Finding and Recommendation 2
Little Hover Commission 2004
Regulation of Acupuncture: A Complementary Therapy Framework
Finding 2:
The new 3,000-hour educational requirement is adequate to prepare entry-level practitioners and to protect the public safety.
A primary goal of educational requirements is to provide some assurance that professionals have the knowledge, skills and abilities necessary to safely practice the profession. And the standard for professional licensing is to ensure that incoming licensees can perform the legally authorized scope of practice as entry-level practitioners.2
Effective January 1, 2005, new students in acupuncture schools will need to complete 3,000 hours in training before they will be able to take the licensure examination. That new standard represents a 28 percent increase over the current 2,348-hour requirement.
The higher educational standard was not prompted by a new increase in the scope of practice. Rather, it was justified in part as a belated increase in training warranted by the 1980 legislative change to allow for direct access to acupuncturists. While there is little evidence that patients were endangered by the previous educational requirements, proponents argued the increase in training was critical to patient safety.
The new requirement - and the desire to further raise the standard to 4,000 hours - also is presented as part of a long-term goal of some professional associations to raise the preparation and standing of acupuncturists to the equivalence of Western medical doctors.
The Department of Consumer Affairs asserts that increases in license requirements should be directly related to the scope of a particular profession as defined in law, necessary to ensure the safety of consumers, and should not inappropriately restrict access to practice.3
By those standards, there is no evidence to support the need to further increase the educational requirements. But there is evidence, documented by the UCSF analysis and supported by other testimony, that implementing the new requirements will be difficult for some schools, and may result in fewer schools generating fewer students eligible to take the California exam.
Recommendation 2:
The number of educational hours should not be increased, and should be focused on traditional Oriental healing practices within a modern framework for patient safety. Specifically, the Acupuncture Board should implement the following policies:
- Educate within scope. The State's required courses for licensed acupuncturists within schools of traditional Oriental medicine should only be for subject matter needed to competently and safely practice the legal scope of practice.
- Devote adequate curriculum to patient safety, including coordination. Once the new curriculum has been implemented, an independent evaluation should be conducted to ensure that concerns about minimum training needs have been met. Special attention should be given to patient safety training, including:
- Up-to-date infection control practices that meet the standards of the National Institutes of Health, such as exclusive use of single-use needles.
- Improving coordination with Western medicine, including recognizing "red flag" conditions, and knowing when and how to refer to and work with physicians.
- Teach within area of expertise. Courses in physiology, chemistry, biology and other sciences should be taken at colleges and universities that are accredited to grant degrees in those areas. The board also should separately consider requiring successful completion of basic science courses as a prerequisite to educational training in traditional Oriental medicine.