alliance), Council of Colleges of Acupuncture and Oriental
Medicine (CCAOM), Federation of Acupuncture and Oriental Medicine Regulatory Agencies (FAOMRA),
National Federation of TCM Associations (NFTCMA), World Federation of Chinese Medicine Societies
(WFCMS) and the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM).
AAOM Representatives:
Gene Bruno, L.Ac., O.M.D., FNAAOM
Kevin Ergil, M.A., M.S., L.Ac.
Howard Kong, L.Ac., M.S.T.C.M.
William Morris, L.Ac., M.T.O.M., O.M.D.
William Prensky, O.M.D., FNAAOM
Alliance Representative: Carla Wilson, L.Ac.,
Dipl. Ac. & C.H. (NCCAOM)
CCAOM Representatives:
Yemeng Chen, L.Ac., F.I.A.C.E.
Patricia Keiko Cronin, L.Ac., Dipl. Ac. & C.H.
(NCCAOM)
Megan Huangs, M.S., L.Ac., Dipl. Ac.
(NCCAOM)
FAOMRA Representatives:
David Canzone, D.O.M. (NM), LLC
David Paton, M.Ac., L.Ac.
NFTCMA Representative:
Joanna Zhao, L.Ac., Dipl.Ac., C.H. (NCCAOM)
WFCMS Representative:
David Maloney, L.Ac., Dipl.Ac., C.H.
(NCCAOM)
ACAOM Representatives:
Howard Simmons, Ph.D.
Dort Bigg, J.D.
Sharon (“Sherry”) Smith, M.Ac., L.Ac.
Dipl. Ac. (NCCAOM)
The Task Force will continue its work by meeting again during the 2004 calendar year. Written
comments from the profession’s constituencies regarding the work of the Task Force are
welcome. Please forward comments to the ACAOM Maryland office or email:
info.md@acaom.org. Information regarding ACAOM’s Doctoral Task Force will be posted to
our web site www.acaom.org in the near future.
Re: ACAOM update -- we gotta make some noise.
Skip's scenario is absolutely right. From talking to ACAOMs exec. director I got the same picture. The standards ARE in existence so now ACAOM needs to just approve them for use by the schools (old or new) to pilot. Once piloted by schools there is a review period and some parameters that have to be met. For example in the existing standards there is a 70% graduation rate. If the programs fell below this they would have to change something...other parameters, like a maxim number of years to complete the program exist as well. But basically as soon as the standards are approved by ACAOM and a school begins to pilot the program, ACAOM can begin the process of applying to USDE for an expanded scope of practice, i.e. to allow for multiple degree levels as entry level for the profession. Once that occurs, Yes they will try to eliminate the masters program.
Mr. Bigg told me that ACAOM has NOT begun this process of applying to USDE for an expanded scope of practice. (so yes there is some time to keep having our objections heard and to spread the word)
At one point I asked him if they were working with the schools to implement the first-professional doctorate (versus to develop the standards). He denied this, but I can't help but think it is not true since why would they go through all of this trouble if there isn't even 1 school out there itching to pilot this.
We might have some positive effect on influencing schools if we can launch/support a strong student voice opposed to this. I know when I was in school this kind of stuff riled me up, but I also felt like I didn't have time to deal with non-academic concerns and had the unfortunate notion that it wasn't really going to effect me. Then I came out of my cave.
Re: ACAOM update -- we gotta make some noise.
I'm starting to feel like I have whiplash.
So I thought I had it on REALLY GOOD AUTHORITY (and that's all I'm sayin') that we couldn't approach the Commissioners directly, but that the ACAOM staff would make sure that all feedback went to the Commissioners. Then when I called the ACAOM office today, basically the first thing Mr. Bigg said to me was, "None of this is going to go to the Commissioners -- not phone calls, not emails, nothing. We are only taking comments on the website."
But, I said, your website is the about the most patient-unfriendly one I can imagine. It's really complex and unclear. A lot of my patients are old and not computer literate, a bunch don't speak English, some don't have computers at all.
"Well, they should make arrangements to borrow one."
What about the people who don't speak English?
"This is America. You have to speak English here."
So, I just want to clarify, we have these petitions with patient signatures, how do you want us to send them?
"Electronically...they may get to the Commissioners that way."
I for one am not holding my breath on that, not with a conversation that started with "None of this is getting to the Commissioners."
So my suggestion to everyone is fax your petitions, but make and keep copies. Write to me and tell me how many you sent.
And everyone get ready for the mother of all letter writing campaigns to the Department of Education. The ACAOM is obviously determined to ram this thing through and clearly does not want feedback from patients. But I think the Dept of Ed might care a little more about that sort of thing.
This is all sort of Kafka-esque. How can you tell if the person on the other end of the phone is actually a giant cockroach?
Re: ACAOM update -- we gotta make some noise.
From what I read into what Cris linked to three comments above mine here, the goal is clear:
1) An entry level doctorate as the only path to get a license. This group is driving this process- make no mistake about it. The ACAOM's commissioners are rubber stamps in the process. By that I mean that these comments that they are pretending to ask for will have no influence on the process. Once the ACAOM approves the accreditation rules (with a minor adjustment or two) they WILL forward them to the USDE.
2) In other words ending the Master's programs.
3) The extra classes will be mainly if not exclusively western allopathic classes.
4) The this is being driven by a) college presidents and b) Californians who think acupuncturists should be primary care doctors on the level of MD's.
---------------------
This is the next big fight in the acu-world. It will be fought state by state if the US Dept. of Education approves of what the ACAOM wants. We should fight them there but I can imagine it passing there. If that happens it will be state by state battles, which honestly I think we can win in most states. California is so far gone (to me) anyways that I can imagine this passing there. Anywhere else will be tougher- especially since we can start organizing now combined with the fact that the laws would have to be changed for them to win.
We can win. To do that we will join forces with people outside of CAN. Patients, other acupunks, I can even imagine MDs being our allies because this is a serious stab at the AMA's turf.
One fallout: Any dreams of establishing programs where we can work of our student loan debts: kiss them goodbye.
Re: ACAOM update -- we gotta make some noise.
I too felt somewhat frustrated by my conversation with ACAOM today too. Mostly because when I tried to ask questions I was talked over. I slowed the interaction several times so that I could ask more questions, like how the process could be stopped/tabled etc.?
It seems that even though ACAOM asserts that it isn't the regulatory body that approves the standards, they aren't really specific as to who those governing bodies are. Even if the governing bodies i.e. state medical boards, legislators, are not directly stakeholders in all of this, certainly those one the task force driving the development of the standards are.
Ultimately it comes down to each state and the enacted laws... of which there have been ongoing attempts to modify in order to mandate a first-professional doctorate. If it really is ultimately up to market forces, as ACAOM contends, why are they putting so much effort/money/time into developing these standards? Is there such a high demand? Wouldn't there be students screaming to get into the existing DAOM programs? Surely they stand to gain. We know this.
To act as if the horse hasn't been put before the cart is lie. Hopefully enough people can see this and stand up for what is in the best interest of our profession: The health of our patients first, and they viability of our practices next. Kudos to all of us who continually broaden our knowledge in our field. Boo on those who think this is the only path of distinguishing ourselves and our medicine.
I was told that the # of people surveyed was about 2,000 (which is more believable that 4-5k.)
It seems that some of the communities of interest that are opposed to this are the existing DAOM programs, or at least maybe some of the students/grads. whose efforts to distinguish themselves will be clouded by the presence of a first-professional doctorate. Which I learned today is not a PhD or a EdD., but really seems to be something more like the existing masters, with more western medicine, and the handy title of Doctor of Acupuncture. Hey, why not just get a Rhode Island license. It's a lot cheaper.
I'll end with a quote from an essay I picked up today by Adrienne Rich:
"We assume politicians are without honor. We read their statements trying to crack the code. The scandals of their politics: not that men in high places lie, only that they do so with such indifference, so endlessly, still expecting to be believed. We are accustomed to the contempt inherent in the political lie."
from Women and Honor: Some Notes on Lying
Re: ACAOM update -- we gotta make some noise.
I am feeling mightily frustrated by this entire process. In calling the ACAOM office today, I learned that
1) on line comments only, please
2) it is their DUTY to develop these standards on account of the COMMUNITIES OF INTEREST having requested it (this apparently includes educators, acupuncturists, researchers, and allegedly, the public )
3) Survey of communities of interest allegedly received many responses (4-5,000) and the majority were said to want the standards developed
4) all this requesting went on 4 or 5 years ago and is now ancient history, no late arriving opinions accepted
5) Said survey data may be available somewhere, but it is certainly not their responsibility to make it available
Could someone with more insight than me into this whole convoluted process explain where, if anywhere, the application of pressure by, say, the public, might still be effective, because I'm not seeing it.
Re: ACAOM update -- we gotta make some noise.
If you haven't already go to :
http://acaom.org/PdfVersion/Portland0regonedi12-07-07jme.pdf
where you can read the meeting notes for the October 2007 Public Hearing Testimony on First-Professional Doctoral Standards and Eligibility Requirements.
Some of what I gleaned from reading this document:
1-That the Doctoral Task Force (comprised of members from 5 major nat'l orgs like AAAOM, FAORMA, CCAOM, and 2 others that I failed to get from my conversation today with Mr. Bigg.--no I'm not joking, that is the exec director at ACAOM) will vote on the final version of the standards next year probably in August.
2-That many members of "the communities of interest, the profession and state legislators and regulators" (aka those who are the ones who approve standard not ACAOM) would like the electronic comments submitted at the ACAOM website to be made public.
3-That members of "the communities of interest, the profession and state legislators and regulators" would like there to be at least one more public hearing before a final vote occurs.
Let's be sure to have representation at this hearing.
4-Elizabeth Goldblatt's comments indicate that she may have her head screwed on right.
5-ACAOM's commission will discuss this February the timing for asking the USDE for an expanded scope (i.e. allowing for the first-professional doctorate)
Just for fun check out the comments on the bottom page 19 between Neil Miller and Dort Bigg.
Also there is a practitioner who's comments were noted as"
Practitioner -- Comments that schools that were approved for the DAOM are the same schools that opposed to raising standards in California. Questions the real direction behind creating this doctorate program, and asks whether it’s a
financial windfall for the schools. "
Made me think of a certain bearded one...
Anyway there is still more noise to be made--
Onward!
Re: ACAOM update -- we gotta make some noise.
I love this idea and will be handing patients the phone in my office to call then and there...301 313 0855...
Say it with me sisters and brothers...
Re: ACAOM update -- we gotta make some noise.
I just talked to Carter at People's Herbs; he hadn't heard of this before. But I suggested he write a short script and give the number to as many people as he knows, so we can make even more noise. He's off now to write up some flyers.
Re: ACAOM update -- we gotta make some noise.
I just chatted briefly with the Executive Director, Mr. Biggs. I was trying to register my comments and at least got it out of my mouth that I was opposed before he told me to please submit my comments on the web site.
I tried to make a little noise...questioning him on whether that was really going to make a difference, quoting the stats above...(55% opposed in 2002). He countered by saying they did a survey 3 years ago or so and the profession was "pretty evenly divided".
Then he said, predictably, we just write the standards, it's up to others to determine what they will do with them.
So I tried to make a little noise....Maybe I should've used Lumiel's script! Thanks Lumiel.
Probably it is a good idea to keep calling, even if they are telling us to go to the web site. Maybe they will actually listen.
Re: ACAOM update -- we gotta make some noise.
I've copied this and added a brief script, then printed out copies to hand to my patients so that they not only have a number to call, they have a script:
“I am opposed to making a doctorate in Acupuncture and Oriental Medicine a First Professional entry-level requirement. I oppose the higher schooling costs, the resulting higher treatment fees, and the smaller numbers of practicing acupuncturists in my community. We need more acupuncture, not less at a higher level. If you want to raise the level of expertise, I’ve heard plenty about how dissatisfied the students are with their education, so why can’t you just work on raising the academic standards in the Master’s programs?”)