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Little Hover Commission 2004

Regulation of Acupuncture: A Complementary Therapy Framework

The issues before the Commission are central and routine to essentially all professional licensure. Moreover, it is not uncommon for disputes, particularly over scope of practice, to be raised in both the regulatory and the legislative arenas.

But in the case of acupuncture, policy-makers have had difficulty resolving these issues. The debates have been confused by conflicting facts and by the fundamental and philosophical differences between traditional Oriental medicine and Western biomedicine. And while some in the profession want to preserve and enhance traditional therapies, others see the profession's future as a blend of traditional Oriental and modern biomedicine.

In addition, the law is clear that the public goal is to provide consumers with an alternative to Western medicine and to give consumers direct access to acupuncturists. But the statute is silent on the authority of acupuncturists to diagnose patients and how they should interact with other health care professionals.

To resolve these issues, lawmakers will need to establish in statute the role of acupuncturists in the health care system and define the "medicine" that practitioners may practice. The Commission believes the public will be best served if lawmakers affirm the existing policy to license traditional Oriental medicine separately from modern biomedicine. Practitioners who want to master both health methods should continue to be dually licensed.

Other states and nations, in fact, are looking for ways to encourage dual training, co-location or other forms of integration that provide access to both healing paradigms. These models allow choice while reducing the risk that some may be misdiagnosed or inappropriately treated because of the limitations of their "primary care provider," be they trained in traditional Oriental or modern biomedicine.

  • New Hampshire requires a baccalaureate, registered nursing or physician's assistant degree as a prerequisite for acupuncture licensure.141 This provides acupuncturists with a grounding in Western biology and familiarity with the overall health care system, while encouraging professionals to be dually trained and licensed.
  • Alternatively, the director of the University of Minnesota's Center for Spirituality and Healing recommends requiring all nursing programs to include traditional healing cultures in their curriculum, asserting that because nurses are ubiquitous in the health care system, they could help patients access simple and often inexpensive traditional therapies.142
  • In many Asian nations, acupuncturists often practice in the same clinics or hospitals with physicians trained in Western medicine. This collaborative model is sometimes referred to in America as "shoulder to shoulder" medicine.
  • An Israeli task force on complementary medicine has recommended that within the first month or eight visits to an acupuncturist, a patient see an MD for a standard physical to ensure that all available treatment options are considered.
  • Many of California's academic medical clinics that provide patients the option of acupuncture and other traditional Oriental healing practices operate collaboratively with MDs.
  • The University of Arizona's Health Sciences Program on Integrative Medicine suggests sharing clinical information between medical doctors and practitioners of traditional Oriental therapies, along with ongoing involvement of MDs to ensure care from the proper specialists.

Most of these solutions were not fashioned by regulators, but by professionals willing to work in collaboration. All of these options enhance consumer choice in ways intended to also improve patient outcomes.

The sole purpose of professional licensure is consumer protection, and that should be the basis for making statutory and regulatory changes. In the biomedical health care system, consumers also benefit from any number of other efforts to improve the outcome for patients by improving the preparation and practices of professionals. But most of those efforts are private and go far beyond the minimum requirements that are the basis of professional licensure.



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