New news:
Word is that the Nevada acupuncture board is poised to require an FPD (or is it a DAOM?) for licensure, even though citizens there are already under-served. I’m trying to get more information. Stay tuned for updates. State actions that limit our profession tend to stay under the radar until it is too late.
The acupuncture school landscape is changing. Last week brought news that Bob Duggan and Dianne Connelly will no longer be part of MUIH faculty or staff. For those who have been paying attention as The Traditional Acupuncture Institute morphed into MUIH, it shouldn’t have been a surprise. But it is sad. While TAI had its good and its bad, many who attended did so because of Bob and Dianne’s contributions. The announcement was quickly followed by a letter, in perfect TAI-speak, that, for the sake of the students, we shouldn’t get caught up in stories about this. As in, don’t even ponder what it is we aren’t telling you.
This week also included the news that NESA is merging with MCPHS, and ACTCM is merging with CIIS. (Thanks, Integrator Blog.) Is the age of the stand-alone acupuncture school coming to an end?
Have you heard of The Acupuncture Now Foundation? They aren’t a membership organization, and they don’t want to get involved in acupuncture-politics. They just want to educate the public about our training, our skills, and the great results from our medicine. Please, support ANF! Marketing the medicine shouldn’t have to be an individual effort.
Older News:
Developments in dry needling, with the hope that we might learn from history:
- Louisiana joined other states with an AG opinion that dry needling is within scope for PT’s and DC’s. Other AG opinions can be seen here.
- Tennessee’s Governor signed Legislation formally adding dry needling to scope for PT’s, joining Utah and Arizona which saw similar legislation in 2014.
- The Maryland Acupuncture Society came out in strength behind HB 979 and SB 0580 that would have set limits for dry needling by PT’s and DC’s. The bills went nowhere, perhaps a blessing in disguise as “success” would have opened a can of worms. (The bills did not define dry needling, MAS support put the acupuncture community’s stamp of approval on a 200 hour standard for acupuncture training that had been previously unacceptable, and the wording opened the door for PT’s with 200 hours of training to argue that they were now, indeed, doing acupuncture.)
The AAAOM website has been updated with board bios and a revamped committee list, but still no answers for any of my sixteen questions for the AAAOM.
ACAOM responded to the petition in response to their Gainful Employment letter in the ACAOM Fall Newsletter. The good news — they heard us. The bad news, they continue to believe that significant student debt is helpful for those who want to serve low-income communities.
There you have it, at least some of the news you aren’t seeing in Acupuncture Today.
Thanks for your post Elaine. I have a few comments on what is going on with the schools and billing insurance. In reverse order, the 2015 Occupational Analysis found ~45% of LAcs report they bill insurance and ~17% participate in Work Comp. The OA is sponsored by the Calif Acu Board so these responses are for California LAcs. I wonder what are the similar rates for providers such as MDs, PTs and DCs. I am guessing much higher; in fact no less than double.
The movement for AOM schools to join up with other larger schools that offer multiple programs is a solution to the coming Gainful Employment Guidelines (GEG) purge. GEG goes live June 1. The first wave of notices supposedly will be released in the late Fall. It was announced at the mid-March AOML meeting that most of the for-profit schools will be closed in 3 years. The non-profit schools are not safe if they have large numbers of students who take out student loans. Here is what I notice about the mergers. (1) This is the end of the silo stand alone degree programs which has been the safe harbor for so much “poor education.” (2) All the mergers lose the references to acupuncture and TCM in their new names. In fact, the eventual disappearance of TCM and Oriental Medicine was a warm topic at the AOML meeting. The message there was this is inevitable. (3) Obviously, these schools are merging with other institutions for protection, so they can survive. What did they give up? M&As typically include the elimination of key personnel for the acquired entity. (4) At the end of March the USDE released a list of ~600 schools on Heightened Cash Management (HCM) alert. The list included 4 AOM schools: MUIH, AIMC, SOMA and another.
This is definitely the end of an era. I look for plenty of other changes.
I just had an opportunity to re-read this article — http://nourishingdestiny.s3.amazonaws.com/wp-content/uploads/2015/02/Turning-Point-Part-I1.pdf?AWSAccessKeyId=AKIAI744XQ7BYALJJ6AQ&Expires=1432159585&Signature=Rv%2BimptYe4RZlUbkTkjHGf%2FRSEo%3D
Not sure if you’ve seen it, Steve, but it is helpful to understand why so many experienced practitioners are so sad about where things are headed.
Can you please repost the link? It doesn’t work. Thanks.
I thought it looked a bit wonky. I’ll try again soon.
Samantha — try this
http://www.nourishingdestiny.com/articles-by-lonny/chinese-medicine-in-america-today-the-turning-point-part-iby-l-jarrett-z-rosenberg.html
Thanks Elaine. I had not seen this piece although I am familiar with the content and issues posed. I have also spent time chatting with the writers and others on their Scholarly chat group. IMO their point of view is out of touch. Reading their material brings images of wind blowing leaves off trees in late autumn. They are experts in antiquities. I prefer watching the Antique Road Show. They are able to make their own livings as speakers, experts and peddlers to their special audience. Good for them. Their knowledge of research methods and EBM is insufficient. The current American Acupuncturist has the corresponding piece to this POV by Jacob Godwin. I hope you will link that article for your readers.
Steve —
You make some bold statements for someone who isn’t a practitioner. You are welcome to link to whatever articles you would like. Lonny and Zev are incredibly experienced, and well-respected in the field with active and successful practices.
Ouch. Not an LAc. I am not sure what that has to do with my qualifications to assess revisionist thinking and to recognize hucksters. This is very likely my final post. I don’t belong here.
I’ve read this article (and am a practitioner) and found it to be a lengthy essay. It is not a piece of scholarship: If it was, there would be at least 40 citations to indicate that adequate research was performed to support their central position that “advanced thinking in AOM is desperately needed” (as evidenced by what?). They also seem to imply that AOM (and by extension, practitioners) will thrive if all practitioners stand for their own integrity and for the integrity of “the medicine.” (again, as evidenced by what?)
Sure, there are significant problems with AOM training, not in the least being that the majority of freestanding AOM schools are for-profit and tantamount to nothing more than expensive and lengthy trade schools. Yes U of Phoenix is a “university” that is for profit, but their programs hold very little water. In my experience, the for-profit RN training programs produce students ill-prepared for the profession as they don’t attract the best educators, nor do they attract the best students.
Perhaps it has changed in the recent years, but it is a known fact that a bachelor’s degree is not necessary to enter into a “master’s” degree program in AOM at the majority of AOM schools–just 60 semester hours of college credit (tantamount to an AA degree)–these were standards set to the ACOAOM and I would think that many of your readers would know this. Additionally, it is de rigeur for any Master’s program to have entry standards and as such, require entrance examinations before applying (eg. GRE for general graduate schools, LSAT, MCAT for specific programs eg Law, Medicine). So graduate AOM education is at a significant disadvantage as there are/were minimal standards to attending (breathing, can read/write, and most importantly, can pay, or demonstrate the ability to qualify for financial aid.
Integrity is as integrity does: standards for attending AOM programs are not established (other than the ability to breathe, read/write, and pay for your education).
No, it is not correct to say that being taught the in-depth principles of AOM will increase the potential success rate of the graduates. “Hence, students are less taught the principles of medicine and are instead taught how to pass an exam…This conclusion is validated by the fact that so many practitioners are foundering after graduation failing to run successful practices.” This is incorrect reductionist thinking at best. Doubling down on the rigors of the classics does not translate into successful practice. Learning how to treat from experienced practitioners via paid clerkships upon graduation is key. Again, integrity, support your own so they can grow and succeed. Additionally, it is also about creating a need where no need exists–which has its own problems of integrity. People want to have access to AOM, they don’t “need” it. The western hemisphere has survived and thrived without it (keep in mind, AOM was regarded as hooey in some circles in China before Mao revitalized it).
Jarrett and Rosenberg seem to wax poetic over the “lost art” implying that a way of practicing in the Han or Qing dynasties was vastly superior. What they fail to realize is that thinking (and medicine) evolves (and sometimes devolves)–biomedicine is not practiced in the same manner as it was during the time of Hippocrates. Perhaps AOM is no different. If there was no evolution, practitioners would be using bian stones on ah shui points, no?
As far as EBP is concerned (vs empirical reporting), even though research has its flaws, statistical evidence does help to determine what is effective (and cost effective) vs what is a waste of time/resources. I suppose that the authors would rather have us believe that zu san li treats all diseases (Deadman, 2001, p. 161) as opposed to evidence that it releases seratonin (yoshimoto, et. al, 2006, tohoku journal of experimental medicine). I’ll take evidence and science over tradition and allegory when it comes to medicine–sorry, that is the “western” mindset. As Dr. Stumpf noted, they have little understanding of EBP.
What I read into their long-winded essay is that they wish for a “simpler” Han dynasty life when “their” medicine “ruled.” AOM schools should close. The for-profit education industry (of which the majority of AOM schools are a part of) is rightfully being regulated. AOM programs should be in regionally accredited education systems with standards for entry. The transition will not be pretty, perhaps it may be the last breath of AOM as we know it (and perhaps that is how it should be).
Also, perhaps as a member of the AAAOM Board Jacob could manage to get someone to answer some pretty straightforward questions posed here about the organization in its current incarnation.
Please keep us updated on Nevada situation. Did I read it right too at the bottom that the annual license renewal might be jumping up as high as $1000?!?!?
Ha, I thought it already was $1000.00. The document is right off of the Board page, so I think it is correct. I will keep you posted. The person who alerted me to the situation told me they were going to require the FPD, but it looks like it is actually the DAOM. I’m trying to find out more, but as you might imagine they’re not exactly being transparent. It is sad to consider that it is Acupuncturists who are making these decisions.
We keep going down the rabbit hole.
By any chance, will you be doing an article about illegal insurance billing? I’m noticing more and more of my peers are doing questionable to illegal insurance billing to make money. What’s happening to us? We have become everything we didn’t want to be.
Samantha —
I have written some posts in the past that look at the impact of insurance on our practices, and think I mentioned “creative billing.”
(It’s been interesting that one of the issues we’ve complained about regarding dry needling is that PT’s are using questionable billing practices. Interesting because we do similar things. And, also, because how people charge for a procedure is rather unrelated to whether or not they should be allowed to perform the procedure.)
Anyway, as to more writing about it. Well, I might, as part of a bigger look at ethics. But the folks who engage is such questionable billing usually have all sorts of justifications for it — the insurance companies are evil, I am only trying to help the patient, I wouldn’t have to do it if they reimbursed reasonably, who are they to determine that I can only treat these conditions. I don’t think writing about it will have any of those folks re-consider what they are doing, so I’m not sure writing about it would be all that useful. But, who knows, I certainly won’t rule it out.
Thanks for the idea.
Best, E
‘don’t even ponder what it is we aren’t telling you’.–Brilliant! I felt the same way.
End of an era there. thanks, tessler
When I read Jeff’s letter I felt such a shut-down. I suppose it was pretty effective, since for a few days there I did just kind of give up. I mean, not only did he use TAI-speak, but there was some Lao Tzu thrown in too. …..Just let it go, have no emotion, it’s all fine, just let it go, don’t think about it…..