DAOM

[Guest guest]

, " Geoffrey Hudson " <list@a...>

wrote:

> I agree as well - I'm all for the entry DAOM. It's probably one of the

> best things we can do to proactively defend our profession.

 

everyone realizes that an entry level doctorate will still result in a

defacto 2 tiered profession for decades to come unless everyone is

grandfathered, right? and this doctorate is a degree not a license, so

unless boards no longer license those with only master's degrees, the DAOM

at entry level won't be very meaningful. Basically ACAOM could mandate

4000 hours and call it a DAOM and various state dept of eds could decide

whether or not to allow schools to grant the degree and then legislatures

would have to decide to grant the license title of doctor. While some

states like CA would allow those with DAOM's to use the title doctor if

they alwys included L.Ac. after their name. Others like Oregon would not

without a legislative change. Currently, an L.Ac. witha Ph.d. who has his

patients call him Dr. is committing unprofessional conduct in OR. I know

of at least one longtime px who lost his license for this.

 

So if we do go the route of entry level DAOM, many longtime px will be

relegated to second class status unless they also are allowed to use the

title. And I do not believe they will be able to use the title so easily.

I personally do not support blanket grandfathering without examination

and neither does any state board in any medical profession in many decades.

Proof of CEU's would not suffice for me either as we all know what a

scam CEUs can be. If you want a grandfathered license, you need to do the

coursework or test out. But this would mean that all current L.Ac. would

have a window of like 5 years to take the test or find a new job. that's

pretty much what pharmacists had to do in most states when pharm D. became

the licensing standard. If we institute a tiered system, instead of

getting stuck in some bizarre professional limbo for 40 years until we

wait for all the masters grads to die off, we will validate the practices

of existing licensees and make room for those who would advance to the

DAOM level. the entry level DAOM basically invalidates the masters.

 

I don't really expect to see states requiring existing licensees to

upgrade their licenses without someone demonstrating a truly compelling

need. To conservatives, that means public safety is being jeopardized by

current standards. Is that the case we want to make. that we are

currently unsafe and incompetent. first of all, this is untrue and there

is no evidence for this case, but were we to try and prove this, it might

very well backfire on us. the tiered professio not only is cost effective

for patients and students, but it preserves the integrity of the current

profession. Dave Molony compared my argument to the era when the old

diplomas were upgraded to master's degrees at all schools. People

screamed then about how this would affect px. the difference is that

there was no signficant title change involved then and there were really

no educational standards at all prior to the masters programs.

 

Jim spoke of income parity, but perhaps MD's make too much. Perhaps their

education costs too much and their services do likewise. Why do we want

to emulate educational and health delivery systems that are inefficient

and may bankrupt this country with their bloatedness. Perhaps the model

you ascribe to is an outmoded dying behemoth. And there are streamlined

alternatives that will actually serve the society of the future better

than the MD model. Aren't the primary care medical systems of much of the

rest of the world tiered even within single professions. MD's in many

european countries may practice at bachelor's, masters or docotoral level

of medicine. Isn't this tiering.

 

I am sure we all think our apporach to this problem will lead to the most

benefit for the world. However, unless someone can prove to me that one

practices herbs better by knowing acupuncture or that one does better

heart surgery by doing gyn exams, then I'll remain convinced otherwise. I

think a just society results when people can receive affordable medical

services (and housing and food and...). I think as long as medical

education remains as it is, healthcare costs will not go down and if we

follow suit, we will only contribute to the mess.

 

 

Chinese Herbs

 

 

" Great spirits have always found violent opposition from mediocre

minds " -- Albert Einstein

[Guest guest]

At 12:16 AM -0700 6/5/03, wrote:

>I am sure we all think our apporach to this problem will lead to the

>most benefit for the world. However, unless someone can prove to me

>that one practices herbs better by knowing acupuncture or that one

>does better heart surgery by doing gyn exams, then I'll remain

>convinced otherwise. I think a just society results when people can

>receive affordable medical services (and housing and food and...).

>I think as long as medical education remains as it is, healthcare

>costs will not go down and if we follow suit, we will only

>contribute to the mess.

--

 

 

As I tried to point out before, this argument confuses two separate

issues. The cost of healthcare is driven by socioeconomic forces

separate from the breadth of the medical school curriculum. In

Europe, or China for that matter, the medical curriculum is equally

broad, yet healthcare delivery in those places costs only a fraction

of what it costs here.

 

Your statement above also confuses two different levels of training

in medicine. Heart surgery is a specialty which is gained through

training which does not include gyn exams. Medical students learn to

do a basic gyn exam in their basic training, where they do not learn

heart surgery. An ob/gyn specialist does extended training in gyn

exam, but does not learn heart surgery. What is included in basic

medical education has evolved in reponse to the need of the medical

profession. To argue that in the basic training that a future heart

surgeon should not have learned a basic gyn exam is to suggest that

everyone should enter a specialty before they have completed their

basic training in medicine.

 

All in all, this doesn't seem like an analogy that helps us

understand the issue of acupuncture and herbs. There are already

programs in Chinese herbology (eg Institute of Chinese Herbology)

that don't include acupuncture. Practicing herbology does not require

a license in many states. Therefore, doesn't what you are looking for

already exist for those who might want it?

 

Rory

--

[Guest guest]

everyone realizes that an entry level doctorate will still result in a defacto 2 tiered profession for decades to come unless everyone is grandfathered, right? and this doctorate is a degree not a license, so unless boards no longer license those with only master's degrees, the DAOM at entry level won't be very meaningful.

 

>>>I totally disagree. If a DAOM is done in such a way that it is comparable to Dr degrees from other professions it would be very meaningful. It is the first step the profession can do to mainstream into the primary medical professions. Its all about perceptions. The fact that older practitioners would not have the DAOM is not that important and would not affect their practices. I do not think that they will be a second class status just like those without the MA degree do not see any effect at all as compared to my generation of LAc. Like you said its the license that dictates ability to work.

Alon

 

[Guest guest]

However, unless someone can prove to me that one practices herbs better by knowing acupuncture or that one does better heart surgery by doing gyn exams, then I'll remain convinced otherwise.

>>>Well if a heart surgeon sees a patient with chest pain and is not aware of the possibility of diaphragmatic irritation from a actompic preg he may do unnecessary surgery. As this can cause chest pain.etc. examples can be given endlessly

alon

[Guest guest]

> Practicing herbology does not require a license in many states.

 

Rory,

 

Which states? It is my understanding that those who make this

assertion are ignorant of the Medical Practices Act which is a part of

virtually all states' legal code.

 

Bob

[Guest guest]

Which states? It is my understanding that those who make this assertion are ignorant of the Medical Practices Act which is a part of virtually all states' legal code.>>>Herbal Medicine is illegal even in CA. But anybody can practice hebology as long as you do not treat diseases. Most herbalists in herb stores in china town do not have any license of official degrees

alon

[Guest guest]

At 2:55 PM +0000 6/5/03, Bob Flaws wrote:

Which states? It is my understanding

that those who make this

assertion are ignorant of the Medical Practices Act which is a part

of

virtually all states' legal

code.

--

 

It seems to be the case in New York, where I'm living, and I

believe it is true in California. From what I've been told over the

years, the practice of herbology is not equivalent to the practice of

medicine. Certainly there are unlicensed practitioners practicing

quite openly. However, I've not looked further into this, so if you

know differently, perhaps you could clarify the issue.

 

Rory

--

[Guest guest]

In a message dated 6/5/03 3:18:25 AM, writes:

 

 

 

I am sure we all think our apporach to this problem will lead to the most

benefit for the world.  However, unless someone can prove to me that one

practices herbs better by knowing acupuncture or that one does better

heart surgery by doing gyn exams, then I'll remain convinced otherwise.  I

think a just society results when people can receive affordable medical

services (and housing and food and...).  I think as long as medical

education remains as it is, healthcare costs will not go down and if we

follow suit, we will only contribute to the mess.

 

 

I'm at a sort of a loss here, in that I see one promoting specialism by saying that one doesn't need to understand the basics of a whole field and the basics of practices of the civilization in which we live in, in order to do any part of it well. Following by saying it would prehaps be cheaper to teach to refer, while I see acupuncturist's acupuncturists being under the impression, as are many homeopaths incidentaly, that they can do everything with acupuncture because the book says they can, ignoring the interaction of cells, nutrition, and lifestyle to energetics.

Why do 92+% of the acupuncturists use herbs? Not to mention diet, supplementation (including understanding the supplements a patient is already taking), and god knows what? Because they have found they need it and it is useful.

I think that with a DOM or whatever is given, we will see people coming out of school with an understanding we just begin to see after 5-10 years in practice, which is perhaps why so many older folks are in favor of it.

David Molony

[Guest guest]

, acuman1@a... wrote:

>

 

> and lifestyle to energetics.

> Why do 92+% of the acupuncturists use herbs? Not to mention diet,

> supplementation (including understanding the supplements a patient

is already taking),

> and god knows what? Because they have found they need it and it is

useful.

 

I wonder what % practice NON-Patent herbal medicine.. and I wonder

what % of those 92% weren't really trained in herbalism.

 

-JAson

[Guest guest]

Rory,

 

All 9or almost all) states have a Medical Practices Act (enacted in

the 1930s) which grants a monopoly on the practice of medicine to

licensed MDs. All other health care practitioners must then get

legislative exemptions to that monopoly, e.g., chiros, podiatrists,

optometrists, dentists, nurses, physical therapists, acupuncturists,

etc. If a person holds themself out to the public as professional who

treats disease, they either have to be a licensed MD or be a member of

a profession which has received a special legislative dispensation

(their own practices act) to practice in that state, just like we

acupuncturists have had to do. In that act, those persons' scope of

practice is defined, and it is illegal to exceed that scope of

practice. If you do, you are infringing on the monopoly of licensed

MDs.

 

The usual definition of a professional health care practitioner is

anyone who collects a fee in money or in kind for their services, who

maintains a professional place of business, advertises or otherwise

holds themself out to the public as a professional health care

practitioner, has signage and/or a letterhead, etc. So most people who

are practicing herbology and getting paid for their services who are

not specifically licensed to do so are unwittingly in contravention of

their state's Medical Practices Act. I know of no state which

specifically licenses herbalists (as opposed to MDs who can do

anything or DCs and Lic.Ac's with herbal medicine written into their

scope).

 

Just because lots of people are ignorant of these laws and are

practicing seemingly without any problem does not make what they are

doing legal. Typically, states' enforcement of the Medical Practices

Act is complaint driven. Someone has to complain to the Attorney

General or Board of Medical Examiners. This could be a patient, a

relative of a patient, or another health care provider, such as an Md

or even an envious competitor. These bodies then institute an

investigation. If the investigation suggests that someone has, in

fact, broken the Medical Practices Act, then prosecution is begun.

Usually, such prosecution is dropped for a written agreement to cease

and desist. Typically, if prosecuted, the first offense is a

misdeamenor accompanied by a fine, but a third offense becomes a feony

with potential time in the state slam.

 

So people who think that the unlicensened practice of herbology is

" alegal " are mostly living in a pipe-dream. They may be able to

practice successfully and without problem for years or even decades.

But all it takes is a single letter or phone call from anyone blowing

the whistle to the BME and then one is in for a year or more of

expensive legal hassles. Potentially, this even includes health store

clerks who advise customers on products for the treatment of disease.

There have been cases of such clerks being popped by undercover

agents, again mostly when someone has lodged a complaint.

 

Bob

[Guest guest]

In a message dated 6/6/03 9:46:20 AM, writes:

 

 

> Why do 92+% of the acupuncturists use herbs? Not to mention diet,

> supplementation (including understanding the supplements a patient

is already taking),

> and god knows what? Because they have found they need it and it is

useful.

 

I wonder what % practice NON-Patent herbal medicine.. and I wonder

what % of those 92% weren't really trained in herbalism.

 

-JAson

 

NCCAOM is probably wondering too. While many patents are innocuous, some aren't. Do these folks know? Add this to the concept that many folks think that the amount of training in herbs at our colleges, if using only the minimal levels to take the NCCAOM exam, qualifies one to mostly only use patents. This is basically the level taught to acupuncturists in China, while herb program folks have significantly greater training in heral medicine, especially specfic to clinical.

David Molony