The AAAOM is not a national professional organization worthy of that designation
- This is an open letter from Mark Seem, PhD, LAc
Time for AOM Leadership
The AAAOM is not a national professional organization worthy of that designation, as the actions of its President of late demonstrate.
Where a national professional organization would steer a steady course to help guide the AOM profession based on consensually agreed upon standards of education and certification, AAAOM has consistently attempted to dismantle those standards and undermine the profession based on the actions of a few politicians in our profession who believe their will is bigger than that of the AOM profession at large. The AAAOM acts like a political action committee instead, rallying its leadership and membership (when it deems membership worthy of even being surveyed) as anyone on its Google group knows around every new crisis of its own making. This sort of leadership is destabilizing and confusing, which doubtless accounts for why so many of us dropped off of earlier AAAOM boards and committees to pursue our serious work in serious organizations dedicated to the greater good, namely CCAOM, NCCAOM and ACAOM.
A case in point, and perhaps THE case in point is that the current AAAOM president and leadership has again raised the battle-cry that the AOM profession is endangered because it has no national identity, no clear vision of degree designation, no clear outcome for the training of licensed acupuncturists.
Nothing could be further from the truth. To wit:
In Spring 1987 the AOM profession established a graduate college Masters entry-level which went through significant revision and amendment to add much more biomedical education especially over two decades;
During these amendments, the issue arose repeatedly, invariably from a few California practitioners that the AOM profession needed to be one degree, the doctorate, and espoused the "California" model of a 4-year Masters in Oriental Medicine that should be transformed into the DOM;
These few people argued repeatedly, and were soundly defeated each time, that Oriental Medicine was primary care and that the biomedicine education ion AOM colleges should be at that level, and train to those outcomes because Oriental Medicine was primary care in California;
That is not true, that has never been true except in the fantasies of the few, and the Little Hoover Commission study and report made it clear that while the CA acupuncture law stated LAcs there could diagnose, which these few portrayed as biomedical differential, and primary care diagnosis, meant Chinese Medical Diagnosis instead; former Governor Brown, who signed the first acupuncture law in CA into law, was interviewed and he made this crystal clear;
The consistent, pit-bull like push to change the entry level to the doctorate, and to have only a doctorate in OM, not even in AOM, and definitely not in Acupuncture failed, and ACAOM and CCAOM and NCCAOM settled on standards, and certification in Acupuncture first and foremost, and later in Oriental Medicine with NCCAOM even adding a separate Chinese Herbal Medicine certification;
The primary educational objective and outcome of an ACAOM candidate or accredited Program education is to graduate Independent Acupuncture providers from the programs in Acupuncture, and Independent Oriental Medicine Providers from Programs in Oriental Medicine; many AOM colleges offer entry level masters Programs in Acupuncture AND in Oriental medicine and these programs have stood the test of time over the past 25 yearsprospective AOM professionals have spoken loudly here as market forces have made each Program viable, with regional differences in preference of one Program over the other but no evidence of a national trend of one or the other: North American AOM has supported two Programs which demonstrates the equal power of both to serve the needs of those who wish to enter the AOM profession;
The thrust of these few people for a single degree title and entry level program always takes the medical profession and the MD degree as the example of such a single-purpose medical profession, and fail to clarify that the medical profession also includes Doctors of Osteopathy, Dentistry, Psychology, and now Physical Therapy, Occupational Therapy, Audiology, and Pharmacy, as well as physician's assistants and nurse practitioners working under MD licensesthe medical profession supports many doctoral and terminal degree titles to its great advantage in being able to meet ever new health care demands;
This debate about a doctoral-entry level was transformed into a discussion and eventual development of standards for a post-graduate Doctorate in AOM where it could be in Acupuncture alone, or in Oriental Medicine (read including herbal medicine) and now about a dozen colleges from Illinois west offer this advanced post-graduate Program;
These post-graduate programs so far are in Oriental Medicine and there is no evidence AOM colleges focused on Acupuncture education primarily see the value in such a program;
The AAAOM has repeatedly raised the issue, as it is doing again now, for the need nationally for more primary care providers with no clear evidence for that need; were this true, and whenever it becomes true, the medical profession writ large is fully capable of increasing the number of physicians assistants and nurse practitioners to meet this need for providing mainstream biomedical primary care;
The AAAOM has failed to even attempt to demonstrate that there is evidence that AOM is a primary care profession IN THIS COUNTRY or how it would benefit the North American health care field were this true;
The real model the AAAOM and these few California politicians seized upon was that of Chiropractic Medicine which snuck into the back door as primary care with the clear understanding that this was in physical medicine only, and never in internal medicine;
For AOM to become primary care this way, the AOM profession would have to supply hard evidence for Chinese herbal remedies as efficacious DRUGS, not FOOD. This is far from having been demonstrated and then law of the land is essentially that Licensed Acupuncturists who also practice Chinese Herbal Medicine must clarify that they are making recommendations and selling herbal remedies to promote health and prevent disease, and not to diagnose or treat any disease, condition or complaint from a biomedical diagnostic stance;
During these past 25 years, the AOM profession has clearly branded itself as Acupuncture & Oriental Medicine, whence the inclusion of AOM in the name of all national AOM organizations (CCAOM, ACAOM, NCCAOM) and yet AAAOM even last year decried the lack of a clear BRAND!
The First Professional Doctoral draft standards, like the Masters entry level standards recognizes two consensually agreed upon Programs for entry into the profession: a 3-year Masters entry level Program in Acupuncture and a 4-year Masters entry level Program in Oriental medicine that have stood the test of time for well over 2 decades and now would add a 3rd and 4th option, namely a 4-year Doctor of Acupuncture and a Doctor of Oriental Medicine;
The FPD standards, contrary to the AAAOM President's recent claims, has significant value added as it not only seeks to train entry level private practitioners of Acupuncture and of Oriental Medicine, but also includes knowledge, skills and competencies that would train practitioners capable of taking AOM into mainstream and integrative care settings for best care at a much larger level;
These value-added competencies include all those espoused by the Institute of Medicine as critical for all 21st century health care providers in Team-based Care (ability to communicate, cooperate and collaborate with other mainstream and CAM providers), Patient-Centered Care (ability to establish a partnership with the patient for best care where the patients health care needs drive the care), Information Literacy (ability to access, and critically evaluate the viability of research and other information for best care including training in quantitative and qualitative research methods), Evidence-Based (and Informed) Practice (the ability to access and consult and make use of evidence where it exists, and exercise sound professional judgment based on AOM treatment principles where it does not) and Risk Management/Quality Improvement;
These are significant value-added competencies that would most certainly make FPD graduates more marketable in mainstream and integrative care settings than current masters level AOM graduates;
What the AAAOM President and the AAAOM over the years really means here is that the FPD standards, like the Masters standards, fail to have one sole entry level program, and fail to include biomedical competencies in primary care (differential biomedical diagnosis, performance and interpretation of tests, etcetera) and in this it is still bucking against 25 years of solid history and evidence for two entry level programs, in Acupuncture and in Oriental Medicine.
It is time for new leadership in the AAAOM, and/or for an AOM Coalition for Consensus on the Future of AOM (a new Visioning Process) not organized or controlled by the AAAOM.
It is time for AAAOM to get the point: there are two entry level degree Programs in the AOM field, and now there are standards that would allow AOM colleges to offer 4-year First Professional Doctoral Program, in Acupuncture or in Oriental Medicine, alongside these other two Programs. This would give more options to prospective AOM students and would attract those with a serious commitment to doctoral entry level education, who might well prefer the DAc or DOM education and designation over MD, DO, DPT, OTD, DPh, DDS, DMD, PsyD.
The marketplace of future AOM professionals will dictate if the eventual FPD Programs ion Acupuncture and in Oriental Medicine will fare as well as, or better than, or even replace the Masters entry level in Acupuncture and in Oriental Medicine.
The only risk here is for the AOM colleges that decide to run the FPD and the Masters entry level programs, as they may not all survive. But that risk pouts the future AOM professional, and not the AAAOM in the drivers seat.
People, not politicians, dedicated to best AOM care, not politics.
It is time for a change, and it is time to rally behind a first professional doctorate parallel to the 25-year old masters, in Acupuncture and in Oriental medicine. The old arguments are stale, and not appropriate to 21st century health care.
Mark Seem, PhD, LAc