Low Numbers and Big Titles: A Report on Status from Rhode Island

Here in Rhode Island if you have a license plate for your car that has a number below 5000 you are special.  I’m serious.  Low number plates are  coveted, family heirlooms , and when you see a car with say number 3476, something inside you yearns to know just who that special someone in that Lexus is.  Or if perhaps you should see 72 on a late ‘90’s Toyota sedan, your mind will wonder, gee, is that a philanthropist?  It’s never hard to conjure up ways to measure ourselves against other people and having a low number on your license plate is one way.   

Having a low number plate is very important; so much so that they created two sets of number plates for each seat in the state senate, and the state house of representatives.  It’s a perk for all the hard working people who make up our state legislature who work many hours for little pay.  It also makes it easier to monitor the parking at the statehouse lot.  

They mayor of Providence has plate number 1, and so does the governor.  They both have a number one plate, but luckily they each have different kinds of cars, so you can still tell who’s who.   

Until recently, all plates in Rhode Island started with two letters, followed by three numbers.  I discovered after living here for a while, and finally getting my out-of-state registration changed over, that when you go to DMV to get your plates, you are allowed to go downstairs to the plate room where if you are lucky, they will have a plate with your initials followed by 3 numbers,.  I opted instead to pick the numbers, liking all things 3, and 9, I picked-RU-999.  Yup, that’s me RU-span style=”font-size:small;” class=”Apple-style-span”> 999, driving down the road in my maroon Subaru wagon- which is a different sort of badge. 

span style=”border-collapse:collapse;font-family:arial, sans-serif;” class=”Apple-style-span”>https://www.colbertnation.com/video?keywords=carcieriWink   These days, the plates are all numbers, 6 of them, so many people are instead of standing out, are disappearing into the huddled masses.   

When I first got my Rhode Island drivers license, I went to DMV, they took my picture with a Polaroid and then laminated the whole thing in a sort of mini-seal-span style=”font-size:small;” class=”Apple-style-span”> a-meal thing right there at the DMV.  The license was warm when the woman handed it to me, and it looked like a much nicer version of the fake i.d. I had in high school.  In the picture, I look like a young Filipino boy. 

This license gives me authority to drive a car on the public roadways in the eyes of the law, and it is an indicator to the insurance companies that I have had sufficient training to make me a safe and effective driver. But it’s my license plate that confers my status as a Rhode Islander, and of course the make, model and year of my car.  Likewise, my license to practice acupuncture grants me the legal authority to do so in the eyes of the law, but what really grants me status is the Doctor of Acupuncture license title that is bestowed upon me by the State of Rhode Island.   

Actually, I have never used my title as a DAc. and my patients all call me Cris, but once, about 8 years ago, I was making calls to an insurance company trying to get reimbursed for acupuncture services, and I was getting frustrated and impatient and I had the idea that if when I called I said it was Dr. Monteiro, things would resolve more quickly.  And they did, but I felt badly about the whole experience when I thought about how differently I was treated when I was perceived as a secretary, versus when I was perceived as a doctor; that I somehow I perceived myself as “more important” when I decided to use my title as an advantage.

In the law of this land

https://www.rules.state.ri.us/dar/regdocs/released/pdf/DOH/DOH_191_.pdf“Acupuncture” means the insertion of needles into the human body by piercing the skin of  the body, for the purpose of controlling and regulating the flow and balance of energy in the body.   

That’s it.  There is no scope of practice, no standard of practice. Our law sets standards for educational, and examination requirements, and rules of professional conduct, but nothing in the law describes what it is we do other than insert needles.  Of course we do other things besides needle, like cupping, and bleeding, and gua sha, and herbs.  But the law doesn’t officially recognize that as what we do even though for years our local acupuncture group has been trying to make this happen.   

Here’s the thing, cars and acupuncture, are only useful when they can get you where you want to go.  If you had a car, let’s say a nice car, and it had a flat tire  and a low number plate, it wouldn’t get you anywhere unless someone decided to stop and help you.  Let’s say the car was dented and not-so-nice looking, but still  had a low-number plate…. do you think as many people would stop?  How about if you just had a plain, ugly car, with a high number plate, or an out of state plate?  Maybe no one would stop to offer you help.  If you understand the basic mechanics of your car you just change the tire.  But if you don’t you have to wait for someone to help get your vehicle running, and by this analogy it seems that a nicer car, or low-number plate might get you the help you need, right?  But let’s just suppose that your flat tire happens in the neighborhood you live in, well then a neighbor drives by and sees you need help, so they stop and call their brother with the tow-truck and he comes to help you out.  In return you give him acupuncture, or money.  You didn’t need the fancy car after all.  You just needed community! 

In a way, the acupuncture profession in Rhode Island is like a car with an ugly paint job, and a low-number (high status) plate.   We have this  “gold standard title of doctor” (low-number plate), and yet  we have no legal scope, and the exactly same struggle to make living that ‘punks in every state encounter.   But here’s the thing, mandatory insurance (or entry-level degrees) can only demand that your car is safe to drive, it can’t specify what kind of car.  Having a license is to shows that you know the rules of the road, and how to be safe.  Moving our profession “forward” with more degrees, and striving for status and legitimacy is like saying everyone needs a fancy car to get on the road to success. It just isn’t true, and it diverts attention and resources from doing things like building  public  transit systems, or just strong community networks.  If we had these things there would be more secure and sustainable ways to get where we want to go.  

It might be easier here in Rhode Island, to get patients to stop and check us out if we advertise our low-number plate/Dr. status, but if the point is to all get where *we* (I mean patients and practitioners) want to go, that is:  wanting relief or improved health, or wanting to make a living, then we need more than the low-number plate/Dr. title.  We need more than status symbols to achieve our goals and even if status symbols may help some people to recognize us, they will alienate, and ultimately this will have a larger affect.  Driving a Hummer will make you seem cool in the eyes of some and wasteful in the eyes of others, and ultimately all of our consumption habits have an effect on others.  Degree titles are consumer products and status symbols; they set individuals and groups apart or together, and have an overall effect on the bigger picture.  Auto  makers aren’t making giant SUVs now, they’re focusing on and fuel economy and alternatives to gasoline, but there still isn’t a lot of focus on good public transit.  Is our medicine more like the car industry than we care to admit?  

People are always going to make judgments based on appearances, and other superficial data; a low-number plate, a title, a lab coat, or a coat of paint, we can use that to our advantage if we want, but need to not confuse it with the truer measures of our abilities.  This comes from somewhere deeper, somewhere more resonant with our goals, and often the road we take to get there.  My goal is to bring acupuncture more widely to the people of my communities and other interconnected communities, which is really everyone.  I am getting there by focusing on keeping my vehicle and my business running along the roads where people I know, my friends, my family, their friends, their families are. I am building practice skills by doing, and by working and driving with a bunch of other people trying to get to similar places.  There’s no need for low-number plates to get where I’m going, in fact history has shown that much ground can be covered when we link arms and simply walk forward together.   

But for all those folks unsure of their path, and for all of those acupuncturists hoping that a doctor title can stabilize their insecurity in the face of new positions in western medical and integrative settings, there is a much, much simpler solution than the much debated FPD:   

Apply for your Rhode Island license,  NOW.   

Before we raise the educational hours…

All you need to do is send $412.50 and an application here. https://www.health.ri.gov/hsr/professions/acup_app.php

With 12% unemployment here, we could use the revenue.  

 RIDOH send you a nifty wall certificate to hang in your office, and you will have 

more letters after your name, and you will be a DOCTOR of ACUPUNCTURE (RI). 

You can also try to apply to RIDMV for a low number plate, but you’ll probably have to wait a long, long, time…unless you know someone… 

You can always say you know me…. 

Dr. Cris Monteiro, LMNOP, MSTCM, Dipl.Ac and CH, NCCAOM,  Doctor of 

Acupuncture (RI), RU-999 

and that and $4 will get you a cup of coffee and a donut. 

Author: crismonteiro

I've always thought that I would live to be 100 years old and now that I have an actual idea of what it might be like to inhabit this body for a century I want to be damn sure that Community Acupuncture is around to help me through my days and in the end, on my way. In the meantime, I am passionate about getting shit done, and also having fun.

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  1. Cris, I want your brains

    And not (just) because I’m a lez zombie.  (Who needs a secret handshake when you’re driving a Subaru wagon, eh?)  I just love this analogy.


  2. Help me out…what is a “lez zombie”

    I’ve become country folk with no connection to modern language.

    “Moving our
    profession “forward” with more degrees, and striving for status and
    legitimacy is like saying everyone needs a fancy car to get on the road
    to success. It just isn’t true, and it diverts attention and resources
    from doing things like building  public  transit systems, or just
    strong community networks.  If we had these things there would be more
    secure and sustainable ways to get where we want to go.”


    Somehow, oh somehow, to convince everyone else of this.  Of all the discussions, this part of the analogy is the only one that needs to be emphasized over and over again.  Because that is the issue, and I paraphrase…”FPD diverts attention from doing other more important things for our profession’s sustainability.”  It’s so simple, doesn’t take long to state, and keeps the discussion on task.  AND, most importantly, it is true.  Thanks Cris. 

  3. I am not an acupuncturist

    I am not an acupuncturist nor am I connected to the acupuncture education and schools. My only connection to the debate is being madly in love with a practitioner….

    That said (in an effort to disclaim my ignorance, mind you), I rather enjoyed your posting. Have you considered switching fields and becoming a writer?? I see several individuals with some serious writing chops popping up here on this blog forum…

  4. Instead of changing fields, I hope Cris

    elevates our profession with her beautiful prose and maybe figure out how to make a buck or two from it (dare I hope for you?).  I also propose that we get more patients to fall madly in love with their practitioners if for no other reason than to get them to come to this forum and say nice things about us.