THE ALLIANCE AND THE AAOM - YIN AND YANG, REPRINTED FROM THE SUMMER 1999 ACUPUNCTURE ALLIANCE QUARTERLY NEWSLETTER, THE FORUM.
The Acupuncture Alliance and the American Association of Oriental Medicine (AAOM) made significant strides toward cooperation at a meeting held between representatives of the two groups in Washington DC January 16th. The AAOM offered to propose to its membership that it hold its annual conference in the fall and both groups agreed to jointly request that the Council of Colleges and the Accreditation Commission hold their Spring meetings in conjunction with the Alliance national conference and their Fall meetings in conjunction with the AAOM national conference. The two associations also agreed to form a joint legislative committee to explore the possibility of working together on state legislation. These joint initiatives represent important steps toward broadening the acceptance of acupuncture and Oriental medicine within the American health system.
Americans are embracing acupuncture and Oriental medicine in a multiplicity of ways, leading to a wide variety of practitioners and practice styles: acupuncturists are practicing at various educational levels and are recognized in 36 states plus DC; detox practitioners have received success and recognition; some states have recognized MD's who practice acupuncture based on three hundred hours of training; many acupuncturists combine their practices with herbs and many do not; a doctorate program is being designed to complement the masters program; Oriental bodyworkers have established national certification.
The Alliance and the AAOM both work to ensure that acupuncture and Oriental medicine practices are based on the best attainable clinical-based practice standards. There is a difference in vision between the organizations, a difference that is complementary and reinforcing rather than competitive. The AAOM represents those professional Oriental medicine practitioners who master all aspects of traditional Chinese medicine and desire to practice as primary care physicians. The Alliance supports this important aspect of the profession and supports and includes members who practice in this way.
The Alliance also supports the right of other practitioners of AOM to practice according to their tradition, scope of practice and education. This includes licensed acupuncturists, Chinese herbalists, Oriental bodywork therapists, acupuncture chemical dependency specialists and doctors of acupuncture, Chinese herbology and Oriental medicine and others qualified by experience and training to use acupuncture and Oriental medicine within their scope of practice and at a level appropriate to their training. The Alliance believes that it is important to insure that all practitioners who use acupuncture and Oriental medicine modalities in their practice do so using professional clinical-based standards that provide all recipients the best chance for optimal outcomes. (Thanks to AAOM, particularly President Robbee Fian, for her help in developing this section.)
Fundamental to the Alliance stand is the ethical principle that practitioners refer to more experienced and/or specialized practitioners when appropriate and identify to the public their correct professional designation regarding their AOM training. As Alliance President Jim Blair states, "An increasing number of health care providers are incorporating acupuncture and Oriental medicine into their practices. It is time to work with consumers and other health care providers to develop standards of competency to practice - for everyone."
The experience of acupuncture and Oriental medicine in America is part of a broadening of the health care system due to consumer demand for free choice, access and patient-based medicine and the societal demand for cost containment. The Alliance was created within this paradigm shift as a new type of membership organization based on a partnership between practitioners and consumers.
The Alliance believes that freedom to practice, based on standards of competency, clear differentiation of title and training, and appropriate referral, provides the best choices to consumers and the best health care to society. As Jim Blair said, "We must look at the differences between the training necessary to do five ear points for chemical dependency, meridian acupuncture for musculoskeletal pain and acupuncture (or herbs) for internal medicine. This has never been done before and is extremely difficult. But it must be done if this medicine is to move into the society in a safe and responsible manner. The heart of the Alliance is the concept that placing patients first supports practitioners. This concept is fundamental to Oriental medicine thinking and critical to the continued health of the medicine."
The founders of the Alliance, many of whom were also members of the AAOM, envisioned a dynamic, interactive organization composed of various 'houses'- acupuncturists, Chinese herbalists, Oriental bodywork therapists, chemical dependency specialists, consumers, medical doctors, students, etc. - discussing clinical medicine and social policy. Each house would establish its own criteria for membership and elect representatives to the Board, which would guide activities to incorporate acupuncture and Oriental medicine principles into every household, clinic, hospital and school. Professional and social issues such as clinical relationships, educational criteria, research, referral patterns, etc. would be discussed with the broadest possible participation within the organization.
The relationship between the Alliance and the AAOM offers enormous opportunity for synergy between focused standards development within organized acupuncture and Oriental medicine, and outward expression of those standards to the expanding fields of Western medicine seeking to use AOM modalities. Indeed, a number of individuals and organizations working to both deepen and broaden the role of acupuncture and Oriental medicine in America hold memberships in both the Alliance and the AAOM. As Jim Blair concluded, "The ideals of the AAOM and the Alliance are valid, valuable and complementary. They may be seen as the yin and yang of the profession, one looking inward, one looking out. We need to work together to create a strong future for our practitioners and a sound health care system for our patients." For further information, see interview with Jim Blair, following.
"Building Bridges Based on Competency", Interview With Jim Blair, L.Ac., President of the Acupuncture Alliance, Spring 1999
Q: Jim, this new position statement is a major step for the Alliance. How did this come about?
A: The Alliance was founded by a group of individuals
who held a broad vision of what the profession is and where it
is going. For the first several years we were in the midst of
establishing ourselves - setting up an office, training staff,
creating the infra-structure for a new organization. Throughout
that time the membership consistently supported the broad view
of the founders. This was shown by the support for the Seattle
Statement, the policy statement adopted by the membership supporting
the work of NADA and acupuncture chemical dependency specialists
(ADSs) and the response to the article on the AAMA. However, it
wasn't until the retreat last August that the Board began to focus
on articulating the entire vision out of which the Alliance was
created. Although we have written several articles about various
aspects of the vision, it was time to pull it together and put
it in one place.
Q: What does this new concept mean in terms of the voting structure of the Alliance?
A: Since we are in the process of creating an entirely new partnership between consumers and health care providers, we don't know how this will develop. This type of organization has never been done before. The vision is clear; the structure is in process.
At this time the voting membership is composed of licensed acupuncturists, NCCAOM certified individuals and graduates of ACAOM colleges practicing in unregulated states. Since the NCCAOM has independent certification programs in Chinese herbology and Oriental bodywork, it means that these members can vote now. The vision that we have created is the possibility that these groups, when they are larger, may choose to create a 'house' within the Alliance, composed solely of Oriental bodywork therapists, Chinese herbalists or chemical dependency specialists in which they discuss issues relating specifically to them and then bring the issues to the whole organization for feedback and action.
Since there are over 1500 members of the American Oriental Bodywork Therapy Association (AOBTA), 4000 NADA trained individuals, 6000 MDs who are AAMA trained, and now two free-standing masters level programs in Chinese herbology, this is a significant group of practitioners and patients, and a powerful vision.
Q: Does this mean that MDs with 200 hours will become voting members of the Alliance?
A: We don't know what the standard for MDs will be. We want to engage in a dialogue regarding appropriate training with the MDs who are currently Associate members of the Alliance as well as the American Academy of Medical Acupuncture, the Acupuncture Foundation of Canada and others who provide training programs for MDs. We have sent a letter to the CCAOM requesting their input regarding standards for medical doctors to practice acupuncture. Several years ago a committee recommended 1000 hours but that was not adopted by the full Council. We have asked the CCAOM to reopen that discussion so we have input from our academic community in any decision that is made.
The Alliance is committed to the principle that everyone who practices acupuncture and Oriental medicine must meet standards of competency. The discussion that must take place is what the standards are.
Out of the discussion, and with sufficient members, a new category of voting membership or 'house' may arise. In order for any 'house' to come into existence for any category of practitioners, a bylaws change must be approved by the voting membership.
Q: How did you personally come to accept other health care providers practicing acupuncture?
A: I have to laugh because I was probably the most resistant person on the Board. If you had spoken to me five years ago I would have said that MDs have no business practicing acupuncture and that only L.Ac.s should do acupuncture for chemical dependency. I think as my experience grew broader, my view changed.
I was a respiratory therapist for fifteen years before I studied acupuncture. Currently I work in an integrated clinic with acupuncturists, PTs, RNs, an herbalist, OTs, behavioral medicine specialists and others. We are located next to one of the largest medical complex of doctors in Washington state. Over 80% of our patients come to us through MD referral.
During the last five years I discovered several things. One is that the MDs are accustomed to referring to highly-trained, specialty providers such as physical therapists, occupational therapists, psychologists, podiatrists, etc. who are the experts in their area. With two and three thousand hours of training in acupuncture, we are the specialists in our field and need to position ourselves as such.
At the same time, we don't have all the insights or answers. One of the most exciting times I had recently was attending the NAFTA conference and talking to medical doctors who were completely turned on by acupuncture and wanted to talk about it. I now have a medical doctor with AAMA training working in my clinic two days a week. We bring different points of view to a patient and we, and the patient, benefit.
We are all practicing acupuncture - whether we do TCM or hand therapy or auricular medicine or medical acupuncture. And all of us - MDs, LAcs, Chinese herbalists, Oriental bodyworkers, chemical dependency specialists, and our patients - are part of Oriental medicine. I think it is time we started talking to each other, learning from each other and supporting one another. That is what the Alliance is about - building bridges based on competency.
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