Acupuncture Licensing and Regulation – The Future

Imagine that your acupuncture license meant you could easily practice in every state.

Imagine that licensure exams focused on the skills and knowledge needed to practice safely.

Imagine that acupuncture schools used the time spent teaching things “you won’t need in practice but they’ll be on the exam” to teach things that you really will need in practice, including all that business stuff.

Imagine that acupuncture boards, associations, and organizations worked to make it easier and less expensive for practitioners to obtain and maintain licenses and practice within their skill set.

I wish I could say “it’s easy if you try” – but for most of us it isn’t. (Unless you look to other professions.)

The Florida Acupuncture Board now requires all new practitioners to spend thousands of hours and tens of thousands of dollars on additional education and testing to become Board-certified in herbs. Even though there was no evidence of public harm under the previous rules, and even for those who won’t use herbs in practice.

The Nevada Board is trying to change the regulations to require a DOM or DAOM of all applicants (about 40K on top of an 80K MAOM). Not because there is evidence of public harm, but because that’s the way it is in China. And never mind that the entire state is served by fewer than 50 acupuncturists.

In July 2015 the White House released Occupational Licensing: A Framework for Policymakers. While acknowledging that licensing can provide health and safety protections to consumers and benefits to workers, it concludes,

“State legislators and policymakers should adopt institutional reforms that promote a more careful and individualized approach to occupational regulation that takes into account its costs and benefits, and harmonizes requirements across States. If they are successful, the collective effect of their efforts could be substantial: making it easier for qualified workers to find jobs and move where they choose, increasing access to essential goods and services, and lessening heavy burdens on certain populations….”

Acupuncturists are the policymakers in our profession. Wouldn’t it be great to determine what’s truly needed for public safety and to adjust educational and licensing requirements accordingly? Rather than blaming others for our difficulties, wouldn’t it be more productive to direct our energy to changing the things we can control? We can demand that the insurance companies pay us more because our education cost so much, or we can make our education less costly. We can sue the PT Boards to try and protect our turf, or we can make sure that anyone who wants acupuncture is able to access convenient and affordable services from an acupuncturist.

I’ll be sharing actions you can take to change our practice environment for the better. Like the Acupuncture Regulation US page on Facebook and stay tuned in here, at The Acupuncture Observer, for updates.

 

 

 

Copyright —

© Elaine Wolf Komarow and The Acupuncture Observer, 2013-2018. Unauthorized use and/or duplication of this material without express written permission from Elaine Wolf Komarow is prohibited. Excerpts and links are encouraged, provided that full and clear credit is given with specific direction to the original content.

5 thoughts on “Acupuncture Licensing and Regulation – The Future

  1. What future is there when David Colquhoun (a University College of London pharmacologist who conducted extensive research in ion channel function of receptor/synaptic mechanisms) and Steven Novella (Yale Neurologist) concluded that after over 3000 trials, acupuncture is no better than theatrical placebo, as published in Anesthesia and Analgesia in 2013? The authors conducted a review of multiple meta-analyses of acupuncture research and questioned the need for further studies after over 3000 trials. In other words, is there really a cost benefit for conducting further research if the results indicate that acupuncture is not statistically significant?

    The rationale for meta-analysis is that individual studies provide inconsistent (ie. contradictory) results. The purpose of a meta-analysis is to statistically determine the effect across a series of studies of a particular intervention.

    In this day and age of meaningful and significant outcomes (ie. evidenced-based practice), there could be little argument to support insurance, let alone medicare/medicaid reimbursement if the prevailing thought is that acupuncture is no better than a placebo. As a side note, I don’t understand how a trade, in certain markets, can get insurance reimbursement without participating in the medicare system. I was under the impression that medicare was the main entry point to being able to participate in insurance reimbursement programs.

    http://journals.lww.com/anesthesia-analgesia/Fulltext/2013/06000/Acupuncture_Is_Theatrical_Placebo.25.aspx

    The authors do have contact information if anyone cares to respond directly to them

    if unable to access, it’s posted here
    http://www.dcscience.net/2013/05/30/acupuncture-is-a-theatrical-placebo-the-end-of-a-myth/

    Please no red herring/ad hominem responses stating the obvious flaws, biases, etc. with bio-medicine. It is time for us to put our grown-up pants on and be self-analytical and self-critical. A profession has 3 components: history, theory, and (self) criticism. Until AOM is able to address the last component, it will still be considered a trade.

  2. Elaine – I am looking forward to this thread. Divisiveness has undermined the profession for too long. I can add some useful info now. There is a difference between licensing and certification. California has the only licensing exam among the 45 states with an acupuncture practice act. Licensing health professions is a right reserved for each independent state. That is highly unlikely to change. Regulatory boards do not represent professionals. Board practice is another matter. In California we have effectively reversed a decades long trend of the acu board ignoring their mission. State regulatory boards are generally established to “protect the public.” Professional groups, i.e., the orgs that represent licensees (like your old pals AAAOM), should be working together to develop KSAs, promote transparency among governmental agencies and accreditation bodies, and develop and support legislation helpful for all stakeholders. This means stop the infighting with AAAOM (“how many members?”) and support the Medicare bill. At least that is my opinion. After introducing those topics I hope we do not see them again! What a hypocrite I am. The time and effort devoted to infighting takes away from seemingly lesser issues like what is going to happen with the dozens of for-profit acu schools whose future is in jeopardy. Your wish for educational transformation may be an inadvertent effect of the inevitable an unavoidable winnowing down of AOM schools.

    • I’ve just been informed that the DC Board is moving forward with revised regulations, but the ASDC (DC professional association) will not share those proposed changes with anyone other than ASDC members. And I’m being called out because my question about what might be changing are seen as disruptive to this very careful process.

      There is no mechanism to resolve the issues that lead to infighting. Is it reasonable for practitioners to know how their ability to practice might change in a given jurisdiction? And to get a chance to weigh in?

    • Steven —

      I’ve got a bit more time now, so wanted to follow-up on some of what you said here. First off, I’m not expecting states to give up their right to regulate professions. I am hoping that the profession will see the value of aligning their requirements as much as possible to allow for reciprocity. Or, at the least, having requirements similar enough that students don’t need to know their ultimate practice jurisdiction before deciding what school to attend or what degree to obtain. Other medical professions, also regulated by the states, have managed to do this.

      Furthermore, questioning the membership of the AAAOM and inquiring into potential outcomes of the Medicare bill is not infighting. It is due diligence. You say the the AAAOM represents licensees, for example, but their membership numbers reflect that they are not, in fact, representing the licensees. There are many excellent reasons not to support the Medicare bill, suggesting that people do so “to stop the infighting” is asking us to go against our best interests. Sadly, this is a circumstance in which the damage of what you call infighting is far less then the damage of going along with a bad plan.

      I am sure you are correct that educational transformation will happen due to outside circumstances. It would be nice if we could use the moment to create something better, through an eyes wide open look at what is working and what isn’t.

Comments are closed.