July 18, 2006

Greeting Friends and Colleagues:

Over the past year member benefits have increased substantially. Almost every month new benefits are added. AAOM benefits do vary, based upon your membership status. In this issue of the Qi-Unity Report, we’ll look at current benefit packages from the perspective of each membership category.


AAOM Offers 3-Great Ways to Join!

AAOM offers a two-year EZ-Pay plan (in four semi-annual installments) that lock-in your dues rate.

Due to minimal dues structures for Students, Friends of Acupuncture and our free OM Advocate membership classifications, EZ-Pay is not provided in these categories.


ACAOM Report '06

The Accreditation Commission for Acupuncture and Oriental Medicine (“ACAOM” or “Commission”) wishes to thank the leaders of the NFTCOM for inviting ACAOM to provide a written report on recent ACAOM activities and projects that may be of interest to your membership.

ACAOM’s core mission is to develop high educational standards for the acupuncture and Oriental medicine profession, and to accredit colleges and programs that meet those standards. 

To better achieve this mission, ACAOM has been engaged in the following activities.  

U.S, Department of Education Recognition:  ACAOM is currently recognized by the U.S. Department of Education (“USDE”) as a reliable authority for quality education and training in the field of acupuncture and Oriental medicine.  USDE recognition of an accrediting agency permits the schools and programs they accredit to establish eligibility for their students to receive Title IV federal student financial aid. To achieve USDE recognition, accrediting agencies must demonstrate that they meet USDE’s many rigorous standards for recognition, and must be reviewed periodically for that recognition to be maintained.

ACAOM submitted its petition in 2005 to seek continued USDE recognition, and to request an expansion of that recognition to also cover the Commission’s candidacy school reviews.  The USDE reviewed that petition, conducted an on-site inspection of ACAOM’s accreditation records and processes in September, and conducted a public hearing on ACAOM’s recognition on December 8, 2005.  

Based on that review, the USDE found that ACAOM fully meets ALL USDE’s recognition standards, renewed ACAOM’s recognition for USDE’s maximum 5-year period, and also granted the Commission’s request for an expansion of its recognition to cover ACAOM’s candidacy school reviews.   As a practical matter, this means that ACAOM candidate schools and programs (in addition to those that have achieved accreditation) can now use ACAOM’s candidacy status to establish eligibility for their students to participate in Title IV federal student financial aid programs.   

Post-Graduate Doctoral Programs (“Doctor of Acupuncture & Oriental Medicine” or “DAOM”):

In 2001 ACAOM adopted accreditation standards for post-graduate doctoral programs in acupuncture and Oriental medicine (“DAOM”). Since that time, several schools have received ACAOM approval to begin offering those programs and two DAOM programs have recently achieved ACAOM candidacy status.  Admission to this program requires graduation from an ACAOM-accredited or candidate Master’s-level program in acupuncture and Oriental medicine or its international equivalent, and thus should be distinguished from a “first-professional”, entry-level doctoral program. Although the Commission is not currently recognized by the U.S. Department of Education for its DAOM program reviews, the Commission will be pursuing this recognition.

The Commission recently announced proposed amendments to the current requirement for post-graduate DAOM programs that they be taught only in the English language. The principal reason that the Commission had adopted an “English-only” requirement was based on the limited number of site visitors who possessed the language skills needed to evaluate such programs. However, over the past three years the Commission has implemented an aggressive site visitor training program, and this has resulted in a growing number of site visitors that are fluent in the Chinese and Korean languages.

The Commission thus has submitted for public comment a proposal that would permit DAOM programs to also be offered in languages other than English, including in Korean and Chinese. If you wish to review that proposal and provide written testimony, please visit our web site www.acaom.org, click the “News and Meetings” link, and review the item titled “Public Comment Sought on Proposed Amendments to Standards for Post-Graduate Doctoral Programs.”

First-Professional, Entry-Level Doctoral Programs

Based on growing support within the Oriental medicine profession for first-professional, entry-level doctoral programs in acupuncture and Oriental medicine, the Commission has been active in developing accreditation standards for reviewing such programs. To ensure that the standards for this program are developed in a professional manner, and to ensure that they will advance the evolving needs of the profession and will also meet U.S. Department of Education strict recognition requirements, the Commission is committed to implementing a thorough and credible standards development process. 

A key component of this process is ensuring that the standards developed for entry-level doctoral programs involves broad-based input from all the Commission’s key constituencies, including professional AOM organizations, practitioners, educators, and licensing boards. Accordingly, ACAOM established a Doctoral Task Force to develop a list of the professional competencies that might be included in possible accreditation standards for reviewing such programs.

The Task Force is comprised of representatives of organizations that reflect a broad cross-section of the profession, including representatives of the American Association of Oriental Medicine (AAOM), National Federation of Chinese TCM Organizations (NFCTCMO), Federation of Acupuncture and Oriental Medicine Regulatory Agencies (FAOMRA), the World Federation of Chinese Medicine Societies (WFCMS), Acupuncture and Oriental Medicine Alliance (AOM Alliance), Council of Colleges of Acupuncture and Oriental Medicine (CCAOM), and the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM).  

The Task Force conducted meetings in March 2004, November 2004 and June 2005, culminating in the development of a comprehensive list of the professional competencies expected of first-professional doctoral program graduates.  Consistent with the accreditation standards for other USDE-recognized doctoral-level health care professions, rather than specifying in detail specific required courses and clinic training requirements for doctoral programs, the Task Force articulated the professional competencies or outcomes that are expected of program graduates. Doctoral programs would be required to demonstrate that their students are achieving all the required competencies and their stated educational objectives to meet the standards for accreditation. 

The ACAOM Doctoral Task Force Report expressly states that any doctoral standards developed must incorporate all the professional competencies expected in Masters’ programs, including those governing Oriental medicine theory, diagnostic skills, treatment planning, treatment techniques, herbal studies, biomedical clinical sciences, ethics and practice management, etc. In addition to the training expectations for students in Master’s programs, the Task Force Report also states that accreditation standards for the entry-level doctorate needs to include sufficient training to prepare program graduates to practice successfully in the emerging, complex, multi-disciplinary settings in which future practitioners may find themselves, such as hospital based practice, practice in integrative medicine settings with allopathic providers, etc.   

The Commission is currently reviewing the Task Force Report to determine the next steps towards developing accreditation standards for the entry-level doctorate.  The Commission welcomes public comment on the report and would highly value any comments or suggestions issued by NFCTCMO members.  If NFCTCMO members or any other members of the profession wish to provide written comments on the report, the full Task Force Report can be downloaded from ACAOM’s web site at www.acaom.org under the “News and Meetings” link under the item titled “Public Comment Sought on Proposed Amendments to Standards for Post-Graduate Doctoral Programs.”

ACAOM Launches New School Resource Web Site/Provides Workshops to Improve Educational Programs

New Web Site:

ACAOM has launched a new test web site to serve as a resource for programs in ACAOM’s accreditation process. The intent of the site is to improve the education provided by ACAOM accredited and candidate programs. The new site www.acaom2.org focuses on training in outcomes assessment, with the objective that individuals accessing the site will:

ACAOM Workshops:

ACAOM has been conducting workshops designed to improve the educational programs in AOM. The last workshop was conducted at the Commission’s fall 2005 meeting, and focused on how programs can assess and improve their educational programs.

Site Visitors Wanted/Receive NCCAOM CEU Credit

ACAOM is seeking qualified practitioners to serve on site visit teams, particularly individuals who are fluent in Korean and Chinese.  Practitioners who serve on site visit teams review a self study report submitted by an acupuncture or Oriental medicine program documenting how they meet ACAOM‘s accreditation standards, followed by a three-four day site visit to the program with a team of experienced site visitors.  Programs in the accreditation process cover all expenses of site visitors including hotel, meals and travel.  Site visitors also receive a $200/day honorarium for their service as site visitors.  NCCAOM Diplomates who serve on site visit teams also earn 10 CEU/PDA credits for NCCAOM recertification purposes.

Site visit teams review all aspects of the educational program, including clinic, office and classroom facilities, compliance with OSHA/HIPPA, patient recordkeeping practices, quality of classroom and clinical training/instruction, adequacy of institutional resources to support quality training, quality of faculty, adequacy of library and other learning resources, etc.   Site visitors review all categories of program records, including patient files, curriculum records, student academic and admissions records, governance, records, financial records, OSHA/Clinical Manuals and Handbooks, etc., followed by interviews of all program constituencies, including administrative staff, faculty, students, alumni, board members, and assessing the quality of actual classroom and clinical instruction.

Site visitors are encouraged to attend a site visitor training workshop prior to serving as an ACAOM site visitor, but this is not mandatory. As an NCCAOM PDA/CEU provider, NCCAOM Diplomates who attend ACAOM site visit training workshops receive 3 PDA/CEU credits for recertification purposes. Workshops are typically held in conjunction with the spring and fall national AOM meetings and provide training in evaluating the quality of AOM educational programs seeking ACAOM accreditation or candidacy status.  Future workshops may be held in conjunction with conferences conducted by state professional AOM associations.  Scheduled site visitor training workshops are announced in the Commission’s newsletters, which can be accessed by clicking the “Newsletter” link on ACAOM web site at www.acaom.org or http://acaom.org/newsletter.asp.

Concluding Remarks:  It is an honor for ACAOM to have been granted an opportunity to provide this report.  As the Commission values comments from all its constituencies, if NFCTCMO members have any suggestions or comments on ways the Commission can improve or strengthen education within the profession, those comments are welcome.   Please do not hesitate to contact the Commission should you wish to provide constructive comments or suggestions.  We look forward to working with you in the future relative to our share objectives of improving education within the profession.


DSHEA Labeling Requirements

For many private practitioners of TCM, the sales of dietary supplements makes up an important tool for the health of our patients as well as the financial health of our practice. However there are federal regulations that describe what we can and cannot say on our labels.

When we prepare to bring our labels up to code or accordance with DSHEA requirements, we must first understand that labeling doesn't just apply to the words and graphics affixed to the bottle or container of the actual product. Any words that are printed on papers inserted with the product are also regulated as labels. In fact any publication, advertisement, or even website that provides a purchase opportunity to your product are all regulated as labeling.

For this reason, bringing your labeling up to code requires that one assess two separate areas of the business. The product's label, and all the words wherever they may appear that support that product. The law actually talks about publications available at the site of purchase. In the case of a website, this would include the webpage to which a purchase opportunity is linked.

Bottle Labels

When it comes to the labeling of your supplements' bottles the most current thinking from the FDA on this topic is found in a "guideline" document for "small entities" which are small businesses. Here's the URL:
http://www.cfsan.fda.gov/~dms/dslg-toc.htm

A quick list of what each label needs to include:

Finally, if there is a structure-function claim made, a disclaimer must be added. (i.e. "Supports the healthy function of the large intestine") Then the disclaimer: "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease."

This guideline document goes into very clear detail as to how large or small the type can be, where it must be placed and what it must say. Please note that if you're grossing less than $500,000/year in sales, you're exempt from the "supplement facts panel" on the side of the bottle or box.

So, what's okay to say and what isn't? This is quite interesting. You can talk about any herb or formula as treating anything you want. Presumably, it will be a well-referenced article or at least favor traditional uses of the formula/herb that is backed up by text books, peer-reviewed journals, etc. This is not a problem, however the moment you include a "buy now" button on a webpage or some other means by which a purchase can be made that favors one brand, manufacturer, distributor, then you've got labeling.

Notice how Margaret Naeser's article on laser acupuncture at gancao.net went to such lengths to list ALL of the outlets where the discussed laser devices could be purchased. If you list them all (or none, or a link to a google search that is random) you're not favoring any outlet and thus avoiding any claims that would be considered labeling.

So, this topic of website labeling now becomes one of "claims". There are a few different types of "claims" that can be found on labels and/or supporting documents of Chinese herbal supplements:

Health claim (aka disease claim): this is a statement that a particular supplement will have a direct effect on a disease. What's a disease? Anything that needs to be fixed is a disease. One page at the FDA site says that if it appears in a medical text, it's a disease. Does that means that Spleen Qi deficiency is a disease? It certainly doesn't appear in too many Western medicine texts. I believe that the answer will end up being "yes". The litmus test of "health claim" is if there's a problem that is being fixed. So, if your materials say that Shen Ling Bai Zhu San treats, cures, mitigates, or otherwise improves a Spleen Qi deficiency, that is a health or disease claim and guess what? Only drugs can do that! Drugs, and a few vitamins and minerals that have gone through rigorous scientific examination. Examples of dietary supplement health claims that can be made include "calcium for osteoporosis" and such. Since this law was passed in 1994, there have only been less than 15 approved health claims!

Now these health claims do not require explicit claims to be made. There are plenty of opportunities for implied claims such as the name of the product. If I wanted to make the formula name "Shen Ling Bai Zhu San" easier for a consumer to remember, I might chose a name like "diarrhea begone" in which case I am making an implied health claim.

Structure-Function claim: There are a few other classes of claims, but the one that we have to pay attention to under DSHEA is the so-called "structure-function" claim. This is where we get in to those "promotes healthy bowel movements" type statements. We can't fix diarrhea, but we can promote healthy bowel movements. Say it loud, say it proud, we can promote healthy bowel movements! But don't forget to say it to the FDA too, before 30 days have passed.

They want to know what structure-function claims are being made. You don't have to prove your claims are true, but they do require that you can maintain some sort of proof on file just in case the subject should come up at a later date. Specifically the "substantiation" that needs to be kept on file is that your claims are truthful and not misleading.

There are a few exceptions to these strict structure-function claims. Health concerns we pass through as part of life such as menopause would not be considered a disease, nor would hot flashes, night sweats, or any of the other symptoms of a normal change of life. Funny thing is, the way that the FDA limits this is by stating that if the symptom that arises occurs in a minority of the population, then it isn't considered part of a life change, but is a disease. So, if 49% of the (menopausal) population get headaches, that is a disease that we cannot claim to treat. However if 51% of the population gets menopausal headaches, it is no longer a minority and thus no longer a disease claim!

Non-Disease States: Another exception is the treatment of something that isn't necessarily related to a specific disease. The guidelines talk about a dietary supplement that "improves absent mindedness" [sic]. Because this could be considered a symptom of Alzheimer's disease, this would be an implied disease claim. However because absent mindedness is also a benign symptom of aging, the rule defaults to the ambiguity and so this statement is allowed.

A third exception deals with transitory non-disease states that are not considered a problem but more of a nuisance. An example of this would be water-weight gain during menstruation, or intermittent insomnia.

There are ways in which practitioners have labeled their Chinese herbal supplements in order to get around making a disease claim, but on further examination of the guidelines, these "implied claims" such as naming a product "Tumor Shrink" is no more legal than the explicit claims of curing cancer.

You can't market a product as "herbal antibiotic" either because the only possible use of an antibiotic is to treat infection. In this case, again we're treating a pathology and hence making a disease claim. However an herbal diuretic that could be applied to "temporary water-weight gain during menstruation" may be permissible.

A product cannot claim to augment a therapy or drug intended to treat disease. An herbal supplement marketed to treat hypertension along side beta-blockers is still making a disease claim that it will lower high blood pressure.

A product that is marketed to mitigate the side effects of drugs that are treating disease is still fixing a problem. We can't fix problems, dietary supplements can only "support normal function". So, marketing Shen Ling Bai Zhu San as a way to mop up any gastrointestinal side effects of antibiotic therapy is prohibited.

For more on structure/function claims guidelines for the small business, please see:
http://www.cfsan.fda.gov/~dms/sclmguid.html

Looking Ahead

There is currently a voluntary reporting system of adverse events for supplements and over-the-counter (OTC) drugs, however the website that is supposed to be maintaining this database has indicated that the database it built for adverse events of dietary supplements was not very workable and so the FDA's "medwatch" is not currently set up to build the necessary data needed for dietary supplements to be distinguished for their safety record. However, the Dietary Supplement and Nonprescription Drug Consumer Protection Act is a new bill in the US Senate that would replace the voluntary reporting system with a mandatory system. Under the proposed law, manufacturers, packers, or distributors of OTC drugs or dietary supplements in the United States must report to the FDA within 15 business days any reports of a serious adverse event associated with their products. Serious events include those that result in death, a life-threatening experience, inpatient hospitalization, disability or incapacity, birth defect, or medical/surgical intervention to prevent one of these outcomes.

In putting together a recent lecture on herb-drug interactions, an attempt was made to compare adverse events due to herbs and adverse events due to OTC medications. While there was no means by which one could compare the two, it quickly became evident that OTC remedies are the tool of choice among 35% of the women attempting suicide in Northern Ireland (1).

It is the opinion of the author that this bill is going to be of great value to the TCM community. Putting our products on a statistically level playing field with OTC remedies will show Americans how safe our products are compared to a class of remedies that are already trusted, namely OTC medications. The Hatch-Durbin bill, S. 3546, is as of the time of the writing of this article still being negotiated in Congress. For more, please see:
http://hatch.senate.gov/index.cfm?FuseAction=PressReleases.Detail&PressRelease_id=1598

While USA regulations remain in the Dark Ages regarding TCM herbal therapies, DSHEA has given us a place at the table to further prove the safety and efficacy of our herbal interventions. With patient respect for the law, a healthy desire to better legislate a means by which we can freely express our claims, and ongoing ethical approaches to the marketing of our remedies we can help Washington decision makers look beyond the fears of the unknown to appreciate what traditional East Asian healers have known for thousands of years.

For a more detailed explanation of DSHEA and a few regulations specific to the state of California, please see:
http://gancao.net/labeling/supplements.shtml

Al Stone is a licensed acupuncturist with a focus on TCM herbal medicines in his Santa Monica, CA practice. Al Stone can be contacted through www.gancao.net.

References:
1. Prevalence of Over-the-Counter Drug-related Overdoses at Accident and Emergency Departments in Northern Ireland - a Retrospective Evaluation
M. Wazaify et al. Journal of Clinical Pharmacy & Therapeutics
Volume 30 Page 39  - February 2005


From the Integrator Blog:

http://theintegratorblog.com/site/index.php?
optionfiltered=com_content&task=view&id=101&Itemid=152

"Accreditation agency recognition by the federal government has been a battle ground in advancement for the AOM, DC and ND professions. To many in AOM, the news was good when an application for US Department of Education recognition of a splinter-group AOM accrediting body, the National Oriental Medicine Accrediting Agency, was withdrawn recently. A 70 page DOE report found 436 violations of guidelines and recommended against recognition of the group. The Association of Acupuncture and Oriental Medicine is among those which opposed the recognition. Meanwhile, the presently-recognized Accreditation Commission for Acupuncture and Oriental Medicine was granted a five year extension by the USDE."


Acupuncture Without Borders

Continuing their work with victims of hurricane Katrina

I am back from Louisiana, along with our first team of this next phase (see photo and names below). I am more convinced than ever that Acupuncturists Without Borders is there at exactly the right time, with the services we have to offer. The stress and trauma has reached monumental proportions. People are really struggling, with a lot of pain, and the ongoing need for a lot of hard work. I want to shake the shoulders of this country and say “look at what is going on here, DO NOT LEAVE THESE PEOPLE BEHIND!!” Almost a year after the storm, and the situation is still so desperate. Almost anyone will tell you that people just don’t get it unless they have seen it with their own eyes.

Some things people said: The cautious fire chief looked me straight in the eye and said he was “worried about his people…how often could we help them with treatments?”

An acupuncture client said: “I could survive the storm, but this is so much harder…”

Another client said: “Some days I just want to give up.”

A police officer told one of our supporters: ‘Even the docs are overdosing due to overstress…”

An acupuncture client told a story about her brother, who had seen his wife floating off after the storm, he swam out and saved her. Months later he was suicidal. They called 38 hospitals in greater area and couldn’t find a psychiatric bed. He committed suicide.

Someone talked about the elderly – whole lives have been so disrupted, and they so badly need stability, knowing where things are…so many of them are going downhill and can’t recover…

An acupuncture client said, after treatment for him and his wife: “I haven’t seen my wife’s eyes sparkle like that since I can’t remember when….”

Diana Fried, M. Ac., MA
Executive Director, Acupuncturists Without Borders

We can do so much more in Louisiana with more funding. We need the support of those of you who understand the value and power of acupuncture in this type of setting. We are applying for grants, and hope to get some, but some of the traditional funding sources that have received a lot of money (Red Cross, United Way, Catholic Charities) are not coming through with support for us. Donations can be sent to: AWB, 37 Kelly Lynn Dr., Sandia Park, NM 87047 or online at www.acuwithoutborders.org

Treatments at New Orleans Fire Department

From Jordan Van Voast (current Team Leader in New Orleans): Things are going well with the Team here in NOLA. People are demanding our services more than we can really keep up with. The healing work required ahead is huge, but one needle, one person, one centered breath at a time, we are making a difference. All of us are incredibly fortunate to be a part of making this work happen.

Team in New Orleans at Odyssey House –
(L to R) Daphne Jochnick (Wash, DC),
Marcey Rosin (AZ), Stephanie Trzaska (NY)

Thank you Daphne, Marcey and Stephanie!

Diana Fried, M. Ac., MA
Executive Director, Acupuncturists Without Borders


AIMS Worker's Compensation Report

Welcome AIMS!

The AAOM welcomes to its Association Membership, the Acupuncture and Integrated Medicine Specialists (AIMS). As a California based association, AIMS is a non-profit business association dedicated to the protection, promotion, and advancement of acupuncture and traditional Oriental medicine and the integration of these practices into the American health care system.

Greetings,

Attached is the latest from "workcomp central" re: W/C Guidelines

AIMS insurance committee felt that the entire profession should be informed on the latest development as soon as possible. We hope you will read it and pass it on to others.

AIMS web site and communication operation is currently under reconstruction. We are asking you to please forward information to individuals, associations, and educational institutions.

This is an election year. It is an important year to be involved in the political process, and especially as it impacts our profession and our abilities to help patients. Look for AIMS bi-monthly updates scheduled to start sometime this summer.

AIMS is currently looking for a location for our State Legislative Town hall meeting tentatively scheduled for Sept/Oct. The subject of workers comp, education and many other statutory and regulatory issues will be discussed and debated. We are currently asking the profession for suggestions for topic of discussion. We will be sending out a survey to further identify areas of concern and then prioritize them for our State Legislative Town hall.

If the State adopts the proposal following this letter, it will be important to have the right person representing the profession. We believe we need to start that discussion as soon as possible.

In the past we have had great representation from Robin Hayes and Kenny Cherman in the W/C arena. Ken is an AIMS board member who has worked well with Robin when she was with c.a.a. and Ken was with C.S.O.M.

Ken and or Robin would be great choices. Another excellent choice would be former AIMS board member and current advisor to the President Shane Buras. Shane has a background of a million years or so of experience in the insurance industry before being reborn as an Acupuncturist. He is also co-chair of the AAOM CPT committee and AAOM board member. He testified before two committees in support of AB-3014 Koretz and proved himself to be extremely knowledgeable, respectable and a very cool head when asked questions under pressure. Alex Katz is another AIMS board member that is highly qualified to represent the profession in the W/C arena. He has made himself an expert on policy and procedures on W/C and has built a very successful career practicing in W/C. In addition, he has been working as a case review expert for several insurance companies as are Kenny and Shane.

AIMS is opening up the subject for discussion and debate. Who would be the best person and a back up to represent the Acupuncture profession should the W/C administrative director choose to have each of the physicians in W/C have such a representative?

I would like to thank Fred Lerner DC of Lerner Education for sending AIMS the latest update from "workcomp central." If ever you want to know the latest on W/C and how to get the most out of ethical billing, you need to attend one of Fred and Shane Burras' ethical billing seminars. The next one is in N. California in the Bay Area next week.

Separate issue.

Thanks to all who have been in support of AB-3014. Please tell others to join you in support. Please contact your State Senator and request their vote. CAOMA and their lobbyist are working hard to defeat this important legislation that the rest of the profession is supporting. CAOMA and the chiropractors and the physical therapists lobby are all working hard to defeat AB-3014 Koretz.

PLEASE HELP.

Neal S. Miller L. Ac., D.N.B.A.O
13735 Ventura Blvd.
Sherman Oaks, CA 91423

(818) 789-2468
(818) 981-2766 FAX

California -- Calif. Regs Would Keep ACOEM as Sole Guidelines: Regulatory [07/10/06]

The American College of Occupational and Environmental Medicine (ACOEM) would remain the source of treatment guidelines in California's workers' compensation system, under proposed rules posted Friday by the Division of Workers' Compensation.

The draft rules, while leaving ACOEM in place, would also establish a medical evidence evaluation advisory committee that will include an orthopedist, a chiropractor, an occupational medicine physician, an acupuncturist, a physical or occupational therapist, a psychologist or psychiatrist, a pain specialist and three other members to be appointed at the administrative director's discretion.

The agency scheduled an Aug. 23 public hearing in Oakland to take testimony on the proposed rules.

Susan Gard, spokeswoman for the Division of Workers' Compensation, said that the proposed regulations represent a step toward filing the gaps in ACOEM, most notably for spinal injuries, chronic pain and carpal tunnel syndrome.

"This sets the hierarchy of evidence," Gard said. "In other words, what's the best way to look at evidence? The Legislature made (ACOEM) the foundation of evidence-based medicine in California's workers' comp system and now we're going to build on that and add to it. That's the good news here."

The regulations, however, do not put in place any treatment guidelines other than ACOEM. The creation of an advisory panel at best will keep alive hopes by specialty groups that eventually California will adopt something they believe is more suitable for their disciplines.

Senate Bill 899, signed into law on April 19, 2004, called for the DWC to adopt a "medical treatment utilization schedule" by Dec. 31, 2004. Unable to complete an exhaustive analysis of the myriad treatment guidelines in existence by that deadline, the DWC adopted ACOEM as the utilization schedule.

"We're happy the process is going to be vetted," said Steve Cattolica, government affairs director for the California Society of Occupational Medicine and Surgery. "These regulations are months behind, and from that perspective we are glad to see that the DWC is stepping up and coming forward."

Orthopedic surgeons, chiropractors, acupuncturists and other practitioners have pleaded that the DWC to augment ACOEM's Occupational Medicine Practice Guidelines with guidelines from their specialties. What's more, the state's labor-management advisory panel, the Commission on Health and Safety and Workers' Compensation, recommended that the DWC adopt guidelines written by the American Academy of Orthopedic Surgery (AAOS) for spinal surgery and ACOEM for all other treatments.

But acting Administrative Director Carrie Nevans decided to stick with a single source, at least for now.

"The system and rigor of scientific review used in the development of evidence-based guidelines varies significantly from one group to another," the DWC said in a statement of reasons that accompanied the proposed regulations. "Should the administrative director adopt multiple guidelines, more disputes will arise as the lack of agreement between guidelines would negate the presumption of correctness under some circumstances."

Diane Przepiorski, Executive Director of the California Orthopedic Association, said she was disappointed that the DWC once again rejected guidelines that most spine surgeons consider superior to ACOEM for their specialty. CHSWC had recommended the orthopedic surgeon's AAOS guidelines because a study by RAND Corp. had deemed them more suitable for back surgery. RAND said ACOEM was superior to AAOS and other treatment guidelines for all other types of treatment, although it didn't find ACOEM or any other set of guidelines particularly comprehensive.

Przepiorski said her group will fight to improve California's treatment guidelines on two fronts: It will push for changes during the rule making process for the current draft regulations and before the medical advisory committee once it is established. Secondly, the American Academy of Orthopedic Surgery is holding discussions with ACOEM to create better guidelines for back surgery.

Przepiorski said ACOEM guidelines are good for treatment of acute back pain conditions, but not so good in recommending treatments for chronic conditions -- typically the type of disorders that surgeons are called in to cure and relieve.

"Ultimately we believe that specialists themselves have the most at stake in developing appropriate treatment guidelines," Przepiorski said. "Unfortunately, orthopedics was one of the specialties that was just not involved" in the drafting of ACOEM guidelines.

The DWC, in its statement of reasons, gave very specific reasons not to replace the spinal surgery section of ACOEM with AAOS. Mainly, the two guidelines give different direction to physicians on how to treat chronic cases. For instance, ACOEM says that X-rays should not be performed on patients suffering low back pain -- even if pain persists more than six weeks -- unless there are red flags that point to serious spinal pathology, while AAOS says X-rays should be considered if pain persists for four to six weeks.

The DWC found similar problems with recommendations to consider separate guidelines for podiatry, chiropractic, physical therapy, occupational therapy, acupuncture and biofeedback.

"... Conflicting recommendations such as those illustrated above will be confusing to the provider, employer, or claims administrator who are required to provide requisite services for an industrial injury and who may incur liability for failing to do so according to the statute," the DWC said in its statement of reasons.

To view the proposed regulations, the DWC's statement of reasons and the notice of public hearing, go here:

http://www.dir.ca.gov/dwc/DWCPropRegs/
MedicalTreatmentUtilizationSchedule/MTUS_regulations.htm

By Jim Sams, Senior Editor

Editor Rob McCarthy contributed to this report.


New Mexico Wins a Round

On Saturday, 8 July, the New Mexico Board of Chiropractic Examiners rescinded their rule change by which they tried last December to give themselves the right to practice "chiropractic acupuncture". The retraction came as a result of the Oriental Medicine Association of New Mexico's filing a lawsuit. In the meantime, representatives of the Association have begun talks with members of the New Mexico Chiropractic Association, and we are pleased to find ourselves in agreement on almost everything, including mutual respect between our professions. It turns out that only 2 or 3 DCs in New Mexico wanted the right to do acupuncture. The OMANM strongly recommends to other states that they contact DC associations and talk with ordinary DCs--we might not need to get sucked into a fight to the death if we can communicate constructively. We have agreed to explore requirements that might apply to both our professions--what would a DOM/LAc need to know to do "adjustments", what would qualify a DC to do acupuncture--using WHO recommendations as a starting point and possibly eventually involving the NCCAOM/ACAOM.


Indiana Association Welcomes New Vice President

Mitchell Harris was recently voted in as Vice President of the Indiana Aassociation of Acupuncture and Oriental Medicine. Jennifer Meador-Stone is active President. Mitch graduated from Pacific College in San Diego. The IAAOM is interested in connecting with other state organizations, especially in the Midwest, to improve member and public services and share ideas.

Indiana Referrals: Please visit our web site at www.iaaom.org 317-255-3030 for an acupuncture referral list of NCCAOM accredited practitioners in the state of Indiana.


Chicago Korean Acupuncture Association - 10th Anniversary

The Chicago Korean Acupuncture Association was established in 1997. Its main goal is to serve the Korean community and further improve our member's quality practice through continuing education.

The Chicago Korean Acupuncture Association will be celebrating its 10 year anniversary in 2007. With the new Governing body that was launched this year, the Association looks forward to being part of the Acupuncture Community and to better serving the "People" of our profession.

To JOIN or learn more about the Chicago Korean Association, please contact:

Scoitt Sang In Lee, L.Ac., DOM, NCCAOM
Phone: (847)808-7575
Email: chunam@juno.com


ACAOM News Release

HOUSTON, TX (June 1, 2006) - American College of Acupuncture & Oriental Medicine (ACAOM) has reached an agreement with Methodist Hospital to offer acupuncture in all of their facilities in Houston and surrounding. The agreement, which was implemented in January, included treating patients at the main Methodist Hospital location in the Texas Medical Center. After a successful start, the College begins treatment of patients at the other Methodist Hospital facilities at San Jacinto, Sugarland, and Willowbrook. 

The Houston institution’s interim president John Paul Liang has been involved with the process since 2005. “Methodist Hospital has been extremely supportive and we are really glad to have this cooperation. I think that we will really be able to help a lot of patients when we can combine Western and Eastern medical care, and for our students it really provides an opportunity that cannot be found in other acupuncture schools,” says John Paul Liang.

This will be a very unique experience for all of the College’s students since Methodist Hospital is one of the most respected medical healthcare systems in the country.  These will be reputable outreach sites for ACAOM students to do their internship and treat patients in a Western medical facility. For patients, this may provide great health benefits now that they have both Western and Oriental medical care. “This is the beginning of cooperative care. Many patients depend on this type of service,” says John Paul Liang. 

The Methodist Hospital is an affiliate of Cornell University’s Weill Medical College and New York-Presbyterian Hospital, which are two of the nation’s top medical education and research.  Named among the nation’s best hospitals for heart and heart surgery, neurology and neurosurgery, urology, ear, nose, and throat, psychiatry, ophthalmology, and gynecology by U.S. News and World Report’s 2005 annual guide, Methodist earned over $1.09 billion in net patient revenue in 2003.

With the addition of four Methodist Hospital sites, the acupuncture school continues to be one of the top Oriental medicine programs in the country with nine outreach locations including Rice University Student Health & Wellness Center, University of Houston Clear Lake Health Center, Memorial Hermann/Houston Baptist University Wellness Center, Memorial Southeast Hospital Outpatient Clinic, and Legacy Community Health Center (HIV & AIDS). 

Partnering with Methodist Hospital is not the only recent cooperation that the institution has done.  The College, which was recently featured in the PBS Show The Connection, is currently partnering with M.D. Anderson Cancer Center and is just completing a 3 year research with Baylor College of Medicine involving over 500 patients with osteoarthritis of the knee.  The study was funded by the National Institutes of Health, and targets the effects of acupuncture for osteoarthritis of the knee as well as the effects of practitioner communication in relation to patient recovery and pain relief.


Tai Sophia Institute Receives Regional Accreditation

The Tai Sophia Institute, a graduate academic institution for wellness-based education, clinical care, research and public policy discourse based in Laurel, MD, has received regional accreditation from the Middle States Commission on Higher Education. The Commission is a voluntary, non-governmental, peer-based membership association dedicated to educational excellence and improvement through peer-evaluation and accreditation. The Commission accredits degree-granting colleges and universities in the Middle States region.

Originally founded as a clinic for acupuncture in 1975, the Institute now offers master’s degrees in acupuncture, herbal medicine and the applied healing arts. “Receiving regional accreditation demonstrates the progress and evolution of the Institute from a small school to an Institution with a broad outlook about healing and wellness. When we first taught acupuncture we were considered outside the mainstream. Today, the concepts of “wellness” and “healing” have become more accepted and we are in the vanguard of preparing practitioners in these areas,” Robert Duggan president of the Tai Sophia Institute says.

The process to receive accreditation began in 2001. It required the Institute to complete a comprehensive “self-study” which involved analysis and planning to meet the 14 standards on which Middle States accreditation is based. The accreditation process also included a site visit from an evaluation team comprised of representatives of other institutes of higher education. The Commission commended Tai Sophia for being a unique institution that has been able to develop measurable outcomes for such concepts as “healing presence” and “personal transformation.”

The Tai Sophia Institute has more than 900 alumni practicing acupuncture, herbal medicine and other healing arts around the country. Its current enrollment totals more than 320 graduate students in its Master of Acupuncture, Master of Science in Herbal Medicine, and Master of Arts in Applied Healing Arts programs. In addition to the degree programs, the Institute offers a wide variety of wellness programs that are open to the community. The Institute also maintains clinics for acupuncture treatment and herbal consultations.

The Middle States Commission on Higher Education is an institutional accrediting agency recognized by the U.S. Secretary of Education and the Council for Higher Education Accreditation. Middle States’ website is www.msache.org.


9th World Congress on Qigong and TCM

CAMEXPO West, the International Complementary and Natural Healthcare Conference and Expo held November 10-12, 2006 and located in Los Angeles at the Hyatt Regency Century Plaza, is pleased to announce it will feature the 9th World Congress on Qigong and Traditional Chinese Medicine.
The 9th World Congress on Qigong and Traditional Chinese Medicine features a body, mind and spirit cultural education for the professional. Experience presentations and demonstrations of remarkable Qigong/TCM healing skills and techniques, research, health promoting martial arts, and research, show casing world class international Masters and scientists, demonstrations of high performance in everyday health and wellness through Qi-energy.. History, theory, policy, science, experiential sessions with instrumental measuring of the Qi demonstrations, Tui na, Ahn Mo (classical Chinese Massage), acupuncture, the healing of Chinese food and herbs, acupressure, cupping, Feng Shui (wind/water/geomancy), Qigong exercises, meditation, and more in the entire Chinese cultural systems approach to whole person health and healing. Participants will experience and learn a multitude of self-healing skills you can take home to use for yourself, family, or patients.

For more information about the 9th World Congress on Qigong and Traditional Chinese Medicine visit www.eastwestqi.com.

Registration for CAMEXPO West opens in July. Visit www.camexpowest.com for more information.

There are excellent opportunities for speakers, exhibitors, and sponsors.

Email full background to: eastwestqi@aol.com


Upcoming Seminars

 

Tung's Orthodox Acupuncture Diploma Course
The most traditional Master Tung's Acupuncture Course, Taught by the late Master Tung's disciple, Dr. Palden Carson MD., author of Tung's Orthodox Acupuncture. Two weekend course: Sept 8,9,10 and Oct 6,7,8. Berkeley, CA. 36 CEUs pending CA and NCCAOM. Please call or email for more info. (510) 225- 8055 or www.worldtaa.org, pc2god@yahoo.com

The Barefoot Doctor/First Aid & Traumatology
From East/West,old/new, first aid and emergency care has been studied and applied in every setting throughout the world and throughout history. Designed to provide easy information for emergency situations, this workshop will allow the participants to gain the knowledge and self-confidence to help when needed.
August 19, 2006; 8:15am-5:30pm; 443 N. New Ballas Rd, #224, St. Louis, MO 63141 (314) 991-6035
8 PDA's (NCCAOM pending)

TCM Pain Management: Pulse Dx & Herbal Tx
Lotus Institute of Integrative Medicine presents Jimmy Wei-Yen Chang, LAc. July 30, 2006 San Francisco, CA. 8 CEUs
For more information, contact 626-780-7182/626-609-2929/info@eLotus.org

Master Tung's Magic Points
A seminar taught by Susan Johnson, L.Ac. registration is extended with price breaks if you sign up by August 18.  Class is held at Antioch University in Yellow Springs, Ohio from 10 am to 5:30 pm on September 9th and 10th. In addition there will be one hour of Qi Gong from 9 am to 10 am. before Tung's class led by a local Tai Qi instructor. 13 CEU's are pending from NCCAOM. Call or e-mail Pat Worth to register. For more information, contact 937-667-8533 phone and fax pworth@woh.rr.com.

Natural Source International, Ltd., Celebrates Its 10th Anniversary
Join Us on October 28, 2006 in New York City
For its 10th anniversary, Natural Source International Ltd invites you to attend its unique seminar, to be held the weekend of October 28th, 2006 at Columbia University. This event, available as a single day or weekend package, will highlight the progress of the last ten years as well as the new projects pertaining to the clinical trials currently underway in the US.

We look forward to sharing with you the results of the ReaLBuild® and Prostabel® related clinical trials. Seats are limited, so register today!

3 Options:
- Seminar Only: $140/person, includes breakfast reception, lunch, coffee breaks and a full day at Columbia University
- Seminar and Dinner: $230/person
- Full Weekend: $280/person, includes a welcome cocktail Friday evening, all-day seminar and dinner Saturday and Sunday brunch.
To register, visit www.natural-resources.com
Please visit our website for all the details.


AAOM Student Organization Bylaws

Bylaws for the AAOM-SO, the new AAOM-sponsored student organization, are currently being reviewed and finalized. AAOM-SO Bylaws create a foundational outline for an energetic and committed student body, eager to establish national communications and cooperative participation in the future of Acupuncture and Oriental Medicine. Two nationwide student task forces have been at work, along with former AAOM Vice President, Cynthia O'Donnell, since the Student Caucus held at the AAOM Chicago Expo last October. Students across the country have brainstormed, networked and collaborated to produce an exceptional guiding document.

The founding bylaws will be presented at the AAOM Phoenix Expo this October. Students nationwide are invited to attend and become a part of the historic unveiling at the Student Caucus Meeting on Saturday morning. Students who live away from the greater Phoenix area are encouraged to create a ride-share initiative and consider using vans or mini-buses to make the trip more affordable and available. Hotel rooms can also be shared by up to four people. Students in colleges who have chosen their AAOM-SO Student Representatives may choose to help pay for their Student Rep.

The AAOM Chicago Expo was outstanding. Phoenix promises to be even better! The AAOM-SO Bylaws demonstrate the extraordinary progress that's been made since Chicago. Choose to help direct your future in Acupuncture and Oriental Medicine. Our profession is becoming more and more accepted in the mainstream, participation in the AAOM-SO contributes to the greater good of our profession’s growth. Be there to participate in the Phoenix Expo. 'We are all angels with only one wing, it's only when we embrace that we can fly!'


World Chinese Entrepreneur Association

2006 National Day Reception

’2006世界华人企业家国庆招待会

邀请函
请登陆www.wea.com.cn
尊敬的　　　　 先生（女士）:
您好！我们非常高兴通知您，鉴于阁下在本行业中的优秀成就和对国际社会作出的杰出贡献，您已被作为华人华侨优秀代表，特正式邀请您出席2006年度世界华人企业家国庆招待会。并免费颁发纯金铂“世界华人企业家国庆招待会海外代表证书”。
会议基本情况及报名方法，请登陆本会网站：www.wea.com.cn。
热线电话：86－10－6594.9480转16或22
值班传真：86－10－6594.9938
手机联系：86－10－13801109899
联系人：常小姐　井小姐　孙先生
世界华人企业家协会
2006年6月16日于北京

2006 National Day Reception of The World Chinese Entrepreneur Association

Dear AAOM Member:

Hello! I am pleasure to notice you! Because of your excellent success and wonderful contribution to the national society.

Congratulation! You have become a representative to overseas Chinese.

Formally, we invite you to attend the 2006 National Day reception of The World Chinese Entrepreneur Association, and a free platinum certificate of The World Chinese Entrepreneur Association National day reception Oversea representative will be given.

Conference’s basic condition and sign up way: http://www.wea.com.cn
Telephone: 86-10-6594.9480 to 16 or 22
Fax: 86-10-6594.9938
Mobile phone: 86-10-13801109899
Person to contact: Miss Chang , Miss Jing or Mr. Sun.

The world Chinese Entrepreneur Association

Reception Party on National Day, 2006

NOTICE

  1. Please fill the blank after your reading and FAX/MAIL your return receipt before Aug 31,2006.
  2. Please send two recent photos without hat (2 inch) or send e-mail to us with your name on the mail title.
  3. More than ten people will make a team. The party leader is free for the conference expense and 20% off for the Room Rate.
  4. Please send your Money Order to us for affirm:
    TEL:86-10-65949480-16/22
    FAX:86-10-65949938
    E-MAIL:YSB168@SOHU.COM

INTERNATIONAL TRADE CENTER OF BEIJING ENTERPRISES UNION
Jun 16,2006

NAME, SEX, AGE, RETINUE NUMBER
COMP.NAME, YOUR TITLE
ADDRESS, POST CODE
TEL:, WORK:, MOBILE:, HOME:
A. Conference expense: 600 USD, including your 2 banquets and all the meals, registration, traffic expense, rent of the field, photos expense with the state leaders during the whole meeting.
B. Room Standard: Diao Yu Tai State Guesthouse,175 USD per room,________(number)Twin Room(s) ,total______USD
Any room standard is wanted, please contact with us about the new expense. Please make sure your registration as soon as possible, all the room expense is raising recently in Beijing, Sept.
I WILL MAKE REMITTANCE, CONFERENCE EXPENSE_______,
ROOM EXPENSE______,
TOTAL_______AT______(DATE),TO YOUR ACCOUNT.

________________(NAME),____________(DATE)

2006年度北京国庆招待会
参会须知

一、请逐项真写下面的参会回执，并于2006年8月31日前寄交或传真我处。

二、请寄交2张2寸个人免冠照片办理大会证件（也可通过电子邮件发送但须注明姓名）。

三、10人以上可成团，团长本人免除会务费，住宿费8折。随团名单可另纸打印。

四、①中国境内汇款，请电汇到下列帐号 帐号：35230188000011806
开户行：北京光大银行北太平庄支行 收款单位：北京华企联合国际经贸中心

②香港汇款：请汇到下列帐号 帐号：015—521—25—01983—5
开户行：东亚银行有限公司湾仔分行 收款单位：中国国际资讯集团有限公司

③境外汇款：请直接汇入下列帐号 帐号：4100600—0188—057139—3
开户行及地址：An Hui Li Sub—office BANK OF CHINA BEIJING
CHAOYNG SUB—BRANCH 收款人：Yu Shun biao 余顺标
五、请将汇款单传真本中心以便确认。

电话：86—10—65949480转16 、22 直拨电话：86—10—6594.9938
传真：86—10—65949938（24小时） 电子信箱：ysb168@sohu.com

北京企业联合国际经贸中心
2006年6月16日

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手机

1、每人会务费600美元（含二次宴会、会期全部餐费、注册、证件制作、交通、场租、与国家领导人合影等各项费用）共       人，合计      元。
2、住宿标准：
钓鱼台国宾馆（外国元首、总统住地），每间夜175美元（双人间），共     间，合计     美元；（若要求住总统套房或商务套间，请另行注明，费用另议）
今年九月北京旅游黄金委节，各种房价均上调，各种住房尤其紧张，请务必提前预定。  

我于2006年    月    日将会务费      元、住宿费      元，合计      元汇出。
                                               签名         2006年     月     日

BEAT THIS SUMMER HEAT


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Whatever status you maintain with the profession – a practitioner, a student, an OM College, an OM Business/Service Provider, a Friend of Acupuncture, or an OM Advocate, it is important to do what you can, when you can to advance the profession.  Remember…

So long as you do not have the power to change the world,
it is useless to say that the world is wrong.

And if you abolish in yourself the things that are wrong in the world,
you will see that the world will no longer be wrong.

The Mother -- 14:p.298

How to Contribute: To meet our monthly publishing deadline, we have found that we need to "move-up" our deadline by one week. Contributions from the profession must be received by close of business the first Monday (rather than second Monday) of each month. If you would like to contribute to this monthly newsletter, we recommend that you read the Qi-Unity Report e-blast as comprehensive instructions are provided. Please no direct emails, as an online form is provided!

...Today, Do Something!

Sincerely,


Rebekah Christensen,
Executive Director

PS: Don't miss Expo 2006, scheduled October 19-23, at the Wigwam Resort and Spa, Litchfield Park (Phoenix), Arizona. You'll find Exhibitor and Attendee Brochures online at www.aaom.org!