CSOMA Update, 8/24/00 plus my 2 cents

[Guest guest]

" Benjamin E. Dierauf " wrote:

 

> Re: FDA - Aristolochic Acid

> AMA Goes On The Offensive

> AB 2764: Herb Sales Tax Exemption

> SB 466 - Vetoed by Governor

> AB 2294: Ephedrine Restriction

> HR 1890 - Acupuncture in Medicare

> National Guild of Acupuncture and Oriental Medicine

>

> Dear Colleagues,

>

> Our profession has had several confrontations recently with the

> medical establishment misinforming the public about the safety of

> Chinese herbs and attempting to limit the use of herbs. As students

> of the tao, licensed acupuncturists understand the nature of change.

> " The times they are a changing, " and we need every licensed

> acupuncturist to join a professional association to help protect our

> profession and fight our battles. If you, or other colleagues, are

> not a member of CSOMA or another organization, please join us now by

> calling our office at 800-477-4564.

>

> Here is a recap of current events:

>

> FDA - Aristolochic Acid (See upcoming Fall CJOM for a comprehensive

> article by John Chen and Jake Fratkin about the story behind

> aristolochic acid).

>

> Recent actions taken by the FDA affect herbs that either contain

> aristolochic acid, or herbs that have been misidentified or

> improperly substituted with other herbs that contain aristolochic

> acid. The commonly used herbs in Oriental medicine affected by this

> action include mutong, madouling, fangji, xixin, muxiang, and

> weilingxian, which the FDA is not allowing into the country unless

> the importer has documentation to prove that aristolochic acid is not

> present. If the proper herb identification is made, only madouling

> contains aristolochic acid; this herb is no longer being imported.

> The other herbs and formulas are still available from responsible

> herbal companies whose importers can provide the proper documentation.

>

> CSOMA recommends that LAc's check with their herb providers to

> insure that only properly identified herbs that don't contain

> aristolochic acid are being supplied. While madouling is probably

> safe if prepared and used in the traditional manner with the guidance

> of a trained practitioner of Oriental medicine, aristolochic acid is

> a nephrotoxin and CSOMA recommends that practitioners

> discontinue use of madouling until further testing demonstrates its

> safety at more realistic TCM dosage levels.

>

> AMA Goes On The Offensive

> The Florida Medical Association (FMA) is suing the Florida Board of

> Acupuncture to limit acupuncturists' scope of practice, including

> ordering lab tests. This is a test case for the AMA, which has

> recently resolved that only a MD, DO, or dentist should be able to

> order lab tests. We could be next, especially if the FMA prevails,

> and this could pose a serious threat to our status as primary care

> physicians. Stay tuned

 

The inclusion of lab test ordering in L.Ac. scope of practice is highly

suspect, for both ethical and legal reasons. Ethically, no

TCM school in the entire country provides adequate training to properly

order and interpret lab tests. Legally, one becomes liable for NOT

ordering necessary tests when they are medically indicated. I am moving

to CA in a week, so these issues concern me personally. But put two and

two together. If one is not trained when and how to order lab tests,

then how can you protect yourself by ordering so-called necessary tests.

I would argue that allowing lab tests actually impedes the practice of

non westernized forms of TCM, by requiring L.Ac.'s to be primary care.

Personally, I do not want to be a primary care provider. I support

integrative medicine. Since I do not accept accept insurance for my

private services, the issue of primary care is moot to me on that accord,

as well.

 

>

>

> AB 2764: Herb Sales Tax Exemption

> AB 2764 (Knox) would remove the unfair sales tax that we are required

> to collect from our patients for herbs and supplements. However, the

> bill is

> currently stuck in the Assembly Appropriations Committee. Its chances

> appear slim, as the governor seems to be intent on spending the

> budget surplus primarily on education.

 

I oppose sales tax. It is regressive. But why should we be exempt? I

am not sure I see the logic.

 

>

>

> SB 466 - Vetoed by Governor

> SB 466 (Perata), our Scope of Practice legislation, after passing the

> Assembly and Senate, was vetoed by Governor Davis as soon as it got

> to his desk, ostensibly because of his concerns with low-level

> lasers. Apparently the Dept. of Consumer Affairs changed their

> position to " oppose " after the bill

 

this is a misplaced battle altogether. much more important ways to spend

lobbying funds. I'd lay odds this was mainly backed by laser machine

manufacturers.

 

>

>

> AB 2294: Ephedrine Restriction

> CSOMA and CAOMA Lobbyist, Steve English, has managed to get AB 2294

> (Davis) amended to include an exemption for Licensed Acupuncturists

> so that our ability to prescribe mahuang

> (ephedrae) to patients under our care will not be restricted. Because

> of language that states that we " prescribe " herbs to our patients, we

> strongly support this legislation. Unfortunately, pharmacists are now

> opposed to it.

 

I hope we win this one. I 've been through it with OR board of Pharm.

Prescribe is not a controlled term. Prescribe is what all independent

licensed providers do (DO,DC,MD,ND). On the other hand, prescription is

a controlled term. However the act of prescribing does NOT make the

prescribed item a prescription in the legal sense. For example, a doctor

may prescribe an OTC non prescription item, but he is still prescribing.

I think the issue for us is what we claim. We prescribe for TCM zheng.

If we claim to prescribe for disease or even most medical symptoms, we

may have crossed the legal line. But the verb is public domain, I

think. Its the nouns we need to worry about, in this case.

 

todd