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“THE BOTTOM LINE”
Jan 29, 2004

John A. Amaro D.C., FIAMA, Dipl.Ac., L.Ac.


Within the last few years as the majority of the States have licensed or are seeking legislation to license the practice of acupuncture, there seems to be an increasingly growing resentment between acupuncturists and medical /chiropractic physicians who are also engaged in the practice of acupuncture.

In most States, in order to be awarded a license to practice as a “Licensed Acupuncturist” (L.Ac.) an acupuncture practitioner must possess a graduate degree from an acupuncture college in excess of 1,850 hours and have been certified through examination by the National Commission for the Certification of Acupuncture and Oriental Medicine which has become the standard for the profession.

After having put so much time, money and effort into school to finally successfully graduate, complete the National examination and ready to embark on a career of healing in the field of acupuncture and Oriental Medicine, it becomes quite disheartening for the acupuncturist to see medical and chiropractic physicians utilizing acupuncture who seemingly have a disproportionate number of hours in the academics of Oriental Medicine.

It is important to understand the licensed acupuncturist (L.Ac.) having attended and graduated from a typical school in the United States, has had the majority of their education centered around not just acupuncture as a modality, but the theories, philosophies and procedures of the entire system known as “Oriental Medicine”. The term “Traditional Chinese Medicine” (TCM) is the most commonly used term to describe the practice of Oriental Medicine in America.

The acupuncture profession as it relates to the”L.Ac.” as opposed to the medical /chiropractic physician utilizing acupuncture, has set their practice description in stone through the naming of its National organizations. Every national organization and the vast majority of colleges have as a part of their name the words “Oriental Medicine” or “Chinese Medicine” in addition to the term “Acupuncture”. This shows a definite descriptive distinction between the practice of “Acupuncture” and “Oriental Medicine” as it is always listed as a separate and distinct entity. The word “and” becomes extremely significant as to general description and scope of practice.

The “Accreditation Commission for Acupuncture and Oriental Medicine” (ACAOM) established in 1982 acts as an independent body to evaluate first professional masters and certificate / diploma programs in Oriental Medicine with concentrations in both acupuncture and herbal therapy. The Commission is recognized by the U.S. Department of Education. A definite distinction is drawn as between “Acupuncture and Oriental Medicine” in its name.

The “ACAOM” was established in 1982 by the “Council of Colleges of Acupuncture and Oriental Medicine” (CCAOM) which was established to advance the status of acupuncture and Oriental Medicine in the United States. The Council has developed the academic and clinical guidelines and core curriculum requirements for masters level programs in acupuncture as well as Oriental Medicine. Curriculum for doctoral level programs have been developed for both Acupuncture and Oriental Medicine.
Again the distinction between Acupuncture and Oriental Medicine must be noted in its name.

The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) was likewise established in 1982 to promote nationally recognized standards of competence for acupuncture and Oriental Medicine. It was originally known as the National Commission for the Certification of Acupuncture (NCCA). The words “and Oriental Medicine” were added several years later to more accurately depict their full scope. The certification is the basis for licensure in more than 90% of States that have set standards for the practice of Acupuncture. It is imperative to note the clear-cut distinction of Acupuncture and Oriental Medicine in its name.

The Acupuncture and Oriental Medicine Alliance is a national professional membership association founded to represent the diversity of practitioners of Acupuncture and Oriental Medicine practitioners in the U.S. A clear-cut distinction between Acupuncture and Oriental Medicine is seen in this national organizations name.

The American Association of Oriental Medicine (AAOM) established in 1981 is a professional organization whose mission is to promote excellence and integrity in the professional practice of Acupuncture and Oriental Medicine. Membership in AAOM provides Oriental Medicine professionals with the opportunity to achieve full recognition of professional status from the medical community at large through involvement with the AMA policy issues and lobbying of Congressional members. It is important to note that this organization does not have Acupuncture in its name however it does draw a clear cut distinction between Acupuncture and Oriental Medicine in it mission statement.

Most States allow the practice of acupuncture by medical professionals through proprietary license. That is, the license to practice any medical procedure regardless of educational background in that field. The Chiropractic profession has on its own merit established 100 – 300 hours of postgraduate education for the practice of Acupuncture as an adjunct to the practice of chiropractic. The chiropractic profession has been intimately involved with the academics and practice of acupuncture since 1972 through the postgraduate department of nine Federally recognized chiropractic colleges. It has never focused its attention at any academic level on the practice of “Oriental Medicine” until the development of the three year acupuncture and Oriental Medicine programs offered by several of the respected chiropractic colleges who have added the full program to their curriculae.

The Acupuncture programs offered by both the medical and chiropractic profession have come under criticism by the general acupuncture profession, primarily because of their length. Course content and core curriculum has never been an issue regarding professional acupuncture programs only the length of the class. At 100-300 hours per program, most acupuncturists who have attended an 1,850 hour college program find this disgustingly inadequate.

However, it must be borne in mind, the didactic and clinical acupuncture programs offered in either the medical or chiropractic profession, focus specifically on the practice of acupuncture not the complexities of “Oriental Medicine”. It is the study of Traditional Chinese Medicine and “Oriental Medicine” which adds the vast majority of hours to the curriculae of the acupuncturist school. Medical / chiropractic programs have historically been interested in general acupuncture as their primary focus.

In order for a medical or chiropractic physician to even enter into a postgraduate program for acupuncture certification in the United States they must have accrued over 4,250 hours of science based curriculae with the attainment of a “Doctorate” degree. These programs specifically deal with “Medical / Clinical Acupuncture” and are geared as an adjunct for the Western based practice.

The Chiropractic profession has within the last two years established a national certification in acupuncture through the National Board of Chiropractic Examiners (NBCE). The NBCE has been the undisputed standard for the examination process in the chiropractic profession for over 40 years being recognized by every State licensure board in the United States.

This examination is offered to those who have completed a recognized postgraduate acupuncture certificate program to include blood borne pathogen awareness. The examination is a 200-question examination just as the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). The NBCE acupuncture examination will be the standard for clinical and educational competence for Doctors of Chiropractic practicing acupuncture in the country.

The American Chiropractic Association has recently formed the “College of Acupuncture” creating the status of “Diplomate” for those who have excelled in the field of acupuncture through additional postgraduate hours of education in addition to passing the rigorous final competency examination.
This certification is in addition to the National Board of Chiropractic Examiners.

The D.C.’s and M.D.’s who are currently practicing acupuncture in addition to the thousands who will join the ranks of practitioners within the next three to five years have all taken comprehensive, accelerated, academically complete programs into clinical acupuncture which have made them formidable practitioners. Their knowledge is significant of Five Elements, point selection and location, Auriculotherapy, Musculo-Tendino and Extraordinary meridians in addition to stimulation modalities along with the myriad of general acupuncture principles. Even though it is impossible to present an acupuncture program without entering into the realm of “Oriental Medicine” this is not the focus of these programs.

Those medical and chiropractic practitioners utilizing acupuncture which incidentally have numbered in the tens of thousands since 1972, have shown little interest as a profession in practicing the complexities of “Traditional Chinese Medicine”. It is here where the contemporary practitioner (L.Ac.) will have their most significant impact in cooperation with the medical professions.

Since few in the medical / chiropractic profession have an academic or clinical interest in exploring the full range of “Oriental Medicine” to add to their busy practices, it would be advantageous if the acupuncture profession not distance themselves from those who can help them the most through their referrals. In speaking to so many of my medical / chiropractic colleagues, a considerable number of them around the nation have experienced total animosity from the acupuncture profession because the acupuncturist feels the professional education is far less than theirs and why should they be able to practice with so few educational hours. In the meantime due to strained relationships experienced through the legislative process in the attainment of State licensure, the acupuncturist and medical / chiropractic professions have put up a wall of defense around themselves in an attempt to distance themselves from each other.

This is exactly opposite of what should be happening. The acupuncturist today should make the stand that they are the experts in “Oriental Medicine” recognizing the fact there are physicians who are likewise performing acupuncture; it is the “Oriental Medicine” that makes them so much different from the other professions. If this were to occur, there would be a newfound relationship between the medical / chiropractic practitioners and the acupuncturist resulting in increased respectability and referrals for all.

The Bottom Line is: There are without question a number of styles of acupuncture which are easily adapted into medical / chiropractic clinical practices as an adjunct to an already existing practice. Few if any medical / chiropractic practitioners are wanting to become acupuncturist as a sole specialty or specialize in the practice of Oriental Medicine. If D.C.’s and M.D.’s are using acupuncture, it is in conjunction with an existing Western style practice. The acupuncturists should hold themselves out to be the uncontested authority in “Oriental Medicine” as every organization and most schools have those words and mission in their name. M.D.’s and D.C.’s practicing acupuncture are not going to give up their right to utilize acupuncture and more states will undoubtedly allow Doctors of Chiropractic the right to practice acupuncture as they move forward legislatively. With National Board of Chiropractic Examiners certification in acupuncture, this is a given.

We can all co-exist and thrive together as professions as long as we are able to put aside the animosities, which have inundated our professions from the beginning. There is absolutely no room for name-calling or the attempt for one profession to try to discredit another especially at the legislative area. It is my wish for 2004 that the professions may move forward with peace and harmony and mutual respect for each other. By doing so, each of us will see an increase in patient base as well as personal satisfaction.

Best Wishes for a great 2004
John A. Amaro D.C., FIAMA, Dipl.Ac., L.Ac.
Carefree, Arizona DrAmaro@IAMA.edu