CA leg update

[Guest guest]

While we're waiting for high-tech science to validate ancient theory and etc.,

we have every reason to stay alert to what might REALLY be going on with

pending Cal amendments. The Licensing Act already has a history of poorly

worded patch additions, most notably _oriental massage_, which attracted a

criminal element to (with or without License holder knowlege) offer guess

what (surprise. surprise).

 

On the surface, 1113 is much improved from how it started (bundled as part of

the acupuncture modality). The fact that it was initially supported by the

CSOMA and others shows how sadly unsophisticated many are when it

comes to legal verbiage, as well as spotting snakes in their bed.

 

AB 1113 (Yee) is now amended as follows:

4937. An acupuncturist's license authorizes the holder thereof:

(a) To diagnose within his or her scope of practice.

 

And ALSO: The Legislative Joint Committee on Boards voted 4-1 to sunset

(eliminate) the California Acupuncture Board.

 

Sen. Figueroa is chair of the Joint Committee on Boards.

Sen. Figueroa is also now listed as co-author of AB1113

 

Why would they use words that do absolutely NOTHING to resolve the real

issues at stake. Perhaps the answer could be that once the Board is

abolished, the new overseer (a Bureau in the Dept of Consumer Affairs) will

have authority to define (read - severely limit) scope of practice, without the

due process that has here-to-fore allowed Licensed practitioners and

supportive public to speak up. Or else they have something else in mind.

Regardless, it smells fishy, and the implications can go far beyond insurance

reimbursement and far beyond California.

Know that Sen Figueroa had previously attempted to define _primary care

provider_ as allowing diagnosis for the purpose of providing acupuncture

treatment.

 

First of all, we don't need diagnostic authority to be GRANTED; it is already

established practice for 25 years backed up by State legal opinion. It would

be without precedent for a licensed health profession to suddenly have

established practice drastically altered without evidence that public safety has

been harmed by such established practice. Secondly, it doesn't take much

awareness to see that the chief beneficiaries would be insurance companies

(health and malpractice) and competing medical professions. Acupuncturists

and schools have been so unsophisticated that they let the main rep for

malpractice insurance (now risk-management psuedo-insurance) teach them

practise management courses (!)

 

The FACT is that diagnosis is NEVER done for the purpose of treatment, but

for the purpose of decision-making. Once you say that it is for the purpose of

treatment, that does not allow for a determination that treatment isn't

indicated,

or that a referral is necessary. This instantly translates to not practising

primary care (which remember was already established in statute), and really

not practising health care at all, but instead makes you a technician. It is a

short step from there to adopt treatment guidelines (for instance NIH, or

ACOEM) that basically say that you as a technician can't do squat.

 

Remember, ICD stands for International Classification of Diseases, which

sounds pretty comprehensive to me, except for people stuck in a time-warp

museum. So that you don't misunderstand me I'll quote my March paper :

 

" ...traditional oriental/asian medicine (and Licensed Acupuncturists) utilize

several different philosophical frameworks to evaluate, and subsequently

develop models for rationale of further decision-making. The choice of

approach depends on personal preference and background as well as the

nature of the presenting patient. This is a body of knowledge in continuing

development and evolution over thousands of years, throughout Asia and in

this country as well. There is nothing fixed about it or set in stone at a

given

year in past history, and it is traditional precisely because it respects this

evolution, and doesn't disavow the validity of concepts that don't fit in all

models.

One such philosophical framework is closely aligned with modern evaluation

methods. Sometimes, this approach is necessary to triage the presenting

patient for the purposes of public safety, to relate to other health

professionals, and to document for reimbursement and establishment of

patient record according to the nationally established standards across the

gamut of medical specialties. It may occasionally also be the best framework

upon which to base treatment rationale. The justifiability of any choice

revolves around establishing a coherent basis upon which to act. "

 

- which is to say that evaluation for public safety and triage requires the same

kind of evaluation that every other healthcare profession does. and that may

indicate the most appropriate action to follow. Your TCM evaluation may or

may not be necessary for you to take the best course of action. It always

hinges on what risk you choose to take on. Hiding behind poesy ancient

terminology means opting out of the healthcare system, period. If that's what

you want to do, then all you need is thorough informed consent releases, -

and you DON'T need a license or accredited schooling - (or payment to

psuedo-insurers who tell you that only their informed consent papers work).

 

The other threatening possibility is that any treatment, including prescribing

herbs (under License) to_promote, maintain, and restore health_, will require

that you only see people who DON'T already have a diagnosis, because

otherwise that treatment could be seen as meeting the definition of a drug,

and the burden wil be on you to show safety and efficacy.

 

I'll put my Cal Amendments paper back on my site (soon). Please read it if

you don't understand this, and get others up to speed. Thanks

 

Joe Reid

www.jreidomd.blogspot.com