Mar/Apr 2008
International News
Practice Management
Continuing Education and Events		 State Legislative Activities
AAAOM Activities
AAAOM Student Organization		 National AOM Issues
Links
Products, Services, and Member Savings

Table of Contents:

International News



State Legislative Activities


Sponsors of:

National AOM Issues



Practice Management


Sponsors of:

AAAOM Activities



Links


Sponsors of:

Continuing Education and Events



AAAOM Student Organization


Products, Services, and Member Savings

 

Greetings AOM Members and Colleagues:

This issue of the Qi-Unity Report may be our most informative to date. Read AOMA President Will Morris’ thoughts on blind acupuncturist Juliana Cumbo’s struggle to get licensed in Texas. Claudia Citkovitz shares her professional acumen on what AOM dynamics influence hospital care and childbirth. John Scott delves further into the complex history surrounding herbs in the United States. Additionally, you have the opportunity to add your voice in opposition to human rights abuses in China. I invite you to help the AAAOM combat misrepresentation in the media, as well.

But that’s not all.

We proudly announce our sponsorship program. You will notice that Golden Flower, Kan Herb, and Mayway have chosen to sponsor the Qi-Unity Report. If you are one of our business partners, wouldn’t you like to join them? Your continued support invigorates the AAAOM and serves to remind us that the AOM profession is, in many ways, the sum of our collective efforts as a community. Thank you, sponsors, for your support. We ask our practitioner members to continually patronize those businesses that have put themselves forward to support your profession.

We hope this edition of the Qi-Unity Report has you thriving, enjoying spring, and also pouring through the pages of The American Acupuncturist.

The AAAOM is interested in your feedback. We invite you to use our General Feedback page to let us know your opinions and insights.

International News

China Human Rights

By Will Fudeman

"As American practitioners of Chinese medicine, we have great respect for Chinese culture, and its gifts to the West. Here in the West, we have the habit of giving our leaders critical feedback. When our leaders persist in ignoring the critiques of the people, the people have the ultimate power to choose different leaders.

"The choices the American people make are not always the wisest choices. It has been our experience that encouraging open discussion of the actions of the leaders of the USA can have a correcting effect on some of the more questionable actions of our leaders. Not always. But, it is our belief that honest and respectful discussions can be productive."

Dear Colleagues in Chinese Medicine,

Many practitioners of Chnese medicine share concerns about reports of human rights abuses by the government of China. In the news media we see, read, and hear reports of Chinese police shooting at with the intent of injuring or killing Tibetan protestors*, as well as jailing outspoken Chinese advocates of human rights for making statements such as "human rights are more important than the Olympics".**

(* March 26, 2008- The New York Times article- "Unrest at Shuttered Gateway to Tibet" by Jake Hooker )

(**March 25, 2008- Toronto Star article- "China slams Jail Door on Olympic Dissent" by Bill Schiller- www.commondreams.org/archive/2008/03/25/7883)

A group of 29 Chinese intellectuals have signed a document entitled "Twelve Suggestions for Dealing With the Tibetan Situation" (www.hrw.org/english/docs/2008/03/22/china18336.htm) which suggests peaceful alternatives to the ineffective ways the Chinese government has, so far, attempted to deal with the Tibetan protestors.

What role can we, as American practitioners of Chinese medicine, play at this critical time? Is there a way that we, as individuals or as members of local and national organizations, might support the people of China and Tibet? Are we willing to issue a collaborative statement of agreement with the"12 Suggestions for Dealing with the Tibetan Situation," or draft and issue a position statement of our own?

What might the impact of a statement from our national acupuncture association be? If it were publicized widely, the courageous Chinese dissenters and Tibetan protestors might feel supported by us. Hugh Masakela, the South African musician, told a concert audience a few months ago that he and his South African friends in the struggle to end apartheid took great comfort in news of communities around the world making statements of support for their cause.

Although the Chinese government may dismiss us as Americans who might better address the human rights abuses of our own government, we believe it is important to not only take action against human rights violations by the Bush/Cheney administration, but to also take action when human rights are being violated anywhere in the world. The United States under the current administration is far from a model in the realm of human rights, but vocal critics of the American administration are not yet being jailed for speaking out.

We have an opportunity to show our solidarity with the Chinese people who are expressing very reasonable concerns about their government's abuse of power. I believe it is worth taking a stand at this time.

Will Fudeman, L.Ac., L.C.S.W.
Ithaca, NY

To get involved and add your voice, please send an email to Will Fudeman at wfudeman@twcny.rr.com no later that May 20th, 2008.

Links to International AOM Articles

If the price of “common” traditional medical ingredients is almost doubled in India, can these kinds of ingredients be far behind in price inflation for the rest of us?

www.newindpress.com

Does eczema afflict you or someone you know? The three articles below consider a combination of Chinese herbs currently being tested that offer relief, compared to placebos. Perhaps eczema sufferers now have a better option. www.marieclaire.co.uk
news.bbc.co.uk
news.scotsman.com

State Legislative Activities

Blindness and Acupuncture Licensing in America:

The social philosopher Ortega Y Gasset wrote: “Legitimacy is the function of the whole life of a people.” When I first started reading about Juliana Cumbo’s attempts as a blind acupuncturist to get licensure in Texas, I realized that this case directly addresses contemporary American cultural, legal and ethical questions that define us as a society—within the profession and also beyond the context of AOM. As managing editor of The Qi-Unity Report, I sought out Will Morris, president of Ms. Cumbo’s acupuncture school, to look into the terms of this precedent-setting case.

QUR: Would you kindly introduce yourself and your position?

WM: Certainly. My name is Will Morris and I serve as president of the Academy of Oriental Medicine, also called AOMA, in Austin, TX.

QUR: I understand, based on various articles I’ve read, that Juliana Cumbo has recently graduated from that school. Is that correct?

WM: Yes, that's correct. Juliana Cumbo is a graduate in good standing of AOMA.

QUR: She received her master’s degree?

WM: Correct. We offer a master of acupuncture and Oriental medicine degree, which is a four-year program with 3210 hours. There is a deep focus on Chinese herbal medicine as well as acupuncture, theory, and biomedical studies.

QUR: Would you say that she was a good student?

WM: My teaching experience with her was as a supervisor in the clinic where she performed at an exemplar level. Yes, Juliana was a good student.

QUR: Are you familiar with something of the history of blind acupuncture in Japan?

WM: Yes. I was first exposed to Japanese models of practice in the mid 1980s. I am familiar with blind acupuncture in Japan and have studied systems such as Toyo Hari and Shaku Ju; both schools are associated with blind acupuncturists. While serving in academic leadership in Los Angeles, I had the opportunity to host the president of the Japanese Blind Acupuncture Association in 2001.

QUR: So you know a little bit about Sugiyama, the father of acupuncture in Japan who was blind?

WM: Yes, a little. The origins of acupuncture in Japan are a little more complex than that. Sugiyama did develop the guide tube method in the 17th Century. It is believed that Chiso brought acupuncture to Japan from the Wu in China in the 6th century.

QUR: Well, according to one article there are roughly 30,000 blind acupuncturists currently practicing in Japan. That's more than the total of acupuncturists practicing in America, isn't it?

WM: Yes, that is my understanding as well.

QUR: This means the public in Japan probably doesn't have a problem going to a blind acupuncturist?

WM: Apparently not. And if we look at what's going on here, Juliana has really changed the terrain of acupuncture in the U.S. The media have asked the question, "Would you go to a blind acupuncturist?" The question is no longer, “Would you get acupuncture?” This represents a significant change in public perception. The question is no longer will you get acupuncture, but rather, will you get acupuncture from a blind person?

QUR: Alright. I think, perhaps, this is a good discussion on a number of levels about the inclusiveness of acupuncture as a profession, isn't it?

WM: That's the idea. Juliana is a hero, and she has changed the conversation in this culture about acupuncture.

QUR: Do you sense any ulterior motives in this case?

WM: I can’t answer that since it would require speculation.

QUR: Okay.

WM: Juliana had demonstrated competency and safety with an immaculate record in treating patients throughout the course of her program. She passed her national licensing exams and met the standards that any sighted individual has to meet.

I think that what we're looking at here is really a problem of culture. It is the culture of the sighted individual versus the culture of the non-sighted individual. It is difficult for a sighted individual to conceive of what a non-sighted individual can do. The possibilities are in fact extraordinary. The human tendency is to see the world from our own point of view. So naturally the sighted person has difficulty imagining the capacities of the non-sighted.

QUR: Please continue.

WM: This is very true in terms of collecting clinical information because the non-sighted individual constructs their world differently. The palpatory skills for the purpose of data collection and case management are heightened, and the olfactory and auditory skills extended beyond those of the sighted individual. But this is assuming that these senses are the only way of building knowledge. New research models defining the feeling plane as a valid instrument for assessment have indicated the possibilities are extensive.

QUR: That makes sense.

WM: Some opposing opinions included: what if the patient faints in the room? and that question did come up. How would she know? The non-sighted person has many sensory mechanisms by which to perceive changes in the environment. Not only does she have that, but the non-sighted acupuncturist often stays in the room the whole time. On the other hand, the sighted acupuncturist often leaves the room and would actually have no way of knowing if the patient fainted after they left the room.

QUR: Interesting point.

WM: So the fainting issue becomes an inquiry from which one doesn't produce a lot of quality information about the capacities of the individual. Rather, it continues to overlay the blind practitioner with the belief and values of the sighted practitioner, and this is the ongoing cultural problem.

We see a similar cultural problem for Chinese practitioners in the U.S. They have appropriate recognition as physicians and doctors in China but cannot use the doctoral title in much of America. This is an example of laws being created that prevent the Chinese physicians from fully expressing their competency in medical care. It is a similar cultural phenomenon as that between the sighted world and the unsighted world and in particular with respect to beliefs about competency. It comes down to an issue of belief. In fac,t Juliana has an excellent safety record—she has demonstrated her competency on hundreds of patient visits.

QUR: Apparently there have been zero complaints from all of the patients she's worked upon?

WM: Well, it's not just zero complaints; there are a high number of rave reviews and a very high number of return patient visits.

QUR: Okay, so really, we're dealing with a set of expectations that are biased from our sighted experience.

WM: That's part of what's going on, certainly.

QUR: That's part of what's happening with the cultural expectation.

WM: Acupuncture performed by non-sighted individuals is not just occurring in Japan. One of our faculty members participated in the training of a non-sighted acupuncturist in China as well.

It is often the case that if we have not experienced something before, it seems impossible that it could exist. This is true for people walking into a snow-filled environment with the Inuit people who have an extraordinary number of descriptions of colors of white for snow.

The issue of belief is conceptual, perceptual, and cultural.

QUR: Okay. So perhaps even in our legal structures, when encountering something for which we don't have a ready-made place we respond with fear?

WM: Well, I suppose that's a possible interpretation. I think it is important to identify the reality of the standards of practice for blind acupuncturists in the world today. But further, the legal obligation for any agency that receives funds from the federal government requires compliance with the Americans with Disabilities Act. In essence, this requires that reasonable accommodations be made for practice by the visually impaired.

QUR: So part of this has to do with a focus that is not sufficiently international?

WM: Well, I did render it globally because we don't have standards of practice particularly here in the U.S...But upon review of a few different licensing boards, the response was "we have nothing in our code which prevents the blind acupuncturist from practicing."

QUR: Is there any opposition at your school in terms of other staff members or students when responding to the idea of a blind practicing acupuncturist?

WM: AOMA stands in solidarity behind Juliana. The trepidations for faculty and staff emerged when she was admitted; they weren't certain that she would be able to do it. The institution performed due diligence, taking the time to identify concerns that any agencies might have. Of course the agencies said they couldn't make a determination in advance, but they didn't say she couldn’t; they said that being visually impaired shouldn't be a reason. And, yes, that shouldn't be a reason, because the Americans with Disabilities Act provides for people in Juliana’s case to be able to pursue a career and with reasonable accommodations. So the question here becomes "what are the reasonable accommodations for an individual in Juliana’s situation?"

The school went to the accreditation commission, the national certification commission, and to the council of colleges and deliberated extensively at the faculty level. Ultimately, the faculty did make the decision that Juliana could be admitted and would be watched very closely. They did watch her progress very closely and were ultimately satisfied. The faculty signed off on her diploma. She is a successful graduate in the institution, having performed all the roles and obligations that any other student would have to perform.

QUR: Where do things stand now in terms of her status as she endeavors to become licensed?

WM: The process is still underway, and we can follow up as soon as there is a resolution.

QUR: Do you feel that this case will have repercussions throughout licensing of acupuncturists in the United States?

WM: Absolutely. Juliana is a pioneer, and her situation--depending on how this case goes-- will determine the state of training and employment of blind acupuncturists in the U.S.

QUR: Is it correct to say that should she prevail legally, this will be an inspiration to blind people who may be contemplating a career in acupuncture?

WM: Well, let's just leave it at “she prevails.” I say this because I believe her case supersedes the domain of legality and enters the realm of the moral. This is the morally correct thing to do: allow Juliana Cumbo licensure, and not just for Juliana, but for the patients that she would serve. And not just for her and her patients, but also for all the patients for whom blind acupuncturists would serve. This is because they serve in a different way--in a way that touches people differently than the sighted practitioner can--and there's a significant contribution potential with this group for our society.

You know, we did our "long nights of lost sleep" determining our role in accepting Juliana into a graduate program. We now believe that we sleep soundly because of having vetted her qualifications fully in the very beginning, and we will continue to stand behind her all the way.


National AOM Issues

Herbs in Context

The Qi-Unity Report interviews John Scott, DOM

QUR: Has there been much variation in use of herbal medicine in the U.S.? If so, why?

JS: Herbal medicine in the U.S. originated from many different traditions. Native Americans have their own tradition that some European settlers adopted. European settlers brought their own herbal traditions with them. In the 18th century it was the female midwives and healers who were the most faithful to herbal medicine where their male counterparts were attracted to the newer more invasive innovations. Now we have the various Asian traditions that are being utilized in the U.S. by Asian immigrants and now the general community.

QUR: Are there any environmental issues that occur with the popularity of specific herbs?

JS: Yes, there certainly are environmental issues when a specific herb becomes popular. Originally, plant medicines were gathered in the wilder areas around where villages were settled. Recently, wild areas are becoming more and more difficult to find. What we have witnessed is that when a particular plant becomes popular as a medicinal herb there is increased pressure on that particular plant species and it becomes endangered.

We saw that when St John’s Wort became popular there was pressure on that plant and more contamination due to pickers becoming less discriminating when they were picking the plant. Golden Seal was put on the list of plants to watch to put on the endangered list. American Ginseng has certainly become much more difficult to find in the wild. This is why it is essential to cultivate medicinal plants. In China the important Chinese medicinal herbs are grown in large quantities. The very important herbs like White Peony (Bai Shao) and White Atractylodes (Bai Zhu) are grown in quantities of tens of thousands on tons.

QUR: Is the way that suppliers get their herbs changing?

JS: Traditionally, herbal practitioners had to go into the wild areas and pick whatever plants they wanted to use themselves. We know that Christopher Columbus stumbled on to America in search of spices many of which are used in herbal medicines and cooking and hygiene. Plants, spices, and herbs for many uses have always been very important in human commerce.

The exchange of New World and Old World plants in the 16th century had an inestimable impact on human history. New World plants like tobacco and potatoes impacted the Old World, and the cultivation of sugar in the New World had a significant effect on the populations of Africa and the Americas. In more recent times, brokers and importers have traded herbs and plants on both large and very small scales.

QUR: Who was Abraham Flexner and how did he influence medical standards in the United States?

JS: Abraham Flexner received backing from the Rockefeller and Carnegie Foundations to survey the 158 existing medical schools in 1910. His very critical survey issued in 1911 was an important step in the creation of the modern medical monopoly that evolved in the 20th century. His report in conjunction with the AMA greatly contributed to the standardization of medical education and the marginalization of the existing traditional healing systems that were flourishing at that time. You can Google “Flexner Report” and find a lot of information on his report and the development of modern medicine.

QUR: How do we take Chinese herbal medicine from where it is now to where it is established as an accepted healing modality in the United States?

JS: This will take a huge commitment on the part of the interested constituencies. It will require significant application of focused attention and money over a period of time. American citizens must be educated that herbal medicine is considered a first thought healing modality in most areas of the planet. They need to be educated to seek the advice of qualified AOM practitioners. Issues of importation and regulation must be addressed in a way to create greater and more reliable access to Chinese herbal medicines. Conventional medical providers must be educated to consider Chinese herbal medicine for their patients and families. Our community must be organized to confront and counter mis-information and smear campaigns organized by conventional medical and pharmaceutical industries.

One of the catch phrases thrown about by the FDA and the medical community is “evidence based medicine.” I believe that this language is used to denigrate any healing modality of substance that the use of is not supported by research methods acceptable to the “scientific” world and the standards set by the double blind standard. It may be a challenge finding a way to illustrate the elegance of our ancient healing system in the language of modern science. Modern science seeks to use greatly refined and concentrated single constituents to address all health problems. Part of the motivation is related to the modern perspective, and the major part I believe is motivated by commercial interests and the desire to have ownership of the specific constituent to provide sufficient profit motive to drive the research and development of those pharmaceutical drugs.

Practicing AOM in Hospital Settings: A Synopsis of Questionnaire Responses

By Felice Dunas, PhD, LAc

The following six page document is a synopsis of responses to a questionnaire that I sent out during the fall of 2007. My goal was to help practitioners move into hospital settings, if they chose to do so, by showing them how their colleagues had done the same thing. Fortunately, dozens of acupuncturists working in medical clinics and hospitals responded. Below you will find the most interesting and educational of those responses. Each bullet is an answer given by an individual practitioner to the questions listed above it. I hope you find this material helpful. --Felice Dunas, PhD

  1. Please tell us about your current position at a hospital or formal medical venue: What is the name of the hospital or medical center? How long have you been working there? What do you do there? Are you on staff? On salary? In what department(s) do you work? Must you work under another practitioner's medical license to serve in this venue? Do you have your own patients in the hospital or are you working under MDs or DOs? Do you work independently or as part of a multidisciplinary team?
    • In PA, I needed to work under the supervision of an MD (The MD did not have to be on the premises, but was within phone reach if needed). I was fortunate to have a neurologist sign my documents, otherwise I would not have been allowed to practice while I was living there.
    • I know a colleague who has a DO friend who has allowed her to accompany her to a hospital one afternoon a week (or something like this) for several years. But she has been volunteering her time, learning from the DO and teaching her Toyohari techniques (which are mainly non-insertive), and nobody has ever offered her a position to be part of the hospital staff or receive a salary.
    • I currently run a community-style clinic at Craig Hospital, a spinal cord rehabilitation hospital in Denver. We have only been operating for 1 week. We bring in our own needles and charts. The patients pay us directly, on our sliding scale, and we are paid directly at that time. In other words, the hospital provides us the space and the referrals and don't dip into our payment. That being said, we currently give back 2% of our profits to a CAM fund which provides acupuncture and massage to patients who could not otherwise afford it. (This percentage may be adjusted in the future). We primarily see outpatients, their family, and staff.
    • I am currently in private practice in Bay Harbor, Florida (Miami Beach). It is a multidisciplinary medical center of which I am a partner. My partner is Dr. Nancy Scheinman. She is the former head of alternative medicine at Miami Heart Hospital in Miami Beach. The Miami Heart Center is no longer in existence as 10 years ago it was too progressive for Miami. I have been in private practice for over 10 years. Our group practice also includes a DO psychiatrist and an MD trained in integrative medicine under Andrew Weil, MD. I am an AP and an LAc. My specialty is nutrition, women’s health, and auto immune disorders. I was originally trained by Andrew Weil 17 years ago. I attended the Natural Gourmet Cooking School in NYC. I do not work under a medical doctor although we have protocols for co-treatment among various psychologists, physiatrists, MDs, and physical therapists. Florida is a great practice area for acupuncturists.
    • I work 2 days a week at East West Acupuncture in Indianapolis, and I work 2 days a week at Bloomington Hospital's Advanced Pain Center in Bloomington, Indiana. I have been with the Pain Center for 4 years. The Pain Center is a small building owned and operated by the hospital but not attached to the hospital. There are 2 anesthesiologists/pain specialists who also practice at the Pain Center on alternating days. The MDs and I are contracted employees who provide services for Bloomington Hospital. The hospital has the contract with East West Acupuncture. East West pays a small rent, $300 a month, and the patients pay at time of visit; checks are payable to East West Acupuncture. I don't have to work under an MD's license, and I'm not associated with an MD.

      I specialize in pain, but I also have a lot of TCM referrals, infertility, female issues, GI stuff, etc. Almost all the patients are referred by their MD. I've worked in 4 different hospital clinics in the last 16 years. The other 3 gigs hired me as a consultant to help put together a CAM clinic. All the other clinics closed after about 2 years due to different things. This is Indiana.
    • I am at Hoag Memorial Hospital Presbyterian, Newport Beach, CA. My contract began September 1, 2007. I provide Asian medicine including acupuncture, cupping, moxibustion, etc. I am able to discuss and prescribe herbs, but they must be dispensed from my private practice office. I am considered allied medical staff. I am paid per patient visit and reimbursed for any expenses I incur for supplies, etc. I am housed in the wellness center but can provide services to any department within the hospital. I work under my own license. The patients are referred to me from physicians and departments within the hospital as well as from the community at large. Patients can see me at Hoag or they can also come to my Tustin office. Likewise, I can also see my Tustin patients at Hoag. I am independent in the sense that someone can just see me for acupuncture but I am also part of the wellness center at the hospital and thusly am seen as part of their multidisciplinary team.
  2. Please tell us how you achieved your position: Was it through a personal contact (did you "know someone") or through a traditional application process? Were you interviewed for this position, and if so, by whom? Have you moved up or been promoted in any way? Are there statutes or regulations in your state that have permitted you to hold the position you hold? If you were mentoring someone who was trying to attain your position in a similar venue, what advice would you give? How would you coach a colleague to acquire a position comparable to yours?
    • Before I finished acupuncture schools I had several offers from plastic surgeons in Miami and South Florida. For the first 2 years of private practice, I worked with the past president of the Florida Academy of Cosmetic Surgery using Chinese medicine and integrative medicine to cut healing time in half, improve results, and reduce side effects. I did not interview for my current or past positions, as my training with Dr. Weil and my school and board scores have opened many doors. I met my partner very serendipitously 8 years ago.At the time, very few acupuncturists had the training in integrative medicine like I did, so we became very good friends and now we practice together. If I was mentoring someone I would encourage them to join a medical practice since it is bar-none the best training ground working with MDs and other Western practitioners. I have learned so much from my colleagues and garnered a tremendous amount of respect from the medical community. It is imperative to “speak their language.” Our integrative team approach enhances compliance and helps patients heal much more rapidly. I also take many of my CEU courses from medical schools which further help me understand Western medicine and what is currently happening regarding research, techniques, etc. Believe it or not, many doctors are very accepting and welcoming.
    • I recently spoke to the administration at my local community hospital about getting privileges. They asked me to find another privately owned community hospital in GA that already had already granted privileges to an AP so they could find out how they had set it up, managed it, etc. While I was working on it, unbeknownst to me, my request was put on the agenda for their next MEC (Medical Executive Committee) meeting. The committee voted not to consider my request. I was not made aware of the meeting, either before or afterwards. I had no opportunity to build support among MEC members. I plan to resubmit my request once I have been able to build support for the idea.
    • I work on the board of a non-profit organization to get alternative healthcare available to people with physical disabilities. The director of the CAM program at Craig Hospital found out about my community clinic through the non-profit and wanted to offer more affordable options for her patients. I was not interviewed; the director had met me a few times, she visited my clinic, and I attended a few CAM meetings at the hospital as a possible outside referral. I had TONS of paperwork to do and it took them almost 3 months to approve me.
    • Bloomington Hospital contacted me 8 years ago because they knew about my experience with hospital clinics, and they were considering a CAM wellness center. They were referred to me by Columbus Regional Hospital; their CAM center was successful, but it still had to close. Bloomington Hospital gave me an office in another building at first because the MD I was working with died suddenly and I had nowhere to practice. Within a year, they encouraged me to move into to the pain center. I'm happy; it's a great fit. All hospitals and clinics are different, and Indiana is different than the East and West coasts. If I were advising someone who was interested in a hospital job, I would warn them about not being able to use moxa and herbs in most clinics, and how to communicate with the Western-minded people, how to dictate, what not to say, etc.
    • I had been discussing a joint venture with a colleague who was, at the time, president of ACOG as well as OB/GYN division director at UCI. She left that position and became head of women's services at Hoag Hospital, and I approached her in her new capacity to bring acupuncture to the wellness center. They had previously been referring out to someone in the community and that process was not working well for them. I had to put together a description of services I would offer, provide a survey of fees for the area to justify my fees, and then was interviewed by the chief of staff and several other medical staff committee members. The application, etc., went to committee and was finally approved after several months of review. Hospitals, more now than ever, are being forced to develop wellness programs that offer their patients broader options for their health and wellness. I would recommend to my colleagues that you do your homework, find out who is in charge of your local hospital's wellness efforts and meet with them to find out what they are already offering and how you may be able to complement it or bring something unique to their program. Be prepared with studies on the efficacy of Asian medicine. Perhaps offer to develop or be part of a specific program such as heart health, breast cancer recovery, women's issues, etc. The main thing is to do your homework, be prepared, and be confident. Be creative about where you can offer something that will help them to attain their goals for their programs.
    • After graduating, my vision was to bring acupuncture into the hospital setting. I picked up the telephone and contacted St. John's Hospital in Santa Monica as well as Daniel Freeman Hospital in Marina del Rey (Los Angeles County, CA). St. John's Hospital stated that privileges for acupuncturists weren't in place yet, but I felt excited when I spoke with Daniel Freeman. The voice on the other end informed me that one week prior to my calling they had just approved the requested privileges. I had to follow the typical application process, which I did. The application process involved references. I included Emperor's College since I was a graduate as well as a clinical supervisor at the time. Following the above, Emperor's College got involved in the process and an "Acupuncture Intern Program" was founded. I became clinical director of this program. It was supervised by an MD (Steve Krems). Several licensed acupuncturists participated and students, under supervision, were allowed on a daily basis and at a specific time to go to the hospital and treat patients. The individual patient's MD had to write "an order" which was placed into the patient's file; the attending RN contacted us, and we went to see the patients. Notes were kept in the patient's file. We were only allowed to perform acupuncture, use the TENS unit and massage. No exceptions. The insurance coverage had to be $1million/3million. We were also allowed a specific time (if no patients needed to be seen) to treat employees of Daniel Freeman Hospital at no cost to them. Many patients were educated and followed through with further acupuncture treatments after being discharged by the hospital. One of the biggest problems about working in a hospital setting is the fact that the average stay per patient is 2.3 days. Unless the patient and the physician are educated about the way acupuncture works and about its treatment process it can by quite a task.
  3. Please tell us about the kinds of work you do: Are there aspects of OM care that you are not permitted to bring into the hospital setting (moxa, laser machines, TDP lamps, herbs, etc.) and how does that limitation impact your practice in this venue? What, if anything, have you developed to compensate for this challenge? Do you perform additional diagnostic (blood work, MRI, etc.) or healing practices (healing touch, chiropractic, etc.) in this medical setting?
    • I cannot moxa patients as my entire building would go crazy from the smell, so I send it home with patients, although as a private practitioner there are of course no restrictions. I do a lot of medical triaging as taught to me by my mentor, Andrew Weil. I use Chinese dietary therapy with all my patients, and nutrition is one of my specialties. I also do quite a bit of pre-op work as I am familiar with surgery from my experience working with the plastic surgeon. I use herbs and supplements, but, moreover, I encourage my patients and tell them that they have the power to heal themselves when I provide them with appropriate tools for lifestyle and dietary change. The nice thing about my practice is I am the boss, so I can do whatever I feel is necessary. I do not perform lab work. I believe it is best to refer patients to their primary care physician or one of my integrative MD partners in my office as I prefer to stay within the scope of OM.
    • I use almost solely acupuncture. Mostly distal points.
    • I can't use moxa at the pain center, but I do use herbs. I have control over that. In some hospital settings, you can only use Western herbs that have been approved for MD use (like Thorne, NewChapter, and Metagenics). I do order MRIs sometimes, but most folks in Bloomington already have them.
    • The only limitations are that I am unable to dispense herbs on the premises, and I am not permitted to treat a pregnant or laboring mother. I can discuss and actually prescribe herbs, however, I must dispense them from my private practice in Tustin. The hospital's stance on pregnancy is not that they feel acupuncture is dangerous or risky but that pregnancy is legally high risk as it is without adding another component. The hospital doesn't want the risk.
  4. Finally, please add any additional details on your experience and ambitions: What are the most difficult challenges you face? What are the greatest rewards? Is there a position for which you are striving or a niche you are trying to create, for yourself and other acupuncturists, through your work at this hospital/medical setting? Is there anything else you'd like to share with colleagues who, like you, are striving to expand our national patient base?
    • My sole purpose for undertaking this effort is to expand the knowledge about the benefits of OM into the communities of Orange County. I strive: to offer people who may have never even considered OM, a safe haven to venture out and try something outside the mainstream and to validate our medicine....."If an institution as conservative and highly regarded as Hoag is offering acupuncture....it must be okay." I do whatever it takes to increase awareness. The biggest challenges I face now are getting the word out that I'm there at the hospital. Hospitals are large, cumbersome institutions that typically aren't very organized with regards to promoting and/or utilizing resources to their fullest. It will largely be up to me to get the word out initially.
    • In Florida, we are actually going through a crucial time for our profession, because auto insurance claims, which were an important part of our contribution as pain management providers, were stopped temporarily in October, 2007, and are now being reconsidered. There is a proposition written on the favor of MDs, DOs and chiropractors to be the only ones allowed treating motor vehicle accident patients that became effective in January, 2008. It will mean our acupuncture practice could be in serious jeopardy, not only regarding MVA insurance claims, but possibly even by private health insurance claims (presently we have the privilege of being able to bill several insurance companies as out-of-network providers). I believe many acupuncture physicians in FL are not aware of this situation or are intimidated to speak up or do anything about it. I do not think FSOMA even has a plan to help us show the government or state representatives how important our contribution in the management of Pain is.
    • My personal goal is to further the concept of integrative medicine where all practitioners recognize their own boundaries and appreciate the contributions others can make in their patients’ health. Just as MDs and DOs are moving down this continuum, it is imperative for alternative/complementary practitioners to become more adept at triaging patients and appropriately referring patients to physicians within their local medical community.
    • I feel the most difficult challenge I face is that many people come to me with bad advice from practitioners of other “alternative” modalities. They are discouraged from integrating their care or they were told not to return to their regular doctor. They may have had a million unnecessary tests solely for the financial benefit of the practitioner. I appreciate the wonderful skills we have learned, but we must integrate and interface with the medical community properly and efficiently. I also feel we need to have a better understanding how to use our friends in the medical community and stay within the scope of our practice. I see many OM practitioners and other “doctors”’ abusing their patients for financial gain.
    • I treat many women of all ages, and I try to teach them how to age gracefully and accept and love their bodies. I would like to co-write a book about this with my partner at some point in time. However I am a mom, which is a demanding job and requires balance. I try to be a role model for my patients, many of whom are working moms like me. Every day is a huge reward going to work as I get to help touch the lives of people and help them help themselves. My business partner and I are both moms, along with all the other female doctors in our office. I am incredibly proud of this as I feel it sends a big message to our patients and colleagues about integration and balance in both our professional and personal lives.
    • I personally think that it may benefit us more at this point to educate the medical practitioners and patients and ensure ourselves a significant and respected position by supporting our work with valid research. Research will be the key factor for the future!

Leavitt Blog

U.S. Department of Health and Human Services Secretary Mike Leavitt explores the healing potential of TCM by way of his recent trip to China.

http://secretarysblog.hhs.gov/my_weblog/2007/12/traditional-chi.html

Integrator Blog News & Reports

Integration, by nature, asks us to open our peripheral visions. We are served to look at the whole of the field. We need to develop new fascia, new connectivity. Opportunities crop up in new places. The Integrator Blog News and Reports is meant to provide you with information, insights and tools to enhance integrated care in the environment you serve.

- John Weeks, publisher-editor

Washington Healthcare Poll Finds 75% of Voters Want Licensed DCs, LAcs, NDs, in Basic Benefits

We know from a CodeBlueNow! Pulse survey that 69% of voters in red state Iowa think licensed practitioners like chiropractors, acupuncturists and naturopathic physicians should be included in basic benefits. Now a follow-up survey, using the same questions, which CodeBlueNow! commissioned from Gilmore research, we learn that 75% of blue state Washington State voters also want these complementary and integrative medicine practitioners included. The question CBN's CEO Kathleen O'Connor asks is: Why are the presidential candidates are not reflecting this public opinion?
More ...

Employer Connection: Chrysler’s Health & Disability Leaders on Their Exploration of Integrative Health Pilot Projects

The Integrator previously reported outcomes of a pilot integrative care mind-body project at Chrysler. 55% of chronic pain patients reported being pain free following the combination of somatic muscle therapy, hypnotherapy, group process and lifestyle counseling. Chrysler is taking the pilot into two new directions this year. But what led them to this exploration? Where is it headed? How does it fit with wellness thinking? As part of the Integrator's IHPM-sponsored examination of the employer connection, I interviewed Kate Kohn-Parrott, Chrysler's director of integrated health care and disability, and Teresa Bartlett, MD, the medical director who directly oversaw the program.
More ...

Expanding the Family: More Comments of Holistic MDs and Naturopathic Doctors Co-Convening in 2008

One commentator on this deepening exchange between naturopathic physicians and holistic physicians notes that "most of us are quite tribal in our DNA." He references the emotions ignited when the two guilds chose to co-locate their 2008 conferences. Here are comments from American Holistic Medical Association (AHMA) trustees Roca, Roberts, Gmeiner and Sands, all MDs; from American Association of Naturopathic Physicians (AANP) board members Alschuler, Guiltinan and Clark, all NDs; from Bill Benda, MD, who sits on both boards; and one from a past AHMA president, Manahan, who advocated closer relationships between the two in his presidency 17 years ago. These are followed by a quick look at some plans, in development, for their August get-together. A hopeful exchange!
More ...

Integrative Clinics and Wellness: Inner Harmony's Amato and Szydlowski on the Deep Lake Strategy

Peter Amato and Steve Szydlowski, DHA, MBA, consulted on the integrative wellness center that would be associated with the 313 acre Deep Lake sustainable community and resort envisioned for rural Michigan and reported here in December 2007. The two, founder and CEO, respectively, with Inner Harmony Group, faced significant challenges based on the Deep Lake location, population and weather. This Integrator double-interview guides you through their process in creating a combined integrative wellness center-spa strategy.
More ...

Brief Notes on Organizational Action in CAM and Integrative Medicine

Action abounds. Here are short notices of activity from the American Botanical Council, American Board of (Integrative) Holistic Medicine, American Association of Acupuncture and Oriental Medicine, Bravewell Collaborative, American Chiropractic Association, Academic Consortium for Complementary and Alternative Health Care, Hawaii Integrative Medicine Consortium, American Association for Health Freedom, American Public Health Association, Council for Responsible Nutrition and ... a taste of CAM developments in Italy.
More ...

Resources

Integrator Archive by Subject for January-June 2007
More ...

Integrator Archive by Subject for 2006: All Hot-linked
More ...

Practice Management

Discussing Chinese vs. Allopathic Medicine With Your Patients

By Billy Reddy, LAc

Articulating the benefits of AOM in comparison to allopathic medicine to a new patient can be a challenging task. This article offers various approaches to this discussion. One of the most critical points to remember is that AOM is a foreign concept to most Americans. Outright disrespect for conventional medicine will not endear you to your patients. There are quite a few Americans who are disenchanted with our current medical system, but we need to be very careful in presenting our side of the story.

I usually begin by extolling the strengths of Western medicine: “I really appreciate the strength of Western medicine’s diagnostic technologies. There are MRIs and angiograms, blood work, and endoscopies. This critical information about your condition makes my job much easier. There’s a place for Chinese medicine in our healthcare system – it fits in where Western medicine may be weak. This might be in areas such as chronic pain, infertility, stroke rehabilitation, heart disease, autoimmune disorders, insomnia and anxiety. If you get hit by a bus, it’s obviously better to go to an emergency room than to an acupuncturist. If you ask your physician what can be done about your arthritis, he or she will recommend anti-inflammatory drugs. But what happens if you decide to STOP taking that drug? The pain returns. What about taking a drug for migraines? Or hypertension?”

In each case, you can lead your patient to the answer: Medications only treat the symptom. This way you’re not TELLING them something; you’re letting them use logic to reach their own conclusions. Americans are programmed to believe there’s a pill for every ill. When they see how we approach health and that they feel much better with treatment of this kind, they make much stronger referrals because they can explain to their friends and family how we differ from allopathic medicine versus making a statement such as “My acupuncturist gave me a few treatments and some funny smelling pills, and I feel much better now.”

Another thing to emphasize is the sheer safety of our medicine in comparison to its younger Western “sibling.” There are over 120,000 deaths per year in this country due to the proper use of medication. The number of deaths from AOM? Zero. That’s why medical malpractice insurance ranges from a low of $60,000 to a high of $160,000 per year for physicians and approximately $900 yearly for our profession. That’s quite an eye-opener.

It’s also important to mention the patient’s role in his or her own path to health. Introduce a hypothetical situation like putting water instead of gas into your gas tank. It probably won’t make your car run very well…The same thing is true about drinking soda or eating fast food. Your body doesn’t react to it beneficially. A GREAT question to ask the patient is: “Instead of thinking about how a particular food tastes, how does this food makes you feel?” Take, for example, a bag of M&Ms. If you eat the entire package, observe how you most likely will feel: nauseous, unable to concentrate, slightly anxious. Then try a Gala brand apple. You’ll find that it’s a life giving food. Your energy level rises, your cognition increases, you feel good. When your patient is able to reach that level of awareness, she doesn’t need to be told what to eat, but she can let her body’s reaction to such foods become the guide. In addition, introducing your patients to self-cultivation methods such as meditation, tai qi and qi gong are also great ways to guide them along their path to wellness.

Some texts compare MDs to mechanics and AOM practitioners to gardeners. The MDs consider the body as a number of “subsystems” such as ignition, exhaust, and transmission. Many urologists view you as a pair of kidneys leading to a bladder that just happens to be attached to a human being. On the other hand, Chinese doctors look at the patient as a garden and evaluate the environmental conditions, proper sunlight, and soil nutrition.

Scientists are slowly recognizing that the body’s inner environment or “milieu” is the single most important factor in cancer growth and metastasis. Sugar compromises the immune system and encourages cancer growth. A tack that mixes respect for allopathic medicine along with respect for holistic logic will help to facilitate your patients’ awareness of the choices they can make to enhance the quality of their lives. Help them see through the lens of an AOM practitioner.

Touro College Acupuncture Internship Program at Lutheran Medical Center

The Qi-Unity Report interviews Claudia Citkovitz

QUR: Please introduce yourself and tell our membership a little about your job.

My name is Claudia Citkovitz. I run the Touro College acupuncture internship program at Lutheran Medical Center, a community hospital in Brooklyn, NY, where we treat inpatients in the neurology, oncology, and labor and delivery units. We’ve also been doing research in these labor and delivery units for about two years now, and we’ve started a postgraduate training program there. We’re training our second cohort now with a third coming up in May, and after that we’ll look at cloning the program for other departments, probably neurology first, then med/surgery, behavioral health, and oncology.

QUR: How long have you worked in a hospital?

I just passed the four year mark, which feels like a milestone because that’s the amount of time most residents are there before becoming physicians.

QUR: Hospitals use a lot of tests. Is there anything wrong with using scientific tests to determine health?

Well, in public health in general there’s a procedural bias towards lab results that give you numbers on a printed page, so they’re deemed objective, versus practitioner assessment, which is inherently subjective. But I don’t think anyone would argue there’s any lab test that determines health per se. And that’s our greatest strength--as practitioners of OM we look at the big picture elements of health – are you running hot or cold, do you have enough qi, blood, fluids? Are they moving OK? These are the giant elephants in the room that really shape a person’s experience of being in their body as they go through their day, and all the more important when they’re sick. So our treatments seem to have a much closer relevance to quality of life than biomedical treatments.

QUR: Is “quality of life” something that can be compromised by the hospital setting?

Oh, my god, have you been in a hospital? It’s a nasty smelling, sterile, uncomfortable place full of sick people that gives you a stress response when you’re feeling fine, let alone when you’re sick and just want to be at home. Add to that, they take away your clothes, put you in a gown that doesn’t close in back, you share a room with a stranger and their family, there’s noise and fuss all night so you don’t sleep a wink, you hate the food, and even if you’re well enough to get out of bed there’s pretty much nowhere else to be. And you’re frightened. If your qi wasn’t in a knot when you got there, it will be soon!

QUR: Do you think the push to create a sterile atmosphere in a hospital affects a patient’s healing path?

Sure, but then so does a staph infection. It’s a question of what precautions are really reasonable and necessary. Like, for most of the women we work with in labor and delivery, they’re not sick, so I always try to tell people to bring a nightie they like and feel powerful and sexy in. I tell them there’s no need for a gown, and if they decide to go for an epidural they can always change. Or the rules about eating and drinking – the idea is to keep their stomachs empty to prevent vomiting and aspiration if there’s a C-section – but how many C-sections and complications happened because people got exhausted after 24, 36 hours in labor and no food? If you don’t study an outcome, you don’t see it.

QUR: How does affirming a person’s health influence labor?

Well, beyond affirming health, we try to actually promote it by taking a symptom as a sign of a constitutional imbalance and helping to rectify that. But even if you’re just talking about affirming it verbally, it’s crucial to remember that the flow of qi in your body is your emotional life, and vice versa. If you’re alone in the room with your partner and neither of you has ever done this before, how do you know how it’s going? A lot of your emotional energy goes into trying to figure out if everything’s OK or not. If there’s someone in there who can say, in all honesty, in 99.9% of cases I’ve seen a ton of labors and, honey, you’re doing a great job, you can do this. You’re affirming the health of her qi, her basic adequacy for this task, and she takes her emotional experience out of pensive mode, racing around trying to figure out if it’s OK, and just lets her body do what it knows how to do. The labor has its own qi flow, and it usually goes fine if the caregivers can just keep from interrupting it with interventions before they’re necessary.

QUR: Are you saying labor has its own qi-- its own morphology?

Gee, I guess I am. I take it as one of the fundamental understandings of OM that the universe is holographic, that you can look at any subset of it and see yin/yang and the five phases. In the hospital in general, they tend to show up really clearly – you see bright red tongues, or thick white coats like toothpaste, or a thick coat on half the tongue and nothing on the other. And it’s really clear in L&D because the main characteristic of labor is that once it’s going, it progresses, it moves. So you pretty much walk into the room, and you can feel if the labor’s going or not. And then if it’s stalled, or we work with a lot of women where it hasn’t really gotten going yet but for medical reasons they’re in the hospital and they need it to go, then you tease out what’s blocking the movement of the yang qi. Is the qi itself deficient, or is there stagnation blocking it, or damp? And then in the treatment, it’s not just what needles you choose, it’s also all the choices you make about what you say and how you use your voice: are you trying to move stagnation or nourish deficiency? With damp patients, for example, it’s much less important exactly what points you do than that you keep changing it to keep her from bogging down.

QUR: Do you think your work’s impact extends beyond labor? If so, how?

I think that having a negative or a positive labor experience really sets up your physical and emotional experience in those critical first days and weeks getting to know the new person in your life. It has to make a difference if you’re feeling completely shattered and beaten down by the birth versus if it was basically a positive experience and you’re tired but happy. I personally believe the birth experience needs to be better studied in relation to postpartum depression.

QUR: How does the way labor goes influence the likelihood of post-partum depression? Could you elaborate on that?

Childbirth is one of the most challenging things that a human being does, and when it goes well, like any challenge you meet and surmount, it builds you as a person. And also if you’re in a relationship, if it goes well, the partnership is immensely strengthened. It’s a great preparation for all the sleep deprivation and crises of parenthood. But when a birth experience is negative, it can be really bad. People question their own decisions, bad enough – if I hadn’t gotten the epidural maybe wouldn’t have had the C-section, if I hadn’t gotten the pain shot maybe we would have bonded better and he wouldn’t have ADHD – all of that. But also, it happens that in a particularly difficult moment a woman genuinely believes that she can’t do it, she’s not good enough, she’s not strong enough. Whatever her partner support and coping mechanisms are, in that moment they’re not enough for her.

In Chinese medicine terms, I’d say her shen are scattered. Usually the moment passes, and it just becomes part of the challenge that she overcame. But if that period of despair lasts a too long or if there’s a less than optimal birth outcome, I think that it has the potential to undermine rather than build a person’s sense of her basic capabilities. There are women called birth Doulas, who basically just hang out with you during your labor and help it to go smoothly and positively. It seems to me that acupuncture can provide a more focused version of that, where we’re using the understandings and techniques of Chinese medicine to keep the labor smooth on a physical level – pain relief, boosting contractions, helping dilation – and also on an emotional level.

Bridging the Knowledge Gap Between the Practitioner and the Layperson

The Qi-Unity Report interviews David Sollars

QUR: Please introduce yourself.

My name is David Sollars. I began practicing Oriental medicine in 1985. I started out as an apprentice in Boston, Massachusetts’s Chinatown. I’ve been involved in seven clinics since that time and currently operate a multidisciplinary practice, FirstHealth of Andover P.C., located in Andover, Massachusetts. Like many practitioners, I’ve combined a diverse vocational background of writing, performing, and martial arts that has led to the continued evolution of my practice style. I am inspired daily by the resiliency of the human spirit, humbled often and strive to assist patients with their journey.

QUR: What led you to write a book for the layperson on Acupuncture?

I was looking for a book for our waiting room. We had brochures and textbooks. I wanted something in-between that was good information set in a context that was easy to read for the beginner. I kept calling publishing companies to inquire about the subject. One of them asked me about writing one. I assisted them with their preliminary research into the field. Since I do a fair amount of teaching and public speaking, I had most of the information they asked for in existing Powerpoint presentations. They were able to see that acupuncture was an emerging popular medicine and that a text on the subject might fit into their mission. The Idiot’s Guide series specializes in publishing books that are a beginner’s first entry into the field and hopefully inspires them to continue to explore the subject. They are a strong and widely available brand. After I did a writing test for them, they asked me to write the text.

QUR: How has your book been received by the public?

The Idiot’s Guide has been in circulation for about three years. By then, the subject usually has had several beginner books written, and they’ve moved on to other subjects. The Idiot’s Guide to Acupuncture and Acupressure, which was published in 2000, is on its second or third printing. It still sells around the world. I’ve asked them to write an updated version, since so many more advancements have been made since I wrote the text, but the sales are good. So many people have yet to experience the benefits of acupuncture. It remains a growing, emerging market, and they believe the text still serves its original purpose. I do get letters that tell me it does still educate and inspire patients to seek an acupuncturist for care. They were so pleased with the book that they asked me to write another text. They saw on my resume that I was also a homeopath. The next year I wrote The Idiot’s Guide to Homeopathy.

QUR: As a practitioner, do you use your book as an ancillary means to connect with your patients?

I’m always looking for ways to communicate clearly and effectively with our patients. Writing a book certainly allows you to tell the story your way. The Idiot’s Guides are informal and conversational, so many patients remark at how reading them is like speaking with me. They have, for better or worse, my sense of humor and organization. I’ve been fortunate to write for several projects. Being a part of several writing collaborative or participating as a senior editor has given me a unique perspective into various fields. I am grateful for getting the opportunity to learn from so many talented practitioners.

Our clinic practitioners participate in a variety of writing projects from customized brochures to sending out comments to media on topical events. We write our own subscription based e-newsletters to thousands of people, create event posters, and populate our website with articles, forms, and video. Business writing is an essential tool for us to communicate the benefits of the therapies we offer along with research and commentary, which reflects our point of view. Writing is a discipline. We don’t always feel like doing it nor have the extra time it requires, but we’ve seen the positive results of our efforts.

QUR: Do you think public outreach should be a high priority for practitioners? If so, why?

We’ve found that the general public is waiting to hear our stories. They are searching for answers to their problems. There remains a growing curiosity and a strong interest within the public regarding the potential benefits of acupuncture, Chinese medicine and many integrative therapies. As practitioners, we have great personal and patient stories to share. When we do articles for the media, they love our stories. They often comment about the genuine caring that is reflected in the practitioner’s point of view for their patients along with the interesting career path that led them to practice Chinese medicine. They publish stories of hope, which demonstrate a high level of patient education about their process of healing. The stories are filled with examples of integrative care being used within our local medical community, establishing realistic expectations, pertinent research and gratitude from a happy patient. If we do not take the lead to educate both the general public and other health care professional, then who will?

QUR: What advice do you have better to bridge the knowledge gap between practitioner and patient?

When I first started practicing, it was challenging to find anyone who thought acupuncture could do anything. Now, I have patients coming in thinking a needle is a cure all without them lifting a finger or making any significant contribution to their care. I take a common sense approach to initial patient education. We ask all of our inquiries and new patients where they heard about us and what were the steps they took prior to making a phone call. This lets us know the information path they took and helps us manage our marketing resources better. We try to work on the information gap well before a patient even makes an inquiry into our services. We’re continually honing our writing skills so that we demonstrate clear and realistic advertising pieces, phone book ads, web site entries and newsletters. We review the medical language chosen for our brochures and fliers that are being distributed for support group lectures, health fairs and even front desk specials. Our reception staff is trained to answer several layers of general questions and a practitioner can always be called to comment on our experience with specific conditions. As a team, we discuss how we would answer questions and communicate to practitioners if we have just spoken with someone who will be seeing them. Giving them a heads up is helpful, especially if we have addressed specific approaches or set expectations for the patient. All of these steps make the initial office visit more effective and efficient.

We have also found out it is paramount not to move on in the initial interview if a patient does not understand the process, our experience, the proposed timeline, how we may work with their other providers or the importance of their participation in their own care. This takes additional time, but it is well worth it to avoid misunderstandings. These clarifications may need to be repeated numerous times. We work as a team to make sure there is a consistent and clear message given to our patients.

QUR: What other avenues do you think are available for the AOM community to reach the public?

Do what you would do anyway. You are only limited by your own imagination and interests. Be a part of the community that you live and practice. I’ve always said that people spread the word about your practice because of who you are not what you are. Get to know people around you and choose activities that you enjoy. I have always gotten a kick from public speaking. It’s fun and a great way to discuss what you do while people get to know you. Writing is similar, in that you are sharing your thoughts. I was also raised doing community service, so I look for opportunities to contribute. I am an active member and past president of the Rotary Club of Andover. We participate in a variety of civic projects in our town. I have also been the chairman of the board for a local non profit, Ironstone Farm, for several years. My wife and I volunteer for this organization that uses horses to provide therapy to disabled children and adults. These activities fulfill our desire to give back, while meeting wonderful people in our area.

QUR: What collective efforts do you think will increase the public profile and sense of legitimacy for AOM in the future?

The profession of Oriental medicine has come so far. The national organizations are united with many of the political and research initiatives underway. I have enormous gratitude for the individuals that have helped to bring our profession along the legislative and organization path. That work needs to continue. I believe the growth opportunity for our profession is strong and there is a willing audience waiting to hear from us. Our job as professionals is to share the excitement and successes of our practice. We need to get our stories out. This can be accomplished from national to local initiatives. National marketing by state or national organizations are helpful. We could combine funds to produce professional information pieces and make larger media buys. The pieces could then be sent to news/media outlets, with practitioners being able to use them on their websites, lectures and e-newsletters. I believe we need to take charge of the messages that get out to the public regarding our profession. An individual can make a difference by getting the word out about the profession Oriental medicine. Share your stories.


AAAOM Activities

Misrepresentation in the Media: Telling the AOM Story

By Douglas Newton

Where might you encounter misrepresentation of AOM? Pick up a newspaper or go online these days, and you are likely to find articles about herbal medicine, acupuncture, and holistic medicine that mis-state facts, blur lines, proffer out-of-line arguments, or violate the spirit of this medicine as you know it. These articles represent the most broadly exposed public consumption of AOM information.

Consider this:

“If you are interested in acupuncture, ask your doctor about it. Healthcare practitioners can be a resource for referrals to acupuncturists. More medical doctors, including neurologists, anesthesiologists, and specialists in physical medicine, are becoming trained in acupuncture.”

(Source: http://www.consumeraffairs.com/news04/2007/10/geezer038.html)

The article referenced above also suggests that over 10,000 acupuncturists practice in the U.S. We know that this asserted figure represents less that half the actual number of AOM practitioners. And why should the interested public ask a doctor about acupuncture instead of going directly to a licensed acupuncturist?

Here is another sampling:

“This trial is particularly interesting because osteoarthritis of the knee is the one thing that is always cited as a triumph for acupuncture. It is common to hear people talk about acupuncture as though it were the acceptable, or even accepted, face of alternative medicine. Perhaps that is because it is not so obviously preposterous as homeopathy. Sticking a needle into you obviously produces a signal in the brain. That is just sensory physiology. But the evidence that this produces any real benefit for patients is, in fact, almost thin as for homeopathy. This paper seems to have been done very well. It is another nail in the coffin of needle quacks.”

(Source: http://dcscience.net/?p=45)

It is inaccurate and often slanderous to present acupuncture in this way. Insults like this could and should be ignored—were they not influencing the public’s sense of AOM validity. I argue that AOM practitioners can ill afford to remain aloof.

As you can see, the existence of attacks on AOM in the media is not speculation but a real presence for whomever chooses to read articles of this nature that are identified through Google or Yahoo Alerts. Where is this misrepresentation found? It is throughout the internet blogosphere. Who is writing this information? The internet has changed the shape of the media, affording communication to a broader range of writers, expanding far beyond conventional journalism. Bloggers on these topics abound. As such, a search for the words “acupuncture,” “Oriental medicine,” “health care,” “alternative medicine,” or “herbal medicine” yields a wide variety of articles and blogs in Google (or Yahoo) Alerts—everything from professional research journals to tabloid articles to outrageous claims. The authorship varies greatly according to this broad range of sources.

Whatever the source, these articles collectively tell a story to the public--and the terms of that story may not necessarily represent the facts that present a clear understanding of AOM. Some articles, like the one cited above, attack all healing modalities as quackery, or seek to associate AOM with all other CAM modalities, casting aspersions on anything that would encroach on allopathic medicine. Still other articles mis-state the roots of acupuncture or assert a lack of scientific proof for AOM.

When these falsehoods are presented to acupuncturists like you, please articulate your arguments to the contrary; let these arguments surface through your educational experience as practitioners, through specific studies you know about, or through direct observations in the clinic. Some of you have conducted research in the field that points not only to the basic existence of channels and qi but also to tangible ways this can be measured or understood. These insights allow us to help you craft statements that can clarify an article and to push back against claims that don’t quite make sense. Are you writing articles like this to contribute your voice to the field?

On that note, I encourage all of you to subscribe to the Alerts I mentioned and to get into the conversation. Unlike within the cultures of many Asian countries, we cannot assume that AOM occupies an intrinsic foundation in the U.S. Despite a recent surge in popularity, in cultural terms this medicine is still nascent, still in its beginning stages of recognition. In light of this, we need all of you to contribute your time, energy, and voices to this larger, ongoing conversation. The public will not absorb the gestalt of AOM without a prolonged campaign that places AOM on the map of popular awareness. Success stories, carefully written public statements, and AOM research do alter perceptions and collectively forge the proper infrastructure for the AOM profession. So we have reason to suspect that our efforts will have a payoff—one that supports the AOM profession’s overall development.

Consider the statement the AAAOM made regarding some misleading references in US News & World Report:

AAAOM's response to US News & World Report article

As AAAOM President Martin Herbkersman shows in the above statement, we can work together to assert the proper professional voice that the public deserves. You have a right to be heard, and I’m here to help you in any way I can.

dnewton@aaaomonline.org
866-455-7999

Look to future editions of The Qi-Unity Report for an article furnishing examples on how to write an effective rebuttal.

Health Fair Report

I was the only acupuncturist invited to the health fair organized by the UPS on March 20. There were about 8-10 booths including yoga, the American Heart Association, Subway, etc. It was held inside the UPS facility where conveyor belts were running. I had to go through a security check before I was escorted to the fair’s location, an area outside their administrative offices, one floor above the conveyor belts. The UPS employees were very nice and warmly welcomed me.

Roughly 100 employees attended the fair. A majority of them stopped by my booth and asked me a lot of questions regarding shoulder pain, tennis elbow, knee pain, etc. They seemed very interested in pain relief.

Frankly, I felt very fortunate being able to attend the fair. It's really a great opportunity for me to promote acupuncture and, hopefully, some of these employees I met will come to me for my treatment.

I found that their main concern was whether or not their insurance plans cover acupuncture. I understand that HMOs and some PPO plans do not cover acupuncture.

However, I don't know exactly which ones do cover it and couldn't give them any answer. But I guess most of their plans do not cover acupuncture treatment. This is why they were so hesitant to come even though they had pain, and this is also one of the big issues acupuncturists in the U.S. are still facing today. I hope AAAOM can help us to get more recognition. Do we need to do more to educate the general public and the health insurance companies to change this situation?

Thanks again for giving me the opportunity to participate in the fair and to promote acupuncture. Please let me know if I can be assistance in the future.

Links

March Links

March Links

Here you will find a set of links to various AOM articles of note found on the web.

The AARP publishes an article addressing the trend toward integrative medicine.
“...integrative medicine—and it's at the forefront of a movement experts say is finally, after more than a decade of prodding from patients, gaining acceptance among the nation's top physicians and medical schools.”

More: www.aarpmagazine.org

AAAOM Board member Bill Reddy writes about AOM and infertility:

More: www.toyourhealth.com

This is a great site that lists many links and displays articles of common concern to us all. Here is an article about FDA regulations on traditional herbal mixtures and how this affects the one-time mixtures.
“Ever since the Food and Drug Administration released its “final rule” on the manufacture of dietary and herbal supplements, herbalists have been wondering exactly how some of the Byzantine record-keeping requirements might be enforced, and whether small-scale or one-time batches of custom formulas might be exempted, or at least overlooked.”

More: aradicle.blogspot.com

A quote from a court order:
“I will fully participate in the program of substance abuse treatment and counseling as set forth in my treatment plan by the Program team. I specifically agree to report regularly to any treatment provider identified in the treatment plan and to participate in any drug testing, acupuncture, counseling, AA/NA meetings and other components of the treatment plan, all of which are designed to enable me to become a better parent.” [Emphasis added.]

Did you ever think you would see this kind of court order? Times are a changin’, especially in California.

More: bobvis.blogspot.com

This blog entry explores use of Chinese medicine for the common cold, and what it means to have a “cure.”

More: deepesthealth.com

Dr. Michael Wilkes writes: “Unlike most alternative therapy, acupuncture has been subject to more clinical research than many orthodox medical treatments, but it still is rarely used.”

More: www.sacbee.com

Looking for a job? This directory offers several listings.

more: www.tcmdirectory.com

Members of the U.S. military use complementary and alternative medicine (CAM) at approximately the same rate and in the same demographic patterns as the wider U.S. population, according to a study published in the journal BMC Complementary and Alternative Medicine. A prior study of military families found that 28 percent reported using at least one CAM per year, while studies of veterans found that between 27 and 50 percent did so.

More: www.naturalnews.com


Continuing Education and Events

AOMA Informational Session

Sunday April 27th, 2-5pm
Explore your future as a practitioner of Oriental medicine at AOMA’s spring open house.

AOMA Campus: 2700 W Anderson Ln, Austin, TX 78757
Campus tours, demonstrations of acupuncture, Chinese herbs, and qigong.

Contact the admissions office to arrange overnight accommodations with a current AOMA student.

admissions@aoma.edu, 512-492-3017 or (800) 824-9987, ext 217
www.aoma.edu

PCOM Receives Maximum Accreditation from ACAOM

The San Diego Pacific College of Oriental Medicine has recently been accredited by ACAOM, the Accreditation Commission for Acupuncture and Oriental Medicine. The Commission awarded PCOM with the maximum periods of five and seven years for its doctorate and master's programs, respectively. This length of time has never previously been granted; three and five years used to be the maximum periods of accreditation possible for schools to earn.

The ACAOM is the only accrediting agency currently recognized by the Department of Education and that is qualified to accredit schools of Oriental medicine. This recent accreditation is a great honor and is testament to the commitment of PCOM's board of education, the knowledge of its faculty, the competence of the administration and staff, and the outstanding results achieved by its students and graduates.

There are 14 areas of examination, known as the Essential Requirements, that PCOM fulfilled in the process of this accreditation. Some of these include the excellent performance of admissions, programs of study, the faculty, the library and surrounding facilities, as well as legal governance records. Pacific College is one of less than five schools in the United States to be awarded the maximum accreditation by ACAOM.

Accreditation enables institutions like PCOM to be eligible for federal financial aid. One of the highest forms of peer review, accreditation recognizes the success and prestige of a campus, makes it more well-known to future applicants, as well as providing more benefits to those that already attend.

For more information on PCOM's accreditation, please contact Pacific College of Oriental Medicine at (800) 729-0941, or visit www.PacificCollege.edu

DOD Grant

The Department of Defense offers a new CAM grant relating to psychological health and traumatic brain injury. For complete details including access to the application, kindly visit the following link:

www07.grants.gov/search/search.do Funding Number: W81XWH-08-PH-TBI

Pacific College Celebrates World Tai Chi & Qi Gong Day

Pacific College of Oriental Medicine is one of many institutions around the world to recognize World Tai Chi and Qi Gong Day (WTCQD). Groups around the world will gather at 10:00 am on Saturday, April 26, to practice Tai Chi and Qi Gong. World Tai Chi and Qi Gong Day will see people in over 80 countries gather to practice these disciplines and to educate the public about the benefits of such exercise.

World Tai Chi and Qi Gong Day provides teachers, schools, and Tai Chi and Qi Gong associations with many free tools and services to educate communities about the potential benefits of these disciplines. It is also a day to promote worldwide wellbeing.

Qi Gong has a long history. In ancient China, people believed that through controlled body movements and mental concentration, paired with various breathing techniques, they could balance and enhance physical, metabolic and mental functions. Qi Gong exercise relies on the traditional Chinese belief that the body has an energy field, known as qi. "Qi" in Mandarin Chinese means breath or to breathe, and "gong" means work or technique. The pairing of the two is the basis for the art of Qi Gong.

Tai Chi is also a centuries-old Chinese discipline that aids health, relaxation, balance, flexibility, strength, meditation, self-defense, and self-cultivation. It is referred to as moving meditation. The practice began as a martial art and is based on the principles of the Yin Yang symbol, called Tai Chi in Chinese, meaning "grand ultimate."

Activities at most events include Tai Chi and Qi Gong exercise demonstrations, and many feature prominent masters leading exercises. Events are free and open to the public. A good way to find events in your area is to check with the nearest Oriental medicine school. In stressful times such as these, a day such as WTCQD is much needed. It can bring both relaxation and a sense of community and shared peace. It also brings people together across economic and geopolitical lines to celebrate health and healing.

To find out more information about World Tai Chi & Qi Gong Day please call Pacific College at (800) 729-0941 or visit www.PacificCollege.edu

Trudy McAllister Fund Scholarship

Have you been thinking about how you can contribute to education in the AOM profession. Or have you been looking for support in your study effort? Click on the link below to read more information on what funds are available to you or how you can contribute to this worthy cause.

www.triskeles.org/phil_tmf_scholarship_fund.asp

Women’s Health Seminar

DATES: Saturday- Sunday, April 26-27, 2008

Gynecology & Infertility Physiology, Pathology and Herbology

Location: Morristown, NJ

Mindbody Center Rehabilitation Center
95 Mt. Kemble Ave. Morristown, NJ 07962

This seminar is a comprehensive presentation of the physiology, pathology, diagnosis and herbal treatment of women's diseases according to TCM. The second day of the seminar will be dedicated to understanding the complexity of treating infertility.

In this seminar you will learn:

Times: Saturday 9-5, Sunday 9-3

Tuition: $250 by April 4, thereafter $275

To register contact: Anastacia White, 510.420.0904, Anaherbs@aol.com
www.eemedicinewisdom.com

Cancellation before two weeks prior to workshop a full refund. Thereafter a $50 cancellation fee will apply.

New York College of Health Professions

Faculty Employment Opportunities

http://www.aaaomonline.info/qiunity/08/03/faculty_ad_nychealth.jpg

A Master's Class in Chinese Medical Diagnosis

In Tucson, with Bob Flaws

http://www.aaaomonline.info/qiunity/08/03/asaom.pdf (PDF)

AAAOM Student Organization

Northwestern Health Sciences University Students Lobby for Equal Access Acupuncture Amendment at State Capitol

BLOOMINGTON, Minn. - More than 60 students, faculty and staff from the Minnesota College of Acupuncture and Oriental Medicine (MCAOM) at Northwestern Health Sciences University lobbied for equal access at the state capitol in St. Paul on March 4. The event was jointly organized with the American Association of Acupuncture and Oriental Medicine (AAAOM).

“We want to make an amendment to the current bill that adds a clause ensuring those seeking acupuncture treatment are also reimbursed for health care costs the way they are for visits to medical doctors and chiropractors,” said Hilary Patzer, a T5 MCAOM student and co-organizer of the event. “We just want the public to have equal access to us.”

Patzer, along with Robert Lowe, T5 MCAOM student, spoke with Marcie Jeffreys, the policy adviser to Sen. Lawrence Pogemiller, D-Minn, about supporting the amendment. They left a packet of information with Jeffreys, and also educated her about acupuncture, as she was unaware acupuncturists were licensed by the state.

“I’m aware of the issue,” Jeffreys told Patzer and Lowe. “I’ll be keeping my eye on it.”

Lowe said he was grateful for the opportunity to lobby. “This is nerve-wracking but really exciting; I’ve never done anything like this before,” Lowe said. “I think this is important because it’s for the future of medicine. The acupuncturists have just started forming groups to lobby and make the public more aware of these issues. It’s critical to education that legislators support us. Short term, I’m hoping for the passage of this bill. Long term, I would love for acupuncture to be considered a key form of health care in this country. We can do really great things for people.”

Mark McKenzie, MOm, LAc, and dean of MCAOM, said he was pleased with the turnout.

“Today has gone great,” McKenzie said. “The student turnout and support of this effort will be extremely important for the passage of the equal access amendment. In addition, it gives students legislative experience so once they become practitioners it will become easier for them to interact with senators and truly inspire change.”

Northwestern Health Sciences University offers a wide array of choices in natural health care education including chiropractic, Oriental medicine, acupuncture, therapeutic massage, human biology, and integrative health and wellness. The University has more than 900 full-time students on a 25-acre campus in Bloomington, MN.

Minnesota Acupuncture Students & Practitioners Fight for Equal Access to Acupuncture at the State Capitol

By Hilary Patzer, AAAOM-SO Central Region Director & NWHSU AAAOM-SOCC President, and Jennie Sweeney, NWHSU AAAOM-SOCC Vice-President

The local AAAOM-SOCC (Student Organization College Chapter) at Northwestern Health Sciences University in Bloomington, MN, helped to organize a lobby day at the capital. Their efforts came to light on March 4th, 2008 when they met at the state capital and lobbied for “Equal Access.” The chapter felt it was important to become involved in this particular legislative issue for three main reasons. First, currently third party payers do cover acupuncture under their health plans. However, they limit their reimbursement to MDs, DOs and DCs, despite the differences in training from acupuncturists. Second, because of the discrepancies in third party reimbursements, the majority of the public is limited to the acupuncture treatments of an MD, DO, or DC. If these providers did not attend a 3 or 4 year program, the public would not experience the same quality of acupuncture that they would if they were permitted access to licensed acupuncturists. Third, this local chapter felt that it was time for acupuncturists to stand up for their rights and start shaping their own future.

Because the enthusiasm behind this lobbying effort was so vibrant, the hours upon hours of planning were exciting and stimulating rather than burdensome. There is a ton of planning that goes into an effort like this, but it is possible for any school or organization to succeed. Here is a quick list of some of the steps this local chapter used:

  1. Get involved with your state association.
  2. Find out what bills are on the table, what the state association is involved with and what the student body is most interested in.
  3. Ask for help and support from your administration; they can play a vital role.
  4. Call the state capital and reserve a room so you have a home base once you are at the capital.
  5. Make a list of what districts your students are from and who their legislators are.
  6. Make appointments with those legislators, making sure that the legislators know that the students are constituents.
  7. Arrange transportation from your school to the capital (buses).
  8. Schedule an information day at your school about a week before the lobby date to inform and educate the students and faculty on what the bill is and how the day will unfold. Providing a script to the students at this time is beneficial.
  9. Start assembling informational folders that you can leave with the legislators with information on the proposed bill and some information on your school.
  10. Create name tags that state your name and the purpose of your visit.
  11. Warn the volunteer lobbyist that it is going to be completely chaotic, but to” go with the flow” and smile.
  12. Invite alumni, state association members and any supporting members of the public.
  13. Walk into the capital with poise. Dress professionally. You deserve to be there and your bill deserves to be heard. Express to the legislators how important your bill is and be respectful and gracious. The legislators’ schedules are incredibly tight and can change at a moments notice.
  14. If a legislator is not available, talk to their assistants. They are very knowledgeable and helpful. They will present your case and information to the legislator, so be sure to respect their position.

The Northwestern Health Sciences University lobby day was a huge success. The school is still buzzing with the energy and enthusiasm that was generated by taking a stand for our rights. The overwhelming response from the over 100 volunteer lobbyists that day was that the legislators were very positive and supportive. They asked a lot of questions, and they were very engaged and extremely approachable. The student lobbyists, in particular, felt energized as legislators opened their doors and ears to what they had to say.

Even if the “Equal Access” bill is not heard this year, efforts will continue to be made towards the goal. The students, association members, alumni and faculty spoke to over 60 legislators that day. That is 60 more people who now understand what acupuncture is, what it can treat, and the difference between licensed acupuncturists and MDs, DOs and DCs. We learned and accomplished so much that day; it really was a great step forward for AOM!

Products, Services, and Member Savings

Dear Prospective Advertiser:

Investing your advertising dollars in The American Acupuncturist and the Qi-Unity Report makes good sense for so many reasons:

Join our current advertisers to infuse growth into the field your products and services benefit. The reunified organizational force behind the AAAOM means more power toward serving the growth of alternative medicine.

With so much to gain, what better time is there to advertise in The American Acupuncturist and the Qi-Unity Report? Please contact me to learn more at (866) 455-7999.

Yours in Health,


Douglas Newton
Manager, Program Development and Business Services, AAAOM
866-455-7999
916-443-4766 (fax)
info@aaaomonline.org

ENCLS: AA/QUR Ad Card (PDF); Adv. Contract (PDF)

In closing,

As always, your feedback serves as a useful lens through which we may look at how well we are serving our members. Please take a moment to express your thoughts to us.

General Feedback

In Health,


Rebekah Christensen,
Executive Director
Douglas Newton,
Managing Editor