Guest guest Posted May 6, 2005 Report Share Posted May 6, 2005 There are many issues with what you have stated in your opinion. Some are noteworthy and others are concerning. This issue should be discussed further with an understanding of what things might actually mean for the profession in CA. I would encourage all to read Marilyn Allen's article on Acupuncturetoday.com website for a better understanding of what this means and how it could affect us. The CSOMA is not the only one speaking out about this issue. If you respect her opinion then read it. I would like to hear responses with solutions to these. Thanks and I hope we can create a civil dialogue about this issue as it is that important. Mike W. Bowser, L Ac > < > >cha > Senate Bill 233 >Fri, 6 May 2005 12:43:15 -0700 > >the continual distortion of the facts of this matter by CSOMA and >AIMs is certainly masterful politics. This open letter makes it >seem as if it is only the Joint Committee on Boards, Committees and >Consumer Protection that supports the sunsetting of the acupuncture >board. However the JC is only following the the recommendation of >the LHC, as well as the advice of the governor. The LHC report was >made with input from numerous independent organizations. In fact, >many groups separate from our field, but with no apparent vested >interest in anything other than public protection have all pretty >much agreed the board must go. I also forwarded a lengthy letter >from Jack Miller, PCOM president and past CCAOM president, siding >with the JC. CSOMA pretty much stands alone in this matter. Groups >like AIMS are really subsets or contractees or lobbyists of >organizations like CSOMA, so they don't really constitute another >independent entity, IMO. As for the rank and file licensees, I don't >recall ever being asked what I thought in any formal CAB survey. But >just as a recent survey showed negligible interest in the doctoral >title across the profession as a whole, I would suspect that most >licensees would just assume see the board go away, too. Most >licensees I speak with do not want the added rights of western >diagnosis, for example, because with those rights comes a whole host >of responsibilities, which if adhered to closely would interfere with >the practice of OM. If I have to spend inordinate amounts of time >playing CYA by doing all this unnecessary testing and examination, >when will I have time to insert needles and perform acupuncture. As I >have written here before, we chose in OR to NOT be primary care to >avoid the legal consequences of being poorly trained yet highly >liable in this area. We should support the abolishment of the board >and we should oppose any backdoor attempts to turn all of us into >minidocs against our wills at the behest of a small group of vocal >but misguided politicos. > > > >On May 5, 2005, at 5:51 PM, CSOMA wrote: > > > > > May 5, 2005 > > > > Dear CSOMA members and colleagues; > > > > The following is the background for an EXTREMELY URGENT request to > > contact our state legislators, urging them to oppose Senate Bill > > 233 (SB233) which, if passed, could have far-reaching detrimental > > effects on our profession, and to your livelihood as a licensed > > acupuncturist. Although the background is somewhat long, we urge > > you to read through it within the next couple days and respond with > > letters to appropriate legislators. A sample letter and listing of > > legislators is provided towards the end of this alert. > > > > On April 25, the State Senate Business and Professions Committee > > voted 4-1 to pass SB233, which will abolish the California > > Acupuncture Board (CAB) on July 1, 2006. The CAB will sunset and > > become a bureau that will be placed under direct supervision of the > > Department of Consumer Affairs (DCA). In addition, a May 3 > > amendment to that bill could effectively prohibit licensed > > acupuncturists from rendering a diagnosis according to accepted > > standards of medical practice. > > > > This bill should be of grave concern and an affront to every > > licensed acupuncturist in California as well as the patients we > > treat. And although in public testimony Senator Figueroa adamantly > > states that SB 233 has nothing to do with the profession, but > > rather the performance of the Acupuncture Board, the recent > > amendments to the legislation validate that this is simply not the > > case. The Joint Committee on Boards, Committees and Consumer > > Protection (JC) recommended that the CAB be abolished for the > > following reasons: > > > > The CAB “has had trouble getting involved in the wrong issues”. The > > JC cited CAB discussions on upgrading educational standards for our > > acupuncture colleges, criticizing its recommendations for a 3,200 > > hour curriculum requirement as a “means of restricting entry into > > the profession”. In fact, the upgraded standards, which were signed > > into law in 2002 with AB1943, are meant to further ensure the > > viability of future acupuncturists as primary care providers. > > The CAB “missed significant opportunities to protect the public”. > > The JC criticized the CAB for its lack of discussion regarding > > “disposable, single-use needles or emerging research on threats to > > public health”. What the JC fails to understand is that the vast > > majority of licensed acupuncturists have received required > > certification in clean needle technique, and have been trained to > > use nothing other than disposable needles. It also fails to see > > that the CAB has made significant efforts to protect the public by > > advocating for higher standards of education that will better > > prepare future acupuncturists to function within integrated > > settings with other medical professionals. > > The CAB has such a relatively small staff, it is not always able to > > operate efficiently. The JC made the same criticism of the Medical > > Board in SB231, yet recommended that it be extended until 2010. The > > JC cites that the CAB function of approving schools of acupuncture > > in California is a drain on its meager time and resources. Behind > > this criticism, however, is the reality that national stakeholders > > have effectively lobbied key legislators in the State Capitol in an > > effort to wrest control from the CAB this vital function. It is > > these same national stakeholders who have consistently opposed > > upgrading educational standards for acupuncture schools in > > California in order to force conformity with lower nationally held > > standards. > > The CAB “misreads its governing statutes concerning the scope of > > practice of licensees”. Our scope of practice and authority to > > diagnose have been a major point of disagreement between the CAB > > and JC. The JC’s intention to restrict our diagnostic authority > > would effectively prevent acupuncturists from participating in > > workers compensation and health insurance as primary care > > providers. Furthermore, it could once again subordinate us under > > the supervision of MDs, ODs and DCs. The JC fails or refuses to > > recognize Legal Opinion 93-11 rendered in 1993. It states that by > > repealing the requirement of referral or diagnosis from an MD, the > > Legislature has authorized acupuncturists to diagnose a patient’s > > condition prior to providing any treatment. > > > >Chinese Herbal Medicine offers various professional services, including >board approved continuing education classes, an annual conference and a >free discussion forum in Chinese Herbal Medicine. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 6, 2005 Report Share Posted May 6, 2005 We should support the abolishment of the board and we should oppose any backdoor attempts to turn all of us into minidocs against our wills at the behest of a small group of vocal but misguided politicos. >>>> i am curious who made you Our voice? I am willing to bet the >>>>majority of LAcs in CA do not want to loose any of our rights including >>>>diagnosis. I do not know how large the membership of CSOMA is but i >>>>guess they should ask their members for feedback. I am sure the vast >>>>majority of chinese LAcs are not with you on any of these issues. All i >>>>am hearing here is the voice of the schools that just do not want to see >>>>any real requirement put upon them. Hopefully the chiropractic schools >>>>will develop more serious programs. Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 7, 2005 Report Share Posted May 7, 2005 Alon et all, Just because the CAB has issues does not mean you just eliminate them, that would be an extremely dangerous precident. It would make more sense to appoint new members. It would be a major let down to have no L Ac representation on professional issues and have to rely on a bureacrat for decisions about practice, who may not know anything about what we typically do. This is a large step in the wrong direction and we should not stand by and let it happen. Mike W. Bowser, L Ac > " " <alonmarcus > > >Re: Senate Bill 233 >Sat, 7 May 2005 00:24:16 -0500 > >We should support the abolishment of the board >and we should oppose any backdoor attempts to turn all of us into >minidocs against our wills at the behest of a small group of vocal >but misguided politicos. > >>>> i am curious who made you Our voice? I am willing to bet the > >>>>majority of LAcs in CA do not want to loose any of our rights >including > >>>>diagnosis. I do not know how large the membership of CSOMA is but i > >>>>guess they should ask their members for feedback. I am sure the vast > >>>>majority of chinese LAcs are not with you on any of these issues. All >i > >>>>am hearing here is the voice of the schools that just do not want to >see > >>>>any real requirement put upon them. Hopefully the chiropractic schools > >>>>will develop more serious programs. > > > > >Oakland, CA 94609 > > > > > >Chinese Herbal Medicine offers various professional services, including >board approved continuing education classes, an annual conference and a >free discussion forum in Chinese Herbal Medicine. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 7, 2005 Report Share Posted May 7, 2005 It has so amazed me over the years that we seem to be the only profession that is eagerly willing to give up scope of practice and tools (like herbs) all without a fight. Many of these losses are the result of politics and not based upon reasonable data nor patient choices. It is no wonder that we are not taken as a serious profession. We are not the ones who speak for ourselves in the media either. This needs to change in a big way in order to turn things around. We are going backwards. Can anyone see that? Mike W. Bowser, L Ac > " " <alonmarcus > > >Re: Senate Bill 233 >Sat, 7 May 2005 00:24:16 -0500 > >We should support the abolishment of the board >and we should oppose any backdoor attempts to turn all of us into >minidocs against our wills at the behest of a small group of vocal >but misguided politicos. > >>>> i am curious who made you Our voice? I am willing to bet the > >>>>majority of LAcs in CA do not want to loose any of our rights >including > >>>>diagnosis. I do not know how large the membership of CSOMA is but i > >>>>guess they should ask their members for feedback. I am sure the vast > >>>>majority of chinese LAcs are not with you on any of these issues. All >i > >>>>am hearing here is the voice of the schools that just do not want to >see > >>>>any real requirement put upon them. Hopefully the chiropractic schools > >>>>will develop more serious programs. > > > > >Oakland, CA 94609 > > > > > >Chinese Herbal Medicine offers various professional services, including >board approved continuing education classes, an annual conference and a >free discussion forum in Chinese Herbal Medicine. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 7, 2005 Report Share Posted May 7, 2005 Hi Todd As a board member of CSOMA, I take offense at your use of the phrase " distortion of the facts " about our view of the bill, especially when your information is derived from a biased account of what is going on. Here is my, personal take (not CSOMA's) on what is going on. First off, I don't believe the LHC recommended sunsetting the board. It said there were problems with it and it needed to be changed, something to which I agree. The governor was for sunsetting the board along with another 70 or 80 boards including the nursing and medical boards. That has been scrapped. Now the ONLY board being looked at for sunsetting is the CAB (CA Acupuncture Board). This is after years of struggle getting out from under the control of the medical board, now you are suggesting we just let it go into obsucurity? Not being able to diagnose means no insurance. Period. It means we cannot bill workers comp, private insurance, or medicare (when that happens). Whatever you think about being able to do western testing, this means we are no longer part of the medical system in this country. It also means that we will be relegated to being under the thumb of the medical profession, where we can do such billing, it is only when a doctor refers to us with a patient's diagnosis. Having said that, we are waiting on legal opinion as to whether this nightmare scenario could come about from Figeroa's amendments. Another area that needs to be cleared up. Jack Miller's letter, as I read it, did NOT advocate the sunsetting of the board. It advocated the sunsetting of THIS board. After he talked with Figeroa, he felt that they would sunrise it again. Something I seriously doubt with these new amendments. I agree this board is not the most effective. It probably should have a new executive director. And sunsetting the board is one way to do that. The most extreme way. Why not fire the ED and hire someone else? Yes, they can do that. As I understand it, and I have not confirmed it, Liz Figeroa gets more money from the California Medical Association than almost anyone in the state house. And they would love nothing else than to see our profession destroyed. There was a public hearing to discuss this bill, which was cancelled at the last minute and the bill passed without public comment. If you read the reasons for the bill Figeroa's committee gives, they are all spurious in the least, and flat out lies at the most. Among the reasons for sunsetting: they exagerated the LHC findings, they emphasized the lack of rules regarding single use needles in our profession (which is not a problem at all), and they bemoaned the fact that the CAB has not had any meetings despite the fact that the governor had not appointed enough members to create a quorum. On this last point, the logic goes: the governor hasn't appointed enough members for you to meet, you don't meet, and because you haven't met, you are ineffective and should be sunsetted. Having said all this, I think some members of our profession tend to get carried away and start predicting doom and gloom and the end of our profession. This is no where near that. I do think these messages are too strident, premature, and harmful to our profession as they make us look like amateurs. We need to slow down, assess the probablity that the bill will go through, find out what it means from legal opinions, create an appropriate strategy, and intiate that strategy. The process for the bill to pass will take at least 4 or 5 months and upwards of a year to play out. There is no need to panic. However, this could be very serious and put our profession decades behind where we are today. We need to keep a close eye on it, engage our politicians, and strategize an effective response. To simply say it needs to go, will hurt our profession dramatically. Whatever you think about the CAB, this bill, our ability to diagnose, one thing is clear: Figeroa and her committee has not dealt appropriately with or engaged our profession and has manipulated the process in such a way that it is completely stacked against us. And for the record, CSOMA is very open to hearing from our profession, members or not. I can attest to the fact that we see and discuss every dissenting opinion and value them. Our web page (http://www.csomaonline.org/) has all the information necessary to contact us. And we encourage it and will be making it more prominent with an imminent redo of our website. CSOMA and AIMS do work together, yet we are separate organizations with separate (if occassionally overlapping) members and sources of funds. CSOMA's position is very clear: we want to work with others in our profession and will work with anyone with similar goals. Despite disagreeing with Jack on this particular issue, we are working with him to try and stop the residency bill from passing. Finally, this is not about diagnosis, it is about the status and stature of our profession. Please do not rehash the old diagnosis argument. Dr. Greg Sperber , wrote: > the continual distortion of the facts of this matter by CSOMA and > AIMs is certainly masterful politics. This open letter makes it > seem as if it is only the Joint Committee on Boards, Committees and > Consumer Protection that supports the sunsetting of the acupuncture > board. However the JC is only following the the recommendation of > the LHC, as well as the advice of the governor. The LHC report was > made with input from numerous independent organizations. In fact, > many groups separate from our field, but with no apparent vested > interest in anything other than public protection have all pretty > much agreed the board must go. I also forwarded a lengthy letter > from Jack Miller, PCOM president and past CCAOM president, siding > with the JC. CSOMA pretty much stands alone in this matter. Groups > like AIMS are really subsets or contractees or lobbyists of > organizations like CSOMA, so they don't really constitute another > independent entity, IMO. As for the rank and file licensees, I don't > recall ever being asked what I thought in any formal CAB survey. But > just as a recent survey showed negligible interest in the doctoral > title across the profession as a whole, I would suspect that most > licensees would just assume see the board go away, too. Most > licensees I speak with do not want the added rights of western > diagnosis, for example, because with those rights comes a whole host > of responsibilities, which if adhered to closely would interfere with > the practice of OM. If I have to spend inordinate amounts of time > playing CYA by doing all this unnecessary testing and examination, > when will I have time to insert needles and perform acupuncture. As I > have written here before, we chose in OR to NOT be primary care to > avoid the legal consequences of being poorly trained yet highly > liable in this area. We should support the abolishment of the board > and we should oppose any backdoor attempts to turn all of us into > minidocs against our wills at the behest of a small group of vocal > but misguided politicos. > > > > On May 5, 2005, at 5:51 PM, CSOMA wrote: > > > > > May 5, 2005 > > > > Dear CSOMA members and colleagues; > > > > The following is the background for an EXTREMELY URGENT request to > > contact our state legislators, urging them to oppose Senate Bill > > 233 (SB233) which, if passed, could have far-reaching detrimental > > effects on our profession, and to your livelihood as a licensed > > acupuncturist. Although the background is somewhat long, we urge > > you to read through it within the next couple days and respond with > > letters to appropriate legislators. A sample letter and listing of > > legislators is provided towards the end of this alert. > > > > On April 25, the State Senate Business and Professions Committee > > voted 4-1 to pass SB233, which will abolish the California > > Acupuncture Board (CAB) on July 1, 2006. The CAB will sunset and > > become a bureau that will be placed under direct supervision of the > > Department of Consumer Affairs (DCA). In addition, a May 3 > > amendment to that bill could effectively prohibit licensed > > acupuncturists from rendering a diagnosis according to accepted > > standards of medical practice. > > > > This bill should be of grave concern and an affront to every > > licensed acupuncturist in California as well as the patients we > > treat. And although in public testimony Senator Figueroa adamantly > > states that SB 233 has nothing to do with the profession, but > > rather the performance of the Acupuncture Board, the recent > > amendments to the legislation validate that this is simply not the > > case. The Joint Committee on Boards, Committees and Consumer > > Protection (JC) recommended that the CAB be abolished for the > > following reasons: > > > > The CAB " has had trouble getting involved in the wrong issues " . The > > JC cited CAB discussions on upgrading educational standards for our > > acupuncture colleges, criticizing its recommendations for a 3,200 > > hour curriculum requirement as a " means of restricting entry into > > the profession " . In fact, the upgraded standards, which were signed > > into law in 2002 with AB1943, are meant to further ensure the > > viability of future acupuncturists as primary care providers. > > The CAB " missed significant opportunities to protect the public " . > > The JC criticized the CAB for its lack of discussion regarding > > " disposable, single-use needles or emerging research on threats to > > public health " . What the JC fails to understand is that the vast > > majority of licensed acupuncturists have received required > > certification in clean needle technique, and have been trained to > > use nothing other than disposable needles. It also fails to see > > that the CAB has made significant efforts to protect the public by > > advocating for higher standards of education that will better > > prepare future acupuncturists to function within integrated > > settings with other medical professionals. > > The CAB has such a relatively small staff, it is not always able to > > operate efficiently. The JC made the same criticism of the Medical > > Board in SB231, yet recommended that it be extended until 2010. The > > JC cites that the CAB function of approving schools of acupuncture > > in California is a drain on its meager time and resources. Behind > > this criticism, however, is the reality that national stakeholders > > have effectively lobbied key legislators in the State Capitol in an > > effort to wrest control from the CAB this vital function. It is > > these same national stakeholders who have consistently opposed > > upgrading educational standards for acupuncture schools in > > California in order to force conformity with lower nationally held > > standards. > > The CAB " misreads its governing statutes concerning the scope of > > practice of licensees " . Our scope of practice and authority to > > diagnose have been a major point of disagreement between the CAB > > and JC. The JC's intention to restrict our diagnostic authority > > would effectively prevent acupuncturists from participating in > > workers compensation and health insurance as primary care > > providers. Furthermore, it could once again subordinate us under > > the supervision of MDs, ODs and DCs. The JC fails or refuses to > > recognize Legal Opinion 93-11 rendered in 1993. It states that by > > repealing the requirement of referral or diagnosis from an MD, the > > Legislature has authorized acupuncturists to diagnose a patient's > > condition prior to providing any treatment. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 It has so amazed me over the years that we seem to be the only profession that is eagerly willing to give up scope of practice and tools (like herbs) all without a fight. >>>>Can you believe it? It is all about getting rid of the current school system we have.As long as they are the only players with money we will never see any positive change. Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 Not being able to diagnose means no insurance. Period. It means we cannot bill workers comp, private insurance, or medicare (when that happens). >>>It means no independent practice Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 , " " <alonmarcus@w...> wrote: > Not being able to diagnose means no insurance. Period. It means we > cannot bill workers comp, private insurance, or medicare (when that > happens). > >>>It means no independent practice I do not partake of any insurance company or workers comp.. My practice is totally cash based and independent...All my patients sign a form that states that under no circumstances will I deal with their insurance company. If my supper bill which has the codes of my diagnosis and treatment is not good enough, it's not my problem..The insurance company is not my patient. Their client is. I've taken this position in light of all the trouble and redtape insurance companies put practitioner through. In my experience, folks that pay out of pocket are more willing to comply, implement lifestyle changes, heal faster and their referals are mostly like minded and able to pay out of pocket. For those who cannot afford my fees, I give them financial considerations as long as they practice what I teach them and ingest what I give them. So far this is working. Insurance money is false economy. Fernando > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 Alon, I've stayed out of the fray so far, as I think most issues that are considered to be 'political' are sometimes more complex then they may appear. Also, people with unpopular positions get 'branded' and demonized unnecessarily. But what has colored the political debate in our profession is similar to what poisons present-day conventional politics; the 'us vs. them' scenario. Blue states vs. red states. First you need a scapegoat or demon. For the practitioners, it is the schools who are the devil, the cause for all our problems as a profession. For the schools, it is the practitioner associations. From AAOM vs. Alliance, the board vs. the schools, this in-grown battle has poisoned our wells for too many years now. I must say that I am not the only one who is disgusted with this situation. " The schools " is not a monolithic entity. There are many people, both professors/teachers and administrators who feel very passionate about the future of our field and are working hard to improve it and help it grow. There are many flaws built into the educational system due to our field's early ignorance that will take time to mend. However, the regulatory system and the practitioners associations are also deeply flawed as well. I am personally tired of getting 'alerts' threatening loss of scope of practice, income, insurance and who knows what else for years, only to find that most of these threats were false alarms meant to generate and support agendas. I want clear facts, and then based on those facts, I can choose an informed position and contribute to that position accordingly. On May 8, 2005, at 10:42 AM, wrote: > It has so amazed me over the years that we seem to be the only > profession > that is eagerly willing to give up scope of practice and tools > (like herbs) > all without a fight. > >>>>> Can you believe it? It is all about getting rid of the current >>>>> school system we have.As long as they are the only players with >>>>> money we will never see any positive change. >>>>> > > > > > Oakland, CA 94609 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 This is also my experience, and my stance as well. I agree on all points. On May 8, 2005, at 1:26 PM, Fernando Bernall wrote: > I do not partake of any insurance company or workers comp.. My > practice is totally cash based and independent...All my patients sign > a form that states that under no circumstances will I deal with their > insurance company. If my supper bill which has the codes of my > diagnosis and treatment is not good enough, it's not my problem..The > insurance company is not my patient. Their client is. > > I've taken this position in light of all the trouble and redtape > insurance companies put practitioner through. > > In my experience, folks that pay out of pocket are more willing to > comply, implement lifestyle changes, heal faster and their referals > are mostly like minded and able to pay out of pocket. > > For those who cannot afford my fees, I give them financial > considerations as long as they practice what I teach them and ingest > what I give them. So far this is working. > > Insurance money is false economy. > > > > Fernando Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 I have to disagree here, Greg. We are hardly united as a profession on the core issue. What is Chinese or Asian medicine? is correct. There is barely enough time in an hourly session to diagnose by pulse, tongue, questioning, etc., not to say prescribe both herbal medicine and acupuncture treatment. Add on to that the various Western diagnostic tests, and it becomes prohibitive to practice what we are supposed to be doing. There are many of us in this field who don't want to be mini-docs. If I want my patients to have biomedical testing, diagnosis or treatment, I refer them to who I think is best in that realm. I want to excel at Chinese medicine. Yes, there is a certain amount of Western medicine that we must know, but we have to be careful not to spread ourselves too thin in our practices. This field seems to be pushing for more biomedical classes, more training, more practice of biomedical specialties. However, I do not see a corresponding trend towards deeper study in Chinese or Asian medicine itself, including learning an Asian language, more in-depth knowledge of acupuncture and herbal techniques, theory, diagnosis, Shang Han Lun, Wen Bing, and a host of other related subjects. I am not in any way for reducing our scope of practice, however, the LHC is right about one thing. We need to keep separate what Chinese and biomedical treatment and diagnosis are in our own minds, and avoid confusing the public. I'd like to see us define our own profession more, instead of trying to absorb more biomedicine into what we do. As Todd says, get additional training if you want to practice biomedicine. Otherwise, we may gain scope of practice, but pay dearly in malpractice insurance to cover it. We may not be legislated out of the medical marketplace, but we may be priced out. Having said this, I agree with you that we need to carefully watch what legislators do and the legislative process. The political realm is filled with twists and turns. On May 7, 2005, at 12:04 PM, sperb1 wrote: > Finally, this is not about diagnosis, it is about the status > and stature of our profession. Please do not rehash the old > diagnosis argument. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 I also only " super bill " patients who then go to their insurance companies. These people have paid several hundred dollars a month for health insurance. As I understand the debate, the issue is wether they take away our right to but a Western code. If so these super bills are worthless for the client to get re-imberesed. doug , " " <zrosenbe@s...> wrote: > This is also my experience, and my stance as well. I agree on all > points. > > > On May 8, 2005, at 1:26 PM, Fernando Bernall wrote: > > > I do not partake of any insurance company or workers comp.. My > > practice is totally cash based and independent...All my patients sign > > a form that states that under no circumstances will I deal with their > > insurance company. If my supper bill which has the codes of my > > diagnosis and treatment is not good enough, it's not my problem..The > > insurance company is not my patient. Their client is. > > > > I've taken this position in light of all the trouble and redtape > > insurance companies put practitioner through. > > > > In my experience, folks that pay out of pocket are more willing to > > comply, implement lifestyle changes, heal faster and their referals > > are mostly like minded and able to pay out of pocket. > > > > For those who cannot afford my fees, I give them financial > > considerations as long as they practice what I teach them and ingest > > what I give them. So far this is working. > > > > Insurance money is false economy. > > > > > > > > Fernando > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 Just my thoughts. Neither the Acupuncture Committee nor the Acupuncture Board, who had LAc in attendance, furthered the interest of Acupuncturists nor the public, hence no one to their rescue. Just karma live free and healthy Ed Kasper L.Ac., Santa Cruz, CA. 95060 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 I am personally tired of getting 'alerts' threatening loss of scope of practice, income, insurance and who knows what else for years, only to find that most of these threats were false alarms meant to generate and support agendas. >>>Zev, for those of us that have warned of exactly what is now occurring over 10 years ago, including the formation of LHC like structures and the conclusions the LHC has made, these are not empty alerts but the coming true of warnings done for many years now. If looked at as a possible progression, these can only be looked at negatively. A loss of any gained status has never occurred in the history on any other profession. There is only one explanation to this and that is the schools and the NCCA (which were married for many years). While the schools are not monolithic their political money has certainly been spent in such a manner for many years now. Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 I also only " super bill " patients who then go to their insurance companies. These people have paid several hundred dollars a month for health insurance. >>>Even on a superbill you need to put down a diagnosis. Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 I'd like to understand something. There are many patients we treat with conditions we treat that are usually diagnosed by biomedical physicians, such as diabetes, hypertension, cancer, heart disease, etc. Most of the conditions that people in our field seem to be contesting for diagnosis are musculo-skeletal. My feeling is that we should have started developing codes for pattern differentiation a long time ago and presented them to insurance companies, or developed our own plans. We are just discovering that the loopholes we've used all along are not being effective anymore. On May 8, 2005, at 5:21 PM, wrote: > I also only " super bill " patients who then go to their insurance > companies. These people > have paid several hundred dollars a month for health insurance. As > I understand the > debate, the issue is wether they take away our right to but a > Western code. If so these > super bills are worthless for the client to get re-imberesed. > doug Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 I think what you call 'gained status' is a bit of an illusion. We've simply taken advantage of loopholes in the system, not unlike classifying herbal medicine as 'food supplements'. Very few practitioners actually make the diagnoses that they use the codes for. Either we have to radically increase biomedical education to deserve our status, or start digging in and defining our own diagnostic codes according to pattern differentiation. We are just being called up to justify our present position(s). On May 8, 2005, at 6:14 PM, wrote: >>>> Zev, for those of us that have warned of exactly what is now >>>> occurring over 10 years ago, including the formation of LHC like >>>> structures and the conclusions the LHC has made, these are not >>>> empty alerts but the coming true of warnings done for many years >>>> now. If looked at as a possible progression, these can only be >>>> looked at negatively. A loss of any gained status has never >>>> occurred in the history on any other profession. There is only >>>> one explanation to this and that is the schools and the NCCA >>>> (which were married for many years). While the schools are not >>>> monolithic their political money has certainly been spent in >>>> such a manner for many years now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2005 Report Share Posted May 8, 2005 We've simply taken advantage of loopholes in the system >>>This is an important legal concept and is used to create standards all the time. Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2005 Report Share Posted May 9, 2005 Hi Z'ev I don't know where this is coming from. At no point in my message did I advocate anything about biomedicine. In this discussion, I don't care how, who, where, or why the diagnosis comes from, but to bill insurance, to create a superbill, to even chart, we need a diagnosis. Whether that is as simple as low back pain or whether that is a narrowing of the spinal canal due to an anterior protruding disk after an MRI is immaterial. We must have the ability to diagnose or we will cease as an independent medicine. Please do not put words in my mouth about biomedical diagnosis. And just to make it clear here, I am not saying that reduction of our ability to diagnose is in the amendments to SB 233. It seems that that may be the case, but I am still waiting to hear a legal opinion. Dr. Greg Sperber , " " <zrosenbe@s...> wrote: > I have to disagree here, Greg. > > We are hardly united as a profession on the core issue. What is > Chinese or Asian medicine? > is correct. There is barely enough time in an hourly session to > diagnose by pulse, tongue, questioning, etc., not to say prescribe > both herbal medicine and acupuncture treatment. Add on to that the > various Western diagnostic tests, and it becomes prohibitive to > practice what we are supposed to be doing. > > There are many of us in this field who don't want to be mini- docs. > If I want my patients to have biomedical testing, diagnosis or > treatment, I refer them to who I think is best in that realm. I > want to excel at Chinese medicine. Yes, there is a certain amount of > Western medicine that we must know, but we have to be careful not to > spread ourselves too thin in our practices. > > This field seems to be pushing for more biomedical classes, more > training, more practice of biomedical specialties. However, I do not > see a corresponding trend towards deeper study in Chinese or Asian > medicine itself, including learning an Asian language, more in- depth > knowledge of acupuncture and herbal techniques, theory, diagnosis, > Shang Han Lun, Wen Bing, and a host of other related subjects. > > I am not in any way for reducing our scope of practice, however, the > LHC is right about one thing. We need to keep separate what Chinese > and biomedical treatment and diagnosis are in our own minds, and > avoid confusing the public. > > I'd like to see us define our own profession more, instead of trying > to absorb more biomedicine into what we do. As Todd says, get > additional training if you want to practice biomedicine. Otherwise, > we may gain scope of practice, but pay dearly in malpractice > insurance to cover it. We may not be legislated out of the medical > marketplace, but we may be priced out. > > Having said this, I agree with you that we need to carefully watch > what legislators do and the legislative process. The political realm > is filled with twists and turns. > > > On May 7, 2005, at 12:04 PM, sperb1 wrote: > > > Finally, this is not about diagnosis, it is about the status > > and stature of our profession. Please do not rehash the old > > diagnosis argument. > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2005 Report Share Posted May 9, 2005 On May 8, 2005, at 1:33 PM, wrote: > I am personally tired of getting 'alerts' threatening loss of > scope of practice, income, insurance and who knows what else for > years, only to find that most of these threats were false alarms > meant to generate and support agendas. I want clear facts, and then > based on those facts, I can choose an informed position and > contribute to that position accordingly. Al rises and claps. -- Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2005 Report Share Posted May 9, 2005 Todd is correct. There is barely enough time in an hourly session to diagnose by pulse, tongue, questioning, etc., not to say prescribe both herbal medicine and acupuncture treatment. Add on to that the various Western diagnostic tests, and it becomes prohibitive to practice what we are supposed to be doing. >>>>>They seem to be able to this this all over the orient quite well. I guess its back to training Oakland, CA 94609 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 9, 2005 Report Share Posted May 9, 2005 Understood. However, we are now in the 'spotlight', because of complaints by certain factions in our profession that we do not have a safe level of education to practice acupuncture. Because of the rift in the profession, the state hired the Little Hoover Commission to make recommendations on issues such as scope of practice, the state board exam, education, etc. We brought this on ourselves. I see a wave of self-destructiveness in the field that needs to be rectified. On May 8, 2005, at 6:45 PM, wrote: > We've > simply taken advantage of loopholes in the system > >>>> This is an important legal concept and is used to create >>>> standards all the time. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 10, 2005 Report Share Posted May 10, 2005 You are talking about collaborative environments in hospital settings, not single practitioner environments. On May 9, 2005, at 11:29 AM, wrote: > > >>>>>> They seem to be able to this this all over the orient quite >>>>>> well. I guess its back to training Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 10, 2005 Report Share Posted May 10, 2005 Zev, We should not forget that decisions to refer rely upon the practitioners and their knowing when to refer and is part of participation in a healthcare system. That, in turn, relies upon us having the WM knowledge to do so. This is something that we need to have in order to properly perform our job in our society and be a part of the healthcare system of America. If we cannot continue in this respect it could jeopardize our profession and have the impact of reducing us to PT or even to MT level. Few people will pay this amount of money to be in that type of situation. Some people and practitioners want us to crawl back under a rock. The progressive vs. conservative mentality is alive and well in our profession, especailly over this issue yet we cannot afford to lose this one. In addition, there are many current instances that I have encountered where modern practitioners use western lab tests as a marker in herbal prescribing. Jake Fratkin makes frequent mention of it in his patent textbook as does Misha Cohen in her hepatitis certification. Western lab tests are not the property of only the MD and do not mean that we conduct surgery, prescribe drugs, etc. This is another tool or way to evaluate the correctness of care. We should fight for this otherwise it will only take one bad herbal formula with a negative herbal outcome to show that we should not be allowed to use herbs. We hear a lot about education on this forum, mostly areas that need to be improved. I can think of no greater way to better our profession than a western understanding of care and also knowledge of lab testing. Practitioners can always refer a patient to their GP and most do for some concerns but we should still be able to read and understand the results. Our educational knowledge is justified by retaining this ability. This is similar to chiropractic in that they can also order routine lab tests. We should take a page out of their playbook. In the end, in oder for the profession to grow and prosper we need to have better integration in the healthcare system. We are seeing various collaberative efforts with schools and hospitals as well as employment ops. We do not want to lose these I would hope. Later Mike W. Bowser, L Ac > " " <zrosenbe > > >Re: Re: Senate Bill 233 >Tue, 10 May 2005 07:38:50 -0700 > >You are talking about collaborative environments in hospital >settings, not single practitioner environments. > > >On May 9, 2005, at 11:29 AM, wrote: > > > > > > >>>>>> They seem to be able to this this all over the orient quite > >>>>>> well. I guess its back to training > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 10, 2005 Report Share Posted May 10, 2005 You are talking about collaborative environments in hospital settings, not single practitioner environments. >>>>>>>>>>> Zev, these days its both, there are many single practitioner environments that integrate. Also, if we are to become part of the system, ie collaborative environments, then we need to be prepared. The road we are taking if for further isolation Quote Link to comment Share on other sites More sharing options...
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