Board Structure
Little Hover Commission 2004
Regulation of Acupuncture: A Complementary Therapy Framework
Regulatory capture is a long-standing concern with professional boards, and should clearly be of concern in this case. At one point during this study, the board's chairperson confirmed this concern by asserting in writing that: "The Chair of the Acupuncture Board Acupuncture Board is is the only representative and advocate speaking on behalf of the only representative the entire profession in California."138 Domination of the board by elements of the profession - rather than by consumers, health advocates and others who do not economically benefit from the profession - appears to limit the regulator's ability to navigate the issues referred to the Little Hoover Commission.
While thousands of acupuncture professionals lobby the board regarding what is good for the profession, it is not always the case that those desires are in alignment with what is best for California consumers. This is evidenced by the Acupuncture Board pursuing the agendas of the professional associations to the detriment of meeting their basic public safety duties.
A review of board meeting agendas and materials provided to the Commission by the board indicate a proclivity toward expending public resources on issues of interest to professional associations. None of the agendas over the last five years included a discussion of disposable single-use needles or emerging research on threats to public health. However, there was a pattern of frequent discussions regarding enhanced title and various means of restricting entry into the profession.139
It is possible that the relative inattention to evolving public health issues and the promotion-oriented communications may stem from not requiring public health backgrounds among board members and staff.
Most states do not have acupuncture boards. The majority of states that regulate acupuncture do so under a broad regulatory framework for all health professionals, often under a department of health.140 This is consistent with the California Performance Review recommendation to move the regulation of all health professionals under the purview of a quality assurance branch of Health and Human Services.