Reform vs. Revolution in action, dateline: Michigan

Yesterday I posted an update on this thread that Darlene started.  In deference to her original wish to keep that discussion amongst the Michiganders (or Michigeese, as the case seems to be), I thought I’d start a new post about it.  I wanted to open up this discussion, because I think it speaks to the issue of reform vs. revolution that sometimes comes up around here.

To clarify: I’m not anti-reform, per se.  But I don’t see reform actually happening.  The Michigan Acupuncture Board, originally formed in 2006 to hash out the same things that are still/currently at issue, doesn’t meet.  And, though the MAAOM seems to be made up of very nice and hard-working people, I balk at paying $200 to join a state association that hasn’t managed to update its website since 2007, so that they can pay a lobbyist to continue working on this. 

Their logic also doesn’t make sense to me.  Here’s a quote from the President of the MAAOM (from an e-newsletter, forwarded to me by a member):

“Registration will not change our legal requirement to obtain referrals from an MD or DO before administering acupuncture.  This is a separate issue which we will have to address in the future.  For now it is the law, and it is imperative that we all continue to adhere to these standards.  Remember, every patient who calls their doctor requesting a referral for acupuncture is demonstrating the public demand for our services.  This process also helps build professional relationships and further integrates us into the medical community.” 

I personally find those last couple of sentences kind of baffling.  First of all, do we want to change the legal requirement for referrals, or not?  Sure, it probably is good PR for acupuncturists to have their patients going to their physicians to ask Father May I.  But besides being patronizing, it’s another barrier to folks getting treatment: in terms of time, money, and because lots of people have perfectly good reasons for avoiding the medical establishment.  Plus, do we really want to “integrate ourselves into the medical community?”  Wouldn’t it be easier, and better, to integrate ourselves into our neighborhoods – our OWN communities?

This brings me back to the issue of how change happens.   I really mean no disrespect to any of the Michigan acupuncturists who have spent many, many unpaid hours to fight for the right to practice acupuncture in Michigan without fear of legal repercussion.  But I think it makes more sense to ask our patients to testify—or at least sign a petition–than to spend more time and money on a lobbyist.  I was hoping to have treated at least a couple thousand people before an issue like this came up; I feel completely humbled that I’ve only treated 350 people (or so) in the ten months I’ve been practicing here.  Still, that’s more than twice the number of state legislators – and I didn’t have to buy any of them lunch!  So, what do you all think – is it time to start tapping the grass roots?

noraneedles
Author: noraneedles

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Conference Keynote: Breaking the Ceiling

The theme for this conference is “Breaking Barriers”. You know, there are so many barriers to break in acupuncture that it was really hard to choose which ones to talk about for this speech. But since I’ve spent so much time talking about classism as a barrier, I thought it might be fun to shift gears a little and talk about numbers.

Responses

  1. what would miriam lee do?

    amen. i think you are totally right on nora. change coming from the roots up is always much more lasting and real than anything the top down dynamic has ever given. we are here to serve our communities needs first. i say go for it, im sure your community will strongly support you in the effort.

  2. I would certainly support a

    I would certainly support a grass roots effort, and I would bet most of the active members of the MAAOM would as well, I think they have done patient support requests during the process, I seem to remember getting emails about it before I moved back to MI.  I am loathe to criticize MAAOM, this “organization” is basically about 5-6 people who have worked their butts off with little support or interest front the rest of the generally apathetic acupuncture community.   They have accomplished a lot even though it doesn’t seem like it, from what I have heard the lobbyist has been essential in navigating the government nightmare esp. because MI has some special circumstances that arose because there were no laws in place for so long.  

    Nora, I think you have great ideas and being new to Michigan can being a new energy to this, but I would like to see all of us acupuncturists in the state work together rather than create a us vs. them scenario. We all need these laws.  As far as the “integrating into the medical community” I think someone was trying to make the best of a bad situation and used some clunky wording, no one wants the referral clause to remain, and at this point most punks in MI are focused on being be legally safe, I don’t think that was meant to be a mission statement.  

  3. I would go to Lansing on the

    I would go to Lansing on the 9th if I thought it would do any good, but I’m not sure it will. It is impossible to tell from the State’s DELEG site (https://www.michigan.gov/dleg/0,1607,7-154-10576_35738_5698—,00.html) how the rulemaking process works.

    If a bunch of us show up and protest the physician oversight rule, are we simply making an attempt to get the board to change its mind? An if it doesn’t, too bad for us? The board has 4 acupuncturists, 3 MDs, and 2 public members. Obviously, the 2 public members have been coopted by the MDs, though I’m not sure how that happened, since the board apparently never met, not even once.

    Is it now our job to convince one of these public members to change their mind?  Other than convincing one of the public members to see the light, do we have any power whatsoever to delay or prevent adoption of this rule?

    If it is a matter of $ for lobbying, we will never compete with the MDs, there simply aren’t enough of us to come up with the funds necessary to “buy” what we need, legislatively.

     

  4. I don’t think the physician

    I don’t think the physician referral is a board decision we have to fight against, I’m not real clear on it, but I think it’s something that is already in the public health code.  I know we are not up against MDs in general, it’s other people that are fighting some things.  A couple of years ago (the process has been loooooooong) I was at a meeting and one of the MD board members expressed support for our rules to be on par with the majority of states, I believe most of the board is in agreement with that.  MI is just not like anywhere else when it comes to acu laws.  I really think we need to hear from the people who have been in the trenches of this for many years to get a clearer idea of what is really going on.  I have missed the last two meetings due to previous obligations so I have lots of questions and just a few answers I try to glean from the minutes.  Some of the board members attend the association meetings.

  5. I think it would serve you

    I think it would serve you folks (the ones that want to end the md referral) to show up on Nov. 9th.  Don’t go to protest (yet) as it appears that they are just asking for input.  Sounds like the MMAOM folks are working for change and it could be good to join forces with them for this as allied members of CAN….

    Maybe show up with a fact sheet about the safety and efficacy of acupuncture, a list of all the states, including neighbors like Illinois or Wisconsin or Indiana that have independent practice acts.  Be friendly, and forthright, assume they can hear you….

    Talk about how many patients you Michigan CA gals have seen in the last year… let them know the kinds of things you treat and how many more treatments you would be safely performing if patients weren’t encumbered by this antiquated medical oversight thing.  Remind them that you went to school so that you know when and why you should refer to MDs, etc. Reassure them that the majority of acupuncturists perform treatments without medical oversight.

    Try to ignore the politics part because it mostly just serves to disgust you about your fellow care givers, who care more about turf, status, and themselves than they do about actual people getting actual treatments.  

     Unfortunately in many a statehouse it matters more who you know or who feels that they “owe you” than the validity and reasonableness of your position.

    See if you can get a rep from Detroit area to come for treatment, or to visit your clinics.  That might help you get rules and regs written later on.  

     Another idea is to propose medical oversight as something that will eventually sunset and become obsolete over a period time–assuming that there are no adverse incidences (which there won’t be) involving acupuncture.  

    You gals have each other and that is a whole lot in the world and work of

    acu-legislative battles.  ONWARD! 

     

     

  6. Before heading out for Lansing,

    maybe you could try connecting with Deborah Lincoln (one of the hard workers you referred to) and see what she has to offer.  From what I’ve seen,she’s pretty much followed the AAOM track, but she’s pretty awesome when it comes to persistence and hard work, and she may share some insights that might serve you.  (I don’t know her personally; met her years ago, but never connected with her, so she doesn’t know me at all.  But her name has been quite prominent in the acu-establishment.)

  7. Well, I’m not actually

    Well, I’m not actually feeling *that* much disgust; it’s just hard to give credit where credit is (probably) due because this process is such a black box.  I probably will join the MAAOM just so I feel like I have the right to keep complaining about stuff (nb: this does not hold for any national org – I reserve the right to complain about the AAAOM without joining it).

    Also, it would be one thing to propose an intial period of medical oversight if Michigan were the first state to license (or in this case register) acupuncturists.  But acupunks have been licensed in California for 34 EFFING YEARS.  That’s enough data!  (Not to mention how long it’s been legally & extralegally practiced elsewhere in the world.)  Especially when we’re talking creating another barrier to folks getting treatment.  Sure, require an MD referral – the day AFTER we get universal healthcare in this country (though even then, you’re talking about a lot of potentially wasted time for both MDs and patients).

    And I do protest that the Board never meets and that the same exact issue is at stake as was at stake four years ago.  WHY?!?!?! 

    I go back and forth between feeling righteously impatient and narcoleptically apathetic (clearly, I don’t post when I’m feeling the latter).  I’d rather hold on to my impatience, I guess; at least it makes me able to potentially do something useful.  

  8. What Miriam Lee did

    Miriam Lee DID pay someone to help make acupuncture legal in California.  Susan Johnson told us the story in her Best of Tungs point class.  Miriam paid some guy $1000 either per week or month to have coffee with the “right people” so acupuncture could be legal and so practioners in CA could be primary care providers.

     She hired a lobbyist after she was arrested. She did have patients testify on her behalf and they flooded the court room when she was on trial.

    Paying for lobbyist sucks.  And I thought the North Carolina board was bad.

     

  9. I am a patients of

    I am a patients of Nora’s–and I’m following this campaign to keep self-referral for acupuncture with a lot of invested interest. Going to acupuncture has changed my life–and probably saved my life. I mean that literally, and am in no way grandstanding.
    Which is why I want to take a few moments to address this post.

    I have a graduates degree in organizing and movement making (yeah, that’s why I don’t have a job either!!! :p)–and I have to say–I think it’s essential to take Nora’s opinion here seriously. Even the smallest level of reform can not happen without a mass base of grassroots support. I personally agree with Nora that the point is not to get medical recognition–but to get community support for community based models of health. But even if there is something good that can come out of joining a broken system (because that’s what the medical community in the U.s. is, completely broken), a single lobbyist isn’t going to do anything to change anybody’s mind.

    The reason Miriam Lee was successful with her lobbyist (and the reason she was able to afford a lobbyist) is because she was operating from a base of power. She had a massive group of people that had made it clear they were willing to do protesting and organizing if lawmakers didn’t do what they wanted.
    In short, she gave her lobbyist negotiating tools. I.e. Oh, go ahead, vote against legalizing acupuncture. And then stand back and watch while all of Miriam’s patients shut down a court room/a street/a politicians office/etc.

    From what I’ve seen during my limited time as a part of an acupuncture community, acupuncturists are often far too willing to concentrate exclusively on legislation and medical community and “professional relationships.” If you feel you need those relationships to get what you need to become a more stable profession, then I guess go for it–but don’t forget your patients. Don’t forget that your patients are connect to far more diverse and interesting communities that are often willing to go to bat for people they love and care about (including their acupuncturists!) in ways that those “professional relationships” simply aren’t.

    An example: I was just talking to a regular reader of my blog who learned about acupuncture through my blog. She has gone to community acupuncture in California every week since she started going over three months ago. She’s also gotten several of her friends to go as well. She’s a regular patient now, because one patient spoke to another.
    Another woman who reads my blog took her husband to an acupuncturist (again in California) who hasn’t gone to any medical professional in decades. Again, you have two very happy people who also have blogs and are willing to do what it takes to repay the favor they were given.
    Because that’s what community acupuncture is to people like me–it’s a blessed favor. It’s my health–given back to me in a loving, considerate, gentle way.

    From an acupuncturist that is a part of my community and is dealing with the same chronic fears I am (those of us from Michigan know what I”m talking about). People who do me a favor, a life giving and enhancing favor–I do what I can for them. I go to bat as much as I physically can for them.
    Trust your patients.
    It just makes practical organizing sense.
    thank you for giving a space for me to speak,
    Nora’s Patient

  10. The MAAOM is a grassroots

    The MAAOM is a grassroots group! It’s members have been working together for change, and while it’s happening slowly…thanks to them its happening. What you don’t seem to understand is that these acupuncturists spend hours of their time, and money out of their own pockets monthly to work towards registration and ultimately licensure. If you took the time to come to a meeting, you might begin to understand the challenges that we face in Michigan as a group and why it hasn’t changed overnight. If you’ve been practicing in Michigan for 10 months then it seems you have much to learn about the situation here. Maybe instead of quoting/mocking a statement from the MAAOM president, you should connect with him and find out how you can become more involved in the change you speak of. Registration is a logical step towards Licensure. Many other states have gone this route. Registration in itself is a good thing for everyone. The most important part is protecting the public from unqualified and untrained individuals who practice in this state and call themselves acupuncturists. There is so much history here that you seem to not know. while you complain about dues and out dated websites, those very people are changing the future for our profession. Personally I think its irresponsible to not do your part to help. This group worked tirelessly over the past week to prepare for tomorrow’s hearing and together will show up and speak up…where will you be?

  11. Since you asked…

    I’ll be in my clinic, treating patients.

    Look, registration might be a logical step towards licensure IF Michigan were one of the first handful of states that was regulating acupuncture.  We’re not.  Michigan *has* actually been on the cutting edge of things before; this is a situation where we can benefit from other states (and countries) having been the leaders – we can point to decades of demonstrated safety.

    I do recognize that there’s a lot of history here I don’t know; I wish it were easier to find it out.  I spoke to people in the MAAOM and the State months before I moved here, and got a little information; mostly of the “don’t worry, all this will be resolved any minute” variety.  I know there’s some big hairy monster under the bed called Blue Heron Academy, which should probably be sued for false advertising, as it tells its prospective students that there are jobs for (their) acupuncturists.  Their grads surely can’t pass the NCCAOM, so make that a requirement of registration–public protected–presto!  Michigan doesn’t have to invent the wheel here.

    I know people have been working hard behind the scenes, I’ve acknowledged as much several times.  That doesn’t mean I have to agree with them.  I’ve been working hard too, and you don’t seem to agree with me.  Read the rest of the comments.

  12. NCCAOM cert . IS part of

    NCCAOM cert . IS part of the registration rules that we put forth to protect the public & We are in no way trying to reinvent the wheel in MI. I agree that information is sometimes hard to find, but its out there if you can connect with other practitioners. Blue Heron has a site called Mich Med Acupuncture that essentially discredits TCM practitioners because their training is rooted in Taoism, and encourages patients to report anyone who isn’t practicing with a physician to them! They suggest that this is a felony and should be reported. If you google acupunture in Michigan, they are everywhere and to an uniformed patient might sound pretty credible. This is what we’re up against. You really can learn a lot by getting involved. You don’t have to agree with everything, this is how change is made. The MAAOM is a collection of different voices all contributing to advance our profession in the state. We truly believe that registration is a vital step on the path to Licensure or we wouldn’t bother. We have been working on this for years and wouldn’t do this lightly. You are more than welcome add your voice.

  13. Okay

    Thanks, Guest.  That is actually very helpful information.  I hadn’t run across the MMAA myself, and no patient that has come to me has asked me about them (and, interestingly, only two of 300+ have wanted to see my license; no one has asked me if I work with a doctor).  To their credit, the MMAA website is chockablock with information; it’s too bad they seem to have pitted themselves against other acupuncturists – or perhaps it was vice-versa.  In any case, more turf wars, when all around there are plenty of potential patients without access to treatment.

    I still have lots of questions.  I will try to come to the next MAAOM meeting this Sunday.