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The Illegal and Unsafe Practice of Acupuncture 

 

Under the Term “Dry Needling”,

 

10 Facts You Should Know

 

Here are 10 facts you should know about the illegal and unsafe practice of acupuncture under the term “dry needling:”

1. “Dry needling” is acupuncture.

“Dry needling” was first described over 2,000 years ago in China’s earliest and most comprehensive extant medical treatise, the Yellow Emperor’s Inner Classic (Huangdi neijing), where it discusses in detail using tender or painful points, also known as “trigger points” or “motor points,” to treat pain and dysfunction, particularly of the neuromusculoskeletal system. Simply described, “dry needling” involves inserting an acupuncture needle into a tender or painful point and then appropriately manipulating (rotating and/or pistoning) it for therapeutic purposes.

 

2. Tender or painful points, also known as “trigger points” or “motor points,” are acupuncture points.

Tender or painful points are located in muscles and connective tissues, and, as their name suggests, are identified through tenderness or pain on palpation. This was, in fact, one of acupuncture’s earliest forms of point selection. China’s preeminent physician, Sun Si-Miao (581–682 C.E.), called these tender or painful points “ashi” points. In Chinese, ashi means Ah yes!(That’s the right spot.). So, when the tender or painful point is pressed, the patient feels an unexpected local and/or referred “wince-pain” and says Ah yes! That’s the right spot. Incidentally, in a 1977 study published in Pain (the official journal of the International Association for the Study of Pain), Melzack, Stillwell and Fox established that “every trigger point [reported in the Western medical literature] has a corresponding acupuncture point.”* A number of studies subsequently published in the Western medical literature have reached this same basic conclusion.

 

* Source: Melzack R, Stillwell DM, Fox EJ. Trigger points and acupuncture points for pain: correlations and implications. Pain. 1977 Feb;3(1):3–23.

 

3. “Dry needling” is not “manual therapy;” it is acupuncture.

It is important to emphasize that “dry needling” is an invasive, acupuncture needle intervention (that is, it is acupuncture, a specialized form of minimally invasive surgery), whereas manual therapy is a noninvasive, hands-on intervention (for example, massage, mobilization/manipulation). Manual therapy certainly does not include the practice of surgery in any form.

 

4. “Dry needling” is not a “technique;” it is acupuncture.

To make clear, the act of inserting an acupuncture needle into the body, under any pretense, or for any purpose whatsoever, is the practice of acupuncture.

 

5. Physical therapists and other allied health professionals who are not licensed by law to practice acupuncture cannot legally purchase acupuncture needles.

The Food and Drug Administration (FDA) classified acupuncture needles as Class II medical devices subject to strict regulations under the federal Food, Drug, and Cosmetic Act (FDCA) and FDA’s regulations. Individuals purchasing or receiving acupuncture needles who are not licensed by law to practice acupuncture are directly violating both civil and criminal provisions of the FDCA intended to protect public safety. 21 U.S.C. § 331(a)–(c), (g). These include the FDA’s requirements that acupuncture needles can only be sold to “qualified practitioners of acupuncture.” 61 Fed. Reg. 64616 (December 6, 1996). FDA prescription labeling requirements themselves specifically prohibit the sale of acupuncture needles to anyone who is not a qualified practitioner of acupuncture. The required FDA prescription labeling on the package from which acupuncture needles are to be dispensed states: “Caution: Federal law restricts this device to sale by or on the order of qualified practitioners of acupuncture as determined by the States.” 21 CFR § 801.109(b)(1) (emphasis added). Any individual who is not licensed by law to practice acupuncture is directly violating the FDCA and FDA’s civil and criminal prohibitions when they purchase or receive acupuncture needles for use in “dry needling.”

 

6. Physical therapists and other allied health professionals who are not licensed by law to practice acupuncture are using acupuncture needles to perform “dry needling.”

Physical therapists and other allied health professionals who are not licensed by law to practice acupuncture would have you believe that they are not using acupuncture needles to perform “dry needling,” when they are, in fact, using acupuncture needles, which are clearly labeled as such on the dispensing package.

 

7. Physical therapists and other allied health professionals who are not licensed by law to practice acupuncture are not qualified to perform “dry needling.”

“Dry needling” is far outside both physical therapists’ and other allied health professionals’ scope of practice and their scope of education and training. In most states, to become a licensed acupuncturist, an applicant must complete a minimum of 1,905 hours of education and supervised clinical training (1,245 hours of education and 660 hours of supervised clinical training). Yet physical therapists and other allied health professionals who are not licensed by law to practice acupuncture are inserting acupuncture needles (up to four inches or more in length) into unsuspecting patients with as little as a weekend workshop in acupuncture.

 

8. There are real risks associated with the use of acupuncture needles by physical therapists and other allied health professionals who lack the education and supervised clinical training of licensed acupuncturists.

These real risks include, but are not limited to, blood vessel, nerve and organ injury from inappropriate acupuncture needle angle and depth of insertion or from inappropriate acupuncture needle manipulation; and infection and cross infection from nonsterile acupuncture needles, poor hygiene in acupuncture needle handling, and inadequate skin preparation.

 

9. There have been recently reported cases of injury or harm from the use of acupuncture needles by physical therapists and other allied health professionals who lack the education and supervised clinical training of licensed acupuncturists.

In one such case, Emily Kuykendall, a high school teacher from Maryland, had suffered nerve damage from the use of acupuncture needles by a physical therapist. In another such case, Kim Ribble-Orr, a former Olympic athlete from Canada, had suffered a punctured lung and a pneumothorax (the presence of air in the cavity between the lungs and the chest wall, causing collapse of the lung) from the use of acupuncture needles by a massage therapist.

*If you or someone you know has suffered injury or harm from the use of acupuncture needles by a physical therapist or other allied health professional who lacked the education and supervised clinical training of licensed acupuncturists, we want to hear from you. Our phone number is 775-301-5255.

 

10. It is illegal for physical therapists or any other providers to submit claims for payment to Medicare for “dry needling” (a non-covered service) as “physical therapy” (a covered service).

Since “dry needling” is acupuncture, it is not a covered service. Use of acupuncture needles is not a covered service, whether an acupuncturist or any other provider renders the service. 42 U.S.C. § 1395y(a)(1). Its billing under Current Procedural Terminology (CPT) codes 97112 (neuromuscular reeducation) or 97140 (manual therapy techniques) is a misrepresentation of the actual service rendered and is considered fraud by Medicare. 31 U.S.C. §§ 3729–3733.

*If you suspect Medicare fraud, call the Medicare Fraud Hotline at 1-800-HHS-TIPS (1-800-447-8477). TTY users should call 1-800-377-4950.

*Information on this page is used with consent from the National Center for Acupuncture Safety and Integrity

http://www.acupuncturesafety.org/10Facts

 

 

 

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To date, there are 1,035 active acupuncturists in MD. Acupuncture Today indicated the members in Maryland is 752(72.6%). And currently VA active acupuncturists  about 485. In Acupuncture Today, is 352(72.6%).

Total acupuncturists in Acupuncture Today is about 25,000. So in 2014, actual active acupuncturists in USA should be 34,435.

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中医针灸在美国第一个州的立法经过

作者:祝君平安  于 2013-4-6 12:30 发表于 最热闹的华人社交网络–贝壳村

中国针灸医学近百年来的发展很快,水准也越来越高,主要原因是疗效优良。当今西洋医学面临着2个大问题:一个是药物治疗后引起的毒害性,另一个是手术治疗后引起的后遗症。还有很多疾病,西洋医学只有诊断而没有治法的。

现代的医学家极力寻找不杀伤性的、温和的新治疗方法。进入20世纪70年代,中医针灸终于成为他们的研究对象,在西洋医学最先进的美国第一个州———内华达(简称内州)就率先立法承认中医针灸的医学地位。

1.内州立法前美国中医针灸发展概述

美国立国200多年,直到20世纪70年代,对中医针灸并不重视。但在华人社区中,尤其是在洛杉矶、三藩市、纽约、华盛顿,中医针灸仍是华人治病的主流。美国人民也喜欢游唐人街,其中的中药店、凉茶铺很多。有人还会去尝试接受治疗,因此,小部份美国人对中医针灸并不陌生。

1947年,美国西医师公会在ATLANTIC城召开医学大会,有医生报道中医针灸的疗效,可惜人数太少,未得到重视。1949年,JOHNSHOPKINS大学研究生ILZAVEITH把《内经》译成英文,在序言中赞许中国医学的防病治病理论,这书后来再被译成意大利文,对推广中国医学起了一定的作用。1953年,PRINCETON大学开设了GEST东方图书馆,收藏75000册中医针灸书,为有识之士提供了接触中国医书的门径。

1971,中国向世界公开宣布针刺麻醉成功的消息,打破了西方医学家蒙昧保守的思维模式,开始接触中国医学,从而热烈的学习研究起来,就这样拉开了“中国针灸热”的序幕。次年2月,中美建交,美总统尼克松访华,其随行医师W.TKACH大力表扬中医针灸的优良疗效,就这样再把“中国针灸热”提升到高峰。医学界纷纷组团来向东方取经,当时到香港学习的不下万人,更多的到中国学习,回国后,就是一窝蜂开设诊所及学习班。以华盛顿地区为例,当时有针灸诊所十多所,但不足2年,差不多全部倒闭。其中的主要原因是水准低,常发生医疗事故,西医师公会多方面攻击阻拦,公安常来检控,禁止东方医师无执照行医。

中医针灸发展到这阶段,开始蕴酿出一场“美国医学革命”,它的“起火”地点就是在内华达州,要求中西医分体独立管治。

2.内州立法经过

1973年1月,纽约西医师公会邀请香港名中医针灸师陆易公氏在纽约亚美利加纳宾馆(AMERICANA)大会堂,为1500名西医师演讲针灸学。事后,得知纽约公安因中医针灸师无执照行医,曾加以拘捕处罚。当时陆氏认为此种做法对于美国人民的健康不公平。因为针灸治疗在中国已有数千年历史,人们赖以治愈病痛,延长生命,假如能够立法认可,人民得到治疗机会,则会对人民健康与生命有利无害。闻悉内州于4月间将会修改法律,何不趁此机会,要求立新法律俾中医针灸合法化。但问及亲朋好友,莫不大笑,认为痴人说梦话,因国有国法,家有家规,岂能由一位旅客身份的中国人改变美国国法,似此不可能的事,决没有成功希望,却有坐牢的可能。

虽然当年陆氏已有61岁高龄,但为了人类健康及提高中医针灸的国际地位,决定亲赴内州,争取立法。当时,惟有一位纽约退休老律师亚瑟·史坦勃(ARTHURSTEINBERG)先生大力支持,因其夫妇曾在香港经陆氏以针灸治愈多年病痛,对中医针灸极有好感及信心,愿协助同行,可免陷法律上的错误。抵达内州后,又因人地生疏,无可适从,幸得介绍认识一位初入公关公司服务的年轻人詹姆·乔埃斯(JIMJOYES)先生,从此,3人便联手进行这个极艰巨的任务。

3人为争取本地民众支持,日夜奔走,拜访居民,加以说服,一时竟引起针灸热潮,短时期内,估计已有3万人赞同。有此成绩,随即赶赴立法院申请立法,准予中医针灸合法行医。立法院诸位议员不相信有3万人的支持。于是,3人连夜赶印详细签名单,幸得大众热心,争相签名支持,州长更将其办公室隔壁小间放置签名单,不数日,名单已堆积如小山,当签满15000份名单时,州长认为人数已足够申请要求。

3人为了证明针灸能在无痛苦、无伤害的情形下安全治愈病者,以免费示范的形式,让真实疗效以示大众。立法院以3天为限,特许陆氏临时行医执照,几经磋商,才批准3个星期示范。此期中,对病者是好是坏,相信会有一个肯定的结果。所有病人均由全国各大医院、政府团体介绍随身带详细病历而来,并选取首府卡森(CARSON)城立法院对街新开业的宾馆奥姆斯贝(ORMSBYHOUSE)开诊。每天由晨8时至晚10时,扶杖及坐轮椅的病人,排若长龙。每天针治120名,无一简单易治之症,每多已在医院开刀一、二次至20余次者。电视台派员由早及晚现场播录治疗经过,若有病人因针刺死亡、或误伤、或疼痛呼叫等情况,即成为最强的医疗事故的证据;还有各大报社记者24小时轮候追随记述;在旁还站有十数位医学专家、政府要员,静观操作,约20分钟换班1次。

在场唯一的助手乃陆易公之夫人陈贞卿女士,精神上的压力,无止无休的体力疲劳,均已达到顶点,当夜11点晚餐时,陈女士昏倒在餐桌上。

宾馆主人的老母中风瘫痪,行动不便,坐轮椅请治,经针治后,自推轮椅归去;一位当地名律师因神经性耳聋,无法医治,无法出庭为客辩护,经针治4次而愈;有患佝偻20余年的小学教员,经针治1星期后,霍然而愈,她的1个二年级的小学生对其母亲说他的驼背老师这几天不知吃了什么东西,高了许多。诸如此类的疗效,不断在街头人群中传播。

美国《时代周刊》4月23日在首页报导针灸疗效犹似神迹,形容示范的宾馆仿佛变成了法国小镇LOURDES显圣迹之地。示范于3月19日至4月6日止,近500名病人得到治疗,结果相当满意。

议员们在立法院与陆易公医师经过一番舌战,公认疗效确切优良,毫无异议。最后投票结果:州众议院以30票对1票,另1票缺席,州参议院以20票对0票,通过法案。立法院内共和党和民主党完全合作,创立法院通过议案的绝对票数纪录。

陆医师及其夫人在获悉大功告成时,随即回房蒙头大睡两日夜,才开始出门见客。据陆医师说虽然精神健康以及经济濒临绝境,但能为中医针灸在国际上开出一条大路,已宿愿得偿了。

3.内州中医针灸法律几项重点

4月19日州长MIKEO’CALLAGHAN正式签署法案,立即成立中医医务局,执行本州内一切中医医务行政、教育、执照及注册等等工作;成立中医教育机构,开设中医各项学位课程;成立中医技术顾问委员会,指导医务局各项医务工作,审核资历,设计考试内容及教育研究工作等。每年考期2次,每次可用中英语作答,分笔试、口试、临床3部份,每部份均要取得合格水准。执照分4种:甲.传统中医学医师DOCTOROFTRADITIONALCHINESEMEDICINE;乙.中草药医师DOCTOROFHERBALMEDICINE;丙.针灸医师DOCTOROFACUPUNCTURE;丁.针灸助理员LICENSEDACUPUNCTUREASSISTANT。法律规定,一切未经中医医务局核准而行医者,均属违法。

4.内州立法后对各界影响

1973年内州中医针灸合法化后,其它各州也相继效法起来,如加州、德州、纽约、华盛顿、夏威夷、阿勒岗、蒙特那等诸州。可惜各地环境因素有异,加上西医师公会的强横势力,中医针灸师依然得不到独立开业权,需要依靠西医师先替病人诊断,然后发出介绍书,方可接受中医针灸治疗,这当然是一种职业歧视。有鉴于此,各州中医针灸界只好继续奔走,争取独立行医法律,其中最受嘱目的要算德州中医针灸法案了。1979年8月由联邦地方法院接手主审,邀请内州陆易公医师及其公子陆伯明医师上庭答辩并放映平日摄录的医案及电脑纪录,以示针灸疗效确切,由早及晚。事后,法官即命搜集有关修改法律的资料。余后数天,由各方代表陈述,其中加州的康宁(RICHARDKRONEING)医师亦掀起高潮。康氏为美国针灸权威,曾首次公开发表针刺止痛乃是脑吗啡分泌增强的作用,申辩的阵容如此坚强,西医医务局最后放弃上诉权。次年7月,判决书由联邦法院审结。这份判决书使日后各州争取独立开业行医权有例可援。

美国中医针灸合法化,亦引起欧联国家的重视,意大利在1997年立法院也有议案准备把中医针灸合法化。据《国际针灸交流手册》(山东科技出版社1992)记载,世界上有100多个国家均有中医针灸医师,深信中医针灸的国际地位会日益增强。

5.结论

美国中医针灸立法的正式起步,先由陆易公医师以深厚的学养、高水准和丰富的临床经验为基础,加上各方面人事的和谐协作,打破了各种政治利益的冲突,又在一个适当的时机和环境中,成功地建立起来了。

这个合法化,首先保障了美国人民应得的有水准的中医针灸治疗机会,造福于美国人民的健康,更重要的就是提高了中医针灸的国际地位,与西方医学共进。有鉴于此,内州政府为了感谢陆氏的重要贡献,特选于1992年7月16日陆氏80寿辰时,由州长BOBMILLER代表本州人民颁布宣言,详述内州为全美第1个州接受中医针灸合法行医,并宣告该日为“陆易公医师日”,嘉许为本州“杰出居民”,加授衔为“内州东方医学之父”。就这样,陆氏名垂于美国中医针灸史上,同时也是我们中国针灸传海外的一项光荣。

Read more: 中医针灸在美国第一个州的立法经过 – 祝君平安的日志 – 贝壳村

Dr.Arthur Fan notes: On March 20,2014, I met a patient who is Jim Joyce’s daughter(Marilee Joyce), mentioned her father’s story in Acupuncture legislation in Nevada in 1973. Both of her grander mother and mother had chronic headache, Jim brought them to see Dr.Lok and got recovery. Her father already passed away in 1993 due to his lung disease. Marilee published a book called “Gentle Giant” to tribute her father.

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By: Acupuncture & Oriental Medicine Society of Oregon, Inc.

Dr. Wai Tak Cheung

http://www.oaaom.com/wp-content/uploads/2011/12/History-of-Acupuncture-By-Dr.-Cheung.pdf
____________________________________________________________

President of Acupuncture and Oriental Medicine Society of Oregon

July 23, 1994

____________________________________________________________

June 11, 1994.

I have heard from some of my colleagues that today many of the younger generation of

practitioners of Oriental medicine may not be aware of the history of their profession in Oregon.

I hope that after reading what follows, all will know. If even one person who did not know this history begins to understand the importance of our professional roots and of our professional future together in Oregon,  then writing this will have been worthwhile.

Hard work, luck and coincidence have made the legal practice of acupuncture in the United States possible.  When President Nixon visited China in 1972, he opened many cultural as well as political doors.  Acupuncture and Oriental medicine were introduced to Americans in late 1972 as reports of acupuncture began to appear in the news media and in books.

Many Americans were having health problems for which they could not find successful

treatment in the United States.  Dorothy Barrett of Oregon had multiple sclerosis.  She heard of Dr. Michael Yau Ferng and went to Taiwan in 1972 to seek treatment from him.  Ms Barrett experienced such tremendous success that she wanted to make Dr. Ferng’s skill available to others in the United States.  Dr. Ferng came to the United States with a traveling visa in 1973 and began treating patients many of whom were Oregon residents.

Also, in 1972, two other doctors, Dr. Duke K. Won and his son Wing S. Won, both DCs and NDs, already living in Oregon before having obtained American citizenship, began treating growing numbers of Americans seeking Oriental medical care (before it was legal in Oregon). These doctors became well known as they successfully continued treating many patients in the state.

The Board of Medical Examiners (BME) soon heard news of their activities. The BME secretary had these three doctors arrested.  Attorney had the doctors freed from jail within twelve hours, since there were no laws in existence pertaining to the practice of acupuncture in Oregon. The judge dismissed the case after issuing a warning to the doctors and made it clear that the practice of acupuncture was illegal in Oregon, except when done by MDs or DOs.

By this time many Oregonians had received acupuncture and benefited from the treatments.  In 1973, many supporters, as well as patients (in particular Dorothy Barrett,  Mary Wilson, Irma Silvon and Mary Lotina), took action by circulating a petition for the legalization of acupuncture in Oregon.  They took the petition to Salem and talked to their state representatives to introduce such a bill to the Legislature.  In order to have the bill pass, it had to be written with specific conditions. An acupuncturist had to work under supervision of a single MD. This meant that anyone seeking acupuncture treatment

in Oregon had to first see an MD who would officially refer them to an acupuncturist.  Every acupuncturist had to work with one supervising MD or DO. The use of moxa was originally excluded from the scope of practice, as the legislature felt its inclusion could prevent the bill from passing.  I think moxa was too new or too exotic for them.  Acupuncture was put under the control of the BME.  There was no lobbying for this bill. The Oregon medical Association did not object to the practice of acupuncture by acupuncturists because it was under the MDs control.  The bill became law on November 15, 1973.

The first legal private acupuncture clinic in the United States was opened in Lincoln City, Oregon.

It was a very busy practice and patients had to book far in advance.  Professor Kok Yeun Leung was the first acupuncturist at the clinic.  He was later joined by Professor Shui Wan Wu and later by Dr. Wai Tak Cheung.  Three of the first seven acupuncturists in Oregon were from Vancouver, B.C. and practiced acupuncture between 1973 and 1975. These early Chinese acupuncturists established the foundation in the Northwest for the growth and development of acupuncture in Oregon.

Dr. James Tin Yau So practiced acupuncture successfully for over 35 years in Hong Kong. Dr. So was brought to the United States by the National Acupuncture Association to work in the clinic at the UCLAMedical  School. This clinic started in 1972 and was the first clinic in the United States.  Dr. So arrived in 1973. In October 1974, Dr William Prensky, Sr. Steven Rosenblatt and Dr. Gene Bruno took Dr.  So to Boston, Mass., where they opened a clinic for him.  Dr. Rosenblatt ad Dr. Bruno then established the New England School of Acupuncture for Dr. So and worked with him closely as instructors and also translated his two books into English.  Dr. Rosenblatt and Dr. Bruno returned to Los Angeles in 1975 where they established the CaliforniaAcupunctureCollege.

Dr, Cheung visited Dr. So in Boston in 1989, by which time Dr. So was retired.  During the visit Dr. So asked if Dr. Cheung had any students.  Dr. So believed passing on Oriental medical knowledge and continuing the education of new generations was vital to long term success of the professions. Dr. Cheung replied that he had no school, although he had 15 inters. Many hundreds of people, many DOs, MDs, and other professionals studied with Dr. So. This was the first acupuncture school in the United States.  Later, many of his students opened acupuncture and Oriental medicine colleges and helped

legalize the practice in many states.

One Chinese doctor was upset with Dr. So, feeling that he was selling out the Chinese people by teaching Oriental medicine to Americans. But Dr. So was proud of himself and he believed that the Chinese had very god knowledge to pass on to Americans. His teachers passed the knowledge to him, and now he wanted to pass it on to others.  Dr. So could have made a good living in private practice, but he chose to open a school and to educate people about Oriental medicine.  He told Dr. Cheung he hoped the proverbial stone tossed into the pond would send out endless ripples so his students, which would influence education and legislation throughout North America.

________________________________________________________________________

CHRONICLE OF ACUPUNCTURE AND ORIENTAL MEDICINE

In the State of Oregon Since 1973

1973:

Acupuncture became legalized in Oregon. An acupuncturist could only practice under a single MD’s supervision. This law passed without opposition. BME regulated the licensing of the acupuncturists in the state. It was the acupuncturist’s responsibility to find the supervisor.  If no MDs were willing to accept them, then the acupuncturist could not practice. Moxibustion was not allowed. The BME licensing examination was established and offered twice a year.

1975:

The OAA was formed.  Professor Mi Po Shu was the OAA president and the first member on the BME acupuncture committee.

Moxibustion was allowed by the BME as a heat therapy by acupuncturists.  NDs and DCs tried through their board to get permission to practice acupuncture.  Their reasoning was that they, too, are physicians and should be able to practice acupuncture.  Their request was denied.  There have been repeated lobbies since then to accomplish this goal.  So far all the attempts have failed.  There were only about seven acupuncturists, all Chinese, practicing in Oregon.  We did not have any lobbyist to promote our profession.

1976:

Dr. Gene Bruno moved from California to Oregon.  He was the first Caucasian to practice acupuncture in Oregon.  Later Dr.  So’s students moved from Boston.  The practice of acupuncture became more widespread and our profession as a whole became stronger.  The need for a more determined and united OAA became even more critical to the future of our profession.

1977:

The OAA consisted of Professor Kok Nung, President; Professor Yet Sun Chan, Vice-President; Tize Kwok Tai, Treasurer/Secretary.

1978:

Dr. Gene Bruno requested privately from the BME that any MD or DO be able to make referrals. This was granted by the BME so that the single supervisor/physician was no longer needed.

Professor Kok Nung had a heart attack. Shortly later he moved back to Vancouver, B.C.

The OAA now consisted of Professor Yet Sun Chan, President; Professor Kok Yeun Leong, Vice-President;

Dr. Wai Tak Cheung, Board member.

1979:

Professor yet Sun Chan had a stroke. Professor Kok Yuen Leung refused the position of president.  He asked Dr. Wai Tak Cheung to take over the position, which he accepted. It took six months to obtain the OAA records and documents (because of the health condition of Prof. Yet Sun Chan).

1980:

OAA members joined with other American practitioners. The OAA members increased in numbers and strength.

1981:

OAA introduced two  bills to the Legislature to:

1. Allow acupuncturists to see patients if they first obtained a diagnosis from an MD, DO, PC, ND or NP.

2. Have equal rights for insurance payment; to pay acupuncturists the same way that the MDs are paid for acupuncture treatment of the same conditions.

The first bill passed.  At this point, we hired a part time lobbyist to help us pass our legislation.  Dr. Gene Bruno, Eric Stephen and our lobbyist did most of the lobbying and other needed procedures.  We were short of money, so Dr. Cheung asked all the members and others to donate money for the OAA objectives.  About $800.00 was collected. Dr. Cheung added $2000.00 of his money for the OAA expenses.

Dr. Cheung proposed to open an acupuncture school under the OAA. Dr. Cheung wanted the school to be under OAA so more financial support from the public could be obtained to run the school more efficiently, and so more research could be done for the advancement of acupuncture in Oregon.

Eric Stephen helped a great deal in finding a part time lobbyist.  Jim Hauser,  Gerald Senogles , Stuart Greenleaf,  Malvin Finkelstein, Betty Chen, and Dirk Friedt were also involved in the process.

I thank all of them for their efforts. Our greatest appreciation is given to Dr. Robert Schwartz.

Without his efforts we might not have been free to do what we do today. Special thanks to Dr. Gene Bruno for his hard work toward achieving our goals. I hope that Dr. Gene Bruno will also write a brief history of events that occurred from 1976 to present. The Equal Right bill for insurance payment was proposed again and failed.  OAA members did not work on this bill, as they thought it would not pass. I tried to convince everybody that it is like the root of a cancer that has to be eradicated, otherwise it would always be an impediment to our practice,  Dr. Gene Bruno was no able to lobby since he was on the BME Acupuncture Committee. In the 1989 Dr. Gene Bruno, Dr. Robert Schwartz and our new lobbyist Steven Kafoury joined forces and successfully passed our insurance bill and convinced the Governor to sign it into law.

Last, but not least, I want to thank John Ulwlling, former BME Executive Director and Dr. Joel Sere, MD,  BME Acupuncture Committee Chairman, for all their help and support during our struggle along the way.  I also thank all the members of the Acupuncture Committee for the work they have done over the years.

After the introduction of our scope of practice bill signed by the Governor of Oregon, Barbara Roberts, No additional opposition from OMA was attempted. The insurance companies fought us in our attempts to pass our insurance bill. Also naturopaths and chiropractors argued against our scope of practice Bill. We came to a friendly agreement with the lobbyist for the chiropractors.

However, the lobbyist for naturopaths and their legislative spokesmen did not want our bill to pass.

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Acupuncture in Veterinary Medicine
January, 2005 .http://www.iama.edu/Articles/Acu_VeterinaryMedicine.htm
John A. Amaro D.C., FIAMA, Dipl.Ac., L.Ac.

Dr. Amaro treats Siberian Tiger
with Laser for Spasmodic Torticollis

In the fall of 1979 I was fortunate to be included on one of the first State Department approved list of observers to visit the People’s Republic of China (PRC). One of my very first acupuncture experiences was to assist in the performance of acupuncture on a hog in rural Liaoning Province in the Dongbei region of northeast China. Two thousand years ago the ancient city of Mukden now known as Shenyang had become a major trading post to peoples living north of the Great Wall. Shenyang would ultimately become the court of the Manchu (the “Masters”) and the capital of Manchuria. It sits in a pivotal position as it is on the land route to both Korea and upper Mongolia.

During the procedure it was explained the acupuncture points of large animals are primarily based on human anatomical transposition of human points onto animals. In other words, just place the human in the all four position much like an animal. The acupuncture points are virtually in the same location. Since the cow, pig, horse, camel and donkey were of vital importance to the ancient Chinese, veterinary acupuncture was developed and texts were written dealing with these animals. Even though through history there have been more than 70 texts on animal acupuncture, only 16 exist today.

Most of the information on veterinary medicine comes from the T’ANG Dynasty which is usually recognized to be from approximately 600 A.D. to 900 A.D. During this period due to the military requirements on the northern front many horses were raised specifically for the ever increasing military presence and purpose. Recognizing the tremendous importance attached to the health and welfare of the horse, the T’ANG Dynasty established an actual Department and School of Veterinary Medicine. This was the first formal education of this type in the history of China and the world. Even though the T’ANG Dynasty is credited with the formalization of veterinary acupuncture, the Spring and Autumn Warring States which was approximately 400 B.C. to 200 B.C., produced the historic practitioner who to this day is considered the Father of Chinese Veterinary Medicine Shun Yang. However, the earliest recorded practitioner of veterinary medicine was during the Chou Dynasty around 950 B.C. Chinese medicine was first introduced into Korea in the Chou Dynasty and then into Japan by way of Korea. Numerous contributions to both human and animal acupuncture have been made by both countries especially during the years 1100 to 1600.

The Jesuits of France were a presence in Macao and as far as Peking (Beijing) as early as 1582. It was the French Jesuit Harvieu who published the first work in a European language on human acupuncture in 1671. However it was not until 1836 that the first mention of veterinary acupuncture appeared in print in France. The case reported was of a paralyzed ox that was treated by implanted needles 3 inches long in two rows bilateral to the lumbar spine. The needles were described as being driven in with a mallet and left in place for two days. In England a passage from the British Veterinary Journal of 1828 stated “two things however are sufficiently evident, that the sudden and magical relief which the human being has sometimes experienced has not been seen in the horse; and that, probably from the thickness of the integument, the animals suffered extreme torture during the insertion of the needles”.

During the last Dynasty to be recorded in China’s long history, the “CH’ING Dynasty (1644 to 1912) there was a countrywide epidemic which had been catastrophic to pigs. As a result of veterinary acupuncture, the disease process had been cured and eliminated. In 1900 the book “A Complete Collection of Pig Diseases” was published. It was the information from this book which was being shared with me on that rural farm in Northeastern China in 1979.


It was not until 1917 the first “School for Chinese Medicine” for humans patterned after western medical schools was established in Shanghai. The school was privately financed and was the first school of its kind to offer a formal program and diploma in Chinese Medicine. There were no schools at this time of Chinese veterinary medicine only western style schools awarding degrees in Veterinary Medicine. In 1944 Chairman Mao Tse Tung issued a directive of historical proportions when he wrote “…if the modern practitioners of human and veterinary medicine do not unite with the more than one thousand traditional practitioners in this region and help them progress in knowledge and ability, they are in fact helping evil and letting many humans and animals die of diseases”.

In 1947 the formation of the beginning of modern Chinese Veterinary Medicine developed with the establishment of the School of Agriculture of the Northern University. This entire school was devoted solely to Chinese Veterinary Medicine which only focused on large animal applications. There has never been a development of small animal practice in the history of China as there is literally no demand for its use due to the cultural differences between the East and West regarding the owning of pets.

Acupuncture anesthesia was first developed in humans in 1958 and first applied to horses and donkeys in 1969. Analgesia was first used outside of China on humans in 1972 in Austria where the first surgery for a tonsillectomy in the Western world was performed.

The history of American veterinary acupuncture had its root beginnings following the national public interest shown in China and acupuncture in 1971-72. Whereas, unknown to most in the profession, acupuncture’s history in the US is quite startling when one considers just a few of its inclusions in the American medical scene.

Acupuncture for human applications have appeared in American medical texts since 1822 when the “Treatise on Acupuncturation” appeared in print which was a review of a British booklet. In 1825 the French book “Memoir on Acupuncture” appeared in the US. By 1829 a three page section on acupuncture appeared in the surgical text “Elements of Operative Surgery”. In the July 28, 1888 issue of Scientific American a two page article on Electric Acupuncture appeared. Perhaps the most famous 20th Century reference to acupuncture outside of the 1971 New York Times article by James Reston on “Now about my Operation” came from the 1907 book “Principles and Practice of Medicine” and the 1917 book by the same name whereby famed surgeon and medical practitioner Sir William Osler stated “….for lumbago acupuncture is, in acute cases, the most efficient treatment. Needles of from 3-4 inches in length (ordinary bonnet needles. Sterilized, will do) are thrust into the lumbar muscles at the seat of the pain, and withdrawn after 5-10 minutes. I many instances, the relief is immediate, and I can corroborate fully the statements of Ringer, who taught me this practice, as to its extraordinary and prompt efficacy in many instances….”. Ringer would be recognized to this day as one of the greatest physicians in history having discovered the isotonic electrolytic infusion solution still used today and known as “Ringers Solution”. A side note is that Dr. Sydney Ringer was British however his two brothers amassed great fortunes in Asia one in Shanghai and the other in Nagasaki Japan. One brother was so successful he was given the name “King of Nagasaki”. Dr. Ringer obviously learned acupuncture through one or both of his brothers and taught it to Osler. The 1910 book “The Principles and Practice of Chiropractic” by D.D. Palmer the founder of Chiropractic, also made specific reference to acupuncture.

Throughout the political history of all professions who have pioneered acupuncture in North America, it has been a very rocky and tumulus road for the veterinary profession. Following interest in acupuncture by a few DVM’s in 1972, Dr. David Bressler of UCLA was contacted and acupuncture procedures were initiated in Southern California on a variety of cases that had been deemed hopeless as they had all failed to respond with conventional Western medicine. The response with the variety of these test cases were overwhelmingly successful. This project was under the guidance of the National Acupuncture Association which Dr. Bressler had founded and presided at UCLA.

The National Association for Veterinary Acupuncture was formed in 1973 and the International Veterinary Acupuncture Society was founded in 1974. By 1975 symposiums were being conducted by the Chinese Academy of Medicine and held at the University of Cincinnati, University of Georgia, Purdue University, The University of California School of Veterinary Medicine and others. The American Veterinary Medical Association took a very cautious position in the early formative years of acupuncture and in 1974 issued a formal statement that stated “the AVMA has serious concern about acupuncture regarding it as entirely experimental until strong evidence is available that the procedure has therapeutic value in animals and additional cases have been evaluated”.

Since those early days in the United States, veterinary acupuncture has become increasingly popular with more than 500 certified Doctors of Veterinary Medicine (DVM) practitioners in North America alone. Its clinical use ranges from equine to feline to canine and avian. The success rate borders on the astonishing in a variety of conditions known and unknown to the human patient.

Most licensed Acupuncturists State licenses deal only with the treatment of the human it does not include animal applications. However as an acupuncture practitioner it behooves us to know of a qualified veterinary doctor utilizing acupuncture and refer to them as necessary. You will find the DVM using acupuncture will reciprocate the referral. Veterinary Acupuncture has come a long way in America from the vision of the original three DVM’s who started it, Dr. R.S. Glassberg, Dr. Marvin Cain and Dr. H. Grady Young. I am proud to say I knew these individuals and was honored to have studied with them at the first official symposium on “Acupuncture for the Veterinarian” in Kansas City in 1974. They are to be commended for following their vision. As a result the Siberian Tiger which is shown with me being treated with laser beam did not have to be euthanised as originally planned. Incidentally, there are no known acupuncture charts in the history of the world for a Siberian tiger. Just treat the points of the animal as if it were a human with the same protocols.

Best Wishes for a phenomenal 2005 in the Year of the Rooster! I wonder how you find the points on a rooster?

John A. Amaro D.C., FIAMA, Dipl.Ac., L.Ac.
Carefree, Arizaona
DrAmaro@IAMA.edu

 

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Born in the year of the Metal Pig, in Dinging County(Arthur Fan notes:阳江县), Guangdong, southern China on July 14, 1911, Dr. Tin Yau So was a Chinese Christian minister and an accomplished acupuncture master who is known as the Father of Acupuncture in America.

Determined to help as many people as he could, Dr. Tin Yau So spent years traveling to villages near his home in southern China to treat thousands of patients in their local hospitals and meeting halls. After World War II, he spent approximately ten years traveling, preaching, and offering medical treatment, in addition to educating students in acupuncture in many countries and regions in Asia. As a result of this work, he trained many highly qualified acupuncturists.

Forever grateful for the gift of Christianity, he was determined to repay the West. He decided the best way to do this was to share the wealth of his experience and wisdom as a master of Traditional Chinese Medicine. President Nixon’s visit to China in 1971 sparked a new found interest in Chinese Medicine and acupuncture.  With the help of two of his American students who had studied with him in Hong Kong,  he came to the USA  in 1973 and worked with UCLA in establising a clinic there.  Since there was no legal vehicle allowing acupuncture to be practiced outside of a research setting, Dr. So and the same two students who were sponsoring him decided to move to Boston in 1975. Together, they created the first licensed acupuncture school in the U.S.A. in Watertown, Massachusetts: The New England School of Acupuncture.

Many of his students in America have started some of the most well-known acupuncture schools (all still in operation);  became involved and/or engaged in the governing of acupuncture in the country; introduced legislation; have taught or are teaching in some of the top educational facilities and hospitals; and continue to participate in groundbreaking research.

Enrolling in one of the first classes at NESA, Marsha Woolf  is one of Dr.Tin Yau So’s senior students, and continued to apprentice with him for many years.  In the 1990s, they worked together on developing a ‘barefoot doctors’ course in keeping with Dr. Tin Yau So’s treatment techniques to teach the Tibetan refugee health workers living in refugee camps in India.

Leaving a legacy of wisdom that spans the world, and continues on through his devoted students, he died in August, 2001 at 90 years of age.

His legacy lives on through his students. He always said to us, ‘I teach you everything”.  And he really, really, tried.

Dr. James Tin Yau So, N.D., LAc., (1911–2001) also known as Dr. So, was an acupuncturist.  http://www.enotes.com/topic/James_Tin_Yau_So

Dr. So’s teacher was Tsang Tien Chi who studied under Ching Tan An. He graduated from Dr. Tsang’s College of Scientific Acupuncture in CantonChina, in 1939. During the same year Dr. So opened his medical office in Hong Kong. In 1941 he opened his own school, The Hong Kong College Acupuncture.

In 1974, Dr. So was part of the NAA group that traveled to Massachusetts and opened the first acupuncture clinic in Boston and a second clinic in Worcester. Dr. Steven Rosenblatt and Dr.Gene Bruno assisted Dr. So in the translation of his three books on the points of acupuncture, the techniques acupuncture and treatment of disease by acupuncture. Dr. So, with the help of Dr. Rosenblatt and Dr. Bruno founded the first school of acupuncture in the US in 1974.[1]

References

  1.  {http://www.aaaomonline.org/}

苏天佑,是近代承淡安针灸大师的第三代传人,作为澄江『1』针灸学派传人,苏天佑(以下简称苏老)曾师从承公的弟子曾天治学习针灸,并于1939年创办“香港针灸医学院”,后因战乱复辗转多地,在极端困难的条件下坚持针灸济世。到抗战胜利1946年返回香港时已累计办学21期。

1962年苏老开始到日、韩、菲、新、马、文莱、泰、越、缅、印尼、美、加及台湾地区施诊、讲学,又培养了众多新生力量。马来西亚吡叻州的著名中医幸镜清『2』、招知行、丘荣清就是苏老的亲传弟子。苏老在马期间,于吡叻州怡保市仁和堂药行开班授课业医,幸、招、丘和已故李绍彬、刘庆忠都在其门下。1973年苏老到美国政府批准的第一家位于华盛顿的针灸治疗所任针灸治疗主持人,并开班传播澄江针灸医术。1975年3月和美国弟子合作开办“纽英伦针灸学校”,后来出版了第一本英文针灸书《经穴学》,此书广泛成为后来开办的针灸学校的教科书。在1986年麻省针灸学会举行第6届会员大会上,苏老获颁“美国针灸之父”,作为其在美国多年办学、培养针灸人才、对当时美国替代医学有巨大贡献的表彰。2001年8月28日,苏老先生病逝。

注1:“澄江”为中国江苏省江阴市古称,澄江针灸学派指的是以近代针灸大师承淡安为代表的精英及其传人几十年努力形成的学术体系。承淡安原籍江阴,为南京中医学院首任校长,在医、教、研方面卓有功绩,系近代杰出的医学家、教育家,他的中医教育思想和针灸学说随其弟子广播四方。澄江针灸学派的学术体系及思想正得到进一步的研究,丰富的针灸经验也为其传人在临床广泛应用。

注2:幸镜清,吡叻州名老中医,已届83高龄,近期曾获颁大马国际名医贡献奖,表彰其43年献身中医药事业和对大马医药保健作出的贡献。

参考文献:张永树·澄江针灸学派传人苏天佑海外医教史迹·中国针灸·2005,25(6):443-444

James Tin Yau So

From Wikipedia, the free encyclopedia

Dr. James Tin Yau So, N.D., LAc., (1911–2000) also known as Dr. So, was an acupuncturist.

Dr. So’s teacher was Tsang Tien Chi who studied under Ching Tan An. He graduated from Dr. Tsang’s College of Scientific Acupuncture in Canton, China, in 1939. During the same year Dr. So opened his medical office in Hong Kong. In 1941 he opened his own school, The Hong Kong College Acupuncture.

In 1974, Dr. So was part of the NAA group that traveled to Massachusetts and opened the first acupuncture clinic in Boston and a second clinic in Worcester. Dr. Steven Rosenblatt and Dr. Gene Bruno assisted Dr. So in the translation of his three books on the points of acupuncture, the techniques acupuncture and treatment of disease by acupuncture. Dr. So, with the help of Dr. Rosenblatt and Dr. Bruno founded the first school of acupuncture in the US in 1974.[1]

尼克松总统访华与美国的“针灸热”

2010-11-16 15:04:43

孟庆云

针灸在美国的流行是20世纪70年代。此前在美国华盛顿、洛杉矶、旧金山等地虽然有不少中医,但精通针灸者未曾有闻。文献记载,早在30年代,有无钖中国针灸研究社社员方复兴移民美国,在罗州开展针灸活动。1947年美国医学界曾在学术讨论中论及中国的针灸术。1955年斯坦福大学曾邀请日本针灸专家赴美讲稿,但尚无针灸研究。

1997年2月21日至28日,美国总统尼克松访华,随行记者500名。记者中詹姆斯.罗斯顿(Jame reston)患阑尾炎,在北京协和医院做阑尾切除术,应用针灸疗法消除术后疼痛,取得成功。在华期间詹姆斯还参观了针刺麻醉,回国后即在7月2日《纽约时报》撰写有关报道,以大副醒目标题刊于头版,在美引起了轰动效应,从而促使国立卫生院(NIH)注意到中国的针灸疗法。

美国政府批准的第一个针灸诊所于1973年7月在华盛顿特区正式成立,由格里戈里奥.柯斯医生当主任,澄江学派传人苏天佑被聘为这家诊所针灸治疗的主持人。苏天佑原名苏佐仁,1911年生于广东阳江县,幼年随父到香港受教育,后来受业于曾天治学习针灸。曾天治是澄江学派创始人承淡安的高足。苏天佑除行医外,还开办学习班,培训针灸人员。1975年3月,苏天佑和美国弟子在波士顿创办“纽英伦针灸学校”(new England school  of Acupuncture)用英语教学,学制初为一年,后为三年。其第一本英文针灸著作是《经穴学》,其门人为此书学序文,文中称苏天佑为“美国针灸之父”。到20世纪末,全美国已有2万余人从事针灸业务,苏天佑首当其功。1997年,美国成立了替代疗法办公室。1998年,美国有高等医学院开设传统医学课程,有20余种针灸期刊,有100余所针灸院校。在美国,针灸主要用于治疗常见病及戒毒,也有报道用于宇航员的训练和治疗航天综合症。可见,针灸学传到美国以后,又与美国的科学文化相结合而有所创新。

摘自《中国中医药报》 2003年3月10日 星期一

what is James Tin Yau So

http://www.infosources.org/what_is/James_Tin_Yau_So.html

Dr James Tin Yau So, ND LAc (1911 – 2000) also known as Dr. So, was one of the most influential individuals of the 29th Century in bringing acupuncture to the United States

Dr So’s teacher was Tsang Tien Chi who studied under Ching Tan An. He graduated from Dr. Tsang’s College of Scientific Acupuncture in Canton China in 1939 During the same year Dr. So opened his medical office in Hong Kong In 1941 he opened his own school The Hong Kong College Acupuncture For the next thirty years Dr. So established himself as one of the most successful and well-respected acupuncturists throughout Asia Practitioner came from all over Asia and Europe to study at his college
Several acupuncturists from the National Acupuncture Association (NAA) sought Dr. So’s assistance in 1972 At the time the NAA offered Dr. So a position as acupuncturist at the UCLA Acupuncture Pain Clinic the only legal acupuncture clinic in California at that time Dr. So accepted and joined the NAA staff of acupuncturists and the UCLA Acupuncture Pain Clinic in 1973
In 1974 Dr. So was part of the NAA group that traveled to Massachusetts and opened the first acupuncture clinic in Boston and a second clinic in Worcester In the fall of 1974 Dr. So founded the New England School of Acupuncture Dr. Rosenblatt and Dr. Bruno assisted Dr. So in the translation of his three books on the points of acupuncture the techniques acupuncture and treatment of diseaseby acupuncture . Dr. So, with the help of his students Dr. Steven Rosenblatt and Dr. Gene Bruno founded the first school of acupuncture in the US, the New England School of Acupuncture (NESA) in 1974 With his approval Dr. Bruno and Dr. Rosenblatt founded the second school in the US, which became the California Acupuncture College located in West Los Angeles
majority of the acupuncture schools in the US were founded by students of Dr. So. This legacy of acupuncture in North America is unparalleled.

 

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Spotlight on the AOM Alliance

Part Two of Acupuncture Today‘s Interview With Floyd Herdrich, LAc, Dipl.Ac.

By Editorial Staff http://www.acupuncturetoday.com/mpacms/at/article.php?id=28391


Floyd Herdrich has played an integral role in the development of the acupuncture and Oriental medicine profession in the United States.

He was a founding member of the Acupuncture Society of Virginia and helped get an independent licensure law passed in that state in 1993. He has also been a board member of the Acupuncture and Oriental Medicine Alliance since 1994, most recently serving as the Alliance’s president.

 

In part two of our interview, Mr. Herdrich expresses his views on the current education levels in acupuncture schools, along with the role of the Alliance and the American Association of Oriental Medicine in the creation of the Vision Search Task Force.


Acupuncture Today (AT): You mentioned the doctoral program and the type of education these programs are offering. What do you think about the level of education the students are receiving now?

Floyd Herdrich (FH): It’s great. It’s wonderful.

ATDo you think there are any areas in which the schools could improve? Are they doing enough to prepare students for life after graduation?

FH: That’s part of the confusion about the business model. Yes, the schools can do more, and I know schools that are doing more, but it’s been a perennial problem, because the economic structure of acupuncture and Oriental medicine is basically entrepreneurial. Look at the number of restaurants that open and close. They’re known as the profession for turnover and failures, but that’s part of the entrepreneurial model: You’ve got something, and you take a chance, and you put your particular practice out there, and you either succeed or you don’t. Part of that has to do with your personality, your charisma and your knowledge, but it’s not for everybody. A lot of people just want to get a job. In any profession, there are people who just want to get a job. There are physicians who are giving up their private practices to work for an agency of some sort. On the other hand, there are also physicians who are giving up their licenses. A particular case that interested me recently involved some West Coast psychiatrists, who were sued by their patients because they refused to prescribe the drugs their patients wanted. In this case, the physicians actually turned in their medical licenses and took out counselor licenses so they could persist in that model.

In the face of the litigiousness of the population and the preparedness of the legal profession to go after medical practitioners, I’m really worried about the first case that we’re bound to see in which a patient goes after an acupuncturist, because the acupuncturist did not detect a medical malady that appeared five years later. In the medical profession, you already have patients who, in a malpractice suit, will look at their most recent MRI, and it’s clear the patient has a large tumor. The question comes up in court: “Well, doctor, you read my MRI five years ago. Didn’t you see it coming?” And the old MRI is reviewed, and the attorney says, “Ah, here’s a trace. This could have been the tumor that wasn’t clearly detected.”

This situation already exists in medical malpractice suits. The point is, acupuncturists have the luxury of very affordable malpractice insurance because we very seldom, if ever, hurt anybody. However, if we start having professional standards creep in state scopes of practice to the point that acupuncturists have the option of ordering MRIs and other medical tests, if anybody in the profession in a given state has that option, it becomes the obligation of all licensed practitioners in that state to be responsible for those tests.

AT: So you could see an increase in malpractice cases, and that could lead to an increase in insurance rates.

FH: Yes! We spend $1,000 or so a year for malpractice based on our history, but when we start getting lumped in with doctors, it’s going to go to $50,000 or $100,000 just like doctors. I know obstetricians personally who have given up their practice because their malpractice shot up to $40,-, $60-, $80-, $100,000 a year, and they can’t afford it. At the same time, the insurance industry has been cutting back on payments, so they’re caught right in the middle. They just look at the business plan and decide to sell Amway.

So, yes – students that came out of my class succeeded and failed 25 years ago probably in the same proportion, or perhaps less, than today, but the complaints from people coming out of the schools today are the same as they were then. Some people feel ill-prepared to go out and take the responsibility for developing a private practice. There’s always been an axiom that it takes three to five years to build a private practice. It doesn’t matter if it’s a legal practice, a medical practice or an acupuncture practice. If you don’t have the resources to get through three to five years to where you have a sound practice, you may fail. If people don’t face that fact when they go in, they’re asleep.

It’s not the fault of the schools. I was prepared to build a practice, and knew how to refer a patient to the allopathic profession, based on my diagnosis through acupuncture and Oriental diagnosis, because I was trained on how to refer out way back then. I don’t think schools have gotten worse at that training, they’ve only gotten better.

About six or seven years ago, we were getting to the place in the profession where we were looking at the problem of “curriculum creep.” When we became legitimate – and we got that way be accrediting the schools, then legitimizing the outcomes by legitimizing national board certification – we got locked into certain kinds of established patterns. To move from a master’s level accreditation to a doctoral level accreditation, you have to show there’s a significant difference and need. While the acupuncture schools were just naturally looking into more and more information, the numbers of hours five, six and seven years ago were already approaching what is taken as the definition of a doctor’s education. How do you show the difference? The question has been around for 10 years. Could we just morph the master’s into a doctorate, or did we have to legitimize ourselves because we’re already in a legitimate academic structure? That’s question has brought us the clinical doctorate as a postgraduate doctorate, but there are people who still think, “Just call us doctors and we’ll be doctors. Give us that title and let us go.” That leads into the probability of acupuncturists having the same kind of legal exposure that doctors have, but with only a half or third or quarter of doctoral training to back it up. I’m concerned about that.

ATI have a few more questions before you before wrapping things up.

FH: All right.

ATThe Alliance and the AAOM are working together; they’ve got the Vision Search Task Force, and they signed a memorandum of understanding so that they’re working for common goals. What’s your perspective on the organizations working together?

FH: You’ve mixed apples and oranges just a little bit. Historically, it’s always been said that there were four national organizations. When you look at it, it’s actually four functions: education, accreditation, certification, and the practitioners were organized. At a certain point, the practitioner branch became two different organizations with slightly different focuses. The organizations – the AOM Alliance and the AAOM – have worked under a memorandum of understanding over the last several years to put out bridges and work together. We’ve been working on an ethics model, which we hope to release as a joint document. We worked under some agreement on putting Acupuncture and Oriental Medicine Day forward. There are a number of areas that we’ve worked together.

The two organizations both participate in a bigger venue, which is the VSTF. That involves both practitioner organizations working together with representatives from accreditation, education and certification. It’s a different way of working together. One is part of a bigger community, where we’re working in parallel with the other members; the other is the groups directly working together to show where we do have significant agreement about the profession. Unfortunately, we still cannot figure out quite how to put forward both the doctorate as a new role, and the maintenance of the master’s level practitioner. That’s basically where the difference lies currently. That’s the one thing we haven’t figured out how to do both in one organization and make clear.

AT: A lot of people aren’t that familiar with the VSTF – its organization and objectives. Could you tell us more about it?

FH: As an observer as somebody who put that idea forward, some of the same people who have been working for the unity in the profession over the years put the idea forward three or four years ago. “Visioning search” is a particular model that exists for finding unity in all kinds of communities. It wasn’t figured out by the acupuncture profession. The basic concept of visioning search is that all of the stakeholders in a particular broad community are all there, and it’s based on putting forward needs and hearing one another’s needs. It’s a modern-day understanding of the idea that a number of stakeholders have their own view of needs. These needs are put forward and heard, and then somehow when the needs are all out in the open and heard by everyone, then you move to a mutual view that can include those needs.

Over the years, there have been several different waves of visioning that took place among the four functions. The boards of the four function groups used to go into a retreat once a year, at the annual conference; this became five members when the practitioner groups branched out. It became evident that one of the stakeholders was not at the table: consumers and patients. That was something the Alliance has held to all along. Some of our board members have been heavily into consumers’ rights. We have a lot of people interested in public health, which is generally underfunded. For instance, the Alliance has an association with NADA, in which some non-acupuncturists use a particular acupuncture protocol in public health venues. We see that as a very legitimate and helpful way to help society.

Some people think only an acupuncturist should touch an acupuncture needle. We don’t see that as a way for the medicine to reach and heal society, so our emphasis has been in large part on the consumer, and how they see us. There was a wonderful statement in the visioning hearing at the AAOM meeting by an old-guard practitioner and educator. She said, “We see the patient as the primary care person. They are the one who chooses who’s going to help them through their medicine.” So the idea that the patient takes on the responsibility of knowing, understanding and having the freedom to choose what form of medicine they choose.

The Visioning Search Task Force has a series of meetings – about two a year – with participants from all four functions of the profession. They became sensitive to the fact that the consumer/lay member public has not been present much in those hearings, but the opinion has been that after the conclusion of this preparatory phase, there would actually be a visioning search format put forward whereby all of those people would be present, and at that meeting, which has not yet happened, the actual “vision” would bubble up. There has been a lot of preparatory work over the last several years, which has looked at the people in the main part of the industry, with only minimal participation by the consumer. Hopefully, that would be a bigger part of the final vision search.

AT: You know, I’m a consumer. I wouldn’t mind being a part of things.

FH: Well, you ought to be!

One of the first annual conferences of the Alliance was in Washington, D.C. One of the plenary speakers at the conference was from President Clinton’s think tank. He had some very interesting things to say back then. One of the scenarios they could see was that in about eight years, the HMOs would have stripped out all the savings to be had from improved management. When that happened, we would see the rate of the costs of Western medicine increase as fast or faster than it ever had. The HMOs didn’t really stop anything; there was just this period where management would save money. So, here we are. We know that HMOs are “dropping out” all over the place, and that health care costs are escalating as fast as they ever have.

The speaker also said that the think tank could see that in about 10 years, we’d see a time where most of indemnity payment for health care would disappear. There would be regional shock trauma units for major medical intervention, and for the most part, all other forms of health care would go to fee-for-service. Now, we’re seeing that come to reality. Insurance hasn’t yet disappeared, but we see it shrinking. I watch the practice my wife has been in for 15 years – an obstetrics practice with 35,000 patient records – and its staff shrinks and expands over the last decade in six-month increments when the insurance industry cranks down, or opens up something. We also know that doctors in many cases have been given mandates: “You had 12 minutes to see a patient; you now have nine.” That’s a fact. I’m not making it up.

We have this industrial machine going on, with medical professionals making snap judgements and carrying out routine, by-the-book medicine. They’re having a hard time performing a science and art to healing. It’s become very codified, and a lot of doctors are dropping out – not in waves, but I know doctors personally who have dropped out and gone to sell Amway, because they could not make the business model they had in mind when they went to school 20 years ago. It just doesn’t work that way anymore.

I don’t take medical insurance. I’ve never filed an insurance claim for a patient. I don’t intend to, and I don’t think it’s necessary, because patients come to me because they want to get better, and they think that I can help them – and in many cases, I can. That’s the basis of my practice, as a master’s trained acupuncturist back when it was 1,200 or 1,500 hours of education, not 3,000. It’s got to be better with 3,000 hours than it was with 1,500, but my practice is sound.

ATAny final thoughts you’d like to share?

FH: Well, there’s the subject we talked about earlier: the recognition and support for the doctorate level of training, which is a legitimate form of academic growth and specialization, and the view that there will be a class of practitioners who will be doctors of Oriental medicine and may very well focus on primary care, but that’s just going to be a class of Oriental medicine, not all of Oriental medicine.

The current economic structure, with mainstream, insurance support, doesn’t have a place for 15,000 doctors of Oriental medicine. However, the American culture certainly has a place for all those people, and in their own level of economic existence, but the medical profession isn’t looking to expand in that way. One of my younger colleagues told me she filled in at a medically owned personal injury clinic in California, had a slot for an acupuncturist. She said she was being asked to see 27 patients before lunch and told me, “I don’t think I was helping them.”

You can’t industrialize acupuncture. This isn’t China. If it was, and everybody walked or rode a bicycle to work, and everybody had the same salary, and the workers were told to take a week off, go back to the clinic and get well – if this culture could let people take a week off when they got sick, they’d probably come back well even if they didn’t go to a doctor, but our culture doesn’t allow that. So to try the old Chinese model of going to the clinic every day for a week and coming back well – as one of the Chinese mentors I sat before said, “That’s in China. Over here, we’re lucky to get a patient in once a week.”

It’s a different culture, and it’s got to be a different model of medicine. It doesn’t go straight across the board because it worked in China.

AT: Thank you.

FH: You’re welcome.


Editor’s note: Part one of Acupuncture Today‘s interview with Floyd Herdrich appeared in the January issue.


Floyd Herdrich has played an integral role in the development of the acupuncture and Oriental medicine profession in the United States.

He was a founding member of the Acupuncture Society of Virginia and helped get an independent licensure law passed in that state in 1993. He has also been a board member of the Acupuncture and Oriental Medicine Alliance since 1994, most recently serving as the Alliance’s president.

 

In part two of our interview, Mr. Herdrich expresses his views on the current education levels in acupuncture schools, along with the role of the Alliance and the American Association of Oriental Medicine in the creation of the Vision Search Task Force.


Acupuncture Today (AT): You mentioned the doctoral program and the type of education these programs are offering. What do you think about the level of education the students are receiving now?

Floyd Herdrich (FH): It’s great. It’s wonderful.

ATDo you think there are any areas in which the schools could improve? Are they doing enough to prepare students for life after graduation?

FH: That’s part of the confusion about the business model. Yes, the schools can do more, and I know schools that are doing more, but it’s been a perennial problem, because the economic structure of acupuncture and Oriental medicine is basically entrepreneurial. Look at the number of restaurants that open and close. They’re known as the profession for turnover and failures, but that’s part of the entrepreneurial model: You’ve got something, and you take a chance, and you put your particular practice out there, and you either succeed or you don’t. Part of that has to do with your personality, your charisma and your knowledge, but it’s not for everybody. A lot of people just want to get a job. In any profession, there are people who just want to get a job. There are physicians who are giving up their private practices to work for an agency of some sort. On the other hand, there are also physicians who are giving up their licenses. A particular case that interested me recently involved some West Coast psychiatrists, who were sued by their patients because they refused to prescribe the drugs their patients wanted. In this case, the physicians actually turned in their medical licenses and took out counselor licenses so they could persist in that model.

In the face of the litigiousness of the population and the preparedness of the legal profession to go after medical practitioners, I’m really worried about the first case that we’re bound to see in which a patient goes after an acupuncturist, because the acupuncturist did not detect a medical malady that appeared five years later. In the medical profession, you already have patients who, in a malpractice suit, will look at their most recent MRI, and it’s clear the patient has a large tumor. The question comes up in court: “Well, doctor, you read my MRI five years ago. Didn’t you see it coming?” And the old MRI is reviewed, and the attorney says, “Ah, here’s a trace. This could have been the tumor that wasn’t clearly detected.”

This situation already exists in medical malpractice suits. The point is, acupuncturists have the luxury of very affordable malpractice insurance because we very seldom, if ever, hurt anybody. However, if we start having professional standards creep in state scopes of practice to the point that acupuncturists have the option of ordering MRIs and other medical tests, if anybody in the profession in a given state has that option, it becomes the obligation of all licensed practitioners in that state to be responsible for those tests.

AT: So you could see an increase in malpractice cases, and that could lead to an increase in insurance rates.

FH: Yes! We spend $1,000 or so a year for malpractice based on our history, but when we start getting lumped in with doctors, it’s going to go to $50,000 or $100,000 just like doctors. I know obstetricians personally who have given up their practice because their malpractice shot up to $40,-, $60-, $80-, $100,000 a year, and they can’t afford it. At the same time, the insurance industry has been cutting back on payments, so they’re caught right in the middle. They just look at the business plan and decide to sell Amway.

So, yes – students that came out of my class succeeded and failed 25 years ago probably in the same proportion, or perhaps less, than today, but the complaints from people coming out of the schools today are the same as they were then. Some people feel ill-prepared to go out and take the responsibility for developing a private practice. There’s always been an axiom that it takes three to five years to build a private practice. It doesn’t matter if it’s a legal practice, a medical practice or an acupuncture practice. If you don’t have the resources to get through three to five years to where you have a sound practice, you may fail. If people don’t face that fact when they go in, they’re asleep.

It’s not the fault of the schools. I was prepared to build a practice, and knew how to refer a patient to the allopathic profession, based on my diagnosis through acupuncture and Oriental diagnosis, because I was trained on how to refer out way back then. I don’t think schools have gotten worse at that training, they’ve only gotten better.

About six or seven years ago, we were getting to the place in the profession where we were looking at the problem of “curriculum creep.” When we became legitimate – and we got that way be accrediting the schools, then legitimizing the outcomes by legitimizing national board certification – we got locked into certain kinds of established patterns. To move from a master’s level accreditation to a doctoral level accreditation, you have to show there’s a significant difference and need. While the acupuncture schools were just naturally looking into more and more information, the numbers of hours five, six and seven years ago were already approaching what is taken as the definition of a doctor’s education. How do you show the difference? The question has been around for 10 years. Could we just morph the master’s into a doctorate, or did we have to legitimize ourselves because we’re already in a legitimate academic structure? That’s question has brought us the clinical doctorate as a postgraduate doctorate, but there are people who still think, “Just call us doctors and we’ll be doctors. Give us that title and let us go.” That leads into the probability of acupuncturists having the same kind of legal exposure that doctors have, but with only a half or third or quarter of doctoral training to back it up. I’m concerned about that.

ATI have a few more questions before you before wrapping things up.

FH: All right.

ATThe Alliance and the AAOM are working together; they’ve got the Vision Search Task Force, and they signed a memorandum of understanding so that they’re working for common goals. What’s your perspective on the organizations working together?

FH: You’ve mixed apples and oranges just a little bit. Historically, it’s always been said that there were four national organizations. When you look at it, it’s actually four functions: education, accreditation, certification, and the practitioners were organized. At a certain point, the practitioner branch became two different organizations with slightly different focuses. The organizations – the AOM Alliance and the AAOM – have worked under a memorandum of understanding over the last several years to put out bridges and work together. We’ve been working on an ethics model, which we hope to release as a joint document. We worked under some agreement on putting Acupuncture and Oriental Medicine Day forward. There are a number of areas that we’ve worked together.

The two organizations both participate in a bigger venue, which is the VSTF. That involves both practitioner organizations working together with representatives from accreditation, education and certification. It’s a different way of working together. One is part of a bigger community, where we’re working in parallel with the other members; the other is the groups directly working together to show where we do have significant agreement about the profession. Unfortunately, we still cannot figure out quite how to put forward both the doctorate as a new role, and the maintenance of the master’s level practitioner. That’s basically where the difference lies currently. That’s the one thing we haven’t figured out how to do both in one organization and make clear.

AT: A lot of people aren’t that familiar with the VSTF – its organization and objectives. Could you tell us more about it?

FH: As an observer as somebody who put that idea forward, some of the same people who have been working for the unity in the profession over the years put the idea forward three or four years ago. “Visioning search” is a particular model that exists for finding unity in all kinds of communities. It wasn’t figured out by the acupuncture profession. The basic concept of visioning search is that all of the stakeholders in a particular broad community are all there, and it’s based on putting forward needs and hearing one another’s needs. It’s a modern-day understanding of the idea that a number of stakeholders have their own view of needs. These needs are put forward and heard, and then somehow when the needs are all out in the open and heard by everyone, then you move to a mutual view that can include those needs.

Over the years, there have been several different waves of visioning that took place among the four functions. The boards of the four function groups used to go into a retreat once a year, at the annual conference; this became five members when the practitioner groups branched out. It became evident that one of the stakeholders was not at the table: consumers and patients. That was something the Alliance has held to all along. Some of our board members have been heavily into consumers’ rights. We have a lot of people interested in public health, which is generally underfunded. For instance, the Alliance has an association with NADA, in which some non-acupuncturists use a particular acupuncture protocol in public health venues. We see that as a very legitimate and helpful way to help society.

Some people think only an acupuncturist should touch an acupuncture needle. We don’t see that as a way for the medicine to reach and heal society, so our emphasis has been in large part on the consumer, and how they see us. There was a wonderful statement in the visioning hearing at the AAOM meeting by an old-guard practitioner and educator. She said, “We see the patient as the primary care person. They are the one who chooses who’s going to help them through their medicine.” So the idea that the patient takes on the responsibility of knowing, understanding and having the freedom to choose what form of medicine they choose.

The Visioning Search Task Force has a series of meetings – about two a year – with participants from all four functions of the profession. They became sensitive to the fact that the consumer/lay member public has not been present much in those hearings, but the opinion has been that after the conclusion of this preparatory phase, there would actually be a visioning search format put forward whereby all of those people would be present, and at that meeting, which has not yet happened, the actual “vision” would bubble up. There has been a lot of preparatory work over the last several years, which has looked at the people in the main part of the industry, with only minimal participation by the consumer. Hopefully, that would be a bigger part of the final vision search.

AT: You know, I’m a consumer. I wouldn’t mind being a part of things.

FH: Well, you ought to be!

One of the first annual conferences of the Alliance was in Washington, D.C. One of the plenary speakers at the conference was from President Clinton’s think tank. He had some very interesting things to say back then. One of the scenarios they could see was that in about eight years, the HMOs would have stripped out all the savings to be had from improved management. When that happened, we would see the rate of the costs of Western medicine increase as fast or faster than it ever had. The HMOs didn’t really stop anything; there was just this period where management would save money. So, here we are. We know that HMOs are “dropping out” all over the place, and that health care costs are escalating as fast as they ever have.

The speaker also said that the think tank could see that in about 10 years, we’d see a time where most of indemnity payment for health care would disappear. There would be regional shock trauma units for major medical intervention, and for the most part, all other forms of health care would go to fee-for-service. Now, we’re seeing that come to reality. Insurance hasn’t yet disappeared, but we see it shrinking. I watch the practice my wife has been in for 15 years – an obstetrics practice with 35,000 patient records – and its staff shrinks and expands over the last decade in six-month increments when the insurance industry cranks down, or opens up something. We also know that doctors in many cases have been given mandates: “You had 12 minutes to see a patient; you now have nine.” That’s a fact. I’m not making it up.

We have this industrial machine going on, with medical professionals making snap judgements and carrying out routine, by-the-book medicine. They’re having a hard time performing a science and art to healing. It’s become very codified, and a lot of doctors are dropping out – not in waves, but I know doctors personally who have dropped out and gone to sell Amway, because they could not make the business model they had in mind when they went to school 20 years ago. It just doesn’t work that way anymore.

I don’t take medical insurance. I’ve never filed an insurance claim for a patient. I don’t intend to, and I don’t think it’s necessary, because patients come to me because they want to get better, and they think that I can help them – and in many cases, I can. That’s the basis of my practice, as a master’s trained acupuncturist back when it was 1,200 or 1,500 hours of education, not 3,000. It’s got to be better with 3,000 hours than it was with 1,500, but my practice is sound.

ATAny final thoughts you’d like to share?

FH: Well, there’s the subject we talked about earlier: the recognition and support for the doctorate level of training, which is a legitimate form of academic growth and specialization, and the view that there will be a class of practitioners who will be doctors of Oriental medicine and may very well focus on primary care, but that’s just going to be a class of Oriental medicine, not all of Oriental medicine.

The current economic structure, with mainstream, insurance support, doesn’t have a place for 15,000 doctors of Oriental medicine. However, the American culture certainly has a place for all those people, and in their own level of economic existence, but the medical profession isn’t looking to expand in that way. One of my younger colleagues told me she filled in at a medically owned personal injury clinic in California, had a slot for an acupuncturist. She said she was being asked to see 27 patients before lunch and told me, “I don’t think I was helping them.”

You can’t industrialize acupuncture. This isn’t China. If it was, and everybody walked or rode a bicycle to work, and everybody had the same salary, and the workers were told to take a week off, go back to the clinic and get well – if this culture could let people take a week off when they got sick, they’d probably come back well even if they didn’t go to a doctor, but our culture doesn’t allow that. So to try the old Chinese model of going to the clinic every day for a week and coming back well – as one of the Chinese mentors I sat before said, “That’s in China. Over here, we’re lucky to get a patient in once a week.”

It’s a different culture, and it’s got to be a different model of medicine. It doesn’t go straight across the board because it worked in China.

AT: Thank you.

FH: You’re welcome.


Editor’s note: Part one of Acupuncture Today‘s interview with Floyd Herdrich appeared in the January issue.

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Spotlight on the AOM Alliance

An Interview With Floyd Herdrich, LAc, Dipl.Ac., ABT – Part One

By Editorial Staff

Since he first enrolled at the Traditional Acupuncture Institute in 1983, Floyd Herdrich has been an active supporter of the acupuncture and Oriental medicine profession.

He was instrumental in getting an independent licensure law passed in Virginia in 1993, and was one of the founding members of the Acupuncture Society of Virginia. In addition to acupuncture, he is certified in Asian bodywork therapy by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). He currently operates a pair of successful practices in Falls Church, Va., and Bethesda, Md., with a model of patient care that combines elements of acupuncture, tai chi and Oriental bodywork.

 

Along with his role as a healer, Mr. Herdrich has been one of the acupuncture and Oriental medicine profession’s most influential leaders of the past decade. He has been on the board of the Acupuncture and Oriental Medicine Alliance since it was created in January 1994, and has served a variety of functions in the organization, including treasurer and vice president.

In May 2003, Mr. Herdrich’s affiliation with the Alliance reached new heights when he was named president of the organization. In this exclusive interview with Acupuncture Today‘s managing editor, Michael Devitt, Mr. Herdrich reflects on his career in acupuncture and Oriental medicine; his role as Alliance president; the importance of the Vision Search Task Force; and his concerns about the future of the profession.

Acupuncture Today (AT): Good afternoon, Mr. Herdrich. Let’s begin by providing our readers with some background information. Where did you go to school, and how long have you been in practice?

Floyd Herdrich (FH): I’ve been involved in the profession for about 20 years. I entered formal schooling in 1983 at the Traditional Acupuncture Institute (now Tai Sophia Institute) in Columbia, Maryland. It became one of the first accredited schools in acupuncture around that time. I’d had some exposure to the work of J.R. Worsley before that. That specific type of work attracted me to the school, along with the school getting itself on the ground firmly.

I graduated from TAI, started licensure in Maryland after that, and continued studying with Dr. Worsley over the years, right up to the present. I started practice as a registered acupuncturist, which was the available entry at the time. It was technically a “physician extender” position: We were registered to a particular physician’s license. It felt independent, but it was not an independent model.

Within a couple of years, I became a licensed acupuncturist in the District of Columbia, which had independent licensure, but with a physician collaborator as a specific requirement, which is not unlike that of nurse practitioners. I’ve lived in Virginia the entire time, where my wife practices as a nurse widwife and nurse practitioner, and as I continued on in my career, I got directly involved in bringing licensure to Virginia. I became a lay lobbyist and saw to it that we got independent license practice in Virginia. As a result, we are licensed practitioners of acupuncture with unrestricted practice of acupuncture and Oriental medicine. I’ve got license #5 in Virginia.

I’ve been involved in the national practitioner organizations throughout all this time, first as a member of the old AAAOM (American Association of Acupuncture and Oriental Medicine) back when I was a student. Living here in the Washington, D.C. area, I’ve had access to a lot of changes. I participated in the first NIH round table on complementary and alternative medicine, which was a phenomenon in itself. There also were efforts to get recognition of acupuncture needles out from under the FDA; that overlapped with the evolution of the Office of Complementary and Alternative Medicine at the NIH.

ATWhat’s your relationship with the Alliance?

FH: I became a life member of the AAAOM as a practitioner. There was a time in the middle of its history where the beginnings of a diversion in practitioner focus took place. There was a difference between those who sought to have a unitary model of the doctor of Oriental medicine, with some leanings toward integration into the Western medical field, and those who saw the acupuncture and Oriental medicine model as a true alternative to mainstream medicine, putting patient responsibility for wellness first and being life coaches and energetic medicine providers. I was there when it came right down to a 51-49 split in the AAAOM. At that time, I was elected to the AAAOM board by the minority, who hoped that we could keep both conversations going within the same organization. I stayed on as a board member for about a year before it was made evident by the majority that my views weren’t consistent with their views, and I wasn’t fit to be a board member.

This is when the Alliance was founded. I was on the founding board of the Alliance, and I’ve been on the board since then. I was elected president of the Alliance last May, and was vice president the year before.

ATWhat’s a typical day like for you as president of the Alliance?

FH: A typical day for me is that of a practitioner. I would like to see a time in my future when I would be more of a practitioner, so that I could be with patients more exclusively. As it is, I have fielded calls from various people over the years who have expressed an interest in expanding licensure and fine-tuning organizations. I was a founder of the Acupuncture Society of Virginia. I’ve moved out of that leadership role already, and the society has gone on its own. Somebody always manages to find me to ask a question about how something might work, so I’ve delved into that pretty willingly over the years.

ATAre there any drawbacks to being president?

FH: Well, acupuncture isn’t a wildly economically grounded profession. We don’t have a product like the AMA’s CPT codes, so there are very few paid positions. I have given significant amounts of my economic time to the voluntary development of the profession. There’s a new generation of people coming on board. I’m the last board member who was on the original founding board of the Alliance. We’re all going on to become grandparents, and I’m looking forward to that. I’m a literal grandfather now, and I’d like to spend a little more time with my grandkids as opposed to the second and third generations of practitioners. It’s been good – I’m not complaining, but I’m just looking out beyond this present time in my personal life.

AT: That’s understandable. What are the most important issues that you see facing the profession?

FH: You know, I just made an address to the Council of Colleges at the AAOM meeting in Florida, and I observed that over the past 20 or 25 years, a lot has changed and nothing has changed. Some things remain the same. The big change is in the numbers of us that are present in the American culture as health care providers, and the fact that what we practice is recognized in almost every state now. Still, even since the very beginning, acupuncture and Oriental medicine are not well understood by the American population. People are discovering it constantly, but if you ask anybody on the street, they may still think it’s just for pain or backaches, and they don’t recognize that it is a broad medicine for a range of human ailments. Those problems persist, and have persisted since the 1970s. Clearly, we’re a household word; we just have not become so firmly established as an economic entity as the old mainstreams. I think that’s one of the main focuses right now.

I was just reading an article in the December issue of Acupuncture Today, and have heard other commentators in other venues. I’m concerned by the comments in AT and elsewhere that feel that AOM graduates are underprepared for entry into the health care profession. The writer of the article, on the other hand, illustrated how well she was prepared, because she talked about how she built a private practice, and everything that she went through, and she was sharing her wisdom with other people. I find that kind of article in your sister publication for chiropractors, and they’ve been out there for more than 100 years.

There’s still a constant need for new practitioners and new graduates to hone their skills at practice building, because it’s an entrepreneurial business model, as opposed to an industry. The mainstream allopathic medical industry is as old as the coal and railroad and steel industries, and the modern-day graduate of a medical school or other health profession seldom goes out and builds a private practice. In allopathic medicine, people go out there and get a job. Very few people go out of AOM training and get a job. It’s just not a reality.

When I look at the numbers of people that come out of the general education or business education models, and go out into entrepreneurial business models, they don’t succeed more often than our practitioners succeed. Some people lament that some practitioners may not continue practicing Oriental medicine, or may not be completely successful economically, but in an entrepreneurial world, we’re really strong when you look at it in that light. Thousands of us have succeeded for decades clinically. Clinically, ours is the safest of professions. It’s proven efficacious for many conditions, it’s known to be a clinically effective treatment by millions of patients, and it’s a viable economic opportunity. We are “all that.” We were that 20 years ago coming out of school, and we are that now. It hasn’t gotten any worse; it’s only gotten better.

There are a myriad of concerns these days, such as fine-tuning regulations, getting increased insurance access, working with the CPT coding to enhance coding for those who do practice with third-party reimbursement, and working with fee-for-service. We’re working on both sides in all of those streams. As the very bottom line, I would have to say that the Alliance clearly has supported the evolution of doctoral education in AOM, which has brought us so far to the postgraduate doctorate program that’s up and running. We can envision that there would be a growth of a class of AOM professionals – doctors, many of whom will integrate into the allopathic industry – but that evolution in no way diminishes the legitimacy and importance of the present and future practice of the AOM master’s-level independent practitioner.

As I mentioned earlier, I was speaking to the Council of Colleges. My friend at that moment was a Korean practitioner and educator from Virginia. He was speaking to the Accreditation Commission for Acupuncture and Oriental Medicine, and was trying to legitimize his teaching of students, which has been basically up to this time, tutorial – a master/student approach. My standing for the Alliance was that at the present, his and my greatest hope was that his children and my children would be able to continue to practice what he and I practice, as opposed to a model that is medically based.

I’m very concerned with a few models out there that have looked at an escalating biomedical component to the AOM education. The issue is that when you look at it in absolute terms is, none of these models put forward are any stronger in biomedicine than, say, the “barefoot doctors” of Mao’s China. If you want to be a medical doctor and know that trade, you probably need to be a medical doctor. The models that are being presented out there in some circles and called doctoral programs, are really about the educational level of a physician assistant, which isn’t an independent practitioner.

I value my lifestyle as an independent practitioner, having my practice built over many years and continuing to build it constantly. Patients value what I do. They come to me because they become frustrated in many cases with an allopathic model that hasn’t cured them of their ailments, and in many cases it has provided them with side-effects that are very degrading to their health. They come because they want an addition or alternative to that model.

One of the things that has occupied my mind occurred two days ago. I received a call on my voice mail. It began, “Hello. I’m calling for my daughter, who’s been your patient. She won’t be coming to her appointment this week.” There was a slight pause, and the voice continued, “Or ever. She passed on last night.” This is a person who came to me a year into allopathic treatment for the radical eruption of a very aggressive cancer, which happened to pop up within months of her husband having gone to work at the Pentagon on Sept. 11 and not coming home. She came to me when she’d already had one breast removed, which was being reconstructed. Her liver metastases were shrinking somewhat with about her fourth or fifth series of chemotherapy. She went through some findings of metastases on her brain, and had more radiation.

I occasionally challenged her to ask why she was coming to me. Obviously, I was not curing her of her cancer; I never intended or thought I could. Why was she coming? I asked. She replied that every time that she came for treatment, she always felt better afterward. She had an appointment for me tomorrow morning, and unfortunately, she won’t be able to keep it.

That woman has been a huge inspiration personally, just to be a part of her life for a year. She was a single mother – she’d just delivered her second child when her husband died, and was nursing when the cancer was detected. So to work with her regularly, over that period of time, as a support for her treatment, and keep her spirit alive as she went ahead, I would consider myself extremely fortunate to have that role, and I wouldn’t want the job of being her allopath, and I wouldn’t want to take her allopath away from her, either. She would have been dead already if it hadn’t been for their heroic treatments. But I don’t want to change my role. I also don’t want to see my role disappear and become some kind of first-line primary care provider in terms of the insurance industry’s definition of “primary care,” because something like only three classes of allopaths are considered primary care, and they have to perform procedures like giving shots, which I don’t always believe in, and a few other ground-level allopathic practices.

There has always been a debate about how much education qualifies a physician to use acupuncture in his or her medical practice. When I was a student with Dr. Worsley, and the first round of physician acupuncturists was coming into being, he once commented, “I don’t know why a first-rate physician would want to become a tenth-rate acupuncturist.” Likewise, I don’t know why I, or anybody, as a first-rate acupuncturist, would want to become a tenth-rate doctor, by medicalizing my profession. That’s the bottom line. While there are those who will do that, and do it well, the majority of us out here are doing something that has been a complement and alternative to allopathic medicine, and I think we’re going to stand for the maintenance of that role, along with the evolution of those doctors who would want to find a way to become that industry’s primary care definition.

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Spotlight on the AAOM

A Question-and-Answer Session With Gene Bruno, LAc, OMD, Part Two

By Gene Bruno, OMD, LAc, FNAAOM and Editorial Staff


Gene Bruno has had a profound influence on the practice of acupuncture and Oriental medicine in the United States.

In the mid-1970s, he helped found two successful acupuncture institutions, and was one of the leaders in a project that introduced veterinary acupuncture to the U.S. He also helped write the scope of practice laws for acupuncture and Oriental medicine in Washington and Oregon. Since 2002, he has served as president of the American Association of Oriental Medicine (AAOM), and has played an integral role in that organization’s recent successes.

 

In part two of our interview, Dr. Bruno discusses the AAOM’s efforts to assist the acupuncture profession, and discusses issues such as new licensing laws, the FDA’s ban on ephedra, the Visioning Search Task Force, and other relevant topics.


Acupuncture Today (AT): How are the AAOM and the other acupuncture organizations working together to help keep the profession moving forward?

Gene Bruno (GB): One of the more significant changes in the last few years is that many AOM organizations are actually communicating more closely than ever before, and in most cases working very well together. The AAOM and the AOM Alliance just recently completed an ethics statement for our profession. This covered more than two years of cooperation and hard work. The Visioning Task Force is another example of this cooperation. The AAOM is working closely with ACAOM by participating in its Doctoral Task Force. The AAOM also communicates regularly with FAOMRA and supports its efforts to involve more regulatory agencies in their work.

The AAOM has close communications with most state associations, and we are often able to assist them in their efforts. Our House of Delegates is made up of AAOM member state associations. Through our House of Delegates, we provide means for regional and state interests to have a direct influence and voice on national issues.

ATOne of the biggest issues facing the profession concerns other health care providers and their ability to practice acupuncture. Currently, about three dozen states allow chiropractors to practice acupuncture, and the training they receive is often far less than what is required for a LAc to practice. What is the AAOM doing to stop, or at least slow down, the practice of acupuncture by chiropractors and other health care providers?

GB: As I mentioned earlier, the attempt by members of other professions to acquire the right to practice acupuncture with minimal, inadequate training has increased dramatically. It is not “often far less” training: it is always less training. And, as you say, it is a major concern. Since the mission of the AAOM is to preserve and protect the integrity of acupuncture and Oriental medicine, it is a full-time job working with the various states where this is taking place and where chiropractors are trying to get new privileges with insufficient training. In this capacity, we work with state associations to educate legislators and licensing boards about the accepted standards of education necessary to practice in order to protect the public trust.

The fact that chiropractors are allowed in some states to practice acupuncture with entirely inadequate training, according to the accepted standards of the profession in the U.S. and the standards of the World Health Organization, should alarm all qualified acupuncturists. This will lead to an increase in public endangerment and erosion of the public trust.

AT: Another big issue remains getting acupuncture licensing laws in all 50 states. What are the prospects of that happening in the near future, and what is the AAOM doing to see that these types of laws get passed?

GB: We expect the last few states to be the most difficult. We hope to have a new law in Michigan soon, and are using our connections and resources to get laws passed in every state that does not yet have a law. The AAOM provides model bills for state associations in their efforts to pass licensing laws, and we provide model bylaws for use by the state associations themselves. We are very supportive of state organizations’ individual desires when working with them.

Additionally, some existing state practice laws often come under challenge. This happened last year in Arkansas. The AAOM took the lead in stopping an attempt to literally gut the standards for licensure in Arkansas. A law was stopped that would have reduced the requirements to 142 total hours of training, which would have completely destroyed the level of competence in the state, and ultimately have a negative impact on national standards.

ATIn April, the FDA’s ban on ephedra went into effect. Do you think the FDA will start removing other herbs and supplements from the market, and if that happens, what effect will it have on the practice of Oriental medicine in the U.S.?

GB: It seems the FDA will continue to remove other herbs unless the work the AAOM and other organizations are doing can lead to a satisfactory agreement that will allow us continued use and access. It is important to understand that the FDA has always considered herbs as drugs, but they have historically avoided pursuing a reclassification of herbs. Although there is a posting on the FDA Web site that states the new ruling on ephedrine alkaloids does not apply to Asian herbal formulas, this language is not included in the rule itself. Because this language is not in the rule, it implies that the labeling of herbal formulas should not list them as supplements.

The effect of this is already apparent in the problems that suppliers are having with importation of herbs. The AAOM and the AHPA have been working together and meeting with the FDA to obtain more clarification so that practitioners will still have access to herbs and so that suppliers will be able to provide that access. But this process will be a lengthy one and will take time.

ATThe Visioning Search Task Force (of which AAOM is a member) is working on a vision process to help shape the profession for the next 10 to 20 years. What role does the AAOM play as a part of the VSTF? Where do you see the profession 10 years from now? Twenty years from now?

GB: The AAOM supports the VSTF in the development of a “Future Search” process. In this regard, we provide leadership, personnel and meeting space in order for the potential common vision that exists within this community to be realized.

It is not the job of the AAOM or any other single agency to determine the future vision of Chinese medicine in America. We are here to serve the vision that is emerging from the key stakeholders within the field. That said, it has been mutually agreed that within 15 years, practitioners will enter the field with doctoral degrees, that there is parity with other professions with regard to reimbursement, and that the profession successfully maintains the treasure house of knowledge that we call Oriental medicine.

AT: There are roughly 4,000 students currently enrolled at acupuncture schools in the U.S. Many of them will have just graduated by the time this interview is published. If you could give these students and new graduates any advice about the profession, what would you tell them?

GB: Join your state association and the AAOM, and support their work. Your state and national associations are a major part of why you have this opportunity to practice the medicine you have worked so hard to master. By contributing to your state and national associations, your ideas, contributions and leadership will help shape the future of your profession.

AT: Any other final comments you’d like to add?

GB: I would like to thank Acupuncture Today for allowing me to address the concerns of our profession in this forum.

ATThank you.


Dr. Gene Bruno is President Emeritus of the American Association of Oriental Medicine and in private practice in Salem. Ore. He may be contacted at www.acudoctor.com.

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Acupuncture Case Study In the U.S. Congress.By Y.C.Chan(Your Health Magazine, July, 2010)

Acupuncture practice reached and gained immense popularity in the United States after President Nixon’s trip to China in 1972.As a medical profession in this country, acupuncture should have scientific explanation to the general public, and a based theory satisfactory to AMA. Furthermore, the acupuncture needle must have FDA approval, because it is considered a medical device.In the early 1970’s most acupuncturists practiced under ground, because there was no licensure procedure available for practitioners. Due to the AMA opposition, many acupuncturists were arrested because they were considered to be practicing without a license. Under the influence of AMA, the government authorities were not favorable to acupuncture.Despite the legislative opposition to acupuncture, there was great patient demand and a growing interest among the general public. In addition, the positive acclaim from two U.S. Governor’s also gathered acupuncture’s popularity.

In the U.S. Congress, the chairman Allen Ertel of subcommittee on science and technology and Chairman George Brown of the subcommittee both agreed to hold a hearing for acupuncture on June 22, 1979. The hearing was created to examine and explore the current views of the U.S. medical profession on acupuncture.

Two acupuncture centers, and two acupuncturists were invited for testimony, as well as others (AMA, representatives, physicians, politicians, and a few patients) and totaled more than 200 people who attended the hearing. The acupuncture profession provided testimony and a copy of acupuncture study plus the author’s six page documentation, for a total of 32 pages for the records. The results of the study showed that for the acupuncture treatment of low back pain, the effective rate was 83% (after six weeks treatment plus 40 weeks intensive observation).

This study was recorded at the U.S. Congress in 1979, during the 96th Congressional Hearing for Acupuncture. The original study was planned in 1976 and completed in 1978 in Montgomery County. Almost 35 years ago, due to the uncertainty of the legal situation, there were only a small group of practitioners in the state. Since the study was not supported by any organizations, all participants were volunteers. It was almost impossible to convince physician’s to perform services without a salary, but fortunately we found the right professional group to join the study.

Acupuncture has become a healthcare profession in recent years and is available in the entire nation, but comprehensive acupuncture studies remain few. This is because most of the practitioners use herbs combined with different products, which can confuse the results. It is very difficult to perform professional studies.

These acupuncture pioneers contributed their valuable time, knowledge, dignity, passion and all efforts to sacrifice themselves to their profession. All records in the U.S. Congress, FDA and AMA proved their comprehensive study. They should be proud and deserve partial credit of acupuncture’s history in the United States of America.

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James Tin Yau So

From Wikipedia, the free encyclopedia  http://en.wikipedia.org/wiki/James_Tin_Yau_So

Dr. James Tin Yau So, N.D., LAc., (1911–2000) also known as Dr. So, was one of the most influential individuals of the 20th Century in bringing acupuncture to the United States.[citation needed]

Dr. So’s teacher was Tsang Tien Chi who studied under Ching Tan An. He graduated from Dr. Tsang’s College of Scientific Acupuncture inCantonChina, in 1939. During the same year Dr. So opened his medical office in Hong Kong. In 1941 he opened his own school, The Hong Kong College Acupuncture. For the next thirty years, Dr. So established himself as one of the most successful and well-respected acupuncturists throughout Asia.[citation needed]

Several acupuncturists from the National Acupuncture Association (NAA) sought Dr. So’s assistance in 1972.[citation needed] At the time the NAA offered Dr. So a position as acupuncturist at the UCLA Acupuncture Pain Clinic, the only legal acupuncture clinic in California at that time. Dr. So accepted and joined the NAA staff of acupuncturists and the UCLA Acupuncture Pain Clinic in 1973.[1]

In 1974, Dr. So was part of the NAA group that traveled to Massachusetts and opened the first acupuncture clinic in Boston and a second clinic in Worcester. Dr. Steven Rosenblatt and Dr. Gene Bruno assisted Dr. So in the translation of his three books on the points of acupuncture, the techniques acupuncture and treatment of disease by acupuncture. Dr. So, with the help of Dr. Rosenblatt and Dr. Bruno founded the first school of acupuncture in the US in 1974.[citation needed] Dr. So, with the help of his students Arnie Freiman and Steven Breeker registered this school the next year and changed the name to the New England School of Acupuncture (NESA), in 1975.[2] With his approval Dr. Gene Bruno and Dr. Steven Rosenblatt founded a second school in the US, which became the California Acupuncture College, located in West Los Angeles.

Dr. So was posthumously awarded the Acupuncturist of the Year award in 2001 by the American Association of Oriental Medicine at their national conference in Hawaii. In 2007, Dr. So Tin Yau was among the first four acupuncturists to be inscribed on the Founders of the Profession Honor Roll by the American Association of Oriental Medicine.[citation needed]

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Dr. Miriam Lee, OMD (Lee Chuan Djin)http://tungspoints.com/lineage/

In 1976, Miriam Lee was one of the first people to be licensed as an acupuncturist in the state of  California. In 1974, she was arrested for practicing medicine without a license.

At her trial, her patients filled the courtroom in protest of her arrest, claiming their right to the only medicine that had truly helped them. Within a few days of Dr. Lee’s trial, acupuncture was authorized as an experimental procedure in California. In 1976, Governor Jerry Brown signed the  legislation that finally legalized acupuncture.

The Acupuncture Association of America was founded by Dr. Miriam Lee in July 1980; Dr. Lee continued to lead the organization until her retirement in 1998. The Acupuncture Association of America was created to promote public education about acupuncture, provide continuing education classes for licensed practitioners, to guide and support legislative advocacy, and to promote research in the field of acupuncture.

For nearly a decade, the Acupuncture Association of America supported Art Krause, a California lobbyist whose primary work has been on behalf of acupuncturists. Dr. Lee offered classes in order to raise funds needed to support this legislative work. Mr. Krause, well respected in Sacramento, was able to negotiate agreements with influential politicians. Among the friends of the Acupuncture Association of America and acupuncture were Dr. Bill Filante, Senators Art Torres and Herschel Rosenthal, all instrumental in getting many acupuncture bills made into law. It is because of the monumental efforts of Dr. Miriam Lee, Art Krause and others that California acupuncturists are now licensed, have a very comprehensive scope of practice, primary care physician status, primary insurance coverage and have been able to accept Medi-Cal.

In 1989, the Council of Acupuncture Organizations was formed to unite the profession in the legislative process. This group was composed of nine different acupuncture organizations throughout California, including three Chinese, two Japanese, two Korean and two Caucasian groups. This was the first attempt to bring together these different acupuncture communities. Unfortunately, the group met for only two years, but during that time, the Council of Acupuncture Organizations was able to procure acupuncture coverage through Worker’s Compensation.

Many new acupuncture organizations were formed during the 1990’s, both in California and nationwide. The Acupuncture Association of America, having had a very significant role in the early formation and legalization of California acupuncture, was then able to focus on providing continuing education classes. Dr. Miriam Lee sponsored many well-known practitioners from China to come to her clinic in Palo Alto to teach seminars. These courses covered a variety of topics such as Tung’s Points, herbal formulation, scalp acupuncture, wrist and ankle points, and Traditional Chinese Medicine gynecology and oncology.

Dr. Miriam Lee retired in 1998, and moved to Southern California to be with her family. Dr. Lee passed away June 24th, 2009. Miriam Lee was a pioneering doctor whose tireless work led to the recognition and legalization of the medical practice of acupuncture in California.

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加州第一位針灸醫師李傳真博士六月二十四日與世長辭

http://news.sina.com   2009年07月03日 00:09   中國日報

  葬禮將於七月三日下午一時於洛杉磯玫瑰崗Hillside Chapel教堂舉行

(本報訊)加州第一位針灸醫師李傳真(Miriam Lee)博士,不幸於二零零九年六月二十四日於洛杉磯托倫斯家中與世長辭,由於李醫師三十多年前的努力,促成加州針灸醫師合法化,進而影響針灸在全美國的發展與推動。更難能者,李醫師與其學生Susan Johnson、Esthersu等在美國與歐洲極力推展發揮董氏奇穴,使董氏奇穴因而風行全美及歐洲,帶動了美國及歐洲針灸界更大的進步。

李傳真醫師,加州針灸的先驅,是促成加州針灸合法化的醫師,出生於中國,1949離開大陸,來美前曾住在新加坡十七年,當她來到加州時,針灸仍是不合法的,他先是在家靜靜的治療病人,之後她與支持她的西醫共用診室,1974年李傳真因為沒有開業執照而被逮捕,開庭時,她的病人擠滿了法庭,抗議她被拘捕,他們聲明只有針灸能真正的幫助他們,他們有權力接受這種治療。之後在幾天內針灸被州長Ronald Reagan列為合法的試驗性的治療方法。1976年,州長Jerry Brown簽字使針灸在加州正式合法化,這使Miriam Lee成為加州第一位針灸醫師。經過三十多年,今日加州的針灸醫師已到達一萬四千多人。

在七零年代及八零年代早期,她以她老師(有名的董景昌,曾治癒高棉總統之半身不遂)的特殊的董氏奇穴為主進行治療,董氏奇穴被西方人名之為「董氏魔術穴位」,她著有有關的英文著作經Blue Poppy出版,這其中有不少創造與革新,該書在美國及歐洲皆極為暢銷。在她的職業生涯中,當其臨床巔峰時期,每小時看十個病人,每周工作八十小時。九零年代起李醫師與其學生Susan Johnson,Esthersu等在美國與歐洲極力推展發揮董氏奇穴,使董氏奇穴因而風行全美及歐洲,帶動了美國及歐洲針灸界更大的進步。

1980美國針灸學會(Acupuncture Association of America)創立,學會的宗旨在提供針灸醫師再教育,支持針灸立法及推廣針灸研究,李醫師被推為會長直至1998年,李醫師近幾年退休後定居於洛杉磯托倫斯(She died peacefully, in her home in Torrance, CA. with her family around her.)直至去逝。李醫師之葬禮將於七月三日下午一時於洛杉磯玫瑰崗Hillside Chapel教堂舉行,然後葬於玫瑰崗墓園。

  • William Morris
    Message 1 of 4 , 02 Jul, 2009

    Palo Alto acupuncture pioneer, 82, dies

    By Shaun Bishop

    Daily News Staff Writer

    Posted: 06/30/2009 11:02:41 PM PDT
    Updated: 06/30/2009 11:02:46 PM PDT

    Miriam Lee, a prominent acupuncturist who pushed for licensing the practice in California and treated patients for two decades in Palo Alto, died last week. She was 82.

    Lee suffered a severe stroke in recent weeks and died June 24 in Southern California, where she lived after retiring in 1997, said Susan Johnson, a former student and longtime friend.

    Lee’s 1974 arrest in Palo Alto for practicing medicine without a license made her an icon for the movement to allow acupuncture to be legalized in the United States, Johnson said.

    She also had a lifelong desire to learn, traveling across the world to pick up new skills and passing on her knowledge to many of her students.

    “She was an extraordinary practitioner, a one-of-a-kind pioneer in terms of techniques and teaching,” said Johnson, who was an intern under Lee in 1982.

    Born Dec. 8, 1926, in China, Lee studied in her late teenage years to be a midwife. She moved to Singapore in 1953, where she worked as a bank teller until she immigrated to the United States in 1969, Johnson said.

    Lee settled in Palo Alto and worked on an assembly line in a Hewlett-Packard factory, treating co-workers who complained of shoulder or neck pain with acupuncture in her home, Johnson said.

    As word of her in-home acupuncture practice spread, Lee attracted a growing number of patients. But authorities caught wind of her popularity, and in 1974 arrested her for practicing medicine without a license.

    According to Lee’s 1992 book, “Insights of a Senior Acupuncturist,” she was acquitted after supporters came to her defense at a court hearing. Lee then pushed for legislation that eventually established acupuncture licensing in California in 1976.

    She founded an acupuncture practice on Cambridge Avenue, where she treated a variety of illnesses, from thyroid problems to migraine headaches, said Jean Leong, who observed Lee’s treatments as an adolescent while her mother worked as Lee’s assistant.

    Lee started her day early and treated as many as 10 patients every hour using different tables in different rooms, Leong said.

    Throughout her career, Lee studied with acupuncture masters in China, learning new skills that she took back to the United States, including unusual techniques not taught in acupuncture schools, Johnson said.

    In 1997 she retired and moved to the Los Angeles area after suffering her first stroke, Johnson said.

    “I just think Miriam was the pioneer,” Leong said. “If it wasn’t for her, I don’t know if acupuncture would have been introduced to the U.S. — and certainly not to California — at the time it happened.”

    A memorial service for Lee will be held 1 p.m. Friday at Rose Hills Park and Mortuary, 3888 Workman Mill Road, Whittier, Calif.

    for more:

    http://www.360doc.com/content/11/0124/01/4702178_88614597.shtml

    SUNDAY, NOVEMBER 15, 2009

    Miriam Lee Tribute Day – FREE acupuncture on December 9, 2009


    Bay Area Community Acupuncture Clinics Honor Pioneer Miriam Lee
    With A Day of Free AcupunctureSeven Community Acupuncture clinics in the greater San Francisco Bay area will offer free acupuncture on December 9, 2009 to honor Miriam Lee, the woman who set off the movement to legalize acupuncture in the US. An eight clinic in San Rafael will offer the free treatments on December 8.Born on December 9, 1926 in China, Lee immigrated to the United States in 1969 and settled in Palo Alto, California. Because it was illegal to practice acupuncture, she took a job on an assembly line. However, Lee found it impossible to not offer her skills and was soon seeing patients clandestinely. Over time, her reputation grew, until her practice became too large for her home. One anecdote related in her book, Insights of a Senior Acupuncturist, mentions the collapse of the steps to her back porch due to the number of people waiting to see her. Eventually, she found a sympathetic M.D. who allowed her to work out of his office during off-hours.In 1974 Lee was arrested for practicing medicine without a license. Her patients filled the courthouse at her hearing, demanding the right to receive acupuncture. Miriam Lee had offered them compassion and health, and now they came to her defense. Thanks to this public outcry, acupuncture was declared an “experimental procedure” and Lee was granted the right to see patients at San Francisco University. In 1976, acupuncture was legalized in California. Lee retired in 1997 and died at age 82 on June 24th of this year.Miriam Lee felt compelled to offer the healing power of acupuncture to as many people as possible. She treated a variety of illnesses for two decades in Palo Alto, starting her day early and treating as many as 10 patients per hour using tables and chairs in several rooms. In order to work quickly and effectively, Lee developed a simple 5-point, 10-needle protocol which proved helpful for the majority of common health complaints.Community acupuncturists draw inspiration from Miriam Lee and share her desire to provide acupuncture to as many people as possible. Following the example of Working Class Acupuncture in Portland, Oregon, Community Acupuncture clinics in the Bay Area offer affordable, sliding-scale acupuncture in quiet group spaces. Their mission is to increase access to regular and frequent acupuncture treatment for people with ordinary incomes and to build a sense of community among those receiving and providing care.

    In Lee’s memory, several Community Acupuncture clinics in the Bay Area will provide her treatment protocol (known as the “Miriam Lee tune up”) free to clients on December 9, 2009.Participating clinics are listed below. Contact them directly for business hours and other details.

     

    Acupuncture Today
    September, 2009, Vol. 10, Issue 09

    In Memoriam: Dr. Miriam Lee (1926-2009)

    http://www.acupuncturetoday.com/mpacms/at/article.php?id=32021(09142013)

    By Susan Johnson, LAc

    My relationship with Miriam began in 1982, when I was privileged enough to begin an internship with her. Through my many years with Dr. Lee, I was trained extensively in her unique style of acupuncture.

    In 1987, we traveled together to Hefei, China, to study bleeding techniques with Dr. Wang Su-Jen. We journeyed together through the “wild ride” of acupuncture politics in the 1980s and 1990s. She was my teacher and my friend, and a pioneer in the field of Chinese medicine in America.

    In Memoriam: Dr. Miriam Lee (1926-2009)

    Miriam was perhaps best known for her work with Master Tung’s “Magic Points.” Master Tung Ching Chang, widely viewed as the greatest acupuncture technician who ever lived, practiced a method of acupuncture that was passed down to him through his family from Shandong, China, for more than 300 years. This system is renowned for the spontaneous and miraculous results obtained using just a few needles. This method is unique in that points are located opposite the affected area, and patients tend to notice effects immediately upon needle insertion. Master Tung broke convention after the Chinese Cultural Revolution and began teaching this amazing system of points outside of his immediate family. Dr. Young Wei-Chieh and Dr. Miriam Lee, both students of Master Tung’s, are responsible for bringing this body of work to America.

    In 1976, Miriam was one of the very first to be licensed as an acupuncturist in the state of California. In 1974, she was arrested for practicing medicine without a license. At her trial, her patients filled the courtroom in protest of her arrest, claiming their right to the only medicine that had truly helped them. Within a few days, acupuncture was legally made an “experimental procedure” by Governor Ronald Reagan. In 1976, Governor Jerry Brown signed the legislation that once and for all, legalized acupuncture.

    It is through the untiring efforts of people like Miriam Lee, founder of the Acupuncture Association of America (AAA), and lobbyist Art Krause, that we here in California can boast acupuncture licensure, primary care physician status and primary insurance coverage. Although I feel personally and eternally indebted to Miriam, we should all remember the work that Miriam and Art did together, for our profession, for more than 30 years.

    For nearly a decade, the AAA single-handedly supported Krause. Dr. Lee would offer Master Tung’s Points classes for her students and licensed practitioners, in order to raise the money needed to support this legislative work. Krause, well-respected in Sacramento, was able to negotiate agreements with influential politicians over a cup of coffee. Things were very different in those days. State senators Art Torres (D) and Herschel Rosenthal (D), both instrumental in getting many acupuncture bills made into law, were among the friends of AAA and acupuncture. It is directly through the efforts of all of the above people, and a few others, that we can boast having the one of the most comprehensive scopes of practice in the country.

    In 1989, The Council of Acupuncture Organizations (CAO) was formed to unite the profession statewide in the legislative process and share Krause’s financial support. This group was composed of nine different acupuncture organizations throughout California; three Chinese, two Japanese, two Korean and two Caucasian. This was the first and only real attempt to date of which I am aware, to bring these different acupuncture communities together. Unfortunately, the group only met for two years, but during that time, the CAO was able to procure acupuncture coverage through worker’s compensation.

    As acupuncture politics evolved through the 90’s, many new organizations were formed, both state and nationwide. The AAA, having had a very significant role in the early formation of California acupuncture, was then able to focus primarily on its purpose of providing quality continuing-education classes. Dr. Lee sponsored many different well-known practitioners from China to come to her clinic in Palo Alto, Calif., to teach. These courses covered a variety of topics, such as Tung’s Points, herbal formulations, scalp acupuncture, wrist and ankle points, TCM gynecology and oncology.

    Upon retiring, Miriam moved to Southern California with her family. As her student of many years I have stepped forward to carry on the work of teaching Dr. Tung’s Points and Miriam’s style of acupuncture, and to continue the work of the AAA. It is my hope that the future will find Tung’s Points available and familiar to all those seeking more than “textbook” acupuncture techniques. They are unique not only because they are so extraordinarily, immediately effective, but also because they are very simple to learn and apply. As Miriam always said: “The important thing is to learn which key opens which lock.” May Master Tung’s Points open as many doors for you as they have for me and for generations before us all.


    Susan Johnson has been practicing Tung’s style of acupuncture since 1982 and licensed in California, since 1985. She studied Master Tung’s Points with Dr. Young Wei-Chieh and Dr. Miriam Lee for more than 12 years and has been using them almost exclusively in her practice since that time. Susan maintains a private practice in Santa Cruz, Calif.

    http://www.acupunctureamerica.com/acupuncture_history_california.html(09142013)

    Acupuncture in California During the 1970s

    CALIFORNIA GETS THE POINT
    by Colin Elbasani

    Special thanks to:
    Paul West
    Linda Barnes, PhD
    Joel Harvey Schreck, LAc
    Susan Johnson, LAc
    Benson You, LAc

    Contents
    1. Introduction
    2. Acupuncture Enters the American Mainstream
    3. The Evolution of Acupuncture in China
    4. Approving Acupuncture Research in California
    5. Medical Issues in the Regulation of Acupuncture
    6. Health Care Delivery Issues in Acupuncture Regulation
    7. Criticism of Acupuncture Regulation
    8. Conclusion
    Appendix. The Practice of Acupuncture: A Legislative Position Paper

    1. Introduction

    Geographically, California is the last stop in the continental United States before Asia. It is not surprising, then, that the medicine, philosophy, and other aspects of Asian culture constitute such a prominent part of the California experience. Although acupuncture is portrayed by some academics—perhaps because of their perspective from the East Coast—as having resulted in a tremendous culture clash between established Western medicine and Eastern exotic medicine, the historical record shows that their differences were more easily reconciled than these critics would have us believe; over the course of the last forty years, acupuncture has been completely integrated into California’s medical delivery system.

    While it may be true that “professions institutionalize control over social capital by establishing licensing procedures, internally run educational institutions, and self-regulation,” they do not exist first and foremost to do so. This is especially the case in the medical profession, where incompetence, carelessness, or plain ignorance can and sometimes does result in the injury or even death of a patient. Rather, these structures are in place to provide standards and safeguards that insure quality patient care. In fact, the evolving legislation regarding acupuncture in California reveals a steady progression from cautious, close scrutiny by the medical profession to its current state, which integrates acupuncture into mainstream healthcare while providing for autonomy of the government’s oversight of the acupuncture profession.

    Given how little scientific basis there was for the argument that acupuncture was effective at all, the medical community was actually quite tolerant, accommodating, and even encouraging of incorporating it into mainstream medical practice. Many members of the California Medical Association (CMA) and the American Medical Association (AMA) shared with laypeople the same curiosity and enthusiasm about the potential benefits of acupuncture to Western medicine in the early 1970s. Nevertheless, they hesitated to accept it as an effective form of therapy. Their reasons for doing so were well-founded, and their concerns over numerous issues raised by the public’s fascination with acupuncture were warranted.

    This thesis will explore the tensions between Western medicine and acupuncture in California, and how the latter came to be accepted as a form of alternative medicine and granted a great degree of professional independence and autonomy by the state. The chronology of acupuncture legislation will provide the framework for the narrative, drawing on the original legislative documents from the California State Archives in Sacramento, articles in newspapers and magazines, articles from the AMA, and the secondary literature available on the history of acupuncture and on the authority structure of established Western medicine.

    2. Acupuncture Enters the American Mainstream

    During the Cultural Revolution under Mao Tse Tung in the 1960s, diplomatic, cultural, and scientific relations between China and the United States relations were all but cut off completely. At this time, American fears of Communist hegemony overshadowed the public’s curiosity about Chinese culture. These Cold War tensions were finally eased by Ping-Pong Diplomacy in April of 1971, and Nixon’s subsequent meeting with Mao Tse Tung in late February of 1972, ultimately lifting the Bamboo Curtain (the Asian equivalent of the Iron Curtain), and opening up a flood of Chinese culture into America. Shortly after the Nixon visit in 1972, a sudden warming of relations between “red” China and the “imperialist” United States caused a surge in American public interest and fascination with many things Chinese.

    The two decades of Chinese isolation from the West only increased American curiosity about all things Asian. Acupuncture, a mysterious healing art that was that bore no relation whatsoever to Western medicine, piqued the curiosity of Americans more than most other subjects. The renewed interest Americans maintained for a seemingly exotic Chinese “other” was quite unlike what Edward Said calls Orientalism; the form of their interest was not imperialist, but anti-imperialist, taking place in a context that followed America’s own Cultural Revolution: the Civil Rights Movement. Many Americans, especially in academia, were revisiting the exoticness of the Chinese, not only with heightened curiosity, but with humility and a new appreciation and respect for non-Western cultures, political ideologies, and even medicine.

    This new China craze led to an avalanche of enquiries for travel visas from Chinese embassies in the United States. In the Bay Area, the San Francisco-based Women for International Understanding, the Asian Art Commission of San Francisco, and local 771 of the American Federation of Teachers, with the support of the California Federation of Teachers State Council in Oakland, Berkeley, and San Francisco, rushed to organize large group trips. In many universities, enrollment in Chinese language courses as much as doubled, numerous seminars and symposia on China were scheduled, and a survey of 165 universities found that the vast majority of students favored exchange programs with China. The New York Times reported, “Scientists are falling all over themselves wanting to go to China even those who know nothing about China.” One professional group particularly affected by the China craze was medical researchers.

    In 1971, the New York Times reporter James Reston’s article, “Now, About My Operation in Peking,” marked a turning point in the acceptance of Chinese medicine in America. Reston and his wife were invited to visit Beijing by the Chinese Government. On July 15, at 10:30 A.M., while speaking to foreign ministers at the Peking International Club, Reston suddenly felt a stab of pain go through his groin. Later that evening, he was bedridden with a temperature of one hundred and three degrees. The next day he was admitted to the Anti-Imperialist Hospital for examination. An hour later, consultants summoned by Premier Chou En Lai gathered around Reston to listen to a troubling irregular heartbeat pointed out by one of the doctors. After a moment’s deliberation the eleven leading medical specialists in Peking returned with their assessment: “Acute appendicitis. Should be operated on as soon as possible.” The two-and-a-half hour surgery was successfully carried out with the use of the anesthetics Xylocaine and Benzocaine. However, later that evening, as Reston lay in bed recovering, he began to experience abdominal discomfort from postoperative gas pains. Li Changyuan, a doctor of acupuncture at the Anti-Imperialist Hospital, inserted three long, thin needles into the outer part of his elbow and below his knees in order to stimulate the intestine and relieve pressure and distension of the stomach. Reston writes of the procedure,

    [it] sent ripples of pain racing through my limbs and, at least, had the effect of diverting my attention from the distress in my stomach. Meanwhile, Doctor Li lit two pieces of an herb called “ai,” which looked like the burning stump of a cheap cigar, and held them close to my abdomen while occasionally twirling the needles into action. All this took about twenty minutes, during which I remember thinking it was a rather complicated way of getting rid of gas on the stomach, but there was a noticeable relaxation of the pressure and distension within an hour and no recurrence of the problem thereafter.

    Reston goes on to assure his readers that his condition was genuine, and not some ‘journalistic trick’ to do investigative reporting of the Chinese medical system, quipping, “This is not only untrue, but greatly overrates my gifts of imagination, courage, and self-sacrifice. There are many things I will do for a good story, but getting slit open in the night or offering myself up as an experimental porcupine is not among them.”

    Although his account of Chinese medicine was met with skepticism, Reston’s personal experience as a patient of acupuncture anesthesia made him living, Western proof to physicians and the American public that acupuncture might be more than propaganda and hype. For the first time, academics and legislators were compelled to seriously consider investigating its potential as a tool in American operating rooms. Given the excitement in the media and curiosity of the public concerning acupuncture that followed, it is generally agreed that Reston’s article for the Times introduced the West to modern acupuncture. As Assemblyman Gordon Duffy, author of the first piece of acupuncture legislation, remarked the following year, “Especially since the self-recorded treatment of Mr. James Reston’s appendicitis by acupuncturists, we have been bombarded with stories about traditional Chinese medicine.” Though it is commonly believed President Nixon’s trip was responsible for introducing acupuncture to the United States in 1972, scholars such as Dr. Li Yongming, president of the Traditional Chinese Medicine Association in the United States have argued otherwise. The China Daily, China’s largest English-language newspaper, has quoted Dr. Li as saying that “acupuncture fever” really began with James Reston a year earlier in 1971.

    3. The Evolution of Acupuncture in China

    American citizens were unknowingly embracing a form of acupuncture that was not a 5,000-year old science, as many believed it to be, but a modern adaptation that was still in an experimental phase of development. Their enthusiasm was partly based on the mystique associated with all things Oriental, but was also due to most coverage in the media describing it as ancient, with the rare exception of the occasional newspaper article that drew the distinction between traditional Chinese medicine and the modern version of it that was now being practiced in China. It is important at this point to give a brief overview of the recent history of acupuncture in China.

    China’s sovereignty became severely compromised by British aggression throughout the nineteenth century. As a result, the shattered perception of cultural superiority that she had maintained for over two millennia led many Chinese, for the first time in the nation’s history, to reevaluate their traditional cultural traditions, especially in regard to science and medicine. It quickly became apparent to the Mandarins that China would have to embrace Western technologies to compete militarily and economically in the modern world. Western medicine was spread by Christian missionaries, who established 340 hospitals in China between 1828 and 1949.

    In the 1920s, following the overthrow of the Emperor, traditional Chinese medicine came under fire by the liberal intellectuals as a vestige of the backwards, failed regime and as having no real benefit compared to the medicine practiced in Europe and the United States. Western medicine was soon referred to as the “new medicine” and traditional Chinese medicine as the “old medicine.” Chen Kuo-fu, a nationalist ideologue aligned with Chiang Kai-shek, condemned the radicals’ seeming renunciation of all things Chinese in favor of all things foreign as unpatriotic. Aware that traditional Chinese medicine had many shortcomings in comparison with modern medicine, Chen advocated a vision of a scientificized version of it, blending Eastern and Western knowledge into a new and superior discipline. Chen’s vision, however, would never come to fruition, as the conservative old and leftist new schools of medicine were too politically and ideologically polarized to reconcile their differences.

    Acupuncture and herbal medicine began to be favored once more with the rise of the People’s Republic of China (PRC) in 1949. While making use of the national resources in the numerous traditionally trained doctors was in line with Mao Tse Tung’s philosophy of self reliance and served to bolster national pride, it was also a necessary measure to address the problem of drastic shortages in Western medicine and trained physicians. Unlike earlier versions, acupuncture in the PRC was stripped of any religious or folkloric overtones, and revisited as something to be applied in the field of paramedicine, and as a subject worthy of research within China.

    By 1963, the PRC had an estimated one trained physician for every ten thousand people (compared to one per nine hundred people in the United States). This considerable gap was addressed by implementing a program of paramedicine, in which traditional healers would provide basic care to their local communities after receiving an elementary education in the fundamentals of first aid. Western-trained physicians were encouraged to “broaden their knowledge” in traditional healing and to create a new scientificized Chinese medicine, ironically echoing Chen Kuo-fu’s proposal decades earlier. By 1966, China boasted twenty institutions of traditional Chinese medicine with an enrollment of over ten thousand students, and an estimated sixty thousand apprentices training under practicing doctors. Apart from the immediate need to address the health care crisis in the countryside, experiments were being done with traditional Chinese medicine, especially acupuncture hypalgesia.

    “Acupuncture hypalgesia,” the proper medical term for pain management by acupuncture, was discussed in the findings of a study group sponsored by the Committee on Scholarly Communication with the People’s Republic of China of the American Council of Learned Societies, the National Academy of Sciences, and the Social Science Research Council, who made a three-week visit to the People’s Republic of China in May of 1974 to witness forty-eight operations involving acupuncture-based pain management in sixteen hospitals. The group concluded “it must be clearly understood that acupuncture does not produce conventional surgical anesthesia. In no instance is sensation totally abolished or consciousness disturbed; thus ‘acupuncture anesthesia’ is a misnomer. There is considerable evidence, however, that acupuncture does affect the pain experience, although our observations suggest complete analgesia may not occur. Therefore the term ‘acupuncture analgesia’ is similarly inappropriate. In view of these limitations, it seems more reasonable to refer to the phenomenon as ‘acupuncture hypalgesia’.” Hypalgesia refers to diminishment of sensitivity to pain, rather than pain itself.

    It is in the context of pain management that acupuncture came to be introduced to mainstream medicine in the United States. In the 1970s, acupuncture was still very new as a mechanism of hypalgesia even in China, with its earliest successful use in this capacity dating back only to 1958 in a tooth extraction in Chansi Province. The first assertions that acupuncture was a science still in its experimental stages were not made by elite members of the American medical profession in the United States in some sort of effort to wrest medical authority from Chinese-Americans who had been practicing acupuncture in insular Chinatown communities, but by Chinese physicians such as Dr. Wei-Jan Wu, the deputy chief of surgery at Capital Hospital of the Chinese Academy of Sciences in Beijing and leader of a Chinese medical delegation to the United States. In November of 1972, Wu told a press conference in San Francisco that acupuncture was still fraught with numerous unanswered questions that had to be addressed, that acupuncture could not replace other methods of hypalgesia, and was not indicated for every patient or every operation in China. “On the other hand,” Wu added, “we couldn’t say it is useless. We can say it is a new kind of anesthesia that can be added to conventional methods with promising prospects.” Wu’s clarification, that acupuncture as an hypalgesic was still experimental, was echoed in reports from American and Canadian delegations returning from China, who had been similarly informed by Chinese physicians during their visits.
    Dr. Samuel Rosen, an otologist at Mt. Sinai Hospital in New York, was one of the first American physicians permitted into China to witness major operations performed using acupuncture hypalgesia. In September of 1971, Rosen, accompanied by cardiologists Paul Dudley White of the University of Boston and E. Grey Dimond of the University of Kansas School of Medicine, were present at fifteen such operations at the Kwangtung Provincial People’s Hospital in Canton and later at the Third Teaching Hospital of the Peking Medical College. They witnessed brain operations, thyroid adenomas, gastrectomies, laryngectomies, and tonsillectomies being performed with acupuncture hypalgesia. The most striking case, for Rosen, was that of a victim of pulmonary tuberculosis. The operating room was much like one would find in any Western hospital and procedures for asepsis and preparation of the patient were consistent with those of Europe and the United States. The only difference, Rosen reported, was the presence of an acupuncturist who placed one needle in the patient’s forearm midway between the elbow and the wrist before surgery. After twirling the needles for twenty minutes to induce the desired effect, the surgeon began to cut into an awake and alert patient. The first incision was made from near the spine across the left side of the chest wall to the sternum. Then, with the use of surgical scissors, each rib was snipped away. Finally, with the use of a thoracic retractor, the chest cavity was exposed, revealing the patients beating heart and the patient’s collapsed lung. All the while the patient sipped tea and conversed with the surgeon, apparently in no pain whatsoever. This was only one of many impressive examples of acupuncture hypalgesia witnessed by Rosen. Others included teeth extractions that appeared to cause no pain to the patient.
    Thomas C. Elmendorf, President-elect of the California Medical Association, experimented with acupuncture treatment at the hands of Drs. B. C. Pien, of San Francisco, and Leung Kok-Yuen, a pain specialist and head of the North American College of Acupuncture in Vancouver, at a meeting of the San Francisco Medical Society on May 9, 1972. He had hoped to find relief from severe arthritis pain in his hip, from which he had suffered for over four years. As soon as the treatment was finished, Elmendorf rose to his feet and declared “there’s no question there is considerable relief of pain in my hip – the pain that I had when I came in is essentially and literally gone.” The treatment was repeated a month later by the same doctors at the California State Capitol building in front of an audience of curious legislators. When all was said and done, Elmendorf popped off the improvised operating table, saying to the onlookers, “it hurts, but it feels good.” Later, Elmendorf was flooded with inquiries about acupuncture and where to find similar treatment for pain relief. Regretting what he later considered a bit of a misleading overstatement, Elmendorf addressed the public with this generic letter:

    …The problem is simply this: acupuncture itself is a procedure in which the skin is penetrated, and as such must qualify as a medical, or perhaps, even surgical procedure. The Chinese physicians do not have licenses to practice medicine in the state of California or for that matter, anywhere in the United States or North America. Therefore, they are not licensed to practice acupuncture here, although acupuncture is not in itself illegal. A physician who had a license to practice medicine and surgery in the state of California, or in any of the states, who learned the procedure of acupuncture and wished to use it in his practice, could legally do so as long as he observed the ordinary prudence required of all medical practice.
    I personally believe that acupuncture has some potential as a technique to relieve pain or even, perhaps, to induce anesthesia for surgical procedures. The truth of the matter is that Western medicine knows very little about acupuncture, and I believe that we should attempt to learn about it. Accordingly, university centers are being encouraged to attempt a scientific evaluation of acupuncture treatment. It may even be possible that enabling legislation will be required; however, we are exploring the situation in depth, and no doubt you will be reading about it in the not too distant future.
    I want to make it perfectly clear, that I do not endorse acupuncture at this time. I am sorry that some of the newspaper articles gave this impression. It is only fair to report to you that a Chinese nurse, also part of the demonstration and who was reported to have multiple disc disease with two surgeries, tells me that she has had complete relief of her pain for a period of four weeks.
    I am immensely pleased that the medical profession here in California has such an open-minded attitude regarding this technique, about which we know very little; nor do we understand the traditional methods of Chinese medical practice.
    I should mention that there are no physicians’ names that I can give to you in the United States who practice acupuncture, although I have heard rumors that there are such physicians in Los Angeles, New York and Philadelphia. I want to emphasize that this is rumor only.
    My heart goes out to you, because I cannot do more for you; but if there is any value to the acupuncture treatment, we intend to find out.

    4. Approving Acupuncture Research in California

    On August 14, 1972, the state legislature passed Assembly Bill 1500 in a 57-0 vote in the assembly and a 35-0 vote in the Senate. It authorized unlicensed practitioners to practice acupuncture under the direct supervision of a licensed physician in an approved medical school in California for the sole purpose of scientific investigation and research. The bill also required medical schools that conducted research on acupuncture to report their research findings to the legislature annually. Finally, it extended the same authority to supervise such experimentation to surgeons and dentists.
    There were several reasons why early research focused chiefly on acupuncture’s effectiveness in the area of pain management. The main reason for this is the way it was first introduced by the media as a miraculous anesthetic that bypassed all methods used by Western medicine. The main demonstrations of acupuncture to Western doctors were in this context. To test the effectiveness of acupuncture as a hypalgesic was to test its veracity, and it goes without saying that many western doctors were skeptical specifically about its application in this regard. Pain was a simple, easy, and timely criterion to test for.
    The prospect of replacing opiates with acupuncture was also appealing to doctors concerned about a host of problems associated with conventional forms of pain management, such as addiction, legal issues with schedule II (highly restricted) drugs, and complications in young, old, allergic or otherwise contraindicated patients. To many medical professionals and politicians during the 1970s, a non-narcotic alternative to pain management drugs could not have come at a better time. On the fourth of July, 1969, President Nixon declared a “war on drugs.” That year, 5.14 percent of college students reported having tried heroin, up from 3.2 percent the previous year. The problem was recognized as not only being limited to countercultural youths; American Vietnam veterans were returning from the Golden Triangle addicted to heroin. As the Yale historian of medicine David F. Musto points out in his book Quest for Drug Control: Politics and Federal Policy in a Period of Increasing Substance Abuse, 1963-1981, the problem of heroin abuse continued to increase into the 1970s.
    Lastly, physicians in the United States and China began to propose explanations for why acupuncture was working that had a scientific basis and could be understood and debated in terms of Western medical theory. Up until that point, western medicine could do nothing but dismiss the theory of qi flowing along meridians as little more than fantasy; modern, scientifically-based acupuncture was an animal with which Western medicine could finally grapple.
    Such an explanation was first given in 1972 to an audience at Caltech by George Wald, a Harvard biology professor and Nobel Laureate, who had recently visited research laboratories in China. Speaking only of modern uses of acupuncture in pain management, and not of traditional Chinese acupuncture for the treatment of disease, which he dismissed as “probably (having) no scientific grounds,” Wald assured the audience that modern acupuncture was “absolutely real” and not the result of hypnotism or suggestion. The research Wald had witnessed on his trip at the Physiological Institute of the Academy of Sciences in Shanghai was based on the recent gate-control theory of pain advanced by the American physician Robert Melzack and the British physician Patrick D. Wall in 1962.
    The gate-control theory challenged a more widely accepted and simpler theory of pain known as the specificity theory, which suggests signals are transmitted along nerves from a site of injury from receptors to the brain, where they are finally processed as pain. Gate-control theory, on the other hand, suggests that pain is less straightforward. According to gate-control theory, a gate-like mechanism exists in the pain-signaling system, which may be opened, partly opened, or completely closed. In the last two cases, pain is either reduced or non-existent. In 1973, Melzack hypothesized that acupuncture might close the gate by stimulating large nerve fibers, which in turn override activity in the small nerve fibers responsible for carrying pain signals to the brain.
    A debate began in 1972 in the letters to the editor section of the Journal of the American Medical Association about the best way to test the effectiveness of acupuncture in pain management. Bernard C. Adler first wrote to the editor proposing a double-blind study be carried out in which acupuncturists treat one group of patients with the proper set of acupuncture points and a control group using points slightly removed from the proper ones. Lester C. Mark responded that Mark’s suggestion of deceiving the patient by using false points would be inappropriate, as the patient is an active participant in the acupuncturist’s attempt to illicit paresthesis by reporting to the doctor if manually twirling the needles on the points is producing thé chi, a feeling of soreness or distention that indicates acupuncture hypalgesia is beginning to take effect. Doctors Chein and Shapiro responded saying that while manual stimulation might not produce the desired effect by manually twirling the needles at the wrong points, electrostimululation of acupuncture points would mimic the same soreness regardless of which points were chosen, adding that known points along meridians could be selected, making a double-blind test for placebo feasible. Mark responded, insisting once again that before any stimulation of the acupuncture points took place, whether manual or electrical, the needles would have to be correctly placed, and that this could not be counterfeited. Finally, Chein and Shapiro responded to Mark’s letter, saying that the only proposed studies up until that point were single-blind, as only the patient, and never the acupuncturist, was being deceived. They proposed a simple solution to the problem:

    …Make the study double-blind by briefly training and hiring naïve technicians, instructed by an acupuncturist without direct contact to the patients. If sufficient numbers of patients are randomly assigned to the specific and non-specific treatments, anomalies, such as grossly abnormal nerve distribution, and other individual differences, would be distributed between the two groups. Since only naïve subjects and acupuncture technicians would interact, the placebo effect of the treatment would affect both groups equally. If the treatment at the presumed acupuncture point resulted in significantly more improvement than at the control or nonspecific acupuncture point, the conclusion would be that acupuncture is better than placebo in the condition under study.
    Such a double-blind study was carried out as early as July of 1972 as part of the UCLA School of Medicine’s research project on the efficacy of treating rheumatoid arthritis patients with acupuncture. Candidacy for participating in the study was determined by whether or not sufferers of arthritis pain were not responding well to the latest treatments available to western medicine. Of the two dozen patients observed over the course of ten weeks, half were treated by inserting needles into prescribed acupuncture points that fell along meridians, while the other half were treated using randomly selected points.

    5. Medical Issues in the Regulation of Acupuncture

    Starting in the 1960s, radical social movements, beginning with the counterculture, then the antiwar movement, and then the women’s liberation movement, emerged on a vast scale in the United States and Europe. Everything that was part of the existing order was questioned and criticized. Medicine, like many other institutions, suffered a stunning loss of confidence in the 1970s. Fantastic accounts coming back from early visits to China by American doctors in 1971 and 1972 set imaginations ablaze and caused physicians as well as laypersons to entertain high hopes that where Western medicine had disappointed traditional Chinese Medicine might succeed.
    Western medicine faced a unique challenge in the arena of popular opinion. Only a year after Reston’s article sparked widespread interest in acupuncture, contemporary authors such as Marc Duke were already criticizing the reception of acupuncture by the Medical profession in 1972. Responding to his question about who might practice acupuncture in the United States, Duke quotes the AMA’s science news editor, Frank Chappell, as saying “it would be the practice of medicine, so it would have to be licensed. That is, it would have to be done by licensed physicians.” Duke then goes on to conjecture:

    Most physicians are dedicated, hard-working men who earn their pay – and more. If acupuncture were to become common in the United States, doctors’ incomes would fall. Surgeons and anesthesiologists would be the hardest hit if acupuncture replaced general anesthesia, as it might. The huge amount of drugs American doctors prescribe would also fall. Fewer prescriptions would mean less money for drug manufacturers, another powerful lobby in Washington. Drug companies contribute huge sums of money to medical research. They are unlikely to support research into a medical system that is not founded on the use of drugs.
    Such scathing remarks about Western doctors’ sentiments about acupuncture were not uncommon in an era when mistrust of government and corporate enterprise was rife. Western medicine was distrusted as part of the ancient régime. However, the comments by Thomas N. Elmendorf, M.D., the President-elect of the California Medical Association, reveal that Chappell’s answer to Duke’s query, if taken as a single-sentence sound bite, is apt to mislead the reader.
    It should come as a surprise to no one that in this initial period of regulation, concerned legislators and medical professionals called for a period of restriction and research to safeguard an eager public from engaging in a practice that posed considerable risks in the wrong hands. The California Medical Association and the California Department of Consumer Affairs responded to a seemingly unbridled acupuncture craze with demands that the state legislature pass some sort of regulation on a form of medical service which, up to that point in time, had none.
    There is a considerable risk of structural damage due to insertion of acupuncture needles, the most common of which is pneumothorax (collapsed lung) . In 1973 and 1974, six cases of pneumothorax as a result of acupuncture were reported in the Journal of the American Medical Association and the New England Journal of Medicine alone. One of the cases involved a patient seeking acupuncture as a treatment for atypical migraine in August of 1973. When she sought medical attention two days later for pain in her left shoulder blade and increasing shortness of breath, doctors discovered that 35% of her left lung had collapsed, requiring re-expansion with a chest tube. When the California State Assembly was deliberating over legislation to follow AB 1500, the CMA voiced concern about such complications, presenting the legislature with an article from the Journal of the American Medical Association entitled “Complications of Acupuncture,” which dealt chiefly with the problem of pneumothorax.
    Other complications leading to structural damage were known to have occurred with acupuncture, including but not limited to cardiac tamponade (an emergency condition in which fluid builds up in the sac containing the heart) caused by too deep of a penetration to an acupuncture point located below the fifth rib, spinal cord damage associated with the ya-men acupuncture point, penetration of the eye as a result of misdirection of needles inserted subpraorbitally or infraoribitally, and damage to the external middle ear.
    Elmendorf’s letter gives us another very critical reason why acupuncture, unlike other traditional Chinese therapies such as herbal treatments, came under such close scrutiny: it is an invasive procedure, that is, a procedure that enters the body, by cutting or puncturing the skin or by inserting instruments into the body. Medical expertise is necessary in such an instance because the skin is the body’s first line of defense against bacterial or viral infection. Whereas HIV infection would probably constitute the chief threat to public health from contaminated needles nowadays, in the 1970s the AMA and CMA were concerned about the spread of hepatitis. Outbreaks linked to poorly sanitized, reused needles were known to have occurred in rural parts of China and while such cases were few and far between in the United States, the concern was not unwarranted. In 1984, a rash of hepatitis B infections struck thirty-five patients at an acupuncture clinic in Rhode Island.
    The arrival of acupuncture in the United States did not signal the first time medicine had to put its foot down and declare a procedure invasive. The admittedly more extreme case of the lobotomist Walter Freeman sheds light on how the grey area between what is and what is not an invasive procedure can be stretched. Although Freeman was more familiar with neuroanatomy than the average psychiatrist, he was not formally trained as a neurosurgeon and therefore lacked the necessary qualifications to participate in brain surgeries as anything more than a surgeon’s assistant. Rather than put his career on hold to receive surgical training, he devised a new procedure that could be performed in a matter of minutes by anyone with an ice pick. This procedure called for entering the brain through the tear ducts, which are naturally sterile, leading him to reason that, apart from sterilizing the instrument used to perform the lobotomy, there was no need for asepsis.
    Knowing he could not perform the new lobotomy in an institutional setting, Freeman began offering his transorbital lobotomy to patients in his private office. Freeman’s critics were often very vocal about how inappropriate they found it for psychiatrists to carry out the work of surgeons. One such critic, David Cleveland, remarked, “the surgeon will shudder, and rightly so, at the thought of cerebral surgery becoming an office procedure in the hands of the usually, very unsurgical psychiatrist.”
    Freeman took an adversarial position, asserting that “neurosurgeons were simply trying to stake out the brain as their exclusive property.” In order to reclaim what he perceived as the surgeons’ monopoly on the right to lobotomize, he went to great lengths to proselytize that his new method was so easy, simple, and efficient that anyone from any discipline, not just surgeons, could do it.
    It could be argued that Freeman’s lobotomies, although extremely invasive, in fact do not require formal training in surgery to be safe and effective. Acupuncture, too, can indeed be practiced safely and effectively without all of the training of a professional surgeon. Although acupuncture is not lobotomy, is far less invasive, and poses far fewer risks, it technically remains an invasive procedure and complications involving the practice can and have occurred.
    The concern about acupuncture being an invasive procedure was not limited to licensed or unlicensed practitioners. The L.A. Times reported that along with the lifting of the Bamboo Curtain, coolie hats, Mao jackets and acupuncture kits were flying off of store shelves. At a hearing on acupuncture in the California State Assembly, legislators expressed concern that laypeople might pick up a book and attempt to practice on themselves. Bob Felt, in an interview with Boston University medical anthropologist Linda L. Barnes, a leading authority on the history of acupuncture in the United States, remarked of informally practicing acupuncture in the 1970s, “we were middle class kids, a lot of us. It was illegal as a practice, and we never thought we would make a living at it. I practiced out of a back room of the bookstore. It was something of an outlaw role. Having gone through our early adult years as outlaws with a feeling of rejection and of not belonging, we probably outlawed it more than it needed to be. But without outlaws, nothing new comes into the culture.” Felt provides an example of the young and naive who dabbled in acupuncture like outlaws in the romantic tradition of Robin Hood. As has been discussed, acupuncture is not a quaint curiosity of the Orient, but a real medical practice with real medical complications. While Felt and others like him might have been well-meaning, acupuncture has no more business being practiced in the back room of a bookstore by amateurs than does a coat hanger abortion.
    The public’s disenchantment with Western medicine also made it prey to rampant charlatanism in acupuncture. The flurry of interest in traditional Chinese medicine occasionally led unwitting patients into the offices of opportunists eager to charge an arm and a leg for their seemingly exotic and cutting edge services. From a public health standpoint, what was especially alarming was that many of these “clinics” or “institutes” that seemed to crop up overnight operated more like ‘mills’, processing hundreds of patients daily. These so-called “quackupuncturists” often promised relief from minor afflictions that tend to cure themselves in time, such as headaches, to more permanent problems, such as baldness. One remarkable example of such deception is that of acupuncture ‘institutes’, and ‘centers’ claiming to cure nerve deafness within a few treatments – an experimental procedure that hadn’t shown any clinical success in China.

    6. Health Care Delivery Issues in Acupuncture Regulation

    AB 1500 was only ten weeks old when the Assembly Committee on Health Manpower held a hearing on acupuncture. The goals of the hearing were to balance their stated desire to help ensure that it became available to the general public to the extent proven therapeutically valuable with the need for protection of public welfare; to protect the public’s right to receive acupuncture on the one hand with the need to protect the public from those who were inadequately trained to administer acupuncture on the other. Dr. Elmendorf was present to represent the California Medical Association’s position:

    …I am here to support the second objective of your committee which is really twofold, and that is to protect the public interest, number one, in the sense that if this is of value, let’s find out what that value is, so that the public may receive it, and secondly, that we see to it that they receive it in the proper way, and that they are protected from the development of cult for the exploitation of the public by those who would do so for monetary reasons or whatever.
    When asked if the legislature should approach the problem of acupuncture by declaring it a medicine that only physicians could practice, Elmendorf responded:

    Well, I would have to struggle with that, as I am sure you are. I would say this, that it would seem that the penetration of the skin with needles does constitute the practice of medicine, although we know of instances where this is done by other than physicians for purposes of diagnosis. We know that earlobes are punctured, for example, by jewelers for ear rings …the procedure of penetrating the skin with needles does carry the risk of infection, it carries risk of penetrating some vital structures, perhaps, and, as you pointed out earlier, it particularly carries the risk of diagnosis and treatment. As you know, we don’t advocate giving morphine for a stomach pain before we know what is causing the pain. One could see the use of acupuncture to relieve a symptom prior to the time an adequate diagnosis was made. So I do believe that the position of the California Medical Association is that this procedure should be in reliable hands. We need to have, in some way, we need to encourage, stimulate, if you would, the medical centers to give a scientific evaluation of this. This is what I think is in legislation now, if it permissive. I would rather not see it mandatory, but if there were some way that we could move this before it gets out of hand, as I think is one of your fears, I would be very much for that, and I am sure the Medical Association would be, too.
    In response to questions from Assemblyman William Campbell about how he came to be temporarily relieved of arthritis pains and how acupuncture works, Elmendorf replied:

    Whether it is hypnotic or not, which the Chinese vehemently deny, and there seems to be substantial evidence against that theory, as well as some evidence for it, or whether it is a type of somatic phenomenon, I really don’t care, as long as an individual has had adequate diagnosis and is not having a delay in needed treatment, I don’t care how his pain is relieved. There are many people that I have found, from letters all over this country, who are in chronic pain and would like to obtain some way to obtain relief. They will grasp at straws. It is, of course, the fear of this committee, and my fear that they may go too far in this thing. Lets [sic.] try to find out what its value is and how it does work.
    A major issue that also came up at the hearing was the impact of AB 1500 on practicing acupuncturists. Dr. William Prensky, Chairman of the Board of the Institute of Taoist Studies, a non-profit organization in California, observed, “we have a major concern that acupuncture, practiced by competent practitioners, not be forced underground in the state of California, and therefore that all practitioners, both competent and incompetent, be forced into the same type of clandestine practice, so that it will forever be impossible to separate those proper practitioners from the improper practitioners.”
    Indeed, for the vast majority of Chinese practitioners of acupuncture, AB 1500 effectively stripped them of any autonomy as caregivers to their communities. Whereas they were once largely ignored by the rest of the public as they practiced in the nooks and crannies of their respective Chinatowns across the state, they were now met with interested outsiders seeking relief they could not find elsewhere. Arrests under the new law followed quickly, as the California Department of Consumer Affairs and the Board of Medical Examiners cracked down to emphasize the point that acupuncture was now subject to medical regulation home.
    The first such arrest occurred in December of 1972, when a client of George Long, a martial arts instructor and the owner of the George Long School of Kung Fu at 1865 Post Street, San Francisco, notified the Department of Consumer Affairs that Long was offering acupuncture treatment without the proper credentials, and that he had been doing so for quite some time. Long was released on five hundred dollars bail, potentially facing a six hundred dollar fine and up to six months in jail on charges of practicing acupuncture without a medical license.
    The most well known of the early arrests of acupuncturists is that of Miriam Lee. On April 16th, 1974, as stunned patients looked on in disbelief, Lee was arrested by agents of the Department of Consumer Affairs on charges of practicing medicine in California without a license in her Palo Alto office at 555 Middlefield Road. She was later freed on five hundred dollars bail and faced an additional five hundred dollar fine and six months in jail if convicted. When Lee appeared at her hearing, over a hundred of her patients showed up as well. News of the widespread support she received drew attention from the legislature, convincing many that the subject of acupuncture was an urgent social and cultural issue as well as a medical one.
    Apart from the immediate need to protect the general public from the potential side effects of acupuncture, there was also a need to integrate Chinese medicine into the existing public health model. Members of the acupuncture research project at UCLA maintained in a written statement to the California State Legislature that lifting the restrictions on acupuncture would be premature, as certain measures would have to be taken to ensure that legalization would result in the formation of a safe and ultimately legitimate profession. Their intentions were not to stifle or control acupuncture, but to facilitate a process that would guarantee acupuncturists as much independence and autonomy from the established medical community as possible. They argued, “licensed acupuncturists should operate their own offices, carry their own malpractice insurance, etc., thus allowing them a certain degree of autonomy from other medical practitioners.”
    The UCLA research team’s statement summarized the conflict between medical authorities and proponents of acupuncture: the first group believed regulating acupuncture was necessary to prevent exploitation and to minimize harm to the public, while the second group believed physicians were too ignorant about acupuncture and too financially vested in maintaining a status quo to regulate it. These two perspectives, they believed, could be reconciled by legislation that provided licensing of all practitioners, qualifications for licensure, standards of practice, establishment of an Acupuncture Advisory Board, and funds for research. The requirements they believed were necessary for licensure included fluent knowledge of the English language, basic knowledge of anatomy and physiology, basic knowledge of western medicine, basic knowledge of aseptic procedure, and basic knowledge of acupuncture.
    The reason they considered a knowledge of anatomy, asepsis, and Western medicine, in general, to be necessary for acupuncturists’ training was solely to prevent complications. In the case of asepsis, for instance, many practitioners of Oriental medicine did not believe in germ theory. In order to prevent the spread of diseases such as hepatitis, the UCLA researchers insisted germ theory should, at least, be respected as plausible until proven otherwise (the document is reproduced in full in the appendix). The incidences of punctured lung, although few and far between, were well known to Western doctors, and this was the chief reason for urging that a basic understanding of anatomical structures be made compulsory in training and certification. That acupuncturists should have a basic understanding of Western medicine may seem ethnocentric, but the researchers argued there were simply too many factors in patient safety, when it came to acupuncture, that Oriental medicine could not account for, such as the ramifications of sticking needles into someone who is taking anticoagulants, or is hemophilic, or the complications that can result from performing electroacupuncture on a patient who has a pacemaker.
    Some of these requirements, such as fluent knowledge of the English language, may strike some as excessive or culturally biased. Foreseeing this, the UCLA team argued that it was only fair that patients be able to obtain clear answers from their caregiver, and caregivers must be able to understand the complaints of patients, adding that foreign trained physical therapists, nurses, psychologists, and other caregivers were required to pass examinations by the Medical Board in English, and that acupuncturists should share the same responsibility as there fellow caregivers.
    In 1975, legislators deliberated over a new bill that was to have profound impact on acupuncturists. Senate Bill 86 was to move acupuncture from being an experimental procedure performed behind the walls of universities back to private practices. It called for the creation of a governor-appointed, seven-member Acupuncture Advisory Committee, consisting of five non-physicians with at least ten years’ experience in acupuncture and two physicians with at least two years’ experience in acupuncture to assist the California Board of Medical Examiners. It also provided, for the first time, a state certification program for acupuncturists by the Board and the automatic certification of acupuncturists upon proving they were in practice for five years or for three years on condition they participate in a designated acupuncture program. Furthermore, the bill permitted certified acupuncturists to practice on patients with a referral or diagnosis from a physician, surgeon, dentist, podiatrist, or chiropractor, and for the acupuncturist to report back to the referring doctor the nature and effects of the treatment upon its completion. Finally, it called for the dismissal of all pending cases of practicing medicine without a license for all those who met the criteria to qualify as acupuncturists under the new guidelines, and for all convictions of acupuncturists for practicing without a license pending on appeal to be remanded to trial court for the verdicts to be appealed and judgments of acquittal entered.

    7. Criticism of Acupuncture by Western Doctors

    Some medical anthropologists, including Paul Root Wolpe and Linda L. Barnes, have argued that the call for regulation of acupuncture by medical doctors was an attempt to assert their authority over and defend the dominant paradigm of western medicine against the threat of traditional Chinese medicine. Barnes argues that the medical profession’s adversarial reaction to the public’s sudden interest in acupuncture was twofold: first they asserted control over acupuncture through the demand for research and clinical trials; secondly, they regulated practitioners in what amounted to another form of social control. Of the emphasis on pain management in acupuncture research and the neglect to study other areas in which acupuncture might prove an effective form of treatment, Wolpe additionally argues:

    …the entire theoretical framework of traditional Chinese acupuncture had to be replaced … Biomedicine had no means of assessing the validity of these cultural models. Traditional acupuncture theory and treatment philosophy was therefore all but discarded, and acupuncture analgesia/anesthesia—a very small part of traditional acupuncture’s therapeutic claims (acupuncture anesthesia was not used in China until the 1960s)—was presented as acupuncture’s only true potential contribution to Western medicine.
    Barnes echoes Wolpe’s suspicion of biomedical “authorities” in her article “The Acupuncture Wars: The Professionalizing of Acupuncture in the United States”:

    To control the actual practice of acupuncture, U.S. physicians argued that it should be categorized as an experimental procedure and that it should only be performed in a research setting either by a doctor or under a doctor’s supervision … by appearing to support research, and by creating structured channels through which to engage with this foreign modality, biomedical authorities could claim that the playing field was not only level but also open to new approaches.
    Her assessment of the medical profession is unflattering. As we have seen and as Barnes also concedes, between acupuncture and Western medicine, the latter modality was the one that was at a disadvantage, as it was met with challenges posed by the former’s having taken on a special meaning to early lay practitioners, patients, and the American public “as part of a broader cultural stance of resistance in the pursuit of alternative ideals.” As recently as 1999, Wolpe continued to argue that “Modern American biomedicine has been singularly successful in excluding competitors from challenging its legitimacy.”
    The case that the medical profession has sought to undermine the profession of acupuncture does not survive scrutiny. As has been described, medical professionals such as Dr. Thomas Elmendorf and the UCLA acupuncture research team demonstrated a sincere willingness to explore the potential of acupuncture and to even see it integrated into mainstream medicine. By 1997, this integration was realized so completely that the National Institute of Health held a two and a half day seminar on acupuncture for the continuing education of physicians.
    Not only is this evidenced by historical documents, but by the timeline of acupuncture legislation, which illustrates a trend towards autonomy. The passage of Senate Bill 86 (Moscone-Song), passed in 1975, legally moved acupuncture from an experimental procedure performed behind the walls of California’s universities back to the private offices of community doctors. SB 86 was a major victory for acupuncturists on several counts. By creating an advisory committee answerable to the Board of Medical Examiners and a state certification program, it paved the way for recognizing acupuncture as a legitimate therapeutic profession.
    The victory for acupuncturists was bittersweet. To the chagrin of many acupuncturists, the required diagnosis and referral by a Western doctor was difficult for patients to obtain, as few medical doctors were willing to refer patients to acupuncturists for fear of compromising their credibility among their peers, many of whom believed that further experimentation was necessary to determine acupuncture’s effectiveness. The requirement of a Western diagnosis was also seen as counterproductive to acupuncturists, whose methods of diagnosis were radically different.
    Legislation that followed between 1978 and 1998, however, reversed many of the initial restrictions placed on acupuncturist, including the requirement of a Western diagnosis and doctor’s referral. The legislation’s trajectory reveals a progression from initial easing up of restrictions, to professionalization via certification, to self-regulation; a path towards recognition and autonomy.
    S.B. 1106, passed in 1978, had several effects. It added four public members to the acupuncture board, each of whom would serve a three-year term, authorized the board of Medical Quality Assurance to approve apprenticeship programs for acupuncturists as specified, established standards for continuing education for acupuncturists, required anyone who failed to renew a certificate within five years of its expiration date to demonstrate skills in acupuncture in addition to any required examinations, and called for the retaining of ten percent of the application fee for an acupuncturist’s certificate if the application were to be denied or withdrawn. It deleted the “grandfather” provision, which allowed a certificate to be issued to anyone who had performed acupuncture for five years. Finally, it required acupuncturists to post their certificates in each location of practice and specified the fee for a duplicate certificate.
    A.B. 1391, which passed 74-25 in the legislature in 1979, repealed that part of SB86 that required a prior diagnosis or referral from a physician, surgeon, chiropractor, dentist, or podiatrist and the requirement that acupuncturists report back to the referring doctor.
    In 1980, A.B. 3040 replaced the Acupuncture Advisory Committee with an Acupuncture Examining Committee, and expanded the scope of practice to include electroacupuncture, herbal remedies and dietary supplements, Oriental massage, and other traditional Chinese therapies. It also articulated a necessity that individuals practicing acupuncture be subject to regulation and control as primary care physicians.
    Finally, in 1998, S.B. 1980 and S.B. 1981 removed the Acupuncture Committee from Medical Board jurisdiction, renaming it the California Acupuncture Board.

    8. Conclusion

    The published analyses of the American medical profession’s negotiation of the sudden introduction and popularity of acupuncture in the early 1970s do not do justice to what was actually a very and progressive response on its part. Authors like Wolpe and Barnes tend to downplay the open-mindedness with which Western physicians met acupuncture in the 1970s, by reifying the medical community and portraying it as an ignorant, hostile, and monolithic entity bereft of any diversity of opinion. Paul Starr has argued, on the contrary, that the uniformity and cohesiveness of the medical profession broke down in the 1970s, as the influx of foreign doctors transformed it into the most ethnically diverse of the upper-income occupations.
    It should not be assumed that this critical evaluation of these authors’ perception of Western medicine’s reaction to acupuncture in the 1970s is only maintained by those partial to the former or suspicious of the latter. In his acupuncture textbook, Understanding Acupuncture, Dr. Stephen Birch echoed similar sentiments:

    [Wolpe] proposes that by placing acupuncture in the ‘holding cell’ of experimental status, that threat [to western medicine] was eliminated. For those who participated in acupuncture licensure efforts, it is clear that both physician opposition and internal conflict among acupuncture’s philosophical and ethnic divisions retarded those efforts. However, the extent of any physician-funded opposition is unclear. And, regarding what future in-depth research will reveal regarding the political role of physicians, the contribution if individual physicians should not go unmentioned.
    The medical profession did indeed encourage legislative restriction on the promising, exciting, and exotic therapy that the public found to be acupuncture in the early 1970s. As we have seen, their reasons for doing so were chiefly out of concern for public welfare. After a period of investigation by open-minded Western doctors and legislators, however, acupuncture was put on a track which led to it becoming fully integrated into mainstream medical practice.

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    Appendix

    The Practice of Acupuncture: A Legislative Position Paper
    Available on microfilm at the California State Archives, file 1, reel 4, item 26

    A. The Problem

    Although acupuncture is probably the world’s oldest known system of medicine, its introduction into the American healthcare delivery system has been highly controversial. Legislation enacted by different state legislatures has varied from total legalization (Nevada) to specific restrictions even upon licensed physicians (New York). Basically, two opposing (but not necessarily conflicting) points of view have emerged: “medical authorities” argue that some kind of regulatory controls must be exercised over non-physician practitioners to prevent exploitation and/or danger to the public, and they cite published reports of infection, nerve damage, cardiac arrest, pnrumothorax, etc. following acupuncture treatment. On the other hand, non-physician acupuncturists (and their supporters) argue that they should not be regulated by physicians who know almost nothing about it and who have a vested financial interest in maintaining a status quo which allows them to practice legally.

    B. The Solution

    We believe that these two positions can be reconciled by the enactment of legislation that provides for the following:

    (1) Licensure of all practitioners.
    (2) Qualifications for licensure.
    (3) Standards of practice.
    (4) Establishment of an Acupuncture Advisory Board.
    (5) Funds for research.

    C. Licensure of all Practitioners

    Although in some states, non-physician acupuncturists are permitted to practice by referral or under the supervision of licensed physicians, the great majority of physicians are untrained in acupuncture and therefore are unable to evaluate the training, experience, and competence of acupuncturists, nor the appropriateness of any technique which they wish to deploy. Therefore, we feel strongly that all practitioners of acupuncture (including physicians and dentists) should be specifically licensed and regulated by the Board of Medical Examiners, if they are able to meet the minimal qualifications listed above. Acupuncture licenses should be subject to periodic review so that appropriate sanctions can be taken against incompetent or unethical practitioners. Licensure will insure at least minimal training and competence, and will permit acquisition of appropriate malpractice insurance and professional certification of non-physician acupuncturists. Like osteopaths, chiropractors, nurse practitioners, registered physical therapists, and other medical paraprofessionals, licensed acupuncturists should operate their own offices, carry their own malpractice insurance, etc., thus allowing them a certain degree of autonomy from other medical practitioners. The penalty for practicing acupuncture without a valid license should be a misdemeanor offense.

    D. Qualification for Licensure

    In order to qualify for licensure, all applicants should be required to pass written and practical examinations demonstrating knowledge in the following areas:

    (1) Fluent knowledge of the English language. In order to communicate effectively with western patients and referring physicians, fluency in English is essential. It is highly unethical to place patients in a situation in which they cannot communicate easily with the therapist, not obtain clear answers to their questions. In addition, Oriental non-physician acupuncturists may attempt to treat inappropriate symptoms unless they readily understand the specific basis for referral. Just as it is the responsibility of foreign trained physicians, nurses, psychologists, physical therapists, etc. to pass licensing board in English, so should acupuncture applicants be required to pass written and oral examinations in English. Although one may argue that a translator may obviate the need for this requirement, in practice it is not a satisfactory substitute, and in addition, such an arrangement is impossible to enforce.
    (2) Basic knowledge of anatomy and physiology. Applicants should demonstrate reasonable knowledge of the locations and functions of the major organs, blood vessels, and the peripheral nerve pathways. For example, the location of the lungs should be well known in order to generate respect for the possibility of pneumothorax following needle insertion in the chest or upper back areas.
    (3) Basic knowledge of western medicine. This would include familiarity with western diagnostic terms and disease entities. For example, acupuncturists should know the ramifications for treating a hemophiliac or a patient taking anticoagulants, and that electro-acupuncture across the chest is contraindicated in patients with cardiac pacemakers. In addition, knowledge of basic first aid techniques (e.g. Cardiopulmonary resuscitation, etc.) should be required.
    (4) Basic knowledge of aseptic procedures. Although many Oriental practitioners do not believe in the “germ theory” of disease, we feel that this notion should be respected (pending evidence to the contrary), in order to prevent the spread of infectious diseases (e.g. hepatitis). Therefore, familiarity with the techniques and principles underlying the use of needle sterilization equipment and aseptic procedures must be demonstrated.
    (5) Basic knowledge of acupuncture. An appropriate examination can be prepared to determine expertise in the principles and practice of acupuncture. Although there are many different systems of acupuncture (e.g. Chinese, Korean, Japanese Kyodoraku, Do-In, Shiatsu, etc.), all are based on fundamental meridian theory, and the point combinations used to treat most illnesses are quite similar. This portion of the licensure should be very fundamental with an emphasis on clinical technique. It is with respect to this item that the Advisory Board can pass judgment on a case by case basis.

    E. “Grandfathering” of Applicants

    We are strongly opposed to “grandfathering” applicants simply because they have a variety of certificates, licenses, or other documentation certifying prior training and experience. First of all, such “evidence” is obtainable in Hong Kong and elsewhere for a small fee, and it is almost impossible to determine the true validity of such claims. Secondly, many “experience” acupuncturists who insist that certain problems can be treated only by causing third degree burns and nerve damage should not be permitted to practice simply because they have been doing so illegally for an arbitrary period of time. Thirdly, most competent and experienced acupuncturists can easily meet the requirements for licensure listed above. The Board of Medical Examiners should be permitted to waive certain requirements in exceptional cases.

    F. Standards of Practice

    Licensed non-physician acupuncturists should be permitted to treat patients only on the basis of the diagnosis and written referral of a licensed physician or dentist (who should be prohibited from fee-splitting). This will insure that primary diagnostic responsibility remains in the hands of appropriately trained medical practitioners. Specific standards of practice should be established to delineate clearly the techniques which are permissible (e.g. needle insertion, moxibustion, auriculotherapy, etc.). Finally, appropriate consent forms should be signed by patients, and detailed records of all procedures used should be kept for at least three years.

    G. Establishment of an Acupuncture Advisory Board

    Given the complexities of determining qualification for licensure and standards of practice, an Acupuncture Advisory Board to the Board of Medical Examiners should be appointed by the Governor. Although it has been said that a camel is a horse that was designed by a committee, a judiciously selected board comprised of well known and highly respected professionals active in the area of acupuncture can be created. For the sake of all practicing acupuncture as a respected medical profession, it is important that the Board be composed of prestigious advocates of acupuncture who will win the support and cooperation of the medical community. Antagonism between the Advisory Board and the Board of Medical Examiners will serve no one’s interest. We recommend that the Advisory Board be composed as follows:

    (1) A representative of the Board of Medical Examiners, to serve as a liaison for the Advisory Board.
    (2) A representative of the California Medical Association, to serve as a liaison with the CMA.
    (3) Two physicians who are trained and experienced in the field of acupuncture.
    (4) One dentist who is trained and experienced in the field of acupuncture.
    (5) Five non-physician acupuncturists (with at least one Chinese, one Japanese, and one Korean member), all of whom meet the qualifications listed.
    (6) A non-physician research scientist who is trained and experienced in acupuncture, and who is readily knowledgeable of the clinical data concerning the proven effectiveness of acupuncture, as well as the potential complications of acupuncture.
    (7) A non-physician academician who is trained and experienced in acupuncture, and who is trained and experienced in educational testing and test design.

    H. Funds for Research

    In light of the fact that much remains to be discovered about the effectiveness, complications, and contraindications of acupuncture, a portion of the fees received from licenses should be distributed to approved, ongoing medical school research projects investigating acupuncture. All licensed acupuncturists should be required to report their results to the Advisory Board on a semiannual basis, which will provide important clinical research information.

    I. Urgency

    Although some may argue that legislation is urgently needed which will permit non-physician acupuncturists to practice immediately, we feel that the safety and best interests of the people of California are served only if all of the safeguards we have outlined above are enacted, no matter how long it takes to implement them. Acupuncture is now widely available throughout California, and although certain non-physician acupuncturists may achieve better therapeutic results than physicians now practicing, we believe that this is outweighed by the potential dangers which may result to the public if these safeguards are not provided

     

     

    http://book.th55.cn/wap.aspx?nid=8085&p=1&cp=3&cid=1414

    灸师李传真医生回忆,她毕业于新加坡针灸学院,l969年移民美国,开始在家里为病人针灸,效果不错,消息传开以后,病人越来越多,应接不暇。她是华裔针灸师中唯一能讲几句英语的中医师,患者基本上都是白人。但是因为针灸的合法性问题,租不到诊所。1972年终于遇到一位好心的西医,敢于将诊所出租给她使用半天,每天从早上5点到下午l点,要看70~80个病人。可是,好景不长,l974年4月16日,里根州长否决了针灸合法化提案的第二天,一大早警察就来到她的诊所,当着十几个病人的面就把她带走,罪名是“无照行医”。开庭那天,她的数百名病人到法庭抗议,说他们都是经过西医治疗无效,才转向针灸并得到了帮助,他们有权利选择针灸疗法。法庭面对挤满屋子的患者,不知所措。其实,就连法官的妻子都是李医生的患者,法官也知道李医生是个好人,最后只好裁定针灸只能作为实验项目进行,罚款500美元,将李医生释放。此事在当时成为轰动一时的社区新闻。
    直到第二年,新任州长布朗签署了加州第一个针灸合法化提案,李医生的“罪名”才得以洗清,500美元的罚款也退了回来。但不幸的是,租给她诊所的那位西医师,因为将诊所租给非法行医者,遭到了吊销行医执照的处罚。事情过了数年后,每当想起此事,李医生都感到内疚,对不起那位好心的医生[70]。
    现在很多人都不知道,70年代以前,美国医学界一直都十分保守,有很多所谓道德伦理的“行规”。如果一位西医将病人转给非正统医生,也就是没有医生执照的“治疗师”,相当于现在所说的替代补充医学行医者,那是要违反“行规”的,很可能会受到医学会伦理道德委员会的制裁。据1974年加州的一份《针灸新闻》(Acupuncture News,July l974)报道,当时曾有42位执照西医师联名上书旧金山法院,提出“针灸转诊请求”,信中说根据当时已有的科学证据,应当允许医生把适当的患者转给针灸师治疗,而最好的针灸师一般并不是执照医生。
    美国西医团体在历史上同其他非正统医学流派历来不合,甚至达到水火不相容的程度。比如,正统西医(MD)过去不承认整骨医生(DO)和整脊医生(DC)为医疗职业,西医主导的医院里不会雇用整骨医生或整脊医生,甚至开诊所也不会跟他们做邻居。后来这两个职业在教育上都做了重大的改革,整骨医生已经逐渐被西医接受,目前的地位已经接近正统的西医了,而整脊医生仍然同正统西医有很大的隔阂和距离。近年来随着医学和社会的变迁,替代补充医学逐渐流行,西医行规也与时俱进,一些过时的老行规也不复存在了。中医针灸作为一种来自东方的传统医学,当年遭受西医的强烈排斥并不奇怪,面对巨大的法律障碍,针灸出师不利,惨遭滑铁卢应在预料之中。
    由于法律不规范,在加州还出现过很可笑的情景。因为法律规定只有执照西医师(MD)才能扎针灸,但西医师又不懂针灸,所以只好请针灸师开针灸“处方”,将需要扎针的穴位贴上标签,然后由西医师扎针,执照西医师反倒成了无照针灸师的“小工”,不知真相的患者,搞不清究竟是谁在给谁打工。这种状态虽然没有持续很长时间,但在东西方针灸史上却留下了可笑的一笔。
    美国有些州早期的行医法律规定,只有执照医师才可以给病人扎针,或者针灸师只能在医学科研中心,在执照医师的“指导”下,才能从事针灸。这些“不平等待遇”,令从事针灸业者,尤其是华裔针灸师十分气愤,他们采用各种办法表达自己的不满,极力争取权益。最常用的方法包括上书国会议员、请患者写信、收集公众签名、游说政客、借助媒体呼吁、出庭抗争、聘请律师诉讼、甚至坚持秘密行医等等。华裔针灸师当时上书议员最常用的抱怨是,我教会了无数西医

     

    http://www.mingyi99.com/forum.php?mod=viewthread&action=printable&tid=21053

    标题: 美國李醫師簡介(節錄轉載自Wikipedia) [打印本页]


    作者: Genie    时间: 2008-12-11 13:14:36     标题: 美國李醫師簡介(節錄轉載自Wikipedia)

    美國李醫師簡介(節錄轉載自Wikipedia) 來源:http://en.wikipedia.org/wiki/Miriam_Lee 美國的針灸醫師Miriam Lee 在加州是許多人心目中的英雄,也是美國針灸界的傳奇人物.她不但是針灸界的先鋒也是促使針灸治療在美國合法化的重要影響角色.Miriam Lee出生於中國大陸,於1947年離開中國.她原本是一名助產士後來成為針灸師.在到美國之前她在新加坡住了十七年,當她剛到加州時,針灸治療是非法的,所以她只好到工廠的裝配生產線工作,並在她家門外私下進行針灸治療.1974年她因無照行醫而被逮捕,在法庭上那些被她治療過的患者成群結隊地抗議,幾天之後,當時的加州州長雷根(Ronald Reagan)成立針灸醫療的合法化評估,兩年後Miriam Lee拿到了合法針灸醫師執照.據稱1970年至1980年間加州的針灸醫師至少有百分之七十是她的學生.李醫師以使用董氏奇穴而著名.(按:我認為奇穴翻譯成“Magic Points”並不恰當,因為奇穴乃正經之外的穴位而非“很神奇的穴位”)在她最忙的時候曾經一個小時看診十位患者,一週看診八十小時.(按:每天約看診約十二小時,無週休,真是忙碌到令人難以想像) 1980年成立的美國針灸協會,李醫師主持該協會自成立至1998年,目前李醫師已退休,和家人住在南加州.李醫師的主要著作有: Insights of A Senior Acupuncturist Master Tong’s Acupuncture 以上是Wikipedia對李醫師的介紹,因為看了呂道人前輩所翻譯的“美國李醫師董針醫案”而感興趣,因而上網做了些搜尋.李醫師在加州對針灸界所做的貢獻可謂不小,但是在巴頓格桑醫師(Dr. Palden Carson)的網站 http://www.worldtaa.org/tong.html 世界董氏針灸協會卻發現不同的聲音: 巴頓醫師說李醫師所著的《董氏針灸》一書(1992年美國出版)其內容大部份源自於巴頓醫師所翻譯,董景昌醫師所著,於1973年台灣出版的《董氏針灸正經奇穴學》.李醫師書中的前言內容還提到巴頓醫師的書是由巴頓醫師和李醫師兩人合著,然而這不是事實,巴頓醫師並不認識這位美國加州的李醫師,也不知道自己的老師有這麼一位私塾的學生,他問過同門師兄弟也沒有人聽過這位李師姊.(按:李醫師1964年到美國,離開中國後十七年皆在新加坡,並未說明何時習於董公,但李醫師用的確實是董氏奇穴) 因為尚未拜讀過巴頓醫師所翻譯的書,所以不知道李醫師的書是不是抄他的.但是僅僅是因為她而使針灸在美國合法化,這點貢獻就很偉大了.而且呂道長所翻譯的醫案的確非常實用,在此謝謝前輩的用心.

     

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[Information in 2006]

-What are the requirements to become an Acupuncturist?

The requirements to practice acupuncture are determined by each individual state and vary according to the different states.  In most states across the country the requirement is graduation from an accredited school of acupuncture and successfully passing the national certification examination (NCCAOM).

There are more than 50 schools of acupuncture accredited in the United States.  Accreditation is done by the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) which is recognized for this purpose by the U.S. Department of Education.  To be accredited, a school must meet a number of standards for facilities, faculty and program.  The degree program is at the Master’s level or higher and typically includes more than 3,000 hours of instruction and supervised clinical practice.  It takes approximately three years to earn the degree.  For most schools, a bachelor’s degree and proficiency in English language is required.  Information about ACAOM and a list of schools can be found at www.acaom.org.  A few states, including
California, do their own accrediting of schools and may recognize schools within and outside of the boundaries of the state.

-Which certification are needed?

For most states, certification involves passing the certification examination of the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). This examination is offered several times each year at different locations around the country(now using computer testing method).  To be eligible to take the examination, a candidate must have graduated from an accredited school of acupuncture.  To maintain certification through a career, an acupuncturist may be required to participate in Continuing Education courses approved by the NCCAOM and submitted to them every two years. Some states, notably California, operate their own certification system and examination and do not use the NCCAOM. Information about certification may be found at www.nccaom.org.

-Which licenses are needed?

Licensing requirements vary widely from state to state for acupuncturists.  In addition, many states permit other health professionals to practice acupuncture under different rules.

Physicians are often permitted to practice acupuncture with little or no additional training.  In some states physicians, chiropractors,naturopaths, and other healthcare professionals may be allowed to practice acupuncture with as little as 100 to 300 hours of instruction.  National organizations like the AOMAlliance (www.aomalliance.org, now AAAOM)  encourage the public to seek out the help of fully trained acupuncturists, usually designated by the letters L.Ac.(Licensed Acupuncturist) following their names.  These are the professionals with the most complete education and training in the field of acupuncture.

-What are the typical starting salaries?

Most acupuncturists do not receive salaries, but work to develop a private practice.  The financial rewards of these practices vary widely with experience, entrepreneurial ability, location, and a host of other factors.  In general, many brand new acupuncturists find the first few years to be financially challenging.  A well established
practice will ultimately yield a comfortable living for a family,ranging from $30,000 per year up.  The most successful acupuncturists may make up to ten times that amount.

More and more acupuncturists are joining integrated medical establishments such as hospitals, larger clinics, etc.  These practitioners often receive salaries and are typically compensated similarly to the higher end technical people or at the lower end of the scale for physicians.

-Are there major salary differences between various US states?

The economics of acupuncture mirror the economy of the nation, with the largest financial rewards coming on the coasts and in urban and suburban areas.  Nearly half of the acupuncturists in the United States are found in California.  The most lucrative practices are found there and in the northeastern U.S.

-What is the typical salary at age 40?

For many practitioners, acupuncture is a second career.  Many do not begin practice until after the age of 40.  For those who move straight from college to acupuncture school and then into practice, the age of 40 will have seen them in practice for about 15 years.  Acupuncturists who have remained in practice for 15 years (regardless of age) fall into the category of well-established practices that usually yield $30,000 annually or more.

– How long does it take for the practice to be established?

Most new practitioners find the first three to five years to be the most difficult.  We find that success is usually established by the fifth year, if not sooner.

-How many clients are expected per day?

There are several different practice methods for acupuncturists.  Some choose to operate much like consulting physicians, dealing with a single patient at a time.  Typically they charge higher fees per patient and see four or five patients a day.  Others operate more like clinics, with two or three practice rooms working together.  Their fees may be less and they may see eight to twelve patients daily. Some acupuncturists practice community-style acupuncture and treat patients in groups.  The largest of these clinics may see more than 50 patients every day.

-What are the opportunities for career progression?

Career progression opportunities in acupuncture are closely related to the notion that most practitioners are in private practice. Successful practitioners often find their practices expanding beyond their own ability to serve them.  They may bring in additional acupuncturists, or add other professionals such as massage therapists
or Chinese herbalists to provide a wider range of services.  They often receive invitations to assist in other medical establishments. The very best find their way into the schools as teachers.

– How much demand for acupuncturist is there?Demand for acupuncture is growing exponentially in America.  The National Center for Complementary and Alternative Medicine (NCCAM) an arm of the National Institutes for Health, has documented the ever-growing number of Americans seeking assistance from all forms of complementary medicine, including acupuncture.  At present, nearly 50% of the population routinely turns to one form of complementary medicine or another.  While the number is smaller for acupuncture, there are still an estimated 3 million active or former acupuncture patients.

 – Will the demand grow in the future?

Federal labor needs statistics have estimated the need for acupuncturists at nearly  100 thousand within the next ten years.  Our current educational system will not be able to create that many, but they will find themselves increasingly in demand year by year. Prospects for a career in acupuncture are becoming dramatically more exciting.

– How many acupuncturists are in the US?

It depends on what you count.  Our best guess is that there are between 22,000 and 23,000 practicing acupuncturists. This includes estimates of those practicing underground in urban ethnic communities or in states where the practice is not regulated by law.  There is a like number of other practitioners who provide some acupuncture as part of other practices.  In all, we estimate that as many as 45,000 individuals offer acupuncture across the country.  Only about half of these are fully trained and licensed.

-How many there will be in the next 10 years?

We anticipate that the number of licensed acupuncturists will double over the next ten years.

How do you see the trend in acupuncture in the next 10 years?

It is becoming increasingly clear that the American healthcare delivery system is in transition.  As traditional Western medicine becomes more expensive and health insurance falls out of the means of more and more people, there has begun a movement to find more cost efficient alternatives.  Acupuncture provides very effective treatment for many conditions at a fraction of the cost.  It is also part of
that complex of patient-centered approaches that focuses on wellness, rather than rescue from illness.  Most policy analysts expect all forms of complementary and alternative medicine, especially acupuncture and Oriental medicine, to gain dramatically in popularity over the next few years.  The medicine is safe, effective, less expensive, and less intrusive than modern scientific remedies relying on drugs or surgery.  Prospects for acupuncturists have never been brighter.

This article is edited by Dr. Arthur Fan, the original info is from: http://answers.google.com/answers/threadview/id/754630.html

www.ChineseMedicineDoctor.us

 
   
 
   

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(Notes: There were 37,886 and 34,481 Licensed acupuncturists in the USA in early of 2018 and 2015, respectively. Please read Dr.Fan’s article at https://www.sciencedirect.com/science/article/pii/S2095496417300122)

There were 20,750 acupuncturists in 2003 in USA, which was a serious data; 6 years passed, how many acupuncturists in USA in 2009?

No exact data. No one have a serious investigation. But as we know there about 3000 to 3500 students in acupuncture and oriental medicine school each year, so, in these 6 years, the graduated students would be 18,000 to 21,000. Let us say just 20,000. Plus those who studied Chinese medicine in other countries 5,000. Total the licensed acupuncturists (LAc) may be 45,000 in 2009.

Plus the acupuncturists other than LAc, such as MDs, Chiropractors, Physical therapiests who also practice acupuncture (or so-called Dry Needle Techniques), or DOs, medical acupuncturists, more than 5,000.

So, total there are about 50,000 practitioners in USA in 2009 practicing acupuncture (included in Dry Needle Techniques) for patients.

If, each week each acupuncturist treats 30 patients on the average(5-6 patient visits per day), 52 weeks/one year, 1,560 patients visits; so, 50,000 acupuncturists would have 78 million patients visits(if on the average, one patient has 3-4 visits, actually, there are about 20 million patients per year) .

If each visit costs $70 on average, each acupuncturist creats $109,200; 50,000 acupuncturists would creat  a 5.46 billion (5,460 million) dollars business in 2009. If this estimate is TOO high, we give a conservative estimate, — use 70% , each acupuncturist on the average creats about $70,000 business, the whole specialty creats 3.5 billion (3,500 million) dollars business in 2009.

We omited another big business here, that is Vet Acupuncture, currently animal/pet acupuncture is a very hot business. Many our patients told us their pets had acupuncture and had a wonderful result, so they also try acupuncture.  We do not know exactly how many Vet acupuncturist in USA, however, we could say –many! let us estimate,just say 5,000.  Each animal treatment costs around $95 (absolutely higher than human patient!!!), every Vet acupuncturist treats 20 pets per week, so, each year would be $1,040.

Each Vet acupuncturist creats about $100,000 business, so 5,000Vet acupuncturists would creat $500 million business.

In 2009, total acupuncture business would be $3,500 million plus $500 million, equal to $4 billion!.

www.ChineseMedicineDoctor.us

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