Not to be outdone by our fun-loving, cyber-savvy, network of nicknamed punks, the Supporters of a First Professional Doctorate in Acupuncture have created their very own Facebook page. In only five short sentences, the group quickly begins disseminating misinformation:
“The ACAOM is in the process of creating a standard for a first doctorate entry level education for Acupuncture and Oriental Medicine. Many states have four year programs but they are masters programs while others have doctorates in Oriental Medicine (DOM). Having a standardized DOM program across the country will greatly improve the profession. There are other groups who are fighting this effort. This group is founded to show support for the efforts of having a standarized DOM first doc program for everyone.”
“The ACAOM is in the process of creating a standard for a first doctorate entry level education for Acupuncture and Oriental Medicine.”
The profession has actually been “in the process” of creating a standard for a first doctorate entry level for 20 years, because they can’t achieve consensus on the stupid issue.
The debate began two decades ago over whether or not the acupuncture profession should establish the policy that all acupuncturists should also be trained in herbs. The NCCA (before the OM was added) tried to get feedback on the issue and got the typical low response rate, but very slightly in favor of not making herbs mandatory with acupuncture training/licensing. This made those who favored it angry and started the division that eventually lead to us having two national associations for some years.
On a related but somewhat different tract, there were those who wanted to see training hours raised to be able to qualify for a doctor title; most of this push came from California. The California group began a kind of takeover of the AAAOM and this was a final straw leading to the Acupuncture Alliance splitting-off. The movement began for a doctorate-level licensing and ACAOM went through a multi-year process of deciding whether or not to raise hours to that level. There was, again, a low level of feedback but slightly in favor of making this doctorate training elective instead of entry-level.
Once again people were pissed at not getting their way and eventually the California people said the heck with you, we will just raise the hours here in California. The people who had spent many years developing the post entry-level elective DAOM opposed this as part of the requirement they established for this degree required at least 1200 hours of additional training beyond entry-level training. If California raised its entry-level hours to 4,000 that would mean the DAOM would go up to at least 5200 hours and no one would go for that. So when legislation was introduced in California, the DAOM supporters fought it leading the issue to be sent to the Little Hoover Commission who said more training was not needed.
Again thwarted, again pissed, those wanting the entry-level laid low for a while and then came back with some bullshit about the Institute of Medicine’s recommendations of primary care, integrative medicine competencies, and the insane idea we should hope for hospital jobs as the entry-level for being able to do acupuncture.
The number-one point is this: over the years, the entry-level training was raised at least twice and every time the hours were raised, there was a long process for raising those hours that supposedly justified those hours as the hours “needed.” Now they want to raise them again with no change to the Scope of Practice. How could the process for the previous hours increases have been sound and justified if we now turn around and say we need more hours? If they were wrong about the hours in the past why should anyone believe they know what they are doing now? If they were right before, doesn’t that mean they are wrong now? It makes no sense and that is what the Little Hoover Commission found.
“Many states have four year programs but they are masters programs while others have doctorates in Oriental Medicine (DOM).”
There are many different academic programs, because of each state’s varied licensing requirements. There are Master’s level certificates in Acupuncture, Master’s Degrees in Oriental Medicine, laddered degrees such as the DAOM (Doctorate of Acupuncture and Oriental Medicine), and there was an OMD (Oriental Medicine Doctor) back in the 80s.
At present, there are at least 5 degree titles for acupuncturists: MTCM, Mac, MAOM, DAOM, DOM (technically those with DOM certificates do not actually have a degree called DOM) and almost as may license titles (LAc, CAc, DAc, AP, DOM). If you find this confusing, imagine how the general public would feel, or a prospective employer, or non-acupuncturist colleague.
“Having a standardized DOM program across the country will greatly improve the profession.”
In what way(s) will a standardized DOM program improve our profession? Standardization does not allow for diversity. The FPD will first crush the small schools which do not have the infrastructure (library, teachers with advanced degrees, etc) necessary to create their own doctorate program. The FPD will likely make the already struggling DAOM programs obsolete–programs which many schools have invested massive amounts of time, money, and energy in creating. Furthermore, the implementation of an entry-level program–the First Professional Doctorate (FPD)–will not automatically standardize licensing requirements across the country. For that, costly legislaive debates will be required.
As Skip discussed in last week’s blog, the question of who will benefit from the FPD is unclear. The FPD is not expected to create new jobs, as there are currently very few jobs for licensed acupuncturists (outside of teaching in acupuncture programs). The FPD will not enhance the private practitioners’ biggest source of new referrals: reputation. Reputation is built upon results, not titles. Research jobs will not become available to entry-level doctorate graduates, as the FPD is not intended to make a significant academic contribution to the field (like a PhD).
Misleading ourselves into thinking that a doctorate title will lead to a bigger piece of the insurance pie for acupuncturists, and therefore will “improve the profession,” overlooks the controlling relationship that insurance companies create with providers. I spoke with a physician earlier this month who described to me how he is unable to prescribe the pharmaceutical which might be best for his patient, because he must prescribe what the patient’s insurance company has “approved” for the specified condition. He warned that if we continue pursuing the insurance industry, we will be met with the same fall-out from that relationship which physicians are currently fighting. We can look forward to being told which points are permitted for which conditions, which type and size of acupuncture needles are covered, how often and for how long a particular illness can be treated…not to mention “whether” acupuncture even “can” treat said condition!
Our acupuncture profession needs to be tied to core values such as access, affordability, patient care, and the creation of a stable and sustainable delivery system. The FPD does not support these values. If we prioritize the need to be seen as “equals” with bio-medical professionals, we cannot prioritize the needs of our patients for simple, inexpensive treatment for almost anything. Our patients deserve: accessible, affordable, effective services. Forcing all future acupuncturists to receive an extra year of schooling keeps health professionals away from their communities for too long (not accessible). It causes a rise in tuition, which translates into higher fees for patients (not affordable). And it confuses students by giving them information overload (not effective).
“There are other groups who are fighting this effort.”
This point I don’t have much contention with. There are other groups which are fighting this effort, not just CAN. The AOMNCC has publicly expressed their opposition, and we are working with other groups who have chosen to help us more quietly. We might be the most vocal and obnoxious, but we are not alone. And there are many, many independent practitioners who have not aligned themselves with any organization but are now coming out of the woodwork to join our opposition.
“This group is founded to show support for the efforts of having a standarized DOM first doc program for everyone.”
(*ahem* It is spelled “standardized.”)
This Facebook group is founded by a student (Beverly Lawrence) at the Phoenix Institute of Herbal Medicine and Acupuncture (PIHMA). First of all, the school blatantly misrepresents its students’ potential for income. Personally, I have an intolerance for dishonesty. How can we trust any information which comes from a school that misleads its students? But more importantly, PIHMA’s president, Catherine Niemic, is a commissioner with the ACAOM–the very same professional governing body which is trying to determine consensus on the issue of the FPD.
I wonder if the additional classes in the FPD will cover ethics? Or professional conduct?
Discussion Board Topic
The only topic up for discussion on their group is this: “Anyone have any ideas for a group logo?”
I think the big blue question mark says it all.