Acupuncture Organizations New and Old

We have a lot of organizations and associations for a small profession. Here’s some of what they’ve been up to.


Finally, communication from the AAAOM. According to their April mailing they’ve revamped their membership structure and are planning their first annual conference in over five years.

The new membership structure includes a free “Basic Membership” category. Does the basic membership give access to the annual report or permit the member to vote in BOD elections? If not, it isn’t a membership, it’s a mailing list. Calling it a membership gives the AAAOM cover to inflate their numbers (they’ve been throwing 7000 around) and mislead policy-makers about their strength.


The first Annual Meeting of the American Society of Acupuncturists was held March 4-5. You can read the full summary here. It includes updates on the activities of many other professional groups. Check it out, including the links.


I’ve only recently been alerted to significant problems in the 7th Edition of the CNT Manual released in July 2015.

One example – is wiping a point with alcohol prior to needling still required? In the position paper on their website and the July 2015 AT article CCAOM indicates that the skin does not necessarily need to be swabbed prior to insertion. Page 97 (or 73 in internal pagination) of the CNT manual puts swabbing with alcohol on the Critical (required) list, with the text “swabbing continues to be recommended.” Which is it, critical, or recommended?

The manual also contradicts itself regarding the cleaning of chairs and tables between patients. Must each table and chair be disinfected or cleaned? Between each patient, or only daily?

With our many traditions and practice styles it is difficult to define or describe a “standard of care” for many aspects of our medicine. This gives documents such as the CNT manual extra weight in the legal system.

This area of practice is outside my bailiwick. Is there an expert out there willing to do a thorough review and write a guest post? It is critical (not recommended) that we get this document right.

NCCAOM Academy of Diplomates

Yes, another new national organization. My feelings about it are as conflicted as my feelings about the NCCAOM.

On the one hand, NCCAOM Diplomates are a significant portion of the profession, and the NCCAOM has the money, power, and support staff to get things done. Earning a seat on the CPT committee (see the ASA report), for example.

On the other hand, an organization that promotes Diplomates only (and how can they vouch for anyone else) runs the risk of deepening a fault line in the profession. The NCCAOM’s history in the regulatory arena shows 1) they are persuasive and 2) their positions often benefit the NCCAOM and some subset of practitioners at the expense of the profession as a whole.

We don’t have a balance of power in the profession. The NCCAOM is in a weight class by itself and the Academy further tilts the scales in their direction.That concerns me. On the other hand, we’ve got no other group heavy enough to get in the ring with non-Acupuncture groups right now.

Let’s keep a close watch on the Academy.


The sparsely attended (30 practitioners?) February Town Hall covered why the NGAOM-affiliated malpractice insurance is such a bargain, how the OPEIU can help the NGAOM, and what’s happening in various states regarding dry needling and insurance reimbursements.

What I didn’t hear was further discussion of NGAOM’s baffling goal of mandating malpractice insurance for licensees in all states. Despite their claims, there is no evidence that lack of mandated coverage has had any impact on scope of practice issues or on how we are seen by other professions. Any insurance plan, landlord, wellness center, or employer can choose to require malpractice coverage. But if a self-employed or unemployed (by choice or circumstance) practitioner decides to bear the risk of working without malpractice insurance, they should be allowed to do so.

If this is the NGAOM’s idea of helping practitioners, we’re in trouble.


A few months ago I mentioned that change might be coming to The Acupuncture Observer. I haven’t yet resolved the tension between sharing breaking news and saving my limited time to explore the broader philosophical and strategic issues facing the profession. Would any of you like to be a breaking news blogger? (ASA, would you like a state update column every now and then?) For now, I’ve added a Facebook feed to the home page of the blog. Checking there (or liking The Acupuncture Observer on Facebook) should help you stay informed between posts.



A Mature Profession? Part Three

I’ve heard it said that, while “The White House Petition” in and of itself can accomplish nothing, it is still a positive development for the profession — that it stirs things in the right direction.  I disagree —

1)       Many people signing it, which includes practitioners and patients, don’t realize that it is meaningless. It increases hopes which are bound to be dashed, contributing to the destructive and already prevalent feeling that we’ve been wronged.

2)      The petition reveals a profession which does not understand how the system works.  It makes us look ignorant (because we are, mostly).

3)      The profession should have other priorities.  We still have six states without licensure.  If we want to have a national week of action on something, why not that?  (I’d say that’s a necessary precursor to being included in Medicare, for one thing.)

4)      We are completely unprepared to do anything with the attention this creates.  If the president called the AAAOM tomorrow and said, wow, we think this acupuncture thing is really interesting, how many practitioners are interested in becoming Medicare Providers, what answer would they get?  If they asked what sort of support we had for our last bill, do you think saying we had 37 Representatives sign on would be impressive?

A petition might be a reasonable piece of a well-thought out plan to change something that had widespread support in the profession, and for which we were on the verge of success, but as an independent statement it is a distraction, a waste of energy, and misleads rather than informs.  A triple threat!

A Mature Profession, Part Two.

(An intercepted letter)

Dear K,

Thanks so much for the time you’ve given to our dialogue and for the work you’ve done for the profession thus far.  You are incredible.  Forgive my response in a numbered list.  There are so many issues and it is often a battle between my natural wordiness and my hope for clarity (and that people will stay tuned in).  Also, I’m quoting you because you bring up good points shared by many; I’m not intending to pull things apart word by word as though your quick email was meant to be read like a scholarly article.

1)       You wrote ” I don’t really think anyone in our profession understands how the federal level works – our profession is still so young that it is really completely state regulated, and differently in every state.”  I agree that our profession has a shortage of individuals with a good understanding of how things work at the federal level.  However, our youth alone is not an excuse.  In fact, if we’d educated ourselves about how things work on a federal level even two years ago, the last time a petition like this went around, we’d be in much better shape today.  Our ignorance is due to the fact that no national organization has made it a priority (or, been able to act effectively if it was a priority) to do the important work of hiring some teachers and consultants to inform us about “how it works,” or even just to provide a safe forum for exploration.  The longer we stumble around in blindness the more lost we get.  The CSA and state orgs are great, but we need national leadership to help us see how state issues impact the whole, and an understanding of federal issues is critical.

2)      If you go to the NCCAOM site and click on the Job Task Analysis Fact Sheet you will see their write-up about the BLS process.  I don’t see a connection between the BLS process and Medicare in that document.

3)      You use the introduction of HR 646 as a clue to help you figure out potential connections (or lack thereof) between BLS and Medicare.  The existence of HR 646 shows only that Congressman Hinchey likes acupuncture and acupuncturists and, in every congress since 1993, has introduced a similar bill.   I’m not going to take time to compile a list of nutty bills, but I’m sure I could.  I’m not saying that 646 was nutty, but that having a bill introduced in Congress is not evidence of much.

4)      Regarding benefits and costs of Medicare Inclusion – I’ve read and written thousands of words on this topic in various acupuncture-related list serves and publications but I have yet to see a careful study and analysis by experts to help us explore this issue.  That is my main complaint here.  There is evidence from other professions on the impact of Medicare.  Let’s have a national exploration of the issue based on more than what you or me or my great Aunt Tilly thinks is a good or bad idea.  I’ve written a lot of checks to national acupuncture organizations over the years.  Is a well-done exploration of this issue too much to ask?  Is distribution (again) of an at best minimally useful petition the best they can do?  And let’s not forget, this isn’t just about the impact of Medicare inclusion on individual practitioners, but on how it could impact the medicine itself.   Issues such as best practices and standardization are sure to arise.

5)      Sorry for the confusion about my use of the word “covered.”  I was referring only to Medicare.  Acupuncturists are not listed as providers in Medicare AND acupuncture is specifically listed as a service that is NOT covered.  So, my thought/question was around whether additional action would be needed to remove acupuncture from the not covered list, even if acupuncturists were listed as providers.   There must be some expert somewhere who could tell me.  (And, yes, the piecemeal nature of state laws about things like titles for professionals who do acupuncture would no doubt complicate any action on a federal level.)

6)      Regarding the EHB effort.  I hear you.  I was on the AAAOM Board at that time and it was like something from a dystopian novel.  The people in power believed what they wanted to believe and anyone who didn’t accept their beliefs was shut down.  There is no way I can succinctly sum up the dysfunction I observed.   It just about broke me.

As for the rest of your email, it fits right in with my Barking up the Wrong Tree post.  We’ve got a bunch of “solutions” being promoted and we don’t even have a good understanding of the problems.   Not only that, it’s been a long, long time since we’ve had a forum or group that’s truly exploring the big picture, helping the profession really understand the problems and explore possible solutions.  That’s not to knock CSA and the hard work of many, many people, but it’s the national level that is missing.


With hope for the future,


A Mature Profession?

Not again.  That misleading petition, forwarded along by many colleagues and even by schools, the AAAOM, and the NCCAOM, is making the rounds again.  You know, the petition that we should all sign to have acupuncturists designated covered health care providers?  Well, just as it was last time around, it’s b.s.  It doesn’t matter how many signatures we get, the Executive Branch does not determine who is a covered provider under the Social Security Act.

It would be nice if I could tell you the process we’d have to go through to make acupuncture a covered service.  I can tell you that finding the information and understanding it isn’t easy, but that my efforts continue!  (Of course, I’ll share what I learn.)  But why should I be the one doing this work?  Surely, one of the national organizations has figured it out.   You’d think, wouldn’t you, that they’d be a resource, providing information so that we knew what we as a profession needed to do to effect change, that, as practitioners we understood what would happen after a “victory” in this battle, that they’d have some ideas about the implications of a win?

Well, I guess, if you’ve been around a while you wouldn’t think that.  And clearly you shouldn’t.  So far, at least to the eyes of an acupuncturist more involved than most, the total input of our national organizations has been to further distribute a misleading petition, encouraging more wasted qi, and doing nothing to educate or inform the profession.

If it is correct that part of this process is to be determined to be a “mature profession” by BLS, as another colleague reports, then this petition, and the response to it by our national organizations, works against us.