Rachel and Medical Oversight

January 22, 2006

List Members,

I haven't had such a good read for months! Rachel's diatribes against the

hippies, mystics, non-conformists, and politically inept brought a little color

to my cheeks and vibrancy to my pulse. But there are those who come to this

list for more than entertainment. I see your week by week efforts at

consultation, recommendation, and referral, your work on translation, treatment,

education, and now the collegial tone is shattered by this woman's prophecies of

-- pandemic? no -- degredation of the food chain? no -- environmental

cataclysm? no -- what she fears is medical supervision.

Some people learn that entrance into a profession can be obtained by hard work

and dedication, by listening to one's superiors, offering assistance,

maintaining the standards of one's preceptors -- others have the sense that

entrance into a profession is obtained by pushing out of the way anyone who may

plausibly obstruct one's access.

Its an empty room, Rachel, once you break down the door.

What frightens people about Rachel is that the mode of speaking does not have

its origin in medicine. One cannot accuse the sick of being complicit in their

own illness and demand an immediate return to health. The sick have to be

expertly treated for their physical difficulties and coaxed to a less

self-destructive path by good teaching and good examples. Or maybe I'm wrong

about that; I can imagine a kind of bull nurse storming around the halls --

perhaps some respond well to that energy, perhaps some get their release (from

life) that way.

On the question of medical supervision, physicians with 100 hours of

acupuncture instruction are as well suited to refer patients to acupuncturists

of superior means as they are with their 100 hours of pediatric medicine to

refer to a good pediatrician, with their 100 hours of oncology to refer to a

good oncologist, 100 hours of endocrinology to refer to an endocrinologist.

When the day comes when every physician has studied 100 hours of acupuncture,

then there will be more work for acupuncturists of every stripe. Some of those

physicians will multiply their 100 hours by factors of 2, 3, 4, or 5 and you

will get some awesome practitioners. Some of those physicians will read about

point injections done in China and set up some innovative programs in the US.

Some of those physicians will travel to China and meet doctors who perform

surgery and practice accupuncture. Some will be disillusioned and quit, some

will be inspired and continue. I have also known some accupuncture

students who elect to go to medical school after TCM. How else will

acupuncture reach the mainstream?

Meanwhile, for the practitioner who maintains a strong research base, who

stays in touch with other pracitioners, who keeps learning, who gets results,

there will be a future in their hard work. Whether it is a physician who

operates the legal apparatus, or an oversight board of other acupuncturists, or

the chiropractic leader of an integrated clinic -- there are many permutations,

none of them necessarily disastrous to the alert healer.

Thank you, listmembers, for your dedication, your countless gems,

Carl Ploss

Photos – Showcase holiday pictures in hardcover

Photo Books. You design it and we’ll bind it!

January 22, 2006

Carl,

Maybe I didn't make this clear enough, but when we try to discuss

problems threatening the profession in a really quiet, meek fashion,

everyone skips over the posts and dives into the " sexy " topics of

points, and picking nits over the term " sedation " . That topic, going

on just before I chimed in, brought the list to a halt and upset the

ladies as well. They called the nit picking " wierd one-upsmanship " .

By contrast, no one has described these issues as " picking nits "

or " wierd one-upsmanship " like the " sedation " debacle. Everyone was

ragging so relentlessly on poor Z'ev that it really was silly. But

Z'ev is a bright guy and can handle it.

If I hadn't created some controversy surrounding these very

important issues, almost no one would have even thought about them;

picking on Z'ev for his use of the word " sedation " was just

more " fun " than thinking about serious problems facing the

profession. However, I came in and hit the listserv like a pitbull,

and intentionally tried to make the posts " sexy " in some fashion, in

order to get more people thinking about these issues. I love to

describe the " hippy dippy trippy " thing because I've heard M.D.s

describe the " medical discussions " they've had with these very

same " special individuals " practicing TCM. The descriptions were

not regarding how impressed the M.D. was with the knowledge and

competence of these individuals, I can assure you. I have to admit

that it was also an M.D. who asked me " but why are so many OM

practitioners " bi-polar cat ladies " ? I can't make up stuff like

this myself. Truth is always stranger (and more painful) than

fiction. The fact that these descriptions drove people into

paroxysms of frustration clearly indicates that the descriptions are

hitting a little to close to home with at least some of these folks.

I have to disagree regarding supervision by M.D.s. Some of us are

studying to be Oriental Medicine practitioners, not just

acupuncturists, because acupuncture, standing alone, is often

inadequate, and proper, competent administration of herbs is

essential. Well developed skills in Tuina and cultivation practice

are also necessary, but I guarantee that no one, even the greatest,

most competent M.D. on earth, comes out of the 100 hour programs

with the knowledge and skills necessary to " supervise " the full

practice of oriental medicine. And they won't be able to " refer "

patients *anywhere* if the TCM practitioners are only allowed to

practice under M.D. supervision. Perhaps you don't understand the

difference between " referrals " and the " supervised practice " bills

currently being proposed in many states, or you would not make the

comments that you made. I strongly urge you to educate yourself

regarding what supervised practice actually means in western

medicine, not what you have casually assumed it to mean. Supervised

practice is nothing like a referral. Licensed practical nurses work

under the supervision of an M.D.; patients are not and cannot

be " referred " to them. If we are under supervised practice, we

won't be out working in our groovy storefronts anymore; we will have

to be practicing under actual supervision, which means the M.D.s

office. Perhaps you missed my post re: this, but in this scenario,

the supervision by M.D.s, on their turf, will raise the costs of TCM

care, and provide no benefit to patients or any other members of the

public. I invited people on the listserv who have training and

experience in western medical clinic finance (you can't compare it

to running a TCM practice, it's far more complex) to explain to us

ways in which the costs could be kept down, despite the change of

location to a " high overhead " , medically supervised practice. No one

has responded. My Health Services Administration training and

experience only exposed me to western medical healthcare finance on

a fairly rudimentary level (I wasn't a bean-counter), and the

obvious way to prevent higher costs from being passed on to the

patient unfortunately appears to be lowering the wage of the

supervised worker, since, an individual who is not practicing

independently " deserves less " pay than an independent practitioner.

That's how western medical types view these kinds of issues. Of

course, it's *possible* that the M.D. might reduce his/her *own*

salary, benefits, etc. to keep costs down for the patients, but that

doesn't seem very likely. At least I've never seen it happen. Why

don't you explain to us how you came to your conclusions regarding

the supervised practice bills that are now being introduced on the

state level. Which part of the statutory language caused you to

believe that M.D.s will just be " referring " patients to TCM

practitioners? If the statutory language was meant to be " refer "

they would have used the word " refer " . But they don't. They use the

term, " supervised practice " .

But please, tell us more specifics of your legislative review that

caused you to conclude that this poses no danger to the continued

independent practice of OM in the United States? I sincerely want to

discuss this issue with someone who has done his homework and knows

what the legislative bills contain. You clearly have, I'm sure, or

you wouldn't have made the absolute statements you made in your post.

As far as " barging in " , I'm putting in my time and serving my dues.

I'm taking far more classes than the minimum necessary to graduate,

take the boards, and get those board certifications in Acupucture,

Herbs, Biomedicine, Asian Bodywork, etc. I've already put in far

more time than any M.D. who hasn't abandoned the practice of western

medicine altogether will ever be able to do, no matter how well-

meaning he or she might be. I'm not trying to " break down "

any " doors " , sir, however, more and more practitioners ARE viewing

the 100 hour people that way. I'm not trying to push anyone out of

the way, sir, however the folks introducing " supervised practice "

legislation are doing just that. People will be pushed out who you

never even imagined, not some poor undergrad who is frightened of

taking a few basic science courses....

Attempting to " vilify " me as pushing people out of the way, while

ignoring the folks who *really* threaten OM in the U.S. just isn't

productive. I'm trying get people to start paying attention to the

facts. To be aware of who really wants to marginalize and control

them, perhaps eliminate, them. I'm not the enemy of any *real* OM

professional. I have no intention of pushing anyone out of the way,

in fact, I'd love to see as many of us as possible be able to

nurture and grow the practice of OM, instead of passively sitting

back and watching our opportunities continue to be taken away from

us, as is the case in California.

Please reply with your educated analysis of the " supervised

practice " bills immediately, as well as your financial analysis of

how everyone will keep getting acupuncture for the same low price,

and everyone will keep earning what they currently do, once we are

subject to " supervised practice " . I'd really love to see your

analysis. If the numbers look reasonable, maybe we should all just

relax and rehearse saying " yes Doctor, right away Doctor, oh, I'm

sorry Doctor, of course YOU are right, not me, Doctor " . Carl thinks

it won't be difficult at all :-)

Best regards and looking forward to your immediate reply with the

analysis you've already developed in order to support your comments.

love,

Rachel

Chinese Medicine , carl ploss

<cploss> wrote:

>

> List Members,

>

> I haven't had such a good read for months! Rachel's diatribes

against the hippies, mystics, non-conformists, and politically

inept brought a little color to my cheeks and vibrancy to my

pulse. But there are those who come to this list for more than

entertainment. I see your week by week efforts at consultation,

recommendation, and referral, your work on translation, treatment,

education, and now the collegial tone is shattered by this woman's

prophecies of -- pandemic? no -- degredation of the food chain? no -

- environmental cataclysm? no -- what she fears is medical

supervision.

>

> Some people learn that entrance into a profession can be

obtained by hard work and dedication, by listening to one's

superiors, offering assistance, maintaining the standards of one's

preceptors -- others have the sense that entrance into a profession

is obtained by pushing out of the way anyone who may plausibly

obstruct one's access.

>

> Its an empty room, Rachel, once you break down the door.

>

> What frightens people about Rachel is that the mode of speaking

does not have its origin in medicine. One cannot accuse the sick of

being complicit in their own illness and demand an immediate return

to health. The sick have to be expertly treated for their physical

difficulties and coaxed to a less self-destructive path by good

teaching and good examples. Or maybe I'm wrong about that; I can

imagine a kind of bull nurse storming around the halls -- perhaps

some respond well to that energy, perhaps some get their release

(from life) that way.

>

> On the question of medical supervision, physicians with 100

hours of acupuncture instruction are as well suited to refer

patients to acupuncturists of superior means as they are with their

100 hours of pediatric medicine to refer to a good pediatrician,

with their 100 hours of oncology to refer to a good oncologist, 100

hours of endocrinology to refer to an endocrinologist. When the day

comes when every physician has studied 100 hours of acupuncture,

then there will be more work for acupuncturists of every stripe.

Some of those physicians will multiply their 100 hours by factors of

2, 3, 4, or 5 and you will get some awesome practitioners. Some of

those physicians will read about point injections done in China and

set up some innovative programs in the US. Some of those physicians

will travel to China and meet doctors who perform surgery and

practice accupuncture. Some will be disillusioned and quit, some

will be inspired and continue. I have also known some accupuncture

> students who elect to go to medical school after TCM. How else

will acupuncture reach the mainstream?

>

> Meanwhile, for the practitioner who maintains a strong research

base, who stays in touch with other pracitioners, who keeps

learning, who gets results, there will be a future in their hard

work. Whether it is a physician who operates the legal apparatus,

or an oversight board of other acupuncturists, or the chiropractic

leader of an integrated clinic -- there are many permutations, none

of them necessarily disastrous to the alert healer.

>

> Thank you, listmembers, for your dedication, your countless

gems,

> Carl Ploss

>

> Photos – Showcase holiday pictures in hardcover

> Photo Books. You design it and we'll bind it!

>

January 23, 2006

Rachel -

You have raised many good points about the future of Oriental Medicine in the

U.S. It's a shame you have felt it necessary to indulge yourself with

belittling and insulting the members of this group and denigrating all of the

truly valuable discussions that take place regarding needling and the need for

more clarity regarding ambiguous nomenclature. These are important issues and

it seems that they would be considered important by a student with such

apparently rigorous standards. There is, and has been, room in this group for

simultaneous discussions regarding both technique and the future of OM.

It is especially unfortunate that after such an auspicious beginning you

descended to the point of sending insulting e-mails devoted to correcting the

spelling and grammar of members of this list - some of whom may not even be

native speakers of English. Such denigrating responses do nothing to further

your arguments; rather, they appear to be examples of an ego that is quite out

of control. I know attorneys rely on sophistry a great deal, but this is

ridiculous.

Your original purpose appears to have degenerated into egotistical

self-aggrandizement. If, as a student of TCM, you find the contributions of

practitioners who have been practicing for decades to be beneath you, please go

elsewhere and start your own listserv from which to disseminate your hateful

vitriol.

Sincerely ;-),

Kim Blankenship, L.Ac., M.S.O.M.

goldenlotuspublishing <goldenlotuspublishing wrote: