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It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
May, 2003, Vol. 03, Issue 05
Mad Qi Disease
By Lisa Marie Bader, AOBTA CP, AOBTA-MN legislative chair
Editor's note: This article originally appeared in the AOBTA newsletter Pulse.
Author's preface: Although this article pertains to the entire Asian bodywork community, I write from the perspective of my personal experience in Minnesota.Asian bodywork therapy has a rich history in this state; an incredible amount of advocacy and hard work by a few key individuals has helped the profession evolve to where it is today.
The interesting thing about being in a position of working with others is that you find quite quickly that issues appearing to be "no brainers" in your mind are not always viewed in the same light by others. Being relatively new to the position of legislative chair, I constantly marvel at how many different viewpoints there are within a group of people representing the same organization. The fact that people are coming together for a common cause doesn't necessarily mean they will flow from point A to point B in the same manner. It is a perfect example of that wonderful diversity within humans that can both bring us together and pull us apart.
Take, for example, our recent meetings in Minnesota regarding language in a voluntary registration bill that had been re-introduced to the state legislature. I knew some topics would require more discussion than others, but I didn't plan on the issue of the NCBTMB's National Certification Exam (NCE) vs. the NCCAOM's Asian Bodywork Therapy (ABT) Exam being one of them. To give you some context, AOBTA-Minnesota has a long history of working with the massage community in attempts to pass legislation that would finally enable us to practice freely in the state, without having to jump through the hoops of individual municipalities. Given that history, the language in the bill reflects its pre-NCCAOM ABT Exam origins. With the development of the ABT Exam three years ago, it seemed quite clear that folks would be of the same mind when it came to the discussion of removing references to the massage and bodywork exam, as it was no longer an appropriate measure of our knowledge. Granted, it never was; it was just all we had in terms of a national exam.
Consider the following facts: The NCE, developed by the National Certification Board for Therapeutic Massage and Bodywork, is a predominantly massage-oriented exam that includes some questions that touch on Chinese medicine - none of which need to be answered correctly to pass the exam. The ABT Exam, developed by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), is a specialty exam for Asian bodywork therapists based solely on Chinese medicine theory. Both are entry-level exams that test knowledge aspiring therapists should have, coming out of their respective educational programs; consequently, the heavily weighted massage nature of the NCE puts it in the massage category because it does not test any level of ABT competence, although there is a danger it could be represented that way. The ABT Exam tests a more comprehensive level of ABT information; you have to demonstrate entry-level competence to pass.
The purpose of creating an educational standard is to ensure a certain level of proficiency in a profession or field of study. It is a way of protecting the public and promoting a particular level of expertise within the profession. In much the same way, the requirement of passing a nationally accredited exam in one's field of study creates a benchmark that regulatory bodies can look to. At this juncture, the NCE most closely satisfies that need within the massage community, as the ABT Exam most closely satisfies that need within the Asian bodywork therapy community. If I take this statement one step further, when considering legislation, it would follow that the language should reflect the standards and exams that apply most closely to one's professional field of study.
On to the next fact. The NCE costs $225; the ABT Exam costs $750. Ouch. "Aha," you say, "I can see where this may be problematic." Indeed, this is often the turning point in the conversation about which exam ABTs should take. People support the ABT Exam until the topic of money comes up; then, boom, quick as a flash, lights go out, doors close and you've lost them. Their eyes glaze over, and you know somewhere in their heads, they must be calculating how many cups of green tea from the local tea shop they are going to have to sacrifice to pay for this test.
I'm not here to justify the cost of the ABT Exam; it's expensive. We could leave it at that, go our separate ways and remain in this box we've created, with budgeting concerns that have the potential to limit our vision and hinder our professional development. Money is a reflection of much more than bean-counting; it's about beliefs, values, planning, etc. Most of us, at one time or another, have had a certain degree of anxiety and issues involving money. I think those concerns come to bear in this conversation and are part of what makes consensus difficult. Nevertheless, I invite you to keep reading, even if it's a bit uncomfortable.
I am not willing to go our separate ways for two reasons: First, I'm deeply disturbed by this "box" we've created, and its implications; second, I am an optimist, and I believe that when people come together and start brainstorming, creative ideas start to bud, and their flowering gradually brings them outside of this box. Sit and chew on these bits with me a few moments longer.
Let's return to the conversations in Minnesota. One of the main concerns arising out of our discussions is that ABTs need to be clearly set apart from massage therapists in this bill. Given the fact that ABTs have to go through massage programs to be able to practice in some states, I believe I can safely say that the general consensus here supports the concern of distinguishing ourselves as a separate profession. Essentially, we would work to put language in the bill so that it is representative of two distinct communities working together to create legislation that benefits both. It was from this starting point that another board member and I attended legislative meetings and worked to ensure that the differences between massage and Asian bodywork were not lost in the politics. So, when many ABTs on our language task force favored keeping the NCE in addition to the ABT Exam, solely for reasons of cost, it felt as if the foundation from which we were operating was being eroded.
This is where I get confused and disturbed. First of all, as I understand it, the exam is not just a hoop one jumps through to be regulated. It is the next step in the process of meeting a professional standard, similar to one taking exams while in school to demonstrate a certain level of knowledge and technique. People who take the ABT exam are showing they have indeed met a certain level of competency that is not automatically assumed just because they meet educational requirements. If that were the case, why bother taking any tests at all during our education, since we have already met the standard by taking the classes? Ridiculous, you say? Precisely. We want to continue to gain credibility in the larger community. Regulators and the general public depend on a board exam to ensure a required minimum standard of knowledge.
Given that exams test for a certain level of proficiency, it simply doesn't make sense to adopt one that is irrelevant to what we do. This undermines not only the Asian bodywork profession, but also the Chinese medicine profession. This is cause for deep concern because, essentially, what I hear people saying is when push comes to shove, it's OK to be identified with massage and to let the public assume that our ABT training and level of knowledge are no different from that of massage therapists.
If that is all the profession means to you, be prepared to go through a massage program to practice Asian bodywork. You also might need to consider adding those ginger chews and muffins into your green-tea-budget equation, because massage school costs about 10 times as much as the ABT Exam. When the cost of an exam is the sole determining factor that dictates an essential piece of our foundation, it all begins to sound like a case of "Mad Qi Disease" to me!
The NCE has been a stepping stone for our profession, and for that I am grateful, but it's time to move on. We're growing as an organization and as a profession. Certain aspects of that growth are exhilarating; other aspects are rather problematic. Change is difficult and often elicits gut-level responses and impassioned speech. This can be good because it generates conversation and discussion. It challenges people to identify what they are unhappy with; how the process can be improved; and what their vision of change is.
I would like to take this one step further, and emphasize that these conversations, suggestions and visions cannot be isolated events that a few individuals discuss among themselves. They need to be passed along and shared with the state board and state representatives, or communicated through your newsletters. Parts of those conversations need to reach AOBTA's national leadership, and some may need to occur in the larger community of Chinese medicine. We cannot isolate ourselves if we are to continue to ensure our place and solidify our identity in that larger community.
I think it's important to realize that as communities (the ABT arm of the NCCAOM and the AOBTA), we are symbiotic. Therefore, although we are working in different ways and with different missions, we achieve a common outcome: advancement in professional development and credibility.
Let's get back to an important point: what we can do to defer the cost of the exam. How about some old-fashioned brainstorming ideas involving fundraisers? This is a great opportunity for the community to come together and have fun (Why do you think they are called "FUNdraisers"?) while creating more public awareness about Asian bodywork. The format can be as simple as a benefit concert, or as involved as organizing a silent-auction dinner party or raffle. Approach a local coffee shop that offers chair shiatsu, and ask to include a tip jar for raising funds to take the ABT exam; or arrange for a bit of street-chair shiatsu downtown, with proceeds being applied to the cost of the exam. Brainstorm with Minnesota Public Radio, which sponsored a here in the Twin Cities that proclaims: "Public Radio ... shiatsu for the mind."
There are numerous ways to go about this (and I'm sure they're far more creative than what I've mentioned). Yes, they do take time and effort; most things worth doing tend to. Frankly, I'd rather spend my time continuing to do the hard, rewarding work of building a stronger community and profession than trying to combat Mad Qi Disease. Don't be afraid to ask the world for what you need. Be empowered. Step outside the box. Allow yourself the freedom to envision and dream. Talk about it. Share your visions with others. When you do, you'll find amazing things can happen. You'll start meeting wonderful people and making incredible connections that can be transformative. Growing is hard, but it doesn't have to be drudgery every step of the way. We are shaping the future of our profession. Let's build it with a solidly rooted foundation. Talk to each other. Visualize the future you want to create - then begin creating it.
Author's note: Special thanks to Yolanda Asher and Andrea Cyr for their support and invaluable input in the creation of this article. I absolutely love the conversation and dialogue percolating around this issue, and I welcome any thoughts, questions or rebuttals you may be inspired to share. I can be reached at ; please reference "Mad Qi" in the subject line.
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