Open Letter in Opposition to ABORM

[Guest guest]

Yehuda,

 

Doesn't ABORM provide just what you are looking for? Why must ABORM

have and association with the NCCAOM, which tests for general

acupuncture competency?

 

ABORM does provide an exam. AND, while not offerring specific

courses or training, the ABORM does offer a specific list of

competencies so that candidates know what areas of training to focus

their study.

 

As I said in an earlier post, this process is not perfect, and it is

not complete. But it is a good agency that is making a good start.

Do you suppose that NCCAOM started out fully developed? You are

using the NCCAOM as a benchmark, but even that organization had

humble beginnings. This process must start somewhere. If we wait

until it is fully developed and without flaw or opposition, then it

will likely never come about.

 

You mentioned that you are concerned about selective reimbursement

from insurance that favors board certified specialists: First of

all, this is a hypothetical fear. No insurance company has stated

that it will only reimburse acupuncture fertility treatments

administered by an ABORM certified practitioner.

 

Furthermore,isn't it ultimately a good thing for patients and the

general public for the market forces to drive patients toward better

trained and qualified practitioners?

 

My clinic specializes exclusively in the treatment of reproductive

disorders and infertility, and I fully support the formation of

ABORM. I can't tell you how many patients I have had who have seen

another acupuncturist before they came to our clinic who was clearly

unqualified to treat infertility. But to the consuner, there is no

way to distinguish one acupuncturist from another. We need this

standard as a benchmark of basic competency.

 

Please support ABORM.

 

David Karchmer

The Texas Center for Reproductive Acupuncture

 

 

, yehuda frischman

< wrote:

>

> Laura,

>

> An important issue to remember is insurance reimbursal, as well

as malpractice insurance. When you have a licensure in place such

as ABORM, people on the outside tend to consider those not licensed

by them to be not necessarily on the same level of competence or

expertise. That can lead to denials of claims or exemptions to

coverage. I would have much less of a problem if there was an

association (however loose) with a national organization such as

NCCAOM, and the licensure would be accompanied by specific courses

and a test. That would level the playing field.

>

> Does that make sense?

>

> Laura Erlich <lauraerlich wrote:

> To all those opposing the formation of ABORM,

>

> With respect, I would like to state that I simply do not

understand how the

> formation of a specialty board would in any way damage the

profession of TCM

> in America. The group of practitioners who are vocalizing this

dissent seem

> to be forgetting one basic notion: that it is our job as

healthcare

> professionals to provide our patients with the best possible care,

and above

> all, to do no harm. Suggesting that it is not important to know

the

> difference between HCG and FSH, because it would not impact the

choice in

> herbs we might prescribe, is flagrantly irresponsible, and in and

of itself

> demonstrates a need for a board like ABORM. Simply put, the

treatment of

> infertility requires detailed knowledge of Western Medicine, due

to the fact

> that a vast number of fertility patients will be SIMULTANEOUSLY

USING

> WESTERN FERTILITY MEDICATION WHILE WE ARE TREATING THEM!! Ignoring

a

> patients western diagnosis in this case could inhibit or even ruin

her

> chances of having a baby. The ABORM exam will at least show a

basic level

> of competence in the realm of western fertility treatments, which

should

> bring patients peace of mind while dealing with this costly,

emotional and

> often painful issue.

>

> Of course, for the patient who is only using TCM in their efforts

to

> conceive, one might argue that we as herbalists can differentiate

between

> yin, yang or qi deficiency, etc., but what argument can be set in

place to

> oppose knowing the effects of our herbs on the endocrine system

and

> fertility medications? Additionally, should we not know when to

refer out

> for structural tests, so that we don't waste our patient's time

and money?

> Is it not our job to work with our patients, and to guide them

through their

> health crisis' with grace? I ALWAYS recommend that my fertility

patients

> get baseline blood work and ultrasound, so that I know where I am

starting

> from. It is my opinion that we should be striving to integrate

with and

> educate our MD colleagues about the effects of TCM on fertility,

so that we

> can provide the most comprehensive care possible to our patients.

Having a

> board such as ABORM puts in place a basic level of competency that

one

> should have in order to go forth as a " specialist " in the area of

fertility.

>

> The notion that we are provided with a sufficient body of

knowledge in

> school to treat ALL conditions as GP's is preposterous. I went to

great

> lengths for the duration of my clinical internship to specialize

in women's

> health, and still feel that it was just the tip of the iceberg. Of

course,

> general practitioners are of great benefit to the public, but so

are people

> who are drawn to know their particular niche in great detail.

Those who

> take the time, and spend the energy and money to specialize,

should be so

> credited. I would advocate for specialty boards for many of the

conditions

> that we commonly treat, as the professional community sees fit.

>

> I truly hope that those who are leading this opposition will re-

consider

> their position, and ask themselves what motivates it in the first

place? It

> is clearly in the best interest of our patients to create ways to

measure

> competence, especially when it comes to specialties that require

integrative

> knowledge in order to be successful.

>

> Sincerely,

> Laura Erlich, LAc, MTOM

>

> _______________

> More photos, more messages, more storage—get 2GB with Windows Live

Hotmail.

> http://imagine-windowslive.com/hotmail/?locale=en-

us & ocid=TXT_TAGHM_migration_HM_mini_2G_0507

>

>

>

> Chinese Herbal Medicine offers various professional services,

including a practitioner's directory and a moderated discussion

forum.

>

>

>

>

[Guest guest]

Caroline,

 

While I can understand your frustration with th eprocess, your

reasoning flawed. You say:

 

" If the profession decides that this is a trend they need to have in

order to be accepted by Western Medicine (by following them as a

role model) then let the entire community decide this..... "

 

Just how do you suppose this decision making process occurs? I don't

recall our 'profession' ever deciding anything by referendum. There

is absolutely no profession-wide infrastructure to make collective

decisions. So, I cannot understand what you are actually proposing

when you suggest that our " profession " should " decide " anything.

Professions are abstractions. They do not make decisions, people do.

 

I know that this may seem like spitting hairs and may come off as

facetious. I am not trying to be inflammatory, but I just do not

understand the process by which our profession could possibly decide

something by consensus. Just what are you proposing?

 

David Karchmer

The Texas Center for Reproductive Acupuncture

 

Your reasoning is > Laura: With all due respect, you may have missed

the point of the

> petition. We are in no way suggesting that knowledge of Western

> medicine is not crucial to giving your patients the best service

and

> treatment. An exam without appropriate training is pointless as it

> does not clearly identify that knowing what the tests are in a

> multiple choice format means that one understands the implications

of

> this in relation to our TCM treatments. It is actually a

disservice

> to patients to suggest that more letters after your name because

you

> passed an exam without appropriate advanced training (which you

also

> identified is lacking in the basic training of practitioners)

makes

> you somehow better qualified then someone who may have done the

work

> and study to understand what the implications are of western tests

in

> the context of our medicine, despite not having the " stamp of

> approval " from a board.

>

> Of course this exam is optional, but we are concerned that this is

a

> dangerous trend, because someday it may not be and do you want to

be

> required to take an exam for every thing you treat or pay

malpractice

> premiums or dues to specialty groups to do what you already do? We

> are advocating for training and want the word to be out there for

all

> practitioners to judge. If the profession decides that this is a

> trend they need to have in order to be accepted by Western

Medicine

> (by following them as a role model) then let the entire community

> decide this, not a few well-qualified and well-intentioned folks

who

> may not have considered all the possible implications of the

> structure they have proposed.

>

> Caroline Radice, MS LAc CA NCCAOM (which is plenty)

>

>

> , " Laura Erlich "

> <lauraerlich@> wrote:

> >

> > To all those opposing the formation of ABORM,

> >

> > With respect, I would like to state that I simply do not

understand

> how the

> > formation of a specialty board would in any way damage the

> profession of TCM

> > in America. The group of practitioners who are vocalizing this

> dissent seem

> > to be forgetting one basic notion: that it is our job as

healthcare

> > professionals to provide our patients with the best possible

care,

> and above

> > all, to do no harm. Suggesting that it is not important to know

> the

> > difference between HCG and FSH, because it would not impact the

> choice in

> > herbs we might prescribe, is flagrantly irresponsible, and in

and

> of itself

> > demonstrates a need for a board like ABORM. Simply put, the

> treatment of

> > infertility requires detailed knowledge of Western Medicine, due

to

> the fact

> > that a vast number of fertility patients will be SIMULTANEOUSLY

> USING

> > WESTERN FERTILITY MEDICATION WHILE WE ARE TREATING THEM!!

Ignoring

> a

> > patients western diagnosis in this case could inhibit or even

ruin

> her

> > chances of having a baby. The ABORM exam will at least show a

> basic level

> > of competence in the realm of western fertility treatments,

which

> should

> > bring patients peace of mind while dealing with this costly,

> emotional and

> > often painful issue.

> >

> > Of course, for the patient who is only using TCM in their

efforts

> to

> > conceive, one might argue that we as herbalists can

differentiate

> between

> > yin, yang or qi deficiency, etc., but what argument can be set

in

> place to

> > oppose knowing the effects of our herbs on the endocrine system

and

> > fertility medications? Additionally, should we not know when to

> refer out

> > for structural tests, so that we don't waste our patient's time

and

> money?

> > Is it not our job to work with our patients, and to guide them

> through their

> > health crisis' with grace? I ALWAYS recommend that my fertility

> patients

> > get baseline blood work and ultrasound, so that I know where I

am

> starting

> > from. It is my opinion that we should be striving to integrate

> with and

> > educate our MD colleagues about the effects of TCM on fertility,

so

> that we

> > can provide the most comprehensive care possible to our

patients.

> Having a

> > board such as ABORM puts in place a basic level of competency

that

> one

> > should have in order to go forth as a " specialist " in the area

of

> fertility.

> >

> > The notion that we are provided with a sufficient body of

knowledge

> in

> > school to treat ALL conditions as GP's is preposterous. I went

to

> great

> > lengths for the duration of my clinical internship to specialize

in

> women's

> > health, and still feel that it was just the tip of the

iceberg.

> Of course,

> > general practitioners are of great benefit to the public, but so

> are people

> > who are drawn to know their particular niche in great detail.

> Those who

> > take the time, and spend the energy and money to specialize,

should

> be so

> > credited. I would advocate for specialty boards for many of the

> conditions

> > that we commonly treat, as the professional community sees fit.

> >

> > I truly hope that those who are leading this opposition will re-

> consider

> > their position, and ask themselves what motivates it in the

first

> place? It

> > is clearly in the best interest of our patients to create ways

to

> measure

> > competence, especially when it comes to specialties that require

> integrative

> > knowledge in order to be successful.

> >

> > Sincerely,

> > Laura Erlich, LAc, MTOM

> >

> > _______________

> > More photos, more messages, more storage?get 2GB with Windows

Live

> Hotmail.

> > http://imagine-windowslive.com/hotmail/?locale=en-

> us & ocid=TXT_TAGHM_migration_HM_mini_2G_0507

> >

>

[Guest guest]

In general all specialty boards should not be privately owned and should be

created by a wide representative group. That is why it is best that AAAOM should

create them. All the current privately owned board are questionable at best

 

 

 

 

 

 

 

 

-

thecornerstoneclinic

Wednesday, August 15, 2007 10:31 AM

Re: Open Letter in Opposition to ABORM

 

 

Yehuda,

 

Doesn't ABORM provide just what you are looking for? Why must ABORM

have and association with the NCCAOM, which tests for general

acupuncture competency?

 

ABORM does provide an exam. AND, while not offerring specific

courses or training, the ABORM does offer a specific list of

competencies so that candidates know what areas of training to focus

their study.

 

As I said in an earlier post, this process is not perfect, and it is

not complete. But it is a good agency that is making a good start.

Do you suppose that NCCAOM started out fully developed? You are

using the NCCAOM as a benchmark, but even that organization had

humble beginnings. This process must start somewhere. If we wait

until it is fully developed and without flaw or opposition, then it

will likely never come about.

 

You mentioned that you are concerned about selective reimbursement

from insurance that favors board certified specialists: First of

all, this is a hypothetical fear. No insurance company has stated

that it will only reimburse acupuncture fertility treatments

administered by an ABORM certified practitioner.

 

Furthermore,isn't it ultimately a good thing for patients and the

general public for the market forces to drive patients toward better

trained and qualified practitioners?

 

My clinic specializes exclusively in the treatment of reproductive

disorders and infertility, and I fully support the formation of

ABORM. I can't tell you how many patients I have had who have seen

another acupuncturist before they came to our clinic who was clearly

unqualified to treat infertility. But to the consuner, there is no

way to distinguish one acupuncturist from another. We need this

standard as a benchmark of basic competency.

 

Please support ABORM.

 

David Karchmer

The Texas Center for Reproductive Acupuncture

 

, yehuda frischman

< wrote:

>

> Laura,

>

> An important issue to remember is insurance reimbursal, as well

as malpractice insurance. When you have a licensure in place such

as ABORM, people on the outside tend to consider those not licensed

by them to be not necessarily on the same level of competence or

expertise. That can lead to denials of claims or exemptions to

coverage. I would have much less of a problem if there was an

association (however loose) with a national organization such as

NCCAOM, and the licensure would be accompanied by specific courses

and a test. That would level the playing field.

>

> Does that make sense?

>

> Laura Erlich <lauraerlich wrote:

> To all those opposing the formation of ABORM,

>

> With respect, I would like to state that I simply do not

understand how the

> formation of a specialty board would in any way damage the

profession of TCM

> in America. The group of practitioners who are vocalizing this

dissent seem

> to be forgetting one basic notion: that it is our job as

healthcare

> professionals to provide our patients with the best possible care,

and above

> all, to do no harm. Suggesting that it is not important to know

the

> difference between HCG and FSH, because it would not impact the

choice in

> herbs we might prescribe, is flagrantly irresponsible, and in and

of itself

> demonstrates a need for a board like ABORM. Simply put, the

treatment of

> infertility requires detailed knowledge of Western Medicine, due

to the fact

> that a vast number of fertility patients will be SIMULTANEOUSLY

USING

> WESTERN FERTILITY MEDICATION WHILE WE ARE TREATING THEM!! Ignoring

a

> patients western diagnosis in this case could inhibit or even ruin

her

> chances of having a baby. The ABORM exam will at least show a

basic level

> of competence in the realm of western fertility treatments, which

should

> bring patients peace of mind while dealing with this costly,

emotional and

> often painful issue.

>

> Of course, for the patient who is only using TCM in their efforts

to

> conceive, one might argue that we as herbalists can differentiate

between

> yin, yang or qi deficiency, etc., but what argument can be set in

place to

> oppose knowing the effects of our herbs on the endocrine system

and

> fertility medications? Additionally, should we not know when to

refer out

> for structural tests, so that we don't waste our patient's time

and money?

> Is it not our job to work with our patients, and to guide them

through their

> health crisis' with grace? I ALWAYS recommend that my fertility

patients

> get baseline blood work and ultrasound, so that I know where I am

starting

> from. It is my opinion that we should be striving to integrate

with and

> educate our MD colleagues about the effects of TCM on fertility,

so that we

> can provide the most comprehensive care possible to our patients.

Having a

> board such as ABORM puts in place a basic level of competency that

one

> should have in order to go forth as a " specialist " in the area of

fertility.

>

> The notion that we are provided with a sufficient body of

knowledge in

> school to treat ALL conditions as GP's is preposterous. I went to

great

> lengths for the duration of my clinical internship to specialize

in women's

> health, and still feel that it was just the tip of the iceberg. Of

course,

> general practitioners are of great benefit to the public, but so

are people

> who are drawn to know their particular niche in great detail.

Those who

> take the time, and spend the energy and money to specialize,

should be so

> credited. I would advocate for specialty boards for many of the

conditions

> that we commonly treat, as the professional community sees fit.

>

> I truly hope that those who are leading this opposition will re-

consider

> their position, and ask themselves what motivates it in the first

place? It

> is clearly in the best interest of our patients to create ways to

measure

> competence, especially when it comes to specialties that require

integrative

> knowledge in order to be successful.

>

> Sincerely,

> Laura Erlich, LAc, MTOM

>

> ________

> More photos, more messages, more storage-get 2GB with Windows Live

Hotmail.

> http://imagine-windowslive.com/hotmail/?locale=en-

us & ocid=TXT_TAGHM_migration_HM_mini_2G_0507

>

>

>

> Chinese Herbal Medicine offers various professional services,

including a practitioner's directory and a moderated discussion

forum.

>

>

>

>

[Guest guest]

Alon,

 

Isn't your proposal just private ownership by the AAAOM instead of

by other agencies like ABORM? Who provides oversight to the AAAOM?

 

It's really a circular argument. At some point, the buck stops, and

the only agency oversight comes from the agency itself. So, why not

have ABORM's legitimacy start and stop with the agency itself?

 

David Karchmer

The Texas Center for Reproductvie Acupuncture

 

, " Alon Marcus "

<alonmarcus wrote:

>

> In general all specialty boards should not be privately owned and

should be created by a wide representative group. That is why it is

best that AAAOM should create them. All the current privately owned

board are questionable at best

>

>

>

>

>

>

>

>

[Guest guest]

AAAOM i think is an open organization, anyone can get voted in. You cannot say

this about any of the other boards

 

 

 

 

 

 

 

 

-

thecornerstoneclinic

Wednesday, August 15, 2007 12:57 PM

Re: Open Letter in Opposition to ABORM

 

 

Alon,

 

Isn't your proposal just private ownership by the AAAOM instead of

by other agencies like ABORM? Who provides oversight to the AAAOM?

 

It's really a circular argument. At some point, the buck stops, and

the only agency oversight comes from the agency itself. So, why not

have ABORM's legitimacy start and stop with the agency itself?

 

David Karchmer

The Texas Center for Reproductvie Acupuncture

 

, " Alon Marcus "

<alonmarcus wrote:

>

> In general all specialty boards should not be privately owned and

should be created by a wide representative group. That is why it is

best that AAAOM should create them. All the current privately owned

board are questionable at best

>

>

>

>

>

>

>

>

 

 

 

 

 

[Guest guest]

Well,

 

I cannot say what the aaaom is doing in terms of board certification

of various specializations. Here is what I do know,

 

According to the aaaom website, the Education/Credentialing

Committee's stated purpose is " to provide expertise from within the

professional association to accrediting, licensing and educating

bodies, and to facilitate the development of board certification

processes. "

 

The committee chair for the aaaom's Education/Credentialing committe

is Will Morris. He is also the president of The Academy of Oriental

Medicine at Austin. This school hosts an annual symposium and the

ABORM exam is being conducted in conjunction with this symposium.

 

So, as far as the aaaom's stance on ABORM, here is what we know:

The chairman of their Education and Credentialing committee is

hosting the ABORM exam.

 

Doesn't sound like the aaaom has a problem with ABORM to me.

 

David Karchmer

The Texas Center for Reproductive Acupuncture

 

 

 

, " Alon Marcus "

<alonmarcus wrote:

>

> AAAOM i think is an open organization, anyone can get voted in.

You cannot say this about any of the other boards

>

>

>

>

>

>

>

>

> -

> thecornerstoneclinic

>

> Wednesday, August 15, 2007 12:57 PM

> Re: Open Letter in Opposition to ABORM

>

>

> Alon,

>

> Isn't your proposal just private ownership by the AAAOM instead

of

> by other agencies like ABORM? Who provides oversight to the

AAAOM?

>

> It's really a circular argument. At some point, the buck stops,

and

> the only agency oversight comes from the agency itself. So, why

not

> have ABORM's legitimacy start and stop with the agency itself?

>

> David Karchmer

> The Texas Center for Reproductvie Acupuncture

>

> , " Alon Marcus "

> <alonmarcus@> wrote:

> >

> > In general all specialty boards should not be privately owned

and

> should be created by a wide representative group. That is why it

is

> best that AAAOM should create them. All the current privately

owned

> board are questionable at best

> >

> >

> >

> >

> >

> >

> >

> >

>

>

>

>

>

[Guest guest]

Caroline -

 

With all due respect to you, I would say that it is you who may have missed the

point.

 

There is absolutely plentiful and appropriate training in the field of Treating

Infertility

with in fact, as you have pointed out several times in your letters to me

and the

AAAOM, you have taught many of these courses yourself. Aren't you teaching one

upcoming at the Swedish Institute? Are we to understand that your course is

worthless or

meaningless regarding the treatment of infertility? Of course not.

 

Moreover, there are a plethora of courses currently being offered on the

Treatment of

Infertility - from beginning level to advanced (i.e. Randine Lewis, Jane

Lyttleton, Mike

Berkley, Miki Shima, Peter Deadman, Bob Damone, Shiaoting Jing, Daoshing Ni,

etc.), and

there are now at least two doctoral programs offering specialties in women's

health - a

part of which emphasize infertility. There are also certification courses in

women's health

being offered by Bob Flaws through Blue Poppy Seminars, and there is a

certification in

women's health being offered by Sharon Weisenbaum. (I apologize for the shamless

plugs

here).

 

The only thing missing in all of this education is some objective measure of

whether or not

someone has retained any of this material, and whether or not they can

demonstrate a

minimum competency in the subject via a balanced, fair, and challenging

examination that

will test the breadth of western reproductive medicine and the depth of TCM

Reproductive

Medicine at least as much as possible given the available published materials on

the

subject allow. It is highly unlikely that someone who has not " done the work

and study to

understand what the implications are of western tests in the context of our

medicine " will

be able to pass the ABORM examination.

 

What is actually a disservice to patients is for them to have no way of knowing

- except

someone's word for it - that they will be seeing a specialist in Oriental

Reproductive

Medicine (if that is what they desire) versus someone who simply took an

Infertility

Workshop at the Swedish Institute or the AAAOM conference, and may or may not

really

have a grasp of the subject.

 

To be sure, there are plenty who have passed the NCCAOM Exam (and might pass the

ABORM Exam), and possibly haven't mastered TCM, but we must start somewhere.

There

are also, plenty of folks who complete 4 years of training in TCM at an

accredited school,

but they are never able to demonstrate that they mastered the subject material

enough to

pass the NCCAOM Exam - a very basic entry level exam. Should we just give them a

certificate for time completed and leave it at that?

 

The ABORM is a non-profit, 501© 6 corporation that is owned and run by it's

members,

those now, and those to come. Every penny earned goes into supporting the

primary goals

of the ABORM: Patient safety, public education on the benefits of TCM for

reproductive

disorders (this will benefit the profession as a whole, not only ABORM members),

research

in the field of TCM vis-a-vis infertility (both herbs and acupuncture) so that

more doors

will be opened to allow us to practice the full scope of TCM related to

Infertility (this will

also benefit the profession as a whole, not only ABORM Members), teaching,

fellowships in

both TCM Hospitals and Western settings in the field of reproductive medicine,

communication and collaboration with our western colleagues in reproductive

medicine in

order to bring the best of both worlds to the infertile population, and so on.

 

Also, the ABORM competency categories, and the structure of the exam directly

relate to

the issue you raise, namely that the person sitting for this exam can

demonstrate not only

a breadth of western reproductive medicine, but more importantly how that

knowledge,

i.e. FSH, E2, HSG, LPD, etc. translate in TCM pathomechanisms and pattens of

disharmony

so that the practitioner can help the patient to conceive - both with

acupuncture, chinese

herbal medicine, and of course knowing when TCM is not the best treatment choice

for

that patient, say for example a patient with the recurrent pregancy loss who has

a balaced

translocation. Of course, you wouln't know this because as I have mentioned to

you

previously, neither you nor Marnae Ergil, nor anyone else bothered to speak to

anyone at

the ABORM before starting this petition with it's misleading information and

scare tactics. I

have asked every person on the ABORM Board of Directors, and no one had heard of

you,

nor from you, prior to this petition.

 

Lastly, regarding your suggestion that, " this exam is optional, but we are

concerned that

this is a dangerous trend, because someday it may not be and do you want to be

required

to take an exam for every thing you treat or pay malpractice premiums or dues

to

specialty groups to do what you already do " ? Again, more scare tactics. Can you

name one

person you have spoken to at AAC who has suggested this doomsday scenario you

are

predicting? Anyone? The National Board of Acupuncture Orthopedics has been

around for

at least a decade, and no one is required to earn that board certification or

purchase an

extra insurance rider to treat lumbago, or lateral epicondylitis. Furthermore,

the ABORM

has had no conversations or contact with the AAC regarding our certification

whatsoever.

How they set rates, or determine risk is up to them and their carriers no doubt,

and you

can no more predict what will happen than I can. So let's leave these baseless

predictions

out this discussion and stick to the issue of whether or not there should

continue to be

specialty boards, and how should they be developed and governed.

 

We obviously feel that there should be, and we are more than happy to fall under

the

jurisdiction of the AAAOM when and if they form an oversight committee for

specialty

boards. In fact, when that day comes, I would hope that yourself and others with

an

interest in this area would lend your years of experience and teaching to the

oversight

committee to help guarantee the most positive outcome for the profession as a

whole.

 

As I have said, the ABORM is a non-profit, regionally represented, gender and

race

represented corporation with members who represent the broadest range of

lineages and

traditions in TCM. Our process is transparent, and we are open to discussion and

participation, or boycott, from all who are interested parties.

 

Ray Rubio, D.A.O.M.

President ABORM

 

 

 

 

 

 

, " cradicepoli " <CarolineRadice

wrote:

>

> Laura: With all due respect, you may have missed the point of the

> petition. We are in no way suggesting that knowledge of Western

> medicine is not crucial to giving your patients the best service and

> treatment. An exam without appropriate training is pointless as it

> does not clearly identify that knowing what the tests are in a

> multiple choice format means that one understands the implications of

> this in relation to our TCM treatments. It is actually a disservice

> to patients to suggest that more letters after your name because you

> passed an exam without appropriate advanced training (which you also

> identified is lacking in the basic training of practitioners) makes

> you somehow better qualified then someone who may have done the work

> and study to understand what the implications are of western tests in

> the context of our medicine, despite not having the " stamp of

> approval " from a board.

>

> Of course this exam is optional, but we are concerned that this is a

> dangerous trend, because someday it may not be and do you want to be

> required to take an exam for every thing you treat or pay malpractice

> premiums or dues to specialty groups to do what you already do? We

> are advocating for training and want the word to be out there for all

> practitioners to judge. If the profession decides that this is a

> trend they need to have in order to be accepted by Western Medicine

> (by following them as a role model) then let the entire community

> decide this, not a few well-qualified and well-intentioned folks who

> may not have considered all the possible implications of the

> structure they have proposed.

>

> Caroline Radice, MS LAc CA NCCAOM (which is plenty)

>

>

> , " Laura Erlich "

> <lauraerlich@> wrote:

> >

> > To all those opposing the formation of ABORM,

> >

> > With respect, I would like to state that I simply do not understand

> how the

> > formation of a specialty board would in any way damage the

> profession of TCM

> > in America. The group of practitioners who are vocalizing this

> dissent seem

> > to be forgetting one basic notion: that it is our job as healthcare

> > professionals to provide our patients with the best possible care,

> and above

> > all, to do no harm. Suggesting that it is not important to know

> the

> > difference between HCG and FSH, because it would not impact the

> choice in

> > herbs we might prescribe, is flagrantly irresponsible, and in and

> of itself

> > demonstrates a need for a board like ABORM. Simply put, the

> treatment of

> > infertility requires detailed knowledge of Western Medicine, due to

> the fact

> > that a vast number of fertility patients will be SIMULTANEOUSLY

> USING

> > WESTERN FERTILITY MEDICATION WHILE WE ARE TREATING THEM!! Ignoring

> a

> > patients western diagnosis in this case could inhibit or even ruin

> her

> > chances of having a baby. The ABORM exam will at least show a

> basic level

> > of competence in the realm of western fertility treatments, which

> should

> > bring patients peace of mind while dealing with this costly,

> emotional and

> > often painful issue.

> >

> > Of course, for the patient who is only using TCM in their efforts

> to

> > conceive, one might argue that we as herbalists can differentiate

> between

> > yin, yang or qi deficiency, etc., but what argument can be set in

> place to

> > oppose knowing the effects of our herbs on the endocrine system and

> > fertility medications? Additionally, should we not know when to

> refer out

> > for structural tests, so that we don't waste our patient's time and

> money?

> > Is it not our job to work with our patients, and to guide them

> through their

> > health crisis' with grace? I ALWAYS recommend that my fertility

> patients

> > get baseline blood work and ultrasound, so that I know where I am

> starting

> > from. It is my opinion that we should be striving to integrate

> with and

> > educate our MD colleagues about the effects of TCM on fertility, so

> that we

> > can provide the most comprehensive care possible to our patients.

> Having a

> > board such as ABORM puts in place a basic level of competency that

> one

> > should have in order to go forth as a " specialist " in the area of

> fertility.

> >

> > The notion that we are provided with a sufficient body of knowledge

> in

> > school to treat ALL conditions as GP's is preposterous. I went to

> great

> > lengths for the duration of my clinical internship to specialize in

> women's

> > health, and still feel that it was just the tip of the iceberg.

> Of course,

> > general practitioners are of great benefit to the public, but so

> are people

> > who are drawn to know their particular niche in great detail.

> Those who

> > take the time, and spend the energy and money to specialize, should

> be so

> > credited. I would advocate for specialty boards for many of the

> conditions

> > that we commonly treat, as the professional community sees fit.

> >

> > I truly hope that those who are leading this opposition will re-

> consider

> > their position, and ask themselves what motivates it in the first

> place? It

> > is clearly in the best interest of our patients to create ways to

> measure

> > competence, especially when it comes to specialties that require

> integrative

> > knowledge in order to be successful.

> >

> > Sincerely,

> > Laura Erlich, LAc, MTOM

> >

> > _______________

> > More photos, more messages, more storage—get 2GB with Windows Live

> Hotmail.

> > http://imagine-windowslive.com/hotmail/?locale=en-

> us & ocid=TXT_TAGHM_migration_HM_mini_2G_0507

> >

>

[Guest guest]

David, I appreciate your response and your question is quite salient

and one I do not have the answer to. The opposition is to so many

things, depending on who you ask, but in answer to your question,

isn't it about time that our professional organizations, i.e., AAAOM,

CCAOM, NCCAOM and the members (who are the community who make up

those organizations) take a stand and show some leadership in trying

to make this profession a community? Does this mean that anyone who

thinks they know something special can write a test and call you a

specialist? ABORM states that their goal is to " set the standard for

this field " because they " have recognized the need for certification

to ensure that practitioners treating patients with OM in the field

of Reproductive Medicine are doing so with a qualified knowledge and

experience " how do they propose that an exam alone without any

training or experience will do this? To me, this is absurd. No one

questions their qualifications, experience, or integrity, but one

test and some more letters make one a superior practitioner? I think

it is the implications that are the largest sticking points, e.g.,

that an exam without training justifies some superior knowledge,

misleads the public, lures the malpractice insurers, etc. This

superior knowledge needs to come from superior training and

experience, not a single exam, and isn't that what the doctoral

programs are supposed to be doing?

 

People are the profession and we make up the organizations that are

supposed to be from all variety of practitioners, so why can't we use

them as a vehicle to establish some standards that are credible? If

this letter can encourage some interest and activity in the future of

the profession politically and in the larger arena of healthcare,

then our time was well spent. Until we unite in our vision, we will

continue to fight for legitimacy.

 

Thanks again for your thoughts,

 

Caroline

 

 

, " thecornerstoneclinic "

<thecornerstoneclinic wrote:

>

> Caroline,

>

> While I can understand your frustration with th eprocess, your

> reasoning flawed. You say:

>

> " If the profession decides that this is a trend they need to have

in

> order to be accepted by Western Medicine (by following them as a

> role model) then let the entire community decide this..... "

>

> Just how do you suppose this decision making process occurs? I

don't

> recall our 'profession' ever deciding anything by referendum. There

> is absolutely no profession-wide infrastructure to make collective

> decisions. So, I cannot understand what you are actually proposing

> when you suggest that our " profession " should " decide " anything.

> Professions are abstractions. They do not make decisions, people

do.

>

> I know that this may seem like spitting hairs and may come off as

> facetious. I am not trying to be inflammatory, but I just do not

> understand the process by which our profession could possibly

decide

> something by consensus. Just what are you proposing?

>

> David Karchmer

> The Texas Center for Reproductive Acupuncture

>

> Your reasoning is > Laura: With all due respect, you may have

missed

> the point of the

> > petition. We are in no way suggesting that knowledge of Western

> > medicine is not crucial to giving your patients the best service

> and

> > treatment. An exam without appropriate training is pointless as

it

> > does not clearly identify that knowing what the tests are in a

> > multiple choice format means that one understands the

implications

> of

> > this in relation to our TCM treatments. It is actually a

> disservice

> > to patients to suggest that more letters after your name because

> you

> > passed an exam without appropriate advanced training (which you

> also

> > identified is lacking in the basic training of practitioners)

> makes

> > you somehow better qualified then someone who may have done the

> work

> > and study to understand what the implications are of western

tests

> in

> > the context of our medicine, despite not having the " stamp of

> > approval " from a board.

> >

> > Of course this exam is optional, but we are concerned that this

is

> a

> > dangerous trend, because someday it may not be and do you want to

> be

> > required to take an exam for every thing you treat or pay

> malpractice

> > premiums or dues to specialty groups to do what you already do?

We

> > are advocating for training and want the word to be out there for

> all

> > practitioners to judge. If the profession decides that this is a

> > trend they need to have in order to be accepted by Western

> Medicine

> > (by following them as a role model) then let the entire community

> > decide this, not a few well-qualified and well-intentioned folks

> who

> > may not have considered all the possible implications of the

> > structure they have proposed.

> >

> > Caroline Radice, MS LAc CA NCCAOM (which is plenty)

> >

> >

> > , " Laura Erlich "

> > <lauraerlich@> wrote:

> > >

> > > To all those opposing the formation of ABORM,

> > >

> > > With respect, I would like to state that I simply do not

> understand

> > how the

> > > formation of a specialty board would in any way damage the

> > profession of TCM

> > > in America. The group of practitioners who are vocalizing this

> > dissent seem

> > > to be forgetting one basic notion: that it is our job as

> healthcare

> > > professionals to provide our patients with the best possible

> care,

> > and above

> > > all, to do no harm. Suggesting that it is not important to

know

> > the

> > > difference between HCG and FSH, because it would not impact the

> > choice in

> > > herbs we might prescribe, is flagrantly irresponsible, and in

> and

> > of itself

> > > demonstrates a need for a board like ABORM. Simply put, the

> > treatment of

> > > infertility requires detailed knowledge of Western Medicine,

due

> to

> > the fact

> > > that a vast number of fertility patients will be SIMULTANEOUSLY

> > USING

> > > WESTERN FERTILITY MEDICATION WHILE WE ARE TREATING THEM!!

> Ignoring

> > a

> > > patients western diagnosis in this case could inhibit or even

> ruin

> > her

> > > chances of having a baby. The ABORM exam will at least show a

> > basic level

> > > of competence in the realm of western fertility treatments,

> which

> > should

> > > bring patients peace of mind while dealing with this costly,

> > emotional and

> > > often painful issue.

> > >

> > > Of course, for the patient who is only using TCM in their

> efforts

> > to

> > > conceive, one might argue that we as herbalists can

> differentiate

> > between

> > > yin, yang or qi deficiency, etc., but what argument can be set

> in

> > place to

> > > oppose knowing the effects of our herbs on the endocrine system

> and

> > > fertility medications? Additionally, should we not know when

to

> > refer out

> > > for structural tests, so that we don't waste our patient's time

> and

> > money?

> > > Is it not our job to work with our patients, and to guide them

> > through their

> > > health crisis' with grace? I ALWAYS recommend that my

fertility

> > patients

> > > get baseline blood work and ultrasound, so that I know where I

> am

> > starting

> > > from. It is my opinion that we should be striving to integrate

> > with and

> > > educate our MD colleagues about the effects of TCM on

fertility,

> so

> > that we

> > > can provide the most comprehensive care possible to our

> patients.

> > Having a

> > > board such as ABORM puts in place a basic level of competency

> that

> > one

> > > should have in order to go forth as a " specialist " in the area

> of

> > fertility.

> > >

> > > The notion that we are provided with a sufficient body of

> knowledge

> > in

> > > school to treat ALL conditions as GP's is preposterous. I went

> to

> > great

> > > lengths for the duration of my clinical internship to

specialize

> in

> > women's

> > > health, and still feel that it was just the tip of the

> iceberg.

> > Of course,

> > > general practitioners are of great benefit to the public, but

so

> > are people

> > > who are drawn to know their particular niche in great detail.

> > Those who

> > > take the time, and spend the energy and money to specialize,

> should

> > be so

> > > credited. I would advocate for specialty boards for many of

the

> > conditions

> > > that we commonly treat, as the professional community sees fit.

> > >

> > > I truly hope that those who are leading this opposition will re-

> > consider

> > > their position, and ask themselves what motivates it in the

> first

> > place? It

> > > is clearly in the best interest of our patients to create ways

> to

> > measure

> > > competence, especially when it comes to specialties that

require

> > integrative

> > > knowledge in order to be successful.

> > >

> > > Sincerely,

> > > Laura Erlich, LAc, MTOM

> > >

> > >

_______________

> > > More photos, more messages, more storage?get 2GB with Windows

> Live

> > Hotmail.

> > > http://imagine-windowslive.com/hotmail/?locale=en-

> > us & ocid=TXT_TAGHM_migration_HM_mini_2G_0507

> > >

> >

>

[Guest guest]

,

wrote:

>Yehuda,

 

While I hear what you are saying, I think that you are jumping way ahead. One

can only

eat an elephant one bite at a time. ABORM is in it's infancy, so instead of

trying to squash

something before it even gets on its feet, why not become a part of shaping it

(and other

boards like it which will inevitably follow)? ABORM is not a licensure, it is a

certification,

and it is not the first one withtin our field (even if it is the first board to

offer it).

Certification is already available in orthopedics and internal medicine, among

others.

 

With regard to the insurance/ malpractice issue, I think the point is this:

people who

specialize WILL be on a different level than those who are not certified, as is

the case with

western doctors who specialize. That does not mean that a GP can't prescribe

Wellbutrin

for depression, but a GOOD GP would refer out to a Psycho-Pharmacologist to make

sure

his patient got the best possible diagnosis and care. That would in turn lead

the patient to

have that much more faith in the GP for the things he or she is best at

treating. I just

don't see insurance comapines (health or malpractice) getting in there to

micro-manage

what one is allowed to treat, though I do hope that we as practitioners will

have the good

sense to send our patitients to others who are more experienced at treating

certain

conditions than we are. TCM is such a young medicine in this country, and we

are all

bound to experience some growing pains, with the increase in doctoral programs,

certifications and other requirements that will inevitably arise as our field

grows and

becomes more mainstream. I think that openness and flexibilty is key to being a

part of

this dynamic field. Insisitng that things only stay the same is fear based, and

ultimatlely

will leave you behind.

 

Does that make sense?

 

 

 

> Laura,

>

> An important issue to remember is insurance reimbursal, as well as

malpractice

insurance. When you have a licensure in place such as ABORM, people on the

outside tend

to consider those not licensed by them to be not necessarily on the same level

of

competence or expertise. That can lead to denials of claims or exemptions to

coverage. I

would have much less of a problem if there was an association (however loose)

with a

national organization such as NCCAOM, and the licensure would be accompanied by

specific courses and a test. That would level the playing field.

>

> Does that make sense?

>

> Laura Erlich <lauraerlich wrote:

> To all those opposing the formation of ABORM,

>

> With respect, I would like to state that I simply do not understand how the

> formation of a specialty board would in any way damage the profession of TCM

> in America. The group of practitioners who are vocalizing this dissent seem

> to be forgetting one basic notion: that it is our job as healthcare

> professionals to provide our patients with the best possible care, and above

> all, to do no harm. Suggesting that it is not important to know the

> difference between HCG and FSH, because it would not impact the choice in

> herbs we might prescribe, is flagrantly irresponsible, and in and of itself

> demonstrates a need for a board like ABORM. Simply put, the treatment of

> infertility requires detailed knowledge of Western Medicine, due to the fact

> that a vast number of fertility patients will be SIMULTANEOUSLY USING

> WESTERN FERTILITY MEDICATION WHILE WE ARE TREATING THEM!! Ignoring a

> patients western diagnosis in this case could inhibit or even ruin her

> chances of having a baby. The ABORM exam will at least show a basic level

> of competence in the realm of western fertility treatments, which should

> bring patients peace of mind while dealing with this costly, emotional and

> often painful issue.

>

> Of course, for the patient who is only using TCM in their efforts to

> conceive, one might argue that we as herbalists can differentiate between

> yin, yang or qi deficiency, etc., but what argument can be set in place to

> oppose knowing the effects of our herbs on the endocrine system and

> fertility medications? Additionally, should we not know when to refer out

> for structural tests, so that we don't waste our patient's time and money?

> Is it not our job to work with our patients, and to guide them through their

> health crisis' with grace? I ALWAYS recommend that my fertility patients

> get baseline blood work and ultrasound, so that I know where I am starting

> from. It is my opinion that we should be striving to integrate with and

> educate our MD colleagues about the effects of TCM on fertility, so that we

> can provide the most comprehensive care possible to our patients. Having a

> board such as ABORM puts in place a basic level of competency that one

> should have in order to go forth as a " specialist " in the area of fertility.

>

> The notion that we are provided with a sufficient body of knowledge in

> school to treat ALL conditions as GP's is preposterous. I went to great

> lengths for the duration of my clinical internship to specialize in women's

> health, and still feel that it was just the tip of the iceberg. Of course,

> general practitioners are of great benefit to the public, but so are people

> who are drawn to know their particular niche in great detail. Those who

> take the time, and spend the energy and money to specialize, should be so

> credited. I would advocate for specialty boards for many of the conditions

> that we commonly treat, as the professional community sees fit.

>

> I truly hope that those who are leading this opposition will re-consider

> their position, and ask themselves what motivates it in the first place? It

> is clearly in the best interest of our patients to create ways to measure

> competence, especially when it comes to specialties that require integrative

> knowledge in order to be successful.

>

> Sincerely,

> Laura Erlich, LAc, MTOM

>

> _______________

> More photos, more messages, more storage—get 2GB with Windows Live Hotmail.

> http://imagine-windowslive.com/hotmail/?locale=en-

us & ocid=TXT_TAGHM_migration_HM_mini_2G_0507

>

>

>

> Chinese Herbal Medicine offers various professional services, including a

practitioner's directory and a moderated discussion forum.

>

>

>

>

[Guest guest]

Caroline,

 

I think Ray Rubio answered this wuestion pretty thoroughly in his

recent post. I will reiterate his sentiments by saying that yes, a

single test SHOULD in fact be an adequate measure of the breadth and

scope of someone's knowledge.

 

This is precisely the measure used by the nccaom in their

certification process. What is implied in the 'one exam' approach is

that a candidate MUST complete adequate study and have adequate

clinical experience in order to pass the exam successfully.

 

You seem to be implying that anybody could just walk in off the

street and ace a comprehensive multiple choice exam without having

any training on the subject. This seems implausible. And, even

though it is possible, when the exam costs $650 plus the cost of

travel to the exam location............who is going to risk it

unless they feel they have genuinely mastered the concepts being

tested?

 

Secondly, I want to say that I really appreciate your desire to have

community in the TCM/OM world. However, community does not imply an

absence of conflict. And on this issue of board certification and

regulating agencies within the OM universe, it is becoming evident

that there is not, nor is there likely to be a consensus. I do not

believe that this implies a lack of community in any way. It simply

highlights the fact that 'community' and 'consensus' are two very

different concepts and that to collapse the two is a recipe for

frustration and disappointment.

 

David Karchmer

The Texas Center for Reproductive Acupuncture

 

 

, " cradicepoli "

<CarolineRadice wrote:

>

> David, I appreciate your response and your question is quite

salient

> and one I do not have the answer to. The opposition is to so many

> things, depending on who you ask, but in answer to your question,

> isn't it about time that our professional organizations, i.e.,

AAAOM,

> CCAOM, NCCAOM and the members (who are the community who make up

> those organizations) take a stand and show some leadership in

trying

> to make this profession a community? Does this mean that anyone

who

> thinks they know something special can write a test and call you a

> specialist? ABORM states that their goal is to " set the standard

for

> this field " because they " have recognized the need for

certification

> to ensure that practitioners treating patients with OM in the

field

> of Reproductive Medicine are doing so with a qualified knowledge

and

> experience " how do they propose that an exam alone without any

> training or experience will do this? To me, this is absurd. No one

> questions their qualifications, experience, or integrity, but one

> test and some more letters make one a superior practitioner? I

think

> it is the implications that are the largest sticking points, e.g.,

> that an exam without training justifies some superior knowledge,

> misleads the public, lures the malpractice insurers, etc. This

> superior knowledge needs to come from superior training and

> experience, not a single exam, and isn't that what the doctoral

> programs are supposed to be doing?

>

> People are the profession and we make up the organizations that

are

> supposed to be from all variety of practitioners, so why can't we

use

> them as a vehicle to establish some standards that are credible?

If

> this letter can encourage some interest and activity in the future

of

> the profession politically and in the larger arena of healthcare,

> then our time was well spent. Until we unite in our vision, we

will

> continue to fight for legitimacy.

>

> Thanks again for your thoughts,

>

> Caroline

>

>

> , " thecornerstoneclinic "

> <thecornerstoneclinic@> wrote:

> >

> > Caroline,

> >

> > While I can understand your frustration with th eprocess, your

> > reasoning flawed. You say:

> >

> > " If the profession decides that this is a trend they need to

have

> in

> > order to be accepted by Western Medicine (by following them as a

> > role model) then let the entire community decide this..... "

> >

> > Just how do you suppose this decision making process occurs? I

> don't

> > recall our 'profession' ever deciding anything by referendum.

There

> > is absolutely no profession-wide infrastructure to make

collective

> > decisions. So, I cannot understand what you are actually

proposing

> > when you suggest that our " profession " should " decide " anything.

> > Professions are abstractions. They do not make decisions, people

> do.

> >

> > I know that this may seem like spitting hairs and may come off

as

> > facetious. I am not trying to be inflammatory, but I just do not

> > understand the process by which our profession could possibly

> decide

> > something by consensus. Just what are you proposing?

> >

> > David Karchmer

> > The Texas Center for Reproductive Acupuncture

> >

> > Your reasoning is > Laura: With all due respect, you may have

> missed

> > the point of the

> > > petition. We are in no way suggesting that knowledge of

Western

> > > medicine is not crucial to giving your patients the best

service

> > and

> > > treatment. An exam without appropriate training is pointless

as

> it

> > > does not clearly identify that knowing what the tests are in a

> > > multiple choice format means that one understands the

> implications

> > of

> > > this in relation to our TCM treatments. It is actually a

> > disservice

> > > to patients to suggest that more letters after your name

because

> > you

> > > passed an exam without appropriate advanced training (which

you

> > also

> > > identified is lacking in the basic training of practitioners)

> > makes

> > > you somehow better qualified then someone who may have done

the

> > work

> > > and study to understand what the implications are of western

> tests

> > in

> > > the context of our medicine, despite not having the " stamp of

> > > approval " from a board.

> > >

> > > Of course this exam is optional, but we are concerned that

this

> is

> > a

> > > dangerous trend, because someday it may not be and do you want

to

> > be

> > > required to take an exam for every thing you treat or pay

> > malpractice

> > > premiums or dues to specialty groups to do what you already

do?

> We

> > > are advocating for training and want the word to be out there

for

> > all

> > > practitioners to judge. If the profession decides that this is

a

> > > trend they need to have in order to be accepted by Western

> > Medicine

> > > (by following them as a role model) then let the entire

community

> > > decide this, not a few well-qualified and well-intentioned

folks

> > who

> > > may not have considered all the possible implications of the

> > > structure they have proposed.

> > >

> > > Caroline Radice, MS LAc CA NCCAOM (which is plenty)

> > >

> > >

> > > , " Laura Erlich "

> > > <lauraerlich@> wrote:

> > > >

> > > > To all those opposing the formation of ABORM,

> > > >

> > > > With respect, I would like to state that I simply do not

> > understand

> > > how the

> > > > formation of a specialty board would in any way damage the

> > > profession of TCM

> > > > in America. The group of practitioners who are vocalizing

this

> > > dissent seem

> > > > to be forgetting one basic notion: that it is our job as

> > healthcare

> > > > professionals to provide our patients with the best possible

> > care,

> > > and above

> > > > all, to do no harm. Suggesting that it is not important to

> know

> > > the

> > > > difference between HCG and FSH, because it would not impact

the

> > > choice in

> > > > herbs we might prescribe, is flagrantly irresponsible, and

in

> > and

> > > of itself

> > > > demonstrates a need for a board like ABORM. Simply put, the

> > > treatment of

> > > > infertility requires detailed knowledge of Western Medicine,

> due

> > to

> > > the fact

> > > > that a vast number of fertility patients will be

SIMULTANEOUSLY

> > > USING

> > > > WESTERN FERTILITY MEDICATION WHILE WE ARE TREATING THEM!!

> > Ignoring

> > > a

> > > > patients western diagnosis in this case could inhibit or

even

> > ruin

> > > her

> > > > chances of having a baby. The ABORM exam will at least show

a

> > > basic level

> > > > of competence in the realm of western fertility treatments,

> > which

> > > should

> > > > bring patients peace of mind while dealing with this costly,

> > > emotional and

> > > > often painful issue.

> > > >

> > > > Of course, for the patient who is only using TCM in their

> > efforts

> > > to

> > > > conceive, one might argue that we as herbalists can

> > differentiate

> > > between

> > > > yin, yang or qi deficiency, etc., but what argument can be

set

> > in

> > > place to

> > > > oppose knowing the effects of our herbs on the endocrine

system

> > and

> > > > fertility medications? Additionally, should we not know

when

> to

> > > refer out

> > > > for structural tests, so that we don't waste our patient's

time

> > and

> > > money?

> > > > Is it not our job to work with our patients, and to guide

them

> > > through their

> > > > health crisis' with grace? I ALWAYS recommend that my

> fertility

> > > patients

> > > > get baseline blood work and ultrasound, so that I know where

I

> > am

> > > starting

> > > > from. It is my opinion that we should be striving to

integrate

> > > with and

> > > > educate our MD colleagues about the effects of TCM on

> fertility,

> > so

> > > that we

> > > > can provide the most comprehensive care possible to our

> > patients.

> > > Having a

> > > > board such as ABORM puts in place a basic level of

competency

> > that

> > > one

> > > > should have in order to go forth as a " specialist " in the

area

> > of

> > > fertility.

> > > >

> > > > The notion that we are provided with a sufficient body of

> > knowledge

> > > in

> > > > school to treat ALL conditions as GP's is preposterous. I

went

> > to

> > > great

> > > > lengths for the duration of my clinical internship to

> specialize

> > in

> > > women's

> > > > health, and still feel that it was just the tip of the

> > iceberg.

> > > Of course,

> > > > general practitioners are of great benefit to the public,

but

> so

> > > are people

> > > > who are drawn to know their particular niche in great

detail.

> > > Those who

> > > > take the time, and spend the energy and money to specialize,

> > should

> > > be so

> > > > credited. I would advocate for specialty boards for many of

> the

> > > conditions

> > > > that we commonly treat, as the professional community sees

fit.

> > > >

> > > > I truly hope that those who are leading this opposition will

re-

> > > consider

> > > > their position, and ask themselves what motivates it in the

> > first

> > > place? It

> > > > is clearly in the best interest of our patients to create

ways

> > to

> > > measure

> > > > competence, especially when it comes to specialties that

> require

> > > integrative

> > > > knowledge in order to be successful.

> > > >

> > > > Sincerely,

> > > > Laura Erlich, LAc, MTOM

> > > >

> > > >

> _______________

> > > > More photos, more messages, more storage?get 2GB with

Windows

> > Live

> > > Hotmail.

> > > > http://imagine-windowslive.com/hotmail/?locale=en-

> > > us & ocid=TXT_TAGHM_migration_HM_mini_2G_0507

> > > >

> > >

> >

>

[Guest guest]

David, I have some concerns with what you have stated.

 

I hardly see how setting a minimum bar for

specialized knowledge is detrimental to our profession.

 

It may not be detrimental to the profession, but it may be to individual

practitioners for reasons I will go into more down post. But more to the

point how is this a minimum bar? It is a test I already took a test. I

passed that test, I have helped scores of women conceive on their own or

succeed with IVF I am not even a specialist. I did this by practicing the

medicine I was trained in. I did not need another stinking test.

 

With the formation of ABORM, consumers now

have some reference point, some means of distinguishing from among

the so called, " specialists. "

 

For the two paragraphs preceding this one you explained how the world was

all sunny and light and you could be ABORM certified or not and still be a

specialist, then you pull the literal rug out and start slighting those who

don't take the test. I think you make the case for most people who question

the potentially dire effects of ABORM right here.

 

It is not harmful

to our profession, it is of great benefit. Like all things

organizational, it will take time to develop and mature. But we must

start somewhere and we must start now.

 

You may not know it, but you already started somewhere when you chose

Oriental Medicine. As did we all. As for needing to do this now, no we

don't. This makes marketing easier. It makes it easier to tell RE's

(Reproductive Endocrinologists) you speak their lingo, all they have to do

is look for the ABORM label, and it makes it easier to advertise to women

desperate to have a baby, relax I am certified by ABORM so I know just what

to do, psst! that other guy he is not certified.

 

Lets acknowledge this for what it is, it is a marketing ploy, it is a very

good marketing ploy. ABORM is not going to teach anything, it is not going

to change anything, it is a test, I think one of the concerns is what is it

a test of? Ray down thread talks about equating hormonal levels with TCM

concepts. I reject that out of hand. I have yet to see it done

succesfully. We have correlations, but most of the time even those are

loose. The paradigm is fundamentally different and the human body is a

multiply redundant complex adapting entity. Xue is not blood or plasma or

rbc or iron or..............! The field of fertility in TCM is very old,

very established, very straightforward and very successful. It is also

basic, we did learn it, or at least the vast majority was learned as we

learned all of our medicine, at school. Now the reality is even if that is

80% it was not always the important parts, in my experience those we learn

from our patients. What we are doing here is new, it is not TCM. How do I

know that? Because none of this existed 50 years ago. We are adapting TCM,

as I think we should do, but in doing so we must remember there may or may

not be a universal right answer. None of this is cut and dry, there is very

little evidence to justify most of this, so there is little objective basis

for forming the test.

 

Rather than a " Board " what we should do is have a registry like the RE's

have and put your info out there. Every fertility patient you have gets

registered, and we record how many treatments and how many babies are made.

Much cheaper to accomplish and much more effective in truly letting the

public know who is achieving the desired goal.

 

I think the calling it a board is what I personally find most irksome. I am

already board certified in acupuncture and herbs and oriental medicine, I

did all of those not because I needed them (I never intended to return to

Texas) but because it gave me more paper for my walls so patients could feel

confidence in me. But each of those tests actually represents established

minimums for practice. As decided by a wide cross section of the Oriental

Medicine practicing community through lots of trial and error. While this

seems to be a test written up by a small group of people, whose credentials

are not that much different than mine. You want to call it a society and

give a certifying test great go for it, the word does not have the same heft

or implication of authority as granted by the profession. Do I need to

point out that none of the people on the board are even ABORM certified, I

mean how much could they know? This may be the first stages of ABORM and it

will learn by trial and error, I consider the start an error but it could

improve. While having a test and camaraderie of fellows is nice, without

the support of the profession it will not mean much.

 

As for the insurance question their is precedence for their stepping in and

restraining practice, so it is wise in my book to be cautious.

 

Good luck, I hope ABORM suits your needs. For the moment I am not convinced

it suits mine, but hey I have changed my mind before.

 

Sincerely,

 

Darby Valley L.Ac. DAOM (pending, graduation in three weeks!!!!) (in womens

health by the way)

[Guest guest]

Darby,

 

You ask, " how is this a minimum bar? It is a test I already took a

test. I passed that test, I have helped scores of women conceive on

their own or succeed with IVF I am not even a specialist. I did

this by practicing the medicine I was trained in. I did not need

another stinking test "

 

By your own admission, you are about to graduate with a DAOM in

women's health. So, I hardly think you are representative of the

field of GP's. Why even bother to pursue a DAOM? Like you said, you

are already certified as an acupuncturist, so........why the need

for any further training?

 

I DO believe that ABORM provides a minumum standard because while

you may have had a good rate of success treating infertility or

complementing IVF, that is certainly no indication that every

acupuncture school graduate possess such competency.

 

You also stated, " For the two paragraphs preceding this one you

explained how the world was all sunny and light and you could be

ABORM certified or not and still be a specialist, "

 

And then you go on, " then you pull the literal rug out and start

slighting those who don't take the test. "

 

Well........I actually don't have any response as I have no idea

what this is referencing. I think you are using a metaphor, but it

is lost on me. Did I literally pull a rug out? I mean come on, now

you are just being silly.

 

I make the point that " ABORM is not harmful to our profession, it is

of great benefit. Like all things organizational, it will take time

to develop and mature. But we must start somewhere and we must start

now. " To which you replied, " You may not know it, but you already

started somewhere when you chose Oriental Medicine. As did we all.

As for needing to do this now, no we don't. This makes marketing

easier. It makes it easier to tell RE's (Reproductive

Endocrinologists) you speak their lingo, all they have to do is look

for the ABORM label, and it makes it easier to advertise to women

desperate to have a baby, relax I am certified by ABORM so I know

just what to do, psst! that other guy he is not certified.

 

I'd like to respond to this, because I think it is an important

aspect of the debate. You say that you do not specialize in

fertility and reproductive health. Well, I do. And I would like to

tell you that as a specialist, I firmly believe that there ARE

generalists practicing OM who are patently NOT qualified to treat

reproductive disorders, infertility or work in a complementary

fashion with RE's and IVF.

 

I have had many patients come to me for help who have defected from

another acupunctrurist. When I ask them about their history, I come

to find that the acupuncturist they were seeing NEVER inquired about

their cycle length, their BBT, their ovulation or cervical mucous.

In short, that person did not treat their menstual cycle.

 

This is common place. And yet, to the average consumer or would-be

patient, this person appears every bit as knowledgeable, well-

trained, and well-qualified as someone who has devoted their entire

practice to reproductive medicine, and who has sought out all

measure of specialized reading, traininig, and continuing education.

 

How does this possibly serve the public interests?

 

You would have us " acknowledge this for what it is, it is a

marketing ploy, it is a very good marketing ploy. "

 

I find this proposterous! That you would cynically reduce this

process to a self-serving ploy designed to increase the market share

of those who engage in it.

 

The far worse transgression is the unknowledgeable practitioner

who " represents " him or herself as a specialist, and acutally has no

credentials of ANY KIND WHATSOEVER. And this is common place. I

know, because that is exactly what I do. Now, in my case I have done

all I can to educate myself and study to actually become the

specialist that I claim to be. But that doen't mean that

every " Fertility Acupuncturist " out there has done the same.

 

A minimum competency process like the one that ABORM is proposing

will help the average would-be patient to know that the " specialist "

they are seeing has at least a basic understanding of the subject

matter. It seems like you are insinuating that the ABORM

certification process is designed to dupe the public when in fact,

quite the opposite is true. Without any minimum recognized

standards, ANYONE can dupe the public by representing themselves as

a specialist.

 

When I said that " must start somewhere and we must start now. " This

is the reason. Right now there is no way for anyone to distinguish a

specialist from a generalist, or one self-proclaimed " specialist "

from another self-proclaimed " specialist. " As it currently stands,

an acupuncturist is a specialist by virtue of his own claims alone.

 

And this is the system that you seem to be advocating.

 

The formation of ABORM does nothing to preclude such claims. Anyone

can still represent themselves to be a specialist (with or without

ABORM certification). What ABORM adds to the landscape is the

ability of would-be patients to distinguish whether or not their

chosen specialist has at least a basic understanding of the

principles and concepts that govern their area of specialization.

 

This is a good thing. And this is why, until I hear cogent argument

against it, or a more viable alternative, I continue to support the

ABORM and I encourage all of you reading this thread to do the same.

 

David Karchmer

The Texas Center for Reproductive Acupuncture

 

 

 

, " Darby Valley "

<darby.valley wrote:

>

> David, I have some concerns with what you have stated.

>

> I hardly see how setting a minimum bar for

> specialized knowledge is detrimental to our profession.

>

> It may not be detrimental to the profession, but it may be to

individual

> practitioners for reasons I will go into more down post. But more

to the

> point how is this a minimum bar? It is a test I already took a

test. I

> passed that test, I have helped scores of women conceive on their

own or

> succeed with IVF I am not even a specialist. I did this by

practicing the

> medicine I was trained in. I did not need another stinking test.

>

> With the formation of ABORM, consumers now

> have some reference point, some means of distinguishing from among

> the so called, " specialists. "

>

> For the two paragraphs preceding this one you explained how the

world was

> all sunny and light and you could be ABORM certified or not and

still be a

> specialist, then you pull the literal rug out and start slighting

those who

> don't take the test. I think you make the case for most people

who question

> the potentially dire effects of ABORM right here.

>

> It is not harmful

> to our profession, it is of great benefit. Like all things

> organizational, it will take time to develop and mature. But we

must

> start somewhere and we must start now.

>

> You may not know it, but you already started somewhere when you

chose

> Oriental Medicine. As did we all. As for needing to do this now,

no we

> don't. This makes marketing easier. It makes it easier to tell

RE's

> (Reproductive Endocrinologists) you speak their lingo, all they

have to do

> is look for the ABORM label, and it makes it easier to advertise

to women

> desperate to have a baby, relax I am certified by ABORM so I know

just what

> to do, psst! that other guy he is not certified.

>

> Lets acknowledge this for what it is, it is a marketing ploy, it

is a very

> good marketing ploy. ABORM is not going to teach anything, it is

not going

> to change anything, it is a test, I think one of the concerns is

what is it

> a test of? Ray down thread talks about equating hormonal levels

with TCM

> concepts. I reject that out of hand. I have yet to see it done

> succesfully. We have correlations, but most of the time even

those are

> loose. The paradigm is fundamentally different and the human body

is a

> multiply redundant complex adapting entity. Xue is not blood or

plasma or

> rbc or iron or..............! The field of fertility in TCM is

very old,

> very established, very straightforward and very successful. It is

also

> basic, we did learn it, or at least the vast majority was learned

as we

> learned all of our medicine, at school. Now the reality is even

if that is

> 80% it was not always the important parts, in my experience those

we learn

> from our patients. What we are doing here is new, it is not TCM.

How do I

> know that? Because none of this existed 50 years ago. We are

adapting TCM,

> as I think we should do, but in doing so we must remember there

may or may

> not be a universal right answer. None of this is cut and dry,

there is very

> little evidence to justify most of this, so there is little

objective basis

> for forming the test.

>

> Rather than a " Board " what we should do is have a registry like

the RE's

> have and put your info out there. Every fertility patient you

have gets

> registered, and we record how many treatments and how many babies

are made.

> Much cheaper to accomplish and much more effective in truly

letting the

> public know who is achieving the desired goal.

>

> I think the calling it a board is what I personally find most

irksome. I am

> already board certified in acupuncture and herbs and oriental

medicine, I

> did all of those not because I needed them (I never intended to

return to

> Texas) but because it gave me more paper for my walls so patients

could feel

> confidence in me. But each of those tests actually represents

established

> minimums for practice. As decided by a wide cross section of the

Oriental

> Medicine practicing community through lots of trial and error.

While this

> seems to be a test written up by a small group of people, whose

credentials

> are not that much different than mine. You want to call it a

society and

> give a certifying test great go for it, the word does not have the

same heft

> or implication of authority as granted by the profession. Do I

need to

> point out that none of the people on the board are even ABORM

certified, I

> mean how much could they know? This may be the first stages of

ABORM and it

> will learn by trial and error, I consider the start an error but

it could

> improve. While having a test and camaraderie of fellows is nice,

without

> the support of the profession it will not mean much.

>

> As for the insurance question their is precedence for their

stepping in and

> restraining practice, so it is wise in my book to be cautious.

>

> Good luck, I hope ABORM suits your needs. For the moment I am not

convinced

> it suits mine, but hey I have changed my mind before.

>

> Sincerely,

>

> Darby Valley L.Ac. DAOM (pending, graduation in three weeks!!!!)

(in womens

> health by the way)

>

[Guest guest]

Ray: Your points are well argued, but I will stand firm that an

arbitrary exam is a pointless measure for who is better qualified to

treat reproductive medicine or any other disorders. If knowing what

an hsg is, " is basically all one needs to know to pass " it, this is

unlikely to be a true measure of one's ability to treat fertility

disorders better than someone who does really treat them everyday.

 

Obviously there are a myriad of certification and ceu classes that

teach about fertility issues, but how can you be sure that all the

info that is taught in these cover what the ABORM test thinks are the

salient points worthy of being asked? What means will you use to

determine whether or not someone's training or experience qualifies

them for this priviledge of sitting for this test other than being

able to pay the $800 for it? This is the difference between your

board cert and that of something like the NCCAOM: they use guidelines

and training measures that are from the breadth of TCM practice, and

require specific training that candidates will earn at accredited

schools. Wouldn't any courses taught by any ABORM board members be

considered a conflict of interest? That leaves out Mike Berkley, Jane

Lyttleton, and Randine Lewis' courses, which are quite good.

 

No one ever questioned the ABORM board's sincerity, qualifications,

or intent to raise the bar, but I just don't see how assuming the

western model of specialization and adding even more letters will do

anything more than mislead the public and the RE's. A practitioner

who treats well, treats well, and one who does not, does not even if

ABORM certified. In more than 12 years, I have never had a single

patient question my experience in treating any disorder, and I do not

claim to be a specialist even though I treat more fertility than

anything else, as apparently so do a myriad of our colleagues. I

believe my work speaks for itself and extra letters add nothing to

the practice I enjoy and am happy to call successful. Continuing to

try to conform to a system that is the polar opposite of what tcm is:

deductionist, fine-point active ingredient western medicine does not

correlate as easily as you apparently think with our inclusionist,

holistic practice and attempting to structure our medicine after a

contrasting model will do nothing other than damage its integrity.

Plenty of practitioners are working with RE's in and out of hospital

in this " specialty " without your credentials, and I think their work

speak for them as well.

 

What you unnecessarily call " scare tactics " are what we call

warnings. Have you even considered all the implications that we

question? Having been at the heart of the conflict with the AAC

excluding gyn coverage (yes, I wrote that letter too and look how

well that turned out for all of us), we have seen them not only

become a monopoly, buying out almost all of the smaller insurers, but

change policy in ways that can be severely limiting, as in the

previous gyn exception. Further, they recently demanded that any

practitioner at PCOM treating facelifts must be certified in the

Wakefield method to be covered, where no one was, and this led to an

outright rebellion amongst the faculty. We need to speak out to

protect ourselves.

 

And your assertions that neither Marnae nor I contacted any members

of the board are again, misinformed. If email are not returned, we

are to fault for this? I had never heard of you, either, until the ad

was placed in Acupuncture Today this month, and neither had hundreds

of other practitioners who are not favoring this direction. So I am

pleased that you are as open as you are to the evolution of this

process, because there is very likely a common ground between what

you propose and what we oppose. I am content to pursue this at the

national level, starting with the AAAOM, CCAOM, and NCCAOM and all

practitioners being informed of the issues at stake.

 

Best as always,

 

Caroline

[Guest guest]

Caroline,

 

I really like your passion, and I agree with several points that you

raise. However, you and I have had some vastly different clinical

experiences, and perhaps these experiences have molded our

respective views.

 

In you last post you said that in, " more than 12 years, I have never

had a single patient question my experience in treating any

disorder, and I do not claim to be a specialist even though I treat

more fertility than anything else. "

 

This differs sharply from my experience, wherein I DO represent

myself as a specialist in Reproductive Acupuncture. My case load is

90-95% fertility related, and people ask me ALL THE TIME about my

experience and credentials. Furthermore, it is my firm belief that

the treatment of infertility and related disorders with Chinese

Medicine IS a specialization - meaning that I do not believe, as

some on this board have stated, that a general acupuncture education

fully qualifies a practitioner to treat fertility and reproductive

disorders effectively.

 

And, as such, I fully support any efforts to provide the care-

seeking public with a means to distinguish between a specialist and

a generalist - and, perhaps more importantly, to distinguish between

one self-designated " specialist, " and another self-

designated " specialist. " To my thinking, this is the most evident

value of the ABORM certification: It provides the care-seeking

public with some kind of standard to help them make a distinction

between the three following classifications of practitioners:

 

1) a generalist who dabbles in fertility treatment

2) a self-designated " specialist " who, with no credentials, training

or specialized study, has deemed themselves to be a fertility

specialist and

3) a genuine specialist. One who has undertaken enough specialized

training, study and clinical practice to successfully pass the ABORM

exam

 

To a certain extent, I agree with your point - that a test alone

does not provide any specific or standardized training. I concur

with your view that a stand-alone test does not fully ensure that

those who pass it are genuinely and fully qualified specialists.

But...when you consider the alternative..........SOME measure of

clinical competency is a vast improvement over NO measure of

clinical competency (which is exactly the situation that currently

exists).

 

While it would be wonderful to have more specialized training

programs available, and to have standardized training accompany a

board certification process, and to have some kind of oversight -

the fact remains that at present there is NO oversight governing the

specialization in Reproductive Acupuncture. NONE.

 

And while I can respect the differences in opinion that are being

expressed - I simply cannot fathom how NO OVERSIGHT (i.e. the

current status quo) is a better approach than SOME OVERSIGHT (i.e.

ABORM certification) in an environment where PERFECT OVERSIGHT (i.e.

whatever you and the ABORM critics envision) is simply not

available.

 

David Karchmer

The Texas Center for Reproductive Acupuncture

 

 

-- In , " cradicepoli "

<CarolineRadice wrote:

>

> Ray: Your points are well argued, but I will stand firm that an

> arbitrary exam is a pointless measure for who is better qualified

to

> treat reproductive medicine or any other disorders. If knowing what

> an hsg is, " is basically all one needs to know to pass " it, this is

> unlikely to be a true measure of one's ability to treat fertility

> disorders better than someone who does really treat them everyday.

>

> Obviously there are a myriad of certification and ceu classes that

> teach about fertility issues, but how can you be sure that all the

> info that is taught in these cover what the ABORM test thinks are

the

> salient points worthy of being asked? What means will you use to

> determine whether or not someone's training or experience qualifies

> them for this priviledge of sitting for this test other than being

> able to pay the $800 for it? This is the difference between your

> board cert and that of something like the NCCAOM: they use

guidelines

> and training measures that are from the breadth of TCM practice,

and

> require specific training that candidates will earn at accredited

> schools. Wouldn't any courses taught by any ABORM board members be

> considered a conflict of interest? That leaves out Mike Berkley,

Jane

> Lyttleton, and Randine Lewis' courses, which are quite good.

>

> No one ever questioned the ABORM board's sincerity, qualifications,

> or intent to raise the bar, but I just don't see how assuming the

> western model of specialization and adding even more letters will

do

> anything more than mislead the public and the RE's. A practitioner

> who treats well, treats well, and one who does not, does not even

if

> ABORM certified. In more than 12 years, I have never had a single

> patient question my experience in treating any disorder, and I do

not

> claim to be a specialist even though I treat more fertility than

> anything else, as apparently so do a myriad of our colleagues. I

> believe my work speaks for itself and extra letters add nothing to

> the practice I enjoy and am happy to call successful. Continuing to

> try to conform to a system that is the polar opposite of what tcm

is:

> deductionist, fine-point active ingredient western medicine does

not

> correlate as easily as you apparently think with our inclusionist,

> holistic practice and attempting to structure our medicine after a

> contrasting model will do nothing other than damage its integrity.

> Plenty of practitioners are working with RE's in and out of

hospital

> in this " specialty " without your credentials, and I think their

work

> speak for them as well.

>

> What you unnecessarily call " scare tactics " are what we call

> warnings. Have you even considered all the implications that we

> question? Having been at the heart of the conflict with the AAC

> excluding gyn coverage (yes, I wrote that letter too and look how

> well that turned out for all of us), we have seen them not only

> become a monopoly, buying out almost all of the smaller insurers,

but

> change policy in ways that can be severely limiting, as in the

> previous gyn exception. Further, they recently demanded that any

> practitioner at PCOM treating facelifts must be certified in the

> Wakefield method to be covered, where no one was, and this led to

an

> outright rebellion amongst the faculty. We need to speak out to

> protect ourselves.

>

> And your assertions that neither Marnae nor I contacted any members

> of the board are again, misinformed. If email are not returned, we

> are to fault for this? I had never heard of you, either, until the

ad

> was placed in Acupuncture Today this month, and neither had

hundreds

> of other practitioners who are not favoring this direction. So I am

> pleased that you are as open as you are to the evolution of this

> process, because there is very likely a common ground between what

> you propose and what we oppose. I am content to pursue this at the

> national level, starting with the AAAOM, CCAOM, and NCCAOM and all

> practitioners being informed of the issues at stake.

>

> Best as always,

>

> Caroline

>

[Guest guest]

Caroline -

 

In the interest of brevity, I will address your points one-by-one:

 

1. The ABORM exam is hardly " arbitrary " . It draws it's material from the primary

reference

sources in reproductive medicine - both western and eastern. It has a pool of

over 1200,

double-referenced, multiple choice questions.

 

2. The quote you make, " knowing what an hsg is, is basically all one needs to

know to

pass " , is a comment taken out of context from an email that I sent to someone

who was

interested in sitting for the ABORM exam but concerned about the level of

difficulty of the

exam. I actually think the the general practitioner, rather than the specialist,

probably

wouldn't know what an HSG is, and therefor would not pass this exam, and

therefor

probably shouldn't be treating fertility patients. Simply assuming that because

a patient

does not exhibit signs of fallopian tube obstruction in their pulse or tongue,

and not

knowing how this obstruction might be the cause of the patient's infertility -

rather than

their " kidney yang deficiency " is tantamount to malpractice.

 

3. Regarding the CEU courses being taught, and whether or not the ABORM

examination

materials are covered in these classes - I can be sure that these classes cover

much of

what the aborm exam considers salient because I have personally been to the

majority of

these courses for the past 3 years, and because these courses + the reading

list, + the

ABORM Exam prep courses that are going to offered by different interested

parties will

more than prepare someone to sit for this exam. As I have stated repeatedly,

this exam is

a vehicle for any practitioner who wishes to demonstrate minimum competency in

the field

of Oriental Reproductive Medicine. It is optional, not required.

 

4. Those who wish to sit for the exam, must have been licensed to practice for a

minimum

of two years.

 

5. The ABORM tests entry level TCM practioners, not subspecialties. Neither the

ABORM,

nor the National Board of Acupuncture Orthopedics, nor the Blue Poppy

Certification

courses for Gynecology, nor the Misha Cohen Certification course for the

Hepatitis C, nor

the Internal Medicine Certification course - have to re-create the entire

training process of

the basic TCM educational process. Only licensed individuals can apply.

 

6. The only courses that would be a conflict of interest for ABORM Board Members

to teach

are those directly related to ABORM Exam preparation. I think you mentioned that

you

have worked on the NCCAOM exam in the past, and you also mentioned that you are

on

faculty, or were on faculty and a school that teaches students who will go on to

sit for the

NCCAOM Exam. I teach Emperor's College, and I used to help write questions for

the

California State Board exam. That is no conflict of interest. The conflict of

interest comes

when the person who has taught the courses leading to an examination, also

writes and

offers the certification courses for that exam. There is an inherent temptation

their to

make sure that enough of your " students " pass the exam, or soon enough your

classes will

be empty. This is why the ABORM steers clear of any Examination Prep classes due

to

conflict of interest.

 

7. Regarding the western model of specialization, and the ABORM's " continuing to

try to

conform to a system that is the polar opposite of what tcm is: deductionist,

fine-point

active ingredient " - neither of these could be farther from the truth. I

consider Randine

Lewis a friend, a colleague, and pretty much a purist when it comes to embracing

the

holistic, inclusionist, whole-person roots of our medicine. She also, however,

has a firm

grasp of western reproductive medicine and pathology - and this has allowed her

to stay

firmly rooted in TCM when treating the patient, while simultaneosly knowing when

it's best

to take a back seat to our western colleaues for a given patient. Also,

specialization has

it's roots in China, not just here in the western medical system. To assume the

the

strength of our medicine comes in being generalists is an ethnocentric point of

view based

on how TCM has evolved here, not how it functions in China.

 

8. Regarding yourself and your colleauges who work with RE's and their work

speaks for

themselves, god bless em'. The ABORM exam is optional, not mandatory, and the

ABORM

has no intention of implying that these practitioners are not qulified to treat

reproductive

disorders. You know, it's interesting, but I remember the same type of

conversation

occuring, with many of these same concerns, when the idea of the Doctoral

Programs were

being discussed: " Will this mean that I will have to go back and get a doctoral

degree in

order to practice? " " Will I be required to have this degree to get malpractice

coverage? " .

" This is just another marketing ploy to allow the schools to make more money,

and it will

imply that the Doctoral Level practioner is better than other practioners, when

in fact there

are many great old Chinese Doctors and other senior practioners who are better

than any

recent grad who happened to get a Doctoral Degree " . " It's just more letters

after the name

and it doesn't mean that this person is any better qualified to treat a

patient " . " This is just

modeling the western system " . etc. In fact, there are many still who oppose the

Doctoral

Degree programs and who think that ACAOM accreditation is meaningless for the

doctoral

level. Well, like Darby, I went and spent the two years to get the DAOM (Doctor

of

Acupuncture and Oriental Medicine) degree, and although I leaned a few more

clinical

pearls, it has not helped me to corner the market on TCM where I practice, and

it has not

degraded anyone elses practice either.

 

I am perfectly aware that by making the above comparison, you will no doubt say,

" Aha!

This is what we mean. The Doctoral Programs are training programs with

curricula,

guidelines, oversight, etc, the ABORM is just a test without training " . I can

only respond as

I have previously: We believe there are more than sufficient training courses,

beginning

level to advanced level - and that what is missing is some sort of vehicle by

which

practioners can demonstrate minimum competency in the treatment of infertile

patients.

Also, regarding the registry that Darby mentioned -sorry to mix threads here - I

think

that's a great idea, and it is one of the things that the ABORM will be working

on. We don't,

however, think that one replaces the other.

 

9. Regarding the " warning " about malpractice coverage. Again, the National Board

for

Acupuncture Orthopedics has been around for over a decade, and no one has had to

pay

for that certfication, nor purchase an extra rider, to be covered treating

lumbago or

cervicalgia. This is an appropriate comparison to the ABORM, not facial

acupuncture. And

again, if you feel that AAC is the bogeyman, go take up these important issues

with them.

The ABORM has no relationship, or agreements with AAC, and we have no input or

control

over how they set policy. Go ask the AAC about the ABORM and get an answer.

Until then,

the Orthopedic Board Certification is a more useful precedent for what we are

attempting,

than any " warnings " that have been made in the opposition letter.

 

10. My assertions that neither you nor Marnae contacted the any members of the

ABORM

are not misinformed. As I have said: I have asked every member of the Board ofs

if they had heard from you - by email or phone, or any other way, and none had.

In fact,

you said to me that you emailed the ABORM once, and when you didn't hear back,

you

" assumed it had been disolved " . While we have recieved thousands of emails from

other

practitioners inquiring about who we were, how we came to be, how was the exam

developed, how were the criteria for examination decided upon, how were Board

Members

chosen, etc. - somehow we missed yours. If this issue was so important to you,

and

Marnae - the principle authors of the boycott petition/opposition letter - why

didn't you

try calling any one of us to voice your concerns? Everyone of us is listed on

the website. Or

try emailing more than once? Even a newspaper writer has to do some fact

checking before

they make public statements about an organization that are based on personal

opinion.

 

We, too, are happy to pursue this at the national level, and I think that on

least one level

we (you and I at least) agree: The issue of specialty boards - the ABORM

included - and

how they are developed and governed, is definitely an iissue whose time has

come, and

one that the profession as a whole - those opposed, and those in favor, need to

address.

 

Regards,

 

Ray Rubio

 

Geez....so much for my " brevity " .

 

 

 

 

 

 

 

, " cradicepoli " <CarolineRadice

wrote:

>

> Ray: Your points are well argued, but I will stand firm that an

> arbitrary exam is a pointless measure for who is better qualified to

> treat reproductive medicine or any other disorders. If knowing what

> an hsg is, " is basically all one needs to know to pass " it, this is

> unlikely to be a true measure of one's ability to treat fertility

> disorders better than someone who does really treat them everyday.

>

> Obviously there are a myriad of certification and ceu classes that

> teach about fertility issues, but how can you be sure that all the

> info that is taught in these cover what the ABORM test thinks are the

> salient points worthy of being asked? What means will you use to

> determine whether or not someone's training or experience qualifies

> them for this priviledge of sitting for this test other than being

> able to pay the $800 for it? This is the difference between your

> board cert and that of something like the NCCAOM: they use guidelines

> and training measures that are from the breadth of TCM practice, and

> require specific training that candidates will earn at accredited

> schools. Wouldn't any courses taught by any ABORM board members be

> considered a conflict of interest? That leaves out Mike Berkley, Jane

> Lyttleton, and Randine Lewis' courses, which are quite good.

>

> No one ever questioned the ABORM board's sincerity, qualifications,

> or intent to raise the bar, but I just don't see how assuming the

> western model of specialization and adding even more letters will do

> anything more than mislead the public and the RE's. A practitioner

> who treats well, treats well, and one who does not, does not even if

> ABORM certified. In more than 12 years, I have never had a single

> patient question my experience in treating any disorder, and I do not

> claim to be a specialist even though I treat more fertility than

> anything else, as apparently so do a myriad of our colleagues. I

> believe my work speaks for itself and extra letters add nothing to

> the practice I enjoy and am happy to call successful. Continuing to

> try to conform to a system that is the polar opposite of what tcm is:

> deductionist, fine-point active ingredient western medicine does not

> correlate as easily as you apparently think with our inclusionist,

> holistic practice and attempting to structure our medicine after a

> contrasting model will do nothing other than damage its integrity.

> Plenty of practitioners are working with RE's in and out of hospital

> in this " specialty " without your credentials, and I think their work

> speak for them as well.

>

> What you unnecessarily call " scare tactics " are what we call

> warnings. Have you even considered all the implications that we

> question? Having been at the heart of the conflict with the AAC

> excluding gyn coverage (yes, I wrote that letter too and look how

> well that turned out for all of us), we have seen them not only

> become a monopoly, buying out almost all of the smaller insurers, but

> change policy in ways that can be severely limiting, as in the

> previous gyn exception. Further, they recently demanded that any

> practitioner at PCOM treating facelifts must be certified in the

> Wakefield method to be covered, where no one was, and this led to an

> outright rebellion amongst the faculty. We need to speak out to

> protect ourselves.

>

> And your assertions that neither Marnae nor I contacted any members

> of the board are again, misinformed. If email are not returned, we

> are to fault for this? I had never heard of you, either, until the ad

> was placed in Acupuncture Today this month, and neither had hundreds

> of other practitioners who are not favoring this direction. So I am

> pleased that you are as open as you are to the evolution of this

> process, because there is very likely a common ground between what

> you propose and what we oppose. I am content to pursue this at the

> national level, starting with the AAAOM, CCAOM, and NCCAOM and all

> practitioners being informed of the issues at stake.

>

> Best as always,

>

> Caroline

>

[Guest guest]

Ray,

 

Brevity can be overrated.

 

I just wanted to clarify, I got more pearls than I could fit in a whole sow

much less her ear during my DAOM, but the MOST IMPORTANT one was that I was

already doing it right most of the time. Well to be fair, now we can begin

a debate on what " right " is.

 

Anyhow, I would love to participate in the registry, I do hope it would be

open to non ABORM certified practitioners as well.

 

Cheers,

 

Darby

 

 

 

[Guest guest]

Well said Darby.

 

Despite the somewhat heated nature of the discourse related to this subject

(specialty

boards), I think that it has definitely provoked a much needed conversation for

the

profession. We seem to be experiencing a great deal of change right now in every

regard -

the DAOM, Specialty Boards, Integration with Hospitals, etc., and the sense I

get is that

interested parties welcome the change for the most part, it's just that we all

want to make

sure it's done right, and as you astutely pointed out - determining what " right "

is make

take some time to develop consensus.

 

I wanted to let every one interested in this thread/topic know that there will

be a series of

live interviews regarding the ABORM and the subject of specialty boards being

aired

sometime next month on www.chinesemedicinetools.com. (I hope this is not a

terrible

fauxpaus to mention another TCM website here on CHA). CMT.com has a radio

section

that you can click on to hear the interviews regarding this subject, and others

previously

recorded.

 

Best,

 

Ray

 

PS: When the ABORM gets to the point of establishing a registry, I will contact

you Darby.

 

 

 

 

, " Darby Valley " <darby.valley

wrote:

>

> Ray,

>

> Brevity can be overrated.

>

> I just wanted to clarify, I got more pearls than I could fit in a whole sow

> much less her ear during my DAOM, but the MOST IMPORTANT one was that I was

> already doing it right most of the time. Well to be fair, now we can begin

> a debate on what " right " is.

>

> Anyhow, I would love to participate in the registry, I do hope it would be

> open to non ABORM certified practitioners as well.

>

> Cheers,

>

> Darby

>

>

>

[Guest guest]

-------------- Original message ----------------------

" emmit_rubio " <RTOO

 

(I hope this is not a terrible fauxpaus to mention another TCM website here on

CHA).

 

It is perfectly fine.